Sierra Leone: 'Poorest health sector in West Africa'

Freetown (Sierra Leone) - Sierra Leone's President Ernest Bai Koroma has said his country has the poorest health facilities and health service delivery in the West African sub region.
Speaking at the opening of the week-long 48th annual conference of West Africa College of Surgeons (WACS) at the Miatta Conference Centre, Mr. Koroma said the UNDP human development index ranked the country as one of those with the highest incidence of infant and maternal mortality in the world. According to available statistics, Sierra Leone can only boast of about 60 medical doctors.

President Koroma said the challenge was for his government to transform the entire health sector in the country to ensure better service delivery, adding: "My government is determined to address the poor health condition in the country because, when conditions improved, it will encourage medics to stay home and serve their people.'' To demonstrate his commitment toward the improvement of the situation, the President said his government would allocate a piece of land to the college to enable it build an institution that would cater for the training of surgeons locally as well as create facilities for other sub-regional specialists.



Hundreds of medical doctors from the sub-region are attending the conference. Chairman of the conference's Local Organizing Committee, Dr. Len Gordon Harris, described it as an annual rotational event.In his address, Sierra Leone's Health Minister, Dr. Socco Kabia, described Sierra Leone's health problem as "serious health service delivery constraints'' and blamed the 10-year civil war for the state of the country's health sector.
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Earlier, President of the West Africa College of Surgeons, Prof. E. Alihonou, said Sierra Leoneans had been giving valuable contributions to the college since its inception. He said the college was charged with the responsibility of organising seminars, conducting examinations, researches and training programmes for its members.

