By Umaru Fofana
Sorie, not his real name, lies on a hospital bed. A bed and bedding not great, but one whose comfort or greatness no one lying on it cares a hoot about. Their wellness - or the lack of it - is their primary concern.
Inside the ward and on about a dozen other beds lie patients in Sorie’s sorry state. They are all chained to their beds to keep them under control, I am told. They are all patients with one form of mental problem or another - from bipolar disorder to schizophrenia. They are all people who clearly badly miss their families and homes. But for the safety of those families they have to be kept here.
“Please unchain me so I can go back to my family” Sorie says. In a country where mental health is seen as a curse and a sentence to immortal stigmatisation, most people with mental health never return to anywhere near normal of they skip their drugs. In a society where ignorance reigns supreme, mental health patients are shunted to the doldrums.
Even our religious organisations which should be the moral conscience of our society do not help look after these people, and they fall short of urging the public to not stigmatise them. It would not be too much to ask the churches and the mosques to step into to this - after all Jesus and Mohammad preached that the poor and the sick be looked after.
Sorie looks pensive. As I stare at him, he stares at the ceiling as if counting the nails hammered in there. He intermittently shakes his toes, he laughs, he rubs his face and he smiles repeatedly, often unwarranted.
On the other bed another patient blabs. Then another sends a jab. Neither is aimed at anyone in particular. They are just delusional. Sorie and over 100 other patients are receiving treatment at the Kissy Mental Home, the first psychiatric hospital in Sierra Leone and in all of Black Africa.
There are not enough workers to look after the patients admitted at the hospital - never mind the huge numbers of people with mental health issues who are outside the hospital. Daily we see filthy-looking semi-naked men and women feasting on filth and roaming the streets; sleeping on the streets; in the cold and in the heat.
Dr Edward Nahim, Sierra Leone’s sole psychiatrist, says some 600,000 people - about 10 percent of the country’s population - have some form of mental health problem. He does not have enough staff to tend to the patients. Even though he has retired, after four decades of service to this delicate category of patients, he cannot be tired. He must keep working or there is no one else qualified in the country to look after them. Nurses and other people who help look after them are stretched to their tether’s end. “We all here sometimes behave abnormally even when we go back home because of our interaction with our patients” one of them tells me, resignedly. Their job comes along with so much trauma and they are at risk of violence from their patients.
At the Kissy Mental Home I felt as much pity for the patients as I admired the courage of the workers there, among them Dr Nahim. This is a man who has spent his entire life working with mental patients, and says he will continue doing so until his last breath or his last strength.
You may wonder why Britain chose to establish the first psychiatric hospital overseas in Sierra Leone. Some have postulated that the country might have had issues with mental health from the beginning. While I have not heard this from any authority, the possibility exists that the freed slaves who were brought to Freetown were in trauma due to what they had gone through.
But it is also fair to say that the former colonial power also prioritised Sierra Leone in many other ways most prominently in the area of education - with the first Western-style university in Sub-Saharan Africa, the first girls’ secondary school, first boys’ secondary school, the lust goes on. But just as education has taken a nose-dive in the country despite all that priority, so has mental health. Resources are basic and care is infinitesimal.
The main causes of mental health have been attributed to drug and alcohol abuse. Binge drinking is creeping into the country and nothing is being said let alone done to address that. The attention - if any - being paid to drug abuse is largely because we are a proven transit point for the shipment of hard drugs from south America to the West. Naturally this does leave residue of the narcotics in the country which rich people can afford.
Our own homegrown initiatives are almost nonexistent. It is shocking to know how much the anti drugs agency receives in its fight against narcotics. It is barely able to transport the agency’s investigators from one place to another. Law enforcement officers have been proven in the past - possibly ongoing - to be involved in the narco-trade. Those who were arrested during out infamous dramatic Hollywood-style narco-plane landing at out airport could well have only been the unlucky ones.
Marijuana which Dr Nahim says accounts for a huge number of those with mental health difficulty in Sierra Leone is grown all over the place - including on some college campuses. If the authorities cannot deal with its growth and distribution and sale, then the least would be to educate people about its use, decriminalise it and impose huge taxes on it which will increase its cost and probably reduce its consumption.
It may not all be gloomy after all. At the Kissy Mental Home I see a group of student nurses trooping out of classroom houses at the hospital. They have just completed their mental health class for the day. Dr Nahim tells me that there is a strategy now for every health worker to get some basic training in mental health. This may just make it easier to attend to cases such as Sorie’s at the early stages before the situation spirals out of control. But much will also depend on mental health education. Many of us only think someone with a mental health problem is a person who strips themselves and roams the streets. But do we even leave those to continue roaming the streets? It doesn't even make anyone of us safe from their tendency to be violent - that is those of us who are not among the 600,000 people and can safely say we are not pixilated. And you wonder why some parents behave the way they do to their children. You wonder why rape is so commonplace. You wonder why there are so many dirty-old-men who find pleasure in sleeping with minors or even marrying them. Methinks all that has to do with some brain malfunction. Yet no one seems to care about mental health. So you see why there may be so many Sorie unnoticed and may just all go mental sooner than later?
(C) Politico 16/02/16
