Mental health training in Somaliland - Day 17

Sunday 6^th October

Over the last two days I have been busy completing my online application form for jobs in the UK, for when I return. Today I travel to the west of the country with colleagues. We drive in convoy with an SPU (special protection unit or guard) travelling behind our vehicle. The movement feels nice after being relatively static in Hargeisa. The landscape changes as we drive, from arid desert to much greener lush scenery, with mountains in the distance. We arrive as the skies open and getting the ton of paperwork out of the car inside proves to be quite a challenge! I am met by the Principal of the University here, who welcomes me. I am pleased to be back here as I visited last year to undertake the 5^th year medical student teaching for the first time. Last year I was here with Dr Peter Hughes, a Consultant psychiatrist who has much experience in the field of teaching mental health in low income countries. He taught me much last year and earlier this year and I am reminded how grateful I am to him for allowing me such opportunities. This year he shall not be joining the teaching, but another doctor from the UK. This means I am leading the trip this time, which is exciting, though I quickly see just how much organization is required to enable it to happen. This year we will also have a larger group of students than ever before, 68!

I am met this evening by Dr Jibriil, a doctor who does a huge amount in terms of mental health/psychiatry work in Somaliland. It is great to see him after a year and a half and he has much to fill me in on, for he has been very busy setting up new community projects here in mental health, opening a new mental health ward in 2012 and working on a project that trains community health workers in mental health. This project has had good results in terms of patients in the community with mental health problems being recognized and referred appropriately to services. The benefits of training community health workers are huge- they are people that know their communities well, are able to communicate in simple and understandable language and gain access to communities in a way that perhaps other health professionals would not be able to. This use of human resources is also about task-sharing, in that it is not imperative for such a person to be a specialist in mental health, with the basics, these people can go out and begin to raise awareness of mental disorders within communities, which may reduce stigma and also enable people with mental disorders to access the help they need. It is a strategy that works, as shown by projects in other countries such as India and Uganda.

Dr. Jibriil and I discuss his progress also- he has been accepted to go to Ethiopia for 3 years from January 2014, to complete his psychiatry residency there. He has done much to prepare for this and is an excellent candidate. We plan for the upcoming TOT training that shall begin tomorrow, which Jibriil shall be co-leading with me on. This is a great opportunity for him to develop his own teaching skills further.