Farma health services June 10, 2008

COUNTRY DESCRIPTION: Sierra Leone is a developing country in western Africa still recovering from a ten-year civil war that ended in 2002. English is the official language, but Krio, an English-based language, is widely used. Tourist facilities in the capital, Freetown, are limited; elsewhere, they are rudimentary or nonexistent. Read the Department of State Background Notes on Sierra Leone for additional information.
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ENTRY/EXIT REQUIREMENTS: A passport and visa are required. Visitors are strongly encouraged to obtain visas in advance of travel to Sierra Leone. Visitors to Sierra Leone are required to show International Certificates of Vaccination (yellow card) upon arrival at the airport with a record of vaccination against yellow fever. The Embassy of Sierra Leone is located at 1701 19th Street NW, Washington, DC 20009; telephone (202) 939-9261. Information may also be obtained from the Sierra Leonean Mission to the United Nations, 245 East 49th St., New York, NY 10017, telephone (212) 688-1656; and from the website of the Sierra Leonean High Commission in London at http://www.slhc-uk.org.uk/. Overseas, inquiries should be made at the nearest Sierra Leonean embassy or consulate. Visit the Embassy of Sierra Leone’s web site at http://www.embassyofsierraleone.org/ for the most current visa information.
Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.
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SAFETY AND SECURITY: Security in Sierra Leone has improved significantly since the end of the civil war in 2002. The United Nations Peacekeeping Mission in Sierra Leone (UNAMSIL) withdrew in December 2005 and Sierra Leone resumed responsibilities for its own security. The Sierra Leonean police are working to improve their professionalism and capabilities, but fall short of American standards in response time, communications, and specialty skills. Areas outside Freetown lack most basic services. Embassy employees are free to travel throughout Sierra Leone. Travelers are urged to exercise caution, however, especially when traveling beyond the capital. Road conditions are hazardous and serious vehicle accidents are common. Emergency response to vehicular and other accidents ranges from slow to nonexistent.There are occasional unauthorized, possibly armed, roadblocks outside Freetown, where travelers might be asked to pay a small amount of money to the personnel manning the roadblock. Because many Sierra Leoneans do not speak English, especially outside of Freetown, it can be difficult for foreigners to communicate their identity. Public demonstrations are rare but can turn violent. U.S. citizens should are advised to avoid large crowds, political rallies, and street demonstrations, and maintain security awareness at all times.For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
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CRIME: Entrenched poverty in Sierra Leone has led to criminality. Visitors and resident Americans have experienced armed mugging, assault and burglary. Petty crime and pick pocketing of wallets, cell phones, and passports are very common especially on the ferry to and from Lungi International Airport. Law enforcement authorities usually respond to crimes slowly, if at all. Police investigative response is often incomplete and don’t provide support to victims. Inefficiency and corruption is a serious problem at all levels within the government of Sierra Leone. Americans traveling to or residing in Sierra Leone should maintain a heightened sense of awareness of their surroundings to help avoid becoming the victims of crime.Upon arrival in Sierra Leone, U.S. citizens are urged to register at the Embassy in Freetown (see Registration/Embassy Location section below) where they may obtain current safety information and advice on minimizing risks.The Embassy receives regular reports from potential American investors who have been victims of fraud, often in the mining industry. While law enforcement authorities have been involved in investigating the cases, many remain unresolved. Investors are urged to proceed cautiously when engaging in business transactions with individuals presenting themselves as legitimate diamond/gold dealers. It is not uncommon for registered diamond/gold dealers to target foreigners using sophisticated scams resulting in significant financial loss.Business fraud is rampant and the perpetrators often target foreigners, including Americans. Schemes previously associated with Nigeria are now prevalent throughout West Africa, including Sierra Leone, and pose a danger of grave financial loss. Typically these scams begin with unsolicited communication (usually e-mails) from strangers who promise quick financial gain, often by transferring large sums of money or valuables out of the country, but then require a series of "advance fees" to be paid, such as fees for legal documents or taxes. Of course, the final payoff does not exist; the purpose of the scam is simply to collect the advance fees. A common variation is the scammer’s claim to be a refugee or émigré of a prominent West African family, or a relative of a present or former political leader who needs assistance in transferring large sums of cash. Still other variations appear to be legitimate business deals that require advance payments on contracts. Sometimes victims are convinced to provide bank account and credit card information and financial authorization that drains their accounts, incurs large debts against their credit, and takes their life savings.The best way to avoid becoming a victim of advance-fee fraud is common sense – if a proposition looks too good to be true, it probably is. You should carefully check and research any unsolicited business proposal before committing any funds, providing any goods or services, or undertaking any travel. It is virtually impossible to recover money lost through these scams. Please see the Department of State’s brochure on International Financial Scams for more information.
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INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
See our information on Victims of Crime.
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MEDICAL FACILITIES AND HEALTH INFORMATION: Quality and comprehensive medical services are very limited in Freetown, and are almost nonexistent for all but most minor treatment outside of the capital. Persons with unstable chronic medical conditions that require on-going medical treatment or medications are discouraged from traveling to Sierra Leone. Medicines are in short supply and due to inadequate diagnostic equipment, lack of medical resources and limited medical specialty personnel, complex diagnosis and treatment are unavailable. The quality of medications in Sierra Leone is inconsistent and counterfeit drugs remain a problem. Local pharmacies are generally unreliable. In the event medications are needed, such as over-the-counter medication, antibiotics, allergy remedies, or malaria prophylaxis, travelers may contact U.S. Embassy Health Unit personnel to receive general information about reliable pharmacies.Medical facilities in Sierra Leone are scarce and for the most part sub-standard; outside the capital, standards are even lower. There is no ambulance service in Sierra Leone, trauma care is extremely limited, and local hospitals should only be used in the event of an extreme medical emergency. Many primary health care workers, especially in rural areas, lack adequate professional training. Instances of misdiagnosis, improper treatment, and the administration of improper drugs have been reported. Life-threatening emergencies often require evacuation by air ambulance at the patient's expense. For a list of hospitals, visit our web site at http://freetown.usembassy.gov/. Gastrointestinal diseases and malaria pose serious risk to travelers in Sierra Leone. For additional information on malaria, including protective measures, see the CDC Travelers’ Health web site at http://www.cdc.gov/malaria/.Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en.
