‘Patients chained to walls and beds’: Freetown’s psychiatric hospital released from the past | global development

hAbubakar Jallow told a group of patients gathered in a room at the Sierra Leone Teaching Psychiatric Hospital in the capital, Freetown, that his family had accused him of being a demon. When the black magic of a local witch doctor didn’t help, he was beaten by his brother and thrown out of the house, he says.

Gallo, 27, has been diagnosed with bipolar disorder, but he’s not happy being here. They sent me here, but I hate staying here. I am not crazy.”

Group counseling is now part of treatment here at the oldest psychiatric institution in sub-Saharan Africa, which has witnessed Dramatic transformation The past few years away from the days when Patients will be chained.

The facilities are basic — Gallo is locked in a large room with bars on the windows with about 20 other men — but things have changed, says Dr. Abdel Gallo, the former director of the hospital. Until 2018, the hospital was like a prison. The conditions were appalling. There was no running water, no electricity, no medicine, and patients were chained to walls and beds.”

The human toll of non-communicable diseases (NCDs) is huge and rising. These illnesses end the lives of approximately 41 million of the 56 million people who die every year – and three quarters of them are in the developing world.

NCDs are simply that; unlike, say, a virus, you can’t catch them. Instead, they are caused by a combination of genetic, physiological, environmental and behavioural factors. The main types are cancers, chronic respiratory illnesses, diabetes and cardiovascular disease – heart attacks and stroke. Approximately 80% are preventable, and all are on the rise, spreading inexorably around the world as ageing populations and lifestyles pushed by economic growth and urbanisation make being unhealthy a global phenomenon.

NCDs, once seen as illnesses of the wealthy, now have a grip on the poor. Disease, disability and death are perfectly designed to create and widen inequality – and being poor makes it less likely you will be diagnosed accurately or treated.

Investment in tackling these common and chronic conditions that kill 71% of us is incredibly low, while the cost to families, economies and communities is staggeringly high.

In low-income countries NCDs – typically slow and debilitating illnesses – are seeing a fraction of the money needed being invested or donated. Attention remains focused on the threats from communicable diseases, yet cancer death rates have long sped past the death toll from malaria, TB and HIV/Aids combined.

‘A common condition’ is a Guardian series reporting on NCDs in the developing world: their prevalence, the solutions, the causes and consequences, telling the stories of people living with these illnesses.

Tracy McVeigh, editor

“,”credit”:””,”pillar”:0}”>

Quick guide

common condition

show

The human toll from non-communicable diseases is huge and rising. These diseases end the lives of nearly 41 million of the 56 million people who die each year – three-quarters of them in the developing world.

Non-communicable diseases are simply; Unlike, say, a virus, you can’t catch them. Instead, they are caused by a combination of genetic, physiological, environmental, and behavioral factors. The main types are cancers, chronic respiratory diseases, diabetes and cardiovascular diseases – heart attacks and strokes. Nearly 80% are preventable, and all are on the rise, spreading relentlessly around the world as population aging and lifestyles driven by economic growth and urbanization make being unhealthy a global phenomenon.

Non-communicable diseases, which were once seen as diseases of the rich, now predominate in the poor. Illness, disability and death are perfectly designed to create and extend inequality – and being poor makes it less likely that you will be accurately diagnosed or treated.

The investment in treating these common and chronic conditions that kill 71% of us is incredibly low, while the cost to families, economies and societies is staggeringly high.

In low-income countries, non-communicable diseases—usually slow and debilitating diseases—see a fraction of the money needed to invest or donate. Attention remains focused on threats from infectious diseases, yet cancer death rates have long outpaced malaria, tuberculosis, and HIV/AIDS combined.

Common Case is a Guardian series on non-communicable diseases in the developing world: their prevalence, solutions, causes and consequences, and tells the stories of people living with these diseases.

Tracy McPhee, editor

Thank you for your feedback.

Neighbors lived with screams coming from the imposing brick building, on a hill in East Freetown. Casey’s Lunacy Asylum, as it was known, existed simply to prevent patients from harming themselves or others.

But, in a country that has historically paid little attention to mental health, the government is working to raise awareness and try to counter stigma as part of President Julius Maada Bio“Human Capital” development agenda, which includes Education reforms.

The Sierra Leone Psychiatric Teaching Hospital in Freetown is the only dedicated mental health facility in the country and the oldest psychiatric hospital in sub-Saharan Africa.
The Sierra Leone Psychiatric Teaching Hospital in Freetown is the only dedicated mental health facility in the country and the oldest psychiatric hospital in sub-Saharan Africa. Photo: PIH

The hospital is operating at full capacity, and 150 patients are receiving free treatment.

After the patient chains were removed, the facility was also connected to the water and electricity supplies. There is now comprehensive care that combines treatment and counseling with the latest medicine. Yoga classes are offered and there is a basketball court.

Anneiruh Braimah, the head psychiatric nurse, began working at the hospital in 1998, and says patients’ behavior has improved dramatically since the reforms.

When people were chained, they were very angry. They were dumping whole buckets of urine and feces on us. What we noticed when we removed the chains is that the attacks did not increase in any way. In fact, they’ve gone down.”

One of the biggest issues is drug abuse. Many of the teens in the hospital use tramadol – an opioid found in cough medicine. Others reach a state of psychosis after smelling the black residue on their exhaust pipes.

Ahmed Lehi, 21, was taken to the hospital in October by his relatives.

My mother called all the local young men to chain me up in our house; she thought I was smoking [drugs],” he says. “But I broke down the door, when they said I was crazy. After that, they brought me here, where I was given an injection to calm me down.

Hague is helped with his addiction. He doesn’t know how long he will stay at the hospital, which was first built by British colonialists in 1820. “The nurses are doing their best for us,” he says. “The only thing is food – it can be a more balanced diet than just beans and rice.”

The improvements are funded largely by a US charity, Partners in Health (PIH), which helps the government with operating costs.

Hospital reception desk, where there is a sign that says
The staff is at the hospital’s reception, where there is a sign that reads “chain free since 2018”. Photo: Finbarr O’Reilly/The New York Times/Evin

The charity provided $2.5m (£2m) towards the renovation. There is now a full-time psychiatrist and residency programme, set up to train seven psychiatrists who will outpace Double the five that currently support The population of Sierra Leone is 8.1 million.

The government is preparing to roll out essential mental healthcare across Sierra Leone’s 16 district hospitals in the coming months, which will reduce pressure on the teaching hospital.

Earlier this year, Dr. Carol Labore was named the first female Presidential Mental Health Counselor.

“Reforming mental health in Sierra Leone is a big undertaking, but we are up to the task,” says Labor. “Our goal is to train 10,000 mental health care professionals in 10 years.”

One of the main challenges is reforming the Lunacy Act of 1902 – a colonial-era law that contains no mention of patients’ rights. Dr. Labore says a “patient-centered bill” has been drafted, which includes protections for patient care. It should be passed in 2023 – to restore dignity to people with mental health problems.

Leave a Comment