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Published On: Sat, Oct 24th, 2015

Somaliland: Poor Conditions At Hargeisa Hospital-video

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Two things have dominated life in the as-yet-unrecognized republic of Somaliland in recent years: war, and khat.

The war is over, for now, in this breakaway region of Somalia. But the use of the herbal stimulant goes on.

At the Hargeisa hospital mental ward, most of the patients are victims of both.

The Hargeisa hospital mental ward in the republic of Somaliland.

Conditions here are so poor that the patients have practically become inmates.

Most are chained and many are isolated to keep them under control.

Lacking money for staff and supplies, hospital staff say they have no other option.

These patients suffer from a variety of illnesses.

Most are extremely disturbed and often prone to violent outbursts.

Others are withdrawn and subdued – silent witnesses to the confusion and commotion that surrounds them.

Some patients, including murderers, are held in solitary cells to prevent them from attacking others.

Sanitation is poor, food is meagre and patients must live within the confines of the chains that shackle them.

They are kept here because there is no where else for them to go.

“I am here now because they don’t have a place for my mind.”
SUPERCAPTION: Ibrahim Mohammed Arraleh (46) former Ministry of Agriculture official

The patients – most of them former soldiers in a 10-year battle for independence – have been broken by war.

Almost all have abused khat, a stimulant commonly used in East Africa and the Gulf.

Initial effects of the stimulant are lack of sleep and depression .

Prolonged periods of chewing the plant can lead to psychosis.

Even short-term use can lead to unpredictable behavior.

But its many users say it reduces tension, helps them think more clearly and is an essential ingredient to any social gathering.

Khat – chewing crosses all social, cultural and class barriers.

In Hargeisa, everyone from peasant farmers to government ministers chews khat in the late afternoon.

At the hospital, although the patients are victims of Khat abuse, the herb is still used to sedate them and avoid violence in the wards.

“A hundred percent of the patients are chewing khat you know…”
(Q): “What does that do to their…”
(A) ” …the problem came from the khat.”
SUPERCAPTION: Faisel Ibrahim Odwa (27) Psychiatric nurse and head
of staff at the mental ward.

Khat use doesn’t just extract a high human cost: it carries a financial one, as well:

Because local crops were destroyed during the war, Somaliland imports huge cargo plane loads of khat daily from Ethiopia and Kenya.

The cost to Somaliland’s economy is one (m) million dollars a month.

It’s a loss the fledgling government can ill-afford.

Cities must be rebuilt and security maintained in the volatile region.

The loss of millions of dollars of hard currency due to khat consumption is shackling the economy.

It will be another two years before the khat that was planted in the self-declared independent republic is ready for harvest.

Khat buyers and sellers fill markets throughout Somaliland.

It costs two dollars for a bag full of the bitter-tasting stimulant that will last into the evening.

The government recently introduced afternoon working hours to try to curb the habit.

But, since khat is not a drug, it has never been made illegal.

“Unfortunately the conclusion was that it wasn’t harmful – it wasn’t a drug, it was a stimulant – that’s all it was you know, and it could do no harm. But it is a habit – a nasty habit which our people have in the afternoon you know… the greatest damage it does is that it averts the people from working.”

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