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MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.
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TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Sierra Leone is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Most main roads in Freetown are narrow and paved but have potholes; extremely narrow unpaved side streets are generally navigable. Most roads outside Freetown are unpaved and are generally passable with a 4-wheel drive vehicle. However, certain stretches of mapped road are often impassable during the rainy season, which usually lasts from May to September. During the rainy season, add several hours to travel time between Freetown and outlying areas. There is a major road repair and resurfacing program going on throughout the country that is slowly improving the quality of roads. Public transport (bus or group taxi) is erratic, unsafe, and not recommended. U.S. government employees are prohibited from using public transportation except for taxis that operate in conjunction with an approved hotel and that are rented on a daily basis.Many vehicles on the road in Sierra Leone are unsafe and accidents resulting from the poor condition of these vehicles, including multi-vehicle accidents, are common. Many drivers on the road in Sierra Leone are inexperienced and often drive without proper license or training. Serious accidents are common, especially outside of Freetown, where the relative lack of traffic allows for greater speeds. The chance of being involved in an accident increases greatly when traveling at night, and Embassy officials are not authorized to travel outside of major cities after dark.Please refer to our Road Safety page for more information.
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AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Sierra Leone, the U.S. Federal Aviation Administration (FAA) has not assessed Sierra Leone’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa. It is not uncommon for regional airlines to alter scheduled stops, cancel or postpone flights on short notice, and overbook flights. Travelers may experience unexpected delays even after checking in and must be prepared to handle alternate ticketing and/or increased food and lodging expenses. European carriers are typically more reliable. American citizens departing Lungi International Airport have reported incidents of attempted extortion by officials claiming that travel documents were not in order. Luggage can often be lost or pilfered.
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SPECIAL CIRCUMSTANCES: Lungi Airport is located across a large body of water from Freetown. There are usually four travel options to/from Lungi airport: helicopter, ferry, hovercraft and by road. While none is without risk, all are used by Embassy personnel. The cost for the ferry service is minimal; however, the service experiences frequent delays, and the ferry terminal is located in East Freetown, which has a higher crime rate than other parts of the capital. When the hovercraft and helicopter services are operating, they charge approximately $50-70 each way (payable in U.S. currency). Passengers departing Freetown by air should expect to pay an airport tax of $40.00 (payable in U.S. Dollars). Sierra Leone is a cash economy. However, an anti-money laundering law passed in July 2005 prohibits importing more than $10,000 in cash except through a financial institution. Travelers are advised not to use credit cards in Sierra Leone because very few facilities accept them and there is a serious risk that using a card will lead to the number being stolen for use in fraudulent transactions. There are no ATMs connected to international networks. Travelers' checks are not usually accepted as payment; however, they can be cashed at some banks including Sierra Leone Commercial Bank, Standard Chartered Bank and Rokel Commercial Bank. The traveler must have proof of identification and a signed receipt by the institution where the travelers’ checks were purchased. Currency exchanges should be handled through a bank or established foreign exchange bureau. Exchanging money with street vendors is dangerous because criminals may "mark" such people for future attack and there is the risk of receiving counterfeit currency.Sierra Leone's customs authorities enforce strict regulations concerning the export of gems and precious minerals, such as diamonds and gold. All mineral resources, including gold and diamonds, belong to the State and only the government of Sierra Leone can issue mining and export licenses. The legal authority for the issuance of licenses is vested in the Ministry of Mines and Mineral Resources. Failure to comply with relevant legislation can lead to serious criminal penalties. For further information on mining activities in Sierra Leone, contact the Ministry of Mines and Mineral Resources: The Director of Mines, Ministry of Mines and Mineral Resources, Fifth Floor, Youyi Building, Brookfields, Freetown, Sierra Leone; tel. (232-22) 240-420 or 240-176; fax (232-22) 240-574.Corruption is a problem in Sierra Leone. Travelers requesting service from government officials at any level may be asked for bribes. Corrupt government officials should be reported to the Anti-Corruption Commission at one of the following locations: The Sierra Leone Anti-Corruption Commission, 3 Gloucester Street, Freetown; 14a Lightfoot Boston Street, Freetown; 37 Kissy Town Road, Bo, Southern Province; Independence Square, Rogbaneh Road, Makeni; tel. (232- 22) 229-984 or 227-100 or 221-701; fax (232-22) 221-900; email: acc@sierratel.sl or info@anticorruption.sl, the web site for the Anti Corruption Commission in Sierra Leone at http://www.anticorruptionsl.org/anonymous.html.Travelers must obtain official permission to photograph government buildings, airports, bridges, or official facilities including the Special Court for Sierra Leone and the United States Embassy. Areas where photography is prohibited may not be clearly marked or defined. People sometimes do not want to be photographed for religious reasons or may want to be paid for posing. Photographers should ask permission before taking someone’s picture.U.S. citizens who are also Sierra Leonean nationals must provide proof of payment of taxes on revenues earned in Sierra Leone before being granted clearance to depart the country. The Government of Sierra Leone now recognizes dual U.S.-Sierra Leonean citizenship. However; the U.S. Embassy may have difficulty assisting American citizens involved in legal or criminal proceedings if they entered the country on a Sierra Leonean passport. Please see our Customs Information.
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CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Sierra Leone laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Sierra Leone are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.
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CHILDREN'S ISSUES: For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

