HEALTH-SIERRA LEONE: Up To 200,000 People Need Psychiatric Care

By Lansana Fofana Reprint | | Print |

Lansana Fofana

FREETOWN, Jun 11 1999 (IPS) - Up to 200,000 people, traumatised by Sierra Leone’s civil war, need psychiatric care, says the country’s only psychiatrist, Dr. Edward Nahim.

“I think that 200,000 people might need psychiatric care,” says Nahim. “But with the present facilities, it is going to be extremely difficult.”

Sierra Leone’s only psychiatric institution, Kissy Mental Hospital, the oldest in west Africa, is in a state of utter collapse.

After more than two decades of steady neglect by successive governments, the hospital reached its worse in January when rebels of the Revolutionary United Front (RUF) invaded the capital Freetown.

“They vandalised the quarters for nurses and offices, burnt down the little available food and drugs and gunned down dozens of mentally ill people,” says Nahim.

Today, the hospital, established more than 100 years ago, is a shadow of its former self. The walls of the asylum are falling apart, a reason why patients roam the streets of Freetown rather than stay in the perimeter of the hospital.

“The situation here is deplorable, not only for the mentally- retarded patients, but also for us nurses. We are not being properly paid, get no training, our quarters have been ravaged and we are suffering,” says Lisa Johnson, who has worked at the hospital for over 15 years.

Nurses get about 21,000 Leones a month. One US Dollar is equal to 2,200 Leones.

According to Nahim, the hospital’s annual budget is about 20 US Dollars a year per patient. This covers salaries for workers and patients’ upkeep, plus drugs, as and when available.

Food and medical services are few and far between. The World Food Programme (WFP), which used to supply the hospital with food rations, is no longer doing so on regular basis.

As a result, only an average of about 100 patients out of a total 400 stay in the asylum at any particular day. “It is not surprising at all that patients don’t stay within the asylum. They get no food supplies, no medicines and basic care,” says Johnson.

Experts have predicted an upsurge in psychiatric cases, as a fall-out of the eight-year long civil war. They point at the level of violence, rape of young women, burning, looting of houses, and amputation of limbs by rebels, as having enduring psychological effects on victims.

With negotiations going on between the government and RUF in Togo to end the war, there are fears that more psychiatric cases could be underway, if the crisis is resolved and thousands of traumatised combatants emerge from the bush.

The RUF rebels and their renegade allies of the former Sierra Leone army, who retreated into the bush, after their military junta, tha Armed Forces Revolutionary Council (AFRC) was ousted in February 1996, are believed to number more than 15,000.

“We may have to contend with a frightening psychiatric situation, when the war comes to an end,” says opposition politician, Saidu Turah.

“The government has failed to pay adequate attention to the Kissy Mental Home, as if the hospital there is not a part of the country’s health care delivery system,” he says.

Concurring, Nahim says he regrets that, “the mental hospital appears not to be a priority in the health delivery system of both the local and international non-governmental organisations.”

“As a result, infrastructure there have been breaking down with little or no support,” he says.

The conflict in Sierra Leone erupted in 1991 when former army corporal Foday Sankoh launched a bush war to overthrow the government of then President Joseph Momoh.

Since then, more than 30,000 people have been killed in the conflict, while an estimated quarter of the country’s 4.5 million people are scattered as refugees in neighbouring countries.