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Images in Psychiatry   |    
Transforming a Dumping Site Into a Psychiatric Inpatient Unit in Somalia
Jibril Handuleh, M.B.B.S.
Am J Psychiatry 2013;170:1248-1248. doi:10.1176/appi.ajp.2013.13010044
View Author and Article Information

Photographs provided by Dr. Handuleh and approved by Borama Hospital and the community. The author thanks everyone who contributes to the services of the unit.

From the Amoud School of Health Sciences, Borama, Somalia.

Address correspondence to Dr. Handuleh (jibriil.mahamed@gmail.com).

Copyright © 2013 by the American Psychiatric Association

Accepted February , 2013.

 
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Above: The new psychiatric unit at the hospital in Borama, Somalia. Left: The doctors and nurses having clinical case discussions after rounds.

Somalia is a country in the horn of Africa in a region known for wars, hunger, and droughts. The country has been in a state of chaos since 1991, when the last serving dictator, Siad Barre, was overthrown. According to the World Health Organization, two out of every five people in the country suffer from mental health disorders (1). Qat, or khat, a stimulant containing an amphetamine-like substance, makes the situation worse and is sometimes associated with psychosis (2). Since 2000, British institutions, including King's College London and the charity Tropical Health and Education Trust, have been helping the local Somali people to develop their own services through education of doctors (3). Local graduating health professionals have been given short courses in psychiatry and, through online tutorials, helped from a distance to develop mental health services in Somalia (4, 5).

The images shown here come from Borama, a town in northwestern Somalia. Borama has a population of 150,000 and is home to Amoud University Medical School. The local community decided to fund a psychiatric inpatient unit in Borama Hospital, to reduce stigma by integrating psychiatry into the hospital. The Somali diaspora communities in northern Europe, with the backing of the local community leaders, raised enough money to build an inpatient psychiatric unit in Borama Hospital with no international support.

The psychiatric unit was built on a former hospital dumping site. Construction began in February 2012, and the unit opened its doors in June 2012. It has 24 beds and an outpatient department.

World Health Organization:  A Situation Analysis of Mental Health in Somalia . http://applications.emro.who.int/dsaf/EMROPUB_2010_EN_736.pdf
 
Odenwald  M;  Neuner  F;  Schauer  M;  Elbert  T;  Catani  C;  Lingenfelder  B;  Hinkel  H;  Häfner  H;  Rockstroh  B:  Khat use as risk factor for psychotic disorders: a cross-sectional and case-control study in Somalia.  BMC Med 2005; 3:5
[CrossRef] | [PubMed]
 
Leather  A;  Ismail  EA;  Ali  R;  Abdi  YA;  Abby  MH;  Gulaid  SA;  Walhad  SA;  Guleid  S;  Ervine  IM;  Lowe-Lauri  M;  Parker  M;  Adams  S;  Datema  M;  Parry  E:  Working together to rebuild health care in post-conflict Somaliland.  Lancet 2006; 368:1119–1125
[CrossRef] | [PubMed]
 
Finlayson  AE;  Baraco  A;  Cronin  N;  Johnson  O;  Little  S;  Nuur  A;  Tanasie  D;  Leather  A:  An international, case-based, distance-learning collaboration between the UK and Somaliland using a real-time clinical education website.  J Telemed Telecare 2010; 16:181–184
[CrossRef] | [PubMed]
 
Syed Sheriff  R;  Whitwell  S:  An innovative approach to integrating mental health into health systems: strengthening activities in Somaliland.  Intervention 2012; 10:59–65
[CrossRef]
 
References Container

Above: The new psychiatric unit at the hospital in Borama, Somalia. Left: The doctors and nurses having clinical case discussions after rounds.
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References

World Health Organization:  A Situation Analysis of Mental Health in Somalia . http://applications.emro.who.int/dsaf/EMROPUB_2010_EN_736.pdf
 
Odenwald  M;  Neuner  F;  Schauer  M;  Elbert  T;  Catani  C;  Lingenfelder  B;  Hinkel  H;  Häfner  H;  Rockstroh  B:  Khat use as risk factor for psychotic disorders: a cross-sectional and case-control study in Somalia.  BMC Med 2005; 3:5
[CrossRef] | [PubMed]
 
Leather  A;  Ismail  EA;  Ali  R;  Abdi  YA;  Abby  MH;  Gulaid  SA;  Walhad  SA;  Guleid  S;  Ervine  IM;  Lowe-Lauri  M;  Parker  M;  Adams  S;  Datema  M;  Parry  E:  Working together to rebuild health care in post-conflict Somaliland.  Lancet 2006; 368:1119–1125
[CrossRef] | [PubMed]
 
Finlayson  AE;  Baraco  A;  Cronin  N;  Johnson  O;  Little  S;  Nuur  A;  Tanasie  D;  Leather  A:  An international, case-based, distance-learning collaboration between the UK and Somaliland using a real-time clinical education website.  J Telemed Telecare 2010; 16:181–184
[CrossRef] | [PubMed]
 
Syed Sheriff  R;  Whitwell  S:  An innovative approach to integrating mental health into health systems: strengthening activities in Somaliland.  Intervention 2012; 10:59–65
[CrossRef]
 
References Container
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