Farma Health Services In Kono District

Main Office: Kono District

Eight years of civil war has displaced and affected 2.2 million people out of the 4.4 million total population of Sierra Leone, as well as disrupted an already deficient health system. The entire population is at risk of major diseases, particularly malaria, acute respiratory infections and malnutrition. Immunization coverage has seen a significant decline in the last decade, from 75 per cent in 1990 to 40 per cent in 1999, while measles and cholera outbreaks are prevalent. Several cases of tuberculosis have been confirmed and sporadic cases of neonatal tetanus have emerged. Sierra Leone has the highest maternal mortality rate in the world, with 1,800 deaths per 100,000 births (according to 1996 estimates)
In January 2000, an outbreak of bloody diarrhea caused by shigella dysentery affected various areas and threatened to evolve into a regional outbreak. Another devastating consequence of war is the dramatic increase in amputations and mutilation of innocent civilians, including women and children. It is estimated that there are more than 1,000 people with lower or upper limbs amputated. The nutritional status of the population has been on the decline in the past two decades and the current humanitarian crisis has exacerbated an already deteriorated situation. The magnitude of the problem of micronutrient deficiency also shows a high proportion of anaemia among pregnant women and children under five. Death and migration of trained health staff, combined with insecurity and not affordable costs of medical services, added a further complication, drastically reducing accessibility to primary health care services.

WHO support to Sierra Leone has an emergency focus, but includes a significant relief and rehabilitation component aimed at recovery of war‑damaged health facilities and services and care for displaced populations. In this context, WHO has been involved in the development of a district health system. WHO is also working increasingly with non-governmental organizations.

WHO=s main activities in Sierra Leone include:
- health situation assessments (disease burden, logistics planning, manpower and facility planning);
- support to surveillance and control of specific disease problems (cholera, Lassa fever, meningitis, malaria, HIV/AIDS and other epidemic‑prone diseases);
- polio eradication (including acute flaccid paralysis surveillance), as part of the national eradication programme, in difficult or inaccessible areas;
- re‑establishment of district health management teams under the supervision of district medical officers;
- focused delivery of emergency drugs and supplies in areas of critical need

TB is a Serious Public Health problem in our Country

The Programme Manager of the National Leprosy and Tuberculosis Programme Sierra Leone, Dr Foday Dafae including Farma Health Services Manager Mr.P.S.Farma has disclosed at press briefing last Friday, March 21st, that Tuberculosis (TB) is a massive global health problem which kills 2 million people yearly and 9 million new cases detected.



Mr. Dafae was speaking ahead of the World TB day which was slated for Monday, March 24th with the Theme: I Am Stopping TB. Giving a brief background about the diseases Mr. Dafae said TB was discovered by Dr. Robert Koch. At that time the discovery of the bacteria that causes tuberculosis astounded scientists the world over.

Mr.Farma warned that TB is an air borne disease that is transferable from one person to another. Describing how the disease transfers, he said that people with TB infected pulmonary (lung) transfer it to other persons when they cough, sneeze or spit in the open. Mr.Farma stressed that to become infected one can only inhale few of those micro-organisms. A TB infected person does not necessarily feel ill; he noted and added that if the person’s immunity is low, the disease might progress into further attacking the lungs and other organs, which subsequently can be fatal if not treated.

However, the National Leprosy/Tuberculosis programme statistics recorded the following registered new cases during the years 2004 - 2007

2004: 5,863
2005: 6,930
2006: 8,208
2007: 9,623

Health workers in Sierra Leone have observed that the estimated figures are far more than the total number of infected persons nationwide.

TB most time kills people in Sierra Leone where there are not medical facilities to diagnose the disease, the 35 years of experience doctor noted. Mr.Farma further disclosed that Sierra Leone is presently boasting of 84 diagnostic centres with HIV/AIDS testing opportunity. He said in 2004, Sierra Leone was having less than 20 centres. He pleaded that members of the press help in informing and educating the general public that TB is a killer disease. He asked that the attention that is given to HIV/AIDS be given to TB. He said this will encourage infected persons to report for medical treatment which is free. Mr.Farma said the World Health Organisation set a target to detect 70% of sputum positive cases out of a successful treatment of 85% per year.
Meanwhile a 52 % detection rate is the latest discovery of TB out spread in Sierra Leone .Mr.Farma declares that it is time bound to take action beyond our current effort as a country that will ensure a goal of success

