FREETOWN, Sierra Leone – Abdul Jalloh was the only practicing psychiatrist in Sierra Leone when he took over the country’s only psychiatric hospital on the outskirts of the capital. Now, six years later, the young doctor is leading a transformation of mental health services in this West African country.
He has abolished the practice of chaining patients to their beds and has worked hard to attract new talent with the help of a US-based non-profit organization that has invested millions of dollars, along with the government of Sierra Leone.
The hospital now has three fully qualified psychiatrists and seven doctors in a new residency program, the first in the country’s history. The hospital also added nine nurses specializing in mental health, along with addiction professionals, clinical psychologists and occupational therapists, for a total of 135 employees.
During a recent visit by the Associated Press, an Afrobeats song played during a men’s soccer game in the courtyard. All were patients, many in treatment for drug addiction.
The scene would have been unthinkable before Jalloh took command.
The hospital was once known among locals as “Crase Yard”, or courtyard for the insane. It is now known as the Sierra Leone University Psychiatric Hospital. new reputation.
“We managed to change the face of this infrastructure,” Jalloh said in an interview. “From a place where people were ashamed to bring their families, a place where even healthcare professionals were afraid to come to work… to a place the country is proud of.”
The transformation was supported by US-based non-profit organization Partners In Health, which invested millions in rehabilitating the hospital, including providing training, equipment and services. A new building opened in mid-June as a rehabilitation center for drug users.
But there is little professional medical help for those living in the rest of the country beyond Freetown. The Ministry of Health created mental health units in all 14 districts of the country almost a decade ago, but few operate as intended due to a lack of trained staff and other resources.
Many people still turn to traditional healers or religious figures for help, as many mental health problems are associated with spiritual or demonic forces.
Sierra Leone’s population is still scarred by a civil war that lasted more than a decade and began in the 1990s. Widespread unemployment, poverty and other hardships also affect mental health, helping to contribute to rising rates of mortality. dependence on a locally produced drug known as kush.
There are also wider systemic challenges for mental health services.
Joshua Abioseh Duncan, head of the Sierra Leone Mental Health Coalition, a group that advocates for mental health, said the long-awaited review of the country’s 1902 Insanity Act, which stigmatizes mental health issues – and disenfranchises people of basic rights – is contributing to the low level of funding and resources.
“Current law treats people with mental health problems as deviants of society who should be kept out of sight,” he said.
Few medical students in Sierra Leone consider psychiatry due to a lack of training opportunities and limited income associated with the career, he added.
The government is taking some measures in coordination with international organizations. The Ministry of Health is implementing a World Health Organization training program that aims to help healthcare professionals identify and manage common mental health problems such as depression, substance abuse and post-traumatic stress. The first 50 workers took the four-day course in June.
The ministry’s director of mental health in Sierra Leone declined to comment to the AP.
“Transforming mental health is a long game, it takes time,” said Giuseppe Raviola, director of Partners In Health, which also set up a mental health helpline in Sierra Leone last year for advice and counselling. “Part of what takes time is not just building local capacity, but also ensuring that services are aligned with cultural beliefs and practices and that things are driven locally.”
Jalloh first came to the psychiatric hospital for training during his fourth year of medical school and was shocked by the conditions.
He told his friends that he would become a psychiatrist, which they considered a joke. The profession is known for making little money and often fails to treat its patients. But after three years, he returned to the hospital and vowed to transform it from a place of suffering into a sanctuary.
Despite the hospital’s transformation, Jalloh said rising addiction rates have taken a toll on his mental health. The hospital continues to face challenges, including a lack of security staff to stop patients from climbing the walls to buy medicine.
“As you can see, I’m not feeling well. There are many challenges. We do not have the capacity to deal with the (kush) crisis, considering human resources, infrastructure, medication,” she said. “It’s a huge challenge and a huge burden for us.”
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Associated Press writer Jessica Donati in Dakar, Senegal, contributed to this report.
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