BAMAKO, Mali (AP) — In the courtyard of a psychiatric ward in Mali’s capital, a small group of patients acts out scenes of a village dispute to the beat of a djembe, a traditional West African drum.

One patient, Mamadou Diarra, cries out to another in the Bambara language, mocking: “You don’t know anything! Just nonsense!”

But both break into smiles, and Diarra dances as he continues launching insults at his fellow performer.

The group is taking part in koteba, a traditional form of theater practiced by Mali's largest ethnic group, the Bambara. It mixes acting, singing and dancing and is usually performed in villages as an outlet to work through problems and an open space for satire.

But here at Point G, one of the largest hospitals in Bamako, koteba is also a way of offering support and a sense of community to people receiving psychiatric care.

Mali has fewer than 50 mental health professionals for a population of more than 20 million, according to a 2022 report by the World Health Organization. People with mental illnesses are often left without treatment and excluded from society.

Though the use of koteba as therapy hasn't been formally studied, Souleymane Coulibaly, a clinical psychologist at the Point G hospital, said the traditional form of theater is uniquely positioned to help people in the psychiatric ward work through their problems.

“Patients who attend koteba leave the hospital more quickly than those who refuse to attend the theater session,” he said.

In the courtyard, Diarra was the star, and other patients gathered as he spoke.

“I’ve never done any kind of theater before. I’ve never danced. But once I started, God gave me the knowledge of these things,” he said.

Adama Bagayoko, 67, the director of the visiting theater troupe, said the weekly performances at Point G are a rare space where patients feel heard and respected.

“We talk to each other, we dance together, we laugh together,” Bagayoko said. “To touch someone shows that we are equal, to listen to them shows that they are important, and what they say is important."

Bagayoko was part of a troupe that brought koteba to the Point G psychiatric ward in 1983, as mental health workers looked for a way to use Mali’s cultural practices to help people receiving psychiatric care.

The first performance was so effective that patients asked the doctors if the actors could return the next day, he said.

Patients and actors have been meeting for koteba performances every Friday since then.

The koteba performances at Point G unfold in three phases, Bagayoko said. First, the troupe plays music to invite patients into the courtyard. Then the troupe asks what the topic or theme of that day's performance should be. After the performance, they sit in a circle and give the floor to any patients who wish to speak.

Because the patients feel at ease, they often tell the actors details about their lives they are not comfortable sharing with their family or doctors, which can help doctors get to the core of any issue they might be dealing with, Bagayoko said.

On a recent Friday, the patients acted out a familiar scene in Mali: A man in a village is accused of stealing. The thief screams and claims he hasn’t stolen anything, while the villagers ask Diarra, playing the village chief, what punishment he deserves.

“Kill him!” Diarra yells amid the screams. But as the angry mob gathers around the man, he escapes and flees.

Bagayoko said the troupe performs other themes proposed by patients including those about women beaten by their husbands, drug problems and alcoholism.

The hospital at Point G is only a short walk from Mali’s political stage — the presidential palace and main military base — where a 2020 military coup has left the country struggling with increased extremist violence and economic hardship. Last month, Islamic militants attacked Bamako for the first time in almost a decade.

But those problems are far away during the koteba performances at the hospital, as Diarra and his fellow patients are immersed in the world they create.

“You know what my problem is? That I see things for what they are,” Diarra said, laughing, during a break.

Bagayoko chimed in: “Okay, we’ll lighten that load for you.”

___

The Associated Press receives financial support for global health and development coverage in Africa from the Gates Foundation. The AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.