Mental health in Sierra Leone
Sandra Zaeh writes on the the mental health challenges in Sierra Leone.
By any Western account, the mental health system in Sierra Leone is struggling.
With one trained government psychiatrist, little funding for psychiatric drugs and mental health facilities, and few opportunities for mental health care outside the capital of Freetown, the majority of mentally ill patients are beyond the reach of biomedical care for mental disorders.
To fill the void, Sierra Leoneans turn to alternatives like traditional healing and spiritual practices to address their mental health needs, options that even Western-trained experts consider crucial to maintaining the country’s mental health. And yet, the balance is tenuous - and, without an infusion of financial and human resources, may not be sustainable.
Mental health is far from the only problem facing Sierra Leone, which ranks at the bottom of the Human Development Index. (1) While the country has shifted from its post emergency phase to one of development since its 11-year civil war ended in 2002, it still faces daunting economic, educational and medical difficulties: nearly 75% of people live on less than $2 per day, the country has a literacy rate of 35%, and infant and maternal mortality rates are among the highest in the world. (2)
In light of these challenges, mental health may seem like a relatively minor problem, but experts at the World Health Organization (WHO) explain that there is “no health without mental health,”(3) and estimates suggest neuropsychiatric conditions are responsible for over 30% of the global burden of disease. (4) As Dr. K. Sheku Daoh, Director of Hospitals Services at Sierra Leone’s Ministry of Health (MOH) explains, mental health is intrinsically linked to many health issues. If we choose not to address mental health, there will be a “multiplying effect on the entire health system.”
Another concern for First Lady Sia Koroma is stability. If Sierra Leone fails to support individuals with drug-induced mental psychosis, she says, it is possible for them to “go to the guns again” and fight. Her concerns are particularly relevant given widespread opinion that a causal factor in Sierra Leone’s Civil War was youth discontent.
Despite the stakes, mental health remains a “neglected issue,” according to the First Lady, a trained psychiatric nurse. A nationally representative survey performed in 2002 suggested that the prevalence of depression within the population was 38%. Additionally, 7% of Sierra Leoneans were afflicted by substance abuse and 65% had suffered from trauma-related distress. (5) A recent longitudinal study of war-affected youth has documented similarly high rates of depression and anxiety disorders. (6)
Despite Sierra Leone’s pressing needs, the Western mental health system is vastly underdeveloped due to a lack of funding, its stigma, and little interest by medical professionals. Dr. Daoh explains that 75% of the minimal health budget is dedicated to reproductive and child health. While mental health is among the MOH’s priorities, he says, there is not enough money to make it a focus.
Dr. Edward Nahim, Sierra Leone’s lone government psychiatrist, expresses concerns that both Sierra Leoneans and Western trained physicians within the country do not see mental health as important health concerns. “They see mental health as something for the juju men,” he says. “They truly don’t understand it.”
The lack of attention paid to mental health in Sierra Leone has resulted in a mental health system which revolves around one man: Dr. Nahim.
On call 24 hours a day, 7 days a week, Dr. Nahim is in charge of Kissy Mental Hospital, the government’s only psychiatric institution, located in Freetown. The 108-year-old hospital, among the oldest psychiatric institutions in West Africa, has a 400 patient capacity, but recently cut its patient load to 150 due to a lack of personnel.
Throughout his tenure as government psychiatrist, Nahim has seen an increase in the prevalence of mental illness in Sierra Leone, mostly linked to an increase in drug abuse. Drug induced psychotic disorders, which used to account for 10% of the admissions to Kissy, now drive more than 80% of psychiatric admissions.
Despite the widening prevalence of mental disorders and limited capabilities of the biomedical mental health system, Nahim is convinced that the mentally needy are receiving the care they need.
“Eighty percent of all mentally ill patients are treated by people in the community - religious healers, spiritual healers, juju men, and black magic men,” he says. “They all do a very good job.”
Nahim argues that traditional healing is successful within Sierra Leone because many people believe their mental illnesses are externalized and associated with an “evil environment,” which can only be cured through traditional medicine.
Dr. Taylor Lewis, founder of the Sierra Leone Traditional Healer’s Association, also believes in the importance of traditional healers in order to achieve WHO’s goal of “health for all.” With over 2,000 traditional healers in Sierra Leone - compared to only 126 physicians - Lewis says that traditional healers provide a valuable resource if they are properly regulated. He sees traditional healers as important for patients who suffer from mental health disorders, as they can “cure mental ailments that Western doctors cannot treat” through traditional ceremonies.
In addition to traditional medicine, the mentally ill also seek spiritual healing. At the City of Rest in Freetown, Pastor N’gobeh leads a residential mental home and drug abuse center that employs biblical counseling and prayer to cure patients, without any psychiatric drugs. N’gobeh’s center is based on the philosophy that “there is no sickness that God cannot cure.”
Even with the use of traditional medicine and spiritual healing, however, there is widespread concern that gaps exist in patient care. Dr. Lewis believes the system is only 30% effective.
Thus, it is essential for the various actors involved to “work together” to build mental health capacity, says Dr. Lewis. In addition to making mental health part of all health initiatives, Lewis believes the first major step is to invest in human resources and increase the number of mental health workers.