Tuesday, 29 October 2013

Mental health training in Somaliland - Day 34

Thursday 24th October

Today’s teaching was a success. It was the first day that the medical students met with patients. Faadumo brought in 10 people with mental illness, who kindly volunteered their time to speak with the students. I, along with Zainab, the mental health rep, also took a group of students to Borama Mental ward, where they had the opportunity to take a history from a patient. This means that all the students will get both an experience of meeting with patients from the community, and also more acutely unwell patients on the in-patient ward. This for some of the students, is the first time they have met with and spoken to a person with mental illness in this context. Many are scared and wonder what it will be like.

It is a joy to witness the students talking with patients and showing respect and curiosity when taking their histories. Even more wonderful is to witness the change in the students when they return from seeing the patients. None of them now say they feel worried about meeting people with mental illness and many of them have clearly been challenging their own beliefs about mental illness whilst taking histories. Faadumo and Dr Jibril have done a fantastic job at managing to arrange this learning experience for the students, for it has taken a lot of organisation. Again today, I am thrilled to see the mental health reps presenting and Abdirahman does a great job with his presentation of mood disorders. Mustafe led the re-cap session and also did a fantastic job. I really am impressed by their teaching skills and their preparation and confidence.

As a short exercise, I ask students to write out cases of attempted suicide or suicide/self-harm they have witnessed or heard about. It is sad to find that every student has a story to tell, of a neighbour, a friend, or a relative. Many have seen neighbours who have attempted suicide. Most often, the cases the students describe are women, 69%, but it is striking that 31% of cases they report are also men. The most common method of attempted suicide or suicide is burning, though also interestingly, there are other methods used such as hanging, shooting, pesticide poisoning and also drug overdose. The students also point out how much stigma results from such acts, with those who have attempted suicide being ostracized and discriminated against.