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The Only Psychiatric Hospital in Sierra Leone

2019-04-09 · documentary visit · John · 6:21 · watch on YouTube

Topic: Global development · mode: Personal essay · tags: on location, heavy topic, fundraising ask, civic or action cta

Visiting Kissy Psychiatric Hospital, Sierra Leone's only mental health hospital, John shows how chained patients and collapsed infrastructure gave way, with Partners In Health support, to medication, power, water and care at home, and argues that isolated interventions fail: only investing in whole systems, and listening, brings systemic results.

What is said

The parts of the video and what is said in each (★ — how much it matters to the video).

00:00:00 — Trip to Sierra Leone; Kissy Psychiatric Hospital and Dr. Abdul Jalloh; John's personal interest

  • ★★ John and Sarah spent last week (week of 1 April 2019) in Sierra Leone learning about its health care system and visited Kissy Psychiatric Hospital. — 00:00:00 · Sarah Urist Green, Sierra Leone
  • ★★ John says Kissy is a 199-year-old facility and the only mental health hospital in Sierra Leone. — 00:00:10 · Sierra Leone

  • ★★★ John says the visit was personal: he has been, at one level or another, a psychiatric patient for most of his life. — 00:00:16 · mental disorder

    “I have been, at one level or another, a psychiatric patient for most of my life.”

  • ★★ John says the hospital is led by Dr. Abdul Jalloh, one of the only psychiatrists in Sierra Leone, a nation of over 7 million people. — 00:00:22 · Sierra Leone

00:00:29 — The hospital a year ago: no medication, water or electricity; chained patients; useless posters

  • ★★★ Dr. Jalloh explained that as recently as a year ago the hospital was dire: no medication, water supply or electricity, broken toilets, almost everything collapsing. — 00:00:30
  • ★★★ John says many patients were chained to their beds for much of the day and night. — 00:00:58

  • ★★★ A poster about chaining frustrated staff: all wanted to end chaining, but without medication or working infrastructure they had no other way to stop aggressive patients' harm; they needed support, not posters. — 00:01:05 · aid effectiveness

    “They didn't need posters. They needed support.”

  • ★★ John says the old pharmacy's shelves had long been nearly empty, leaving no medication for psychic pain, very few clinicians for therapy, and no water or electricity. — 00:01:27

00:01:56 — Wrong generators, then Partners In Health's changes: power, staff, medication, water, patients at home, chaining ended

  • ★★★ A charity donated two huge generators that were far too powerful for the hospital's grid and shorted everything out; staff could have said what they needed, but no one asked. — 00:01:56 · aid effectiveness
  • ★★★ Partners In Health, working with the Ministry of Health, Dr. Jalloh, staff and patients, brought the right generator, more staff, hundreds of medications, new beds and running water. — 00:02:10 · Partners In Health
  • ★★★ With medication and other treatment available, many patients now live at home; as a nurse explained, a year ago almost all Kissy's patients stayed in hospital, and now most live at home. — 00:02:42
  • ★★★ John says chaining has ended: patients walk freely in their care area, and humane restraints, used when patients threaten themselves or others, are now rare. — 00:03:11
  • ★★ Several patients talked with John; one long-term patient described how life at Kissy has changed in the past two years. — 00:03:28

00:03:40 — Still a long way to go; rising demand; John's kinship with the patients

  • ★★ John says no one wants to be a psychiatric patient, chronic mental illness is extremely hard to live with even at best, and Kissy still has a long way to go. — 00:03:40 · mental disorder
  • ★★ More areas will open: a lecture hall to train Sierra Leonean clinicians, and a ward that will be the country's first dedicated drug addiction rehabilitation center. — 00:03:52 · Sierra Leone
  • ★★ John predicts that as Sierra Leoneans come to trust mental health care to work, demand for services will keep rising, bringing new challenges. — 00:04:05 · mental disorder, Sierra Leone
  • ★★★ John says the transformation so far is truly profound and has immeasurably improved the patients' lives. — 00:04:15

  • ★★★ John feels kinship with the patients because he owes his life to effective mental health treatment, the kind they are at last beginning to receive. — 00:04:22 · mental disorder

    “I owe my life to effective mental health treatment”

00:04:39 — Isolated interventions fail; invest in systems and listen

  • ★★★ Single interventions like a poster campaign or a donated generator often fail because the whole system must change together; isolated investments yield isolated results, investing in systems yields systemic ones. — 00:04:39 · aid effectiveness

    “Isolated investments often yield isolated results. But if you invest in systems, you can get systemic results.”

  • ★★★ Investing means time and attention to listen carefully, not barging in with preconceived solutions: what the community learned from a decade working with Partners In Health. — 00:05:05 · aid effectiveness, Partners In Health, Nerdfighteria

  • ★★ John says PIH succeeds because it builds systems and listens to the people it serves; it's no coincidence that 96% of PIH Sierra Leone's employees are Sierra Leonean. — 00:05:20 · Partners In Health, Sierra Leone

00:05:30 — The Sierra Leone project, newsletter sign-up, questions in comments, thanks

  • ★★★ In coming months and years John and Hank will focus on long-term support for Sierra Leone's health care system, by far the channel's biggest project: intimidating, but the need is immediate and critical. — 00:05:30 · Hank Green, Sierra Leone
  • ★★ Seeing what Kissy's staff and patients accomplished in two years, John knows real change is possible. — 00:05:50
  • ★★★ John hopes viewers will sign up for the new newsletter about the Sierra Leone project, linked in the doobly-doo, to learn more. — 00:06:00 · Sierra Leone, doobly-doo
  • ★ John says he will be in the comments to answer questions. — 00:06:10

In the description and comments

  • ★★ The description asks viewers to donate to Partners In Health at pih.org/hankandjohn. — video description · Partners In Health
  • ★★ The description asks viewers concerned about their mental health to contact their local crisis center, and links resources. — video description · mental disorder
  • ★★ John thanks viewers who have donated to the first half of the Project for Awesome in the last few years: they helped fund Kissy's ongoing transformation. — video description · Project for Awesome

Threads in this video

Where the stories that moved here went next

Mentioned

Central: Kissy Psychiatric Hospital · mental disorder · Partners In Health · Sierra Leone · systems thinking

Also: Abdul Jalloh · aid effectiveness · doobly-doo · Drug rehabilitation · Ministry of Health and Sanitation (Sierra Leone) · Physical restraint · Sarah Urist Green

Only in the description or credits: Freetown · Project for Awesome

Also centred on Kissy Psychiatric Hospital: Instantly Debateable

Also centred on systems thinking: The Things that People Do (Thoughts from New York City) (Pizzamas Day 7) · SYSTEMS!!!! · It's My Fault Too

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