Catching up continured

When Salah initially invited me to Somaliland back in January of 2018, I had no idea what I was in for. Salah had done a lot of legwork in anticipation of my visit and we were able to do a pretty deep dive into the mental health world of Somaliland in a relatively short period of time. We visited mental health facilities in Borema, Berbera, and Hargeisa. We were able to give presentations on mental health topics to the hospital staffs in Berbera and Hargeisa.  We found the health care workers to be very receptive to our teaching. We spent time teaching validation and the psychosocial model of illness. One participant pointed out that they hadn’t had any in service education like ours for over a decade. Mental health is still highly stigmatized in Somaliland. The mental health units are located away from the other medical units of the public hospitals. The staff told us, it was hard to get the regular doctors to come over to the mental health side of things to see patients with medical concerns. Salah and I actually spent quite a bit of time trying to treat a severe mouth infection of one of the patients we saw in one of the public mental institutions. What became increasingly clear to both of us, was there was a profound lack of mental health care providers in the area. We realized trying offer any kind of mental health services without increasing capacity by training more providers would be fruitless. We were able to treat several people in that short period of time and we felt there would be plenty of people open to our more Western approach to mental health. My first visit to Somaliland was 6 weeks. I had made a commitment to a colleage in the US to help with the develpment of some new psychiatric services in the US, I returned to the US with the commitment to return to Somaliland for at least a year when my job in the US was completed.