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PerspectivesFull Access

Transforming a Dumping Site Into a Psychiatric Inpatient Unit in Somalia

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.

From the Amoud School of Health Sciences, Borama, Somalia.
Address correspondence to Dr. Handuleh ().

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.

References

1 World Health Organization: A Situation Analysis of Mental Health in Somalia. http://applications.emro.who.int/dsaf/EMROPUB_2010_EN_736.pdfGoogle Scholar

2 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; 3:5Crossref, MedlineGoogle Scholar

3 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; 368:1119–1125Crossref, MedlineGoogle Scholar

4 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; 16:181–184Crossref, MedlineGoogle Scholar

5 Syed Sheriff R, Whitwell S: An innovative approach to integrating mental health into health systems: strengthening activities in Somaliland. Intervention 2012; 10:59–65CrossrefGoogle Scholar