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I see Zamzam on the ward. Zamzam regularly
helps us in our training in Somaliland. She has bipolar disorder
but is well now and employed as a cleaner in the hospital. When
unwell she has gone to battle front lines and put herself at great
risk. She has a child as well, who she is sole parent for. She
recognises me and even knows my name. It is great to see her
doing so well.
It is a Friday and day off but some of the
staff have agreed to come in on their day off to have a case
supervision session with me. It is effectively a CBD with a group.
The nurses struggle to speak English but can understand. We
go through many cases and I think they have learnt some things. I
tell them that I am not here to tell them what to do. However I can
pass on what WHO tells them to do with their new mhGAP IG document
which is a practical manual for treatment of mental illness in low
I leave the hospital with sadness. I wish I
could stay and be part of an exciting time of improvement. I always
am left wondering whether I am more useful back in UK or in
Somaliland where it can be so rewarding. It takes an immense
amount of energy and commitment to change an inpatient unit in a
place such as this. With Julie, I think they have someone who can
do this if anyone can.
I make sure to have the goat kebab as my treat
before leaving. This is one of Somaliland’s best
attractions. I am about to leave. We have achieved our goals
but there is much still to be done in this challenging environment.
There is a drought but not to the extent of Somalia in the South.
It is one of the most difficult environments for a foreigner but it
is also one of the most rewarding experiences. The needs are
immense, but you can make a difference.
What I get most from this, apart from
direct experience and sense of accomplishment, is that for these
few weeks I can totally forget my NHS work and stress! It’s
all about the clinical care and nothing more. Somaliland is my best
vacation destination for that reason - and so many more. It is
a country where I have grown to feel very much at home.
I can genuinely say I want to come back - yet
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Dr Peter Hughes is a consultant psychiatrist
based at Springfield University Hospital, London. He has an
interest in international psychiatry and has been travelling to
Africa over the last five years doing short-term assignments in
mental health. He has recently flown to Somaliland to
work on a mental health programme.
This personal blog reflects Dr. Hughes' own
views and does not represent any Somaliland organisation in
the UK. However Dr. Hughes is indebted to KINGS-THET partnership
for providing an opportunity to take part in
this exciting project. He is grateful to Dr. Susie Whitwell
who leads the programme for mental health, and companions
Professor John Rees, Dr. Suleiman Yusuf, Helena Tabry from UK and
all colleagues in Somaliland.