Where hyenas are used to treat mental illness By Richard Hooper BBC World Service Somalia has one of the highest rates of mental illness in the world and with a healthcare system devastated by years of war, most sufferers receive no medical help. Many are chained up - to trees or at home. Some are even locked in cages with hyenas. But one man is trying to change all that. Dr Hab's advert runs up to three times a day on Mogadishu's radio stations. "He's gone crazy! He's running away!" screams the actor. "Chain him down!" The scenario is familiar in Somalia. A man has become possessed by spirits and the only option for his family is to restrain him and call the sheikh. But as the young man protests, a voice that challenges Somali tradition booms out. "Stop with the chains!" the voiceover orders. "Take him to Dr Hab's hospital! If he's having mental problems, take him to Dr Hab. He won't chain him, he'll help him." Dr Hab is not actually a real psychiatrist. Rather it's the persona of Abdirahman Ali Awale, a nurse who after three months of specialist training from the World Health Organization (WHO), has made it his mission to rescue Somalia's mentally ill. He claims he is able to treat everything from post-natal depression to schizophrenia. But the alternative to a trip to Hab could be a visit to one of Somalia's popular herbalists or sheikhs who still advocate traditional - and sometimes barbaric - cures. "There is a belief in my country that hyenas can see everything including the evil spirits people think cause mental illness," says Hab. "So in Mogadishu, you will find hyenas that have been brought from the bush and families will pay £350 ($560) to have their loved one locked in the room overnight with the animal." The expensive treatment - more than the average annual wage - is as brutal as it sounds. By clawing and biting at the patient, the hyena is thought to force the evil spirit out. Patients, including young children, have been known to die during the process. "We are trying to show people that this is nonsense," says Hab. "People listen to our radio advert and they learn that mental illness is just like any other and needs to be treated with scientific methods." Hab's campaign was prompted by an incident in 2005 when he witnessed a group of female patients being chased through the streets by youths. "There was no-one to help them," he says. "I decided after that I would have to open Somalia's first mental hospital." The Habeb Public Mental Health Hospital in Mogadishu became the first of Hab's six centres across Somalia. Together, they have now treated over 15,000 patients. There were only three practising psychiatrists in the whole of Somalia at the last count, and Hab - despite his lack of advanced qualifications - is head of what has become the country's leading provider of mental health services. He even carries a letter from the minister of health that says so. Chaining mentally ill patients to trees has been a widespread practice in Somalia Hab faces a near insurmountable task. WHO estimates that one in three Somalis either is or has been affected by mental illness, compared to a global average of one in 10. In parts of the country, where the population has been the most psychologically scarred from decades of conflict, the rate is even higher. Cases of post-traumatic stress disorder are common and the situation is further complicated by widespread substance abuse. "Khat is a big, big problem," says Hab of the herbal stimulant which has been chewed for centuries in East Africa. Side effects are thought to include anxiety and even psychosis. "We treat them in the hospital and they leave, but then they start eating khat again. Sometimes I see the same patients seven or eight times." Western aid agencies in Somalia have often promoted projects targeting communicable diseases, not least because results are quicker and cheaper to obtain. Hab, meanwhile, says he is left to run his organisation with minimal resources and an erratic supply of psychotropic medicines that he sources from NGOs and private pharmacies. Even getting sufferers to recognise that their condition constitutes an illness is difficult. Psychological problems are more likely to be reported by Somalis as physical pain - headaches, sweating, and chest pain. Some concepts of mental illness do not even exist in Somali culture - depression, for example, translates as "the feelings a camel has when its friend dies". Dr Hab uses his minibus to rescue patients who have been left in chains But nothing is more indicative of the population's poor understanding of mental health than the widespread practice of chaining-up sufferers to trees and in rooms. GRT, an Italian NGO, has documented sufferers who have been chained up their entire life. "I myself have saved many patients who have been left to die," says Hab who drives a minibus into rural areas, unchaining people and taking them to one of his centres. "Parents, siblings, relatives - they've just been chained up to a tree and the family has gone." The WHO has funded a "Chain Free Initiative", with the aim of eradicating the practice altogether, starting with the use of chains in hospitals. But even Hab admits to having chained up some of his most aggressive patients. He tells the story of how, in 2007, one unintended consequence of his acquisition of a batch of the anti-psychotic drug, fluphenazine hydrochloride, was an increased appetite in his patients. They took to scaling the walls of his hospital in Mogadishu to scavenge for food. But still desperately unwell, some of the escapees had been shot when they ignored orders at a military checkpoint. Chaining them to their beds, concluded Hab, was the only option. Dr Hab regularly speaks in public to raise awareness of mental health issues "Many patients take a long time to treat," he says. "There has been no outside help focussed on treating mental health problems and the main reason NGOs are not getting involved is because of the expense." Hab is motivated by the thousands of patients he believes remain chained up in private homes. He sends through a spreadsheet showing what he needs - new mattresses, food for patients, and diesel for his minibus. There is also a shortage of qualified psychiatrists and nurses. The daily struggle to provide for his patients and the suffering he witnesses is clearly taking its toll. "Physiologically and mentally it's a very hard job" he says. "I was healthy when I started, now I suffer from diabetes. I am dealing with big, big problems all by myself. "I have cried on TV, I have cried in public places, I have cried in front of presidents," he says. "Even now I feel like crying."

Alpha Blondy;981867 wrote: :D inabti, wa inaad xaal ka bixisid hadalkaagan xun, ruunti. sowdigan ''SL'' cay iyo aflaagado ka la daali waayey. wa inaan ku gursado anigoo. taas uun ayaa laga aqbali doona, ma garatay? maxaad ka qabto, inabti? :cool: Mooge - inaar, so kaxey reerka Saffz, saaxiibadeed (including indhoyar folks), deriskeeda, shaqaalaha aay la shaqeyso, saddex iyo toban halaad iyo fanaanada cod macan oon wali khiyaamooyinka khaadka baran. Shiekh Nuune - abti, so diyaar garow aad sii kala shaandhaysid wixii caqliga gala iyo wixii aan caqliga galayn eh. Wadani - inantan feminist-ka ah ee ku magac dheere Saffz aana hadaa kadib qabaa ee sida uula soco adiguna.

Wadani;981810 wrote: Don't mix up marriage with politics. I am 100% in favour of inter-clan marriage. I'm a pan-somali at heart whose politics isn't always as idealistic, as the realities on the ground won't allow it. I, and many of us here, are prisoners of circumstance. Few things are more political than marriage... Abbaas;981826 wrote: Mooge, just give up abti, after reading the quote below. Safferz weey tagtoooooooow weey talaabteeeeeeeey ee get over it! Abbaas :mad: That ain't right lol

Saalax;981777 wrote: What does the constitution of Somalia say about Somalia citizenship for people born to Somali women and foreign fathers? In Somaliland in order to be considered a Somalilander majority of the time one has to have a Somaliland father to be a Somalilander. That's because clan is at the core of Somaliland nationality whether it's openly stated or not, and citizenship through paternal inheritance is the only way of ensuring the clan makeup of the country stays the same. I can't think of another constitution in the world (in the 21st century) that excludes women from full rights of citizenship in this way, and it's something Somaliland will have to rethink if it wants to continue fashioning itself as a democratic, politically stable "oasis" in the Horn. Incidentally, Wadani's agreement with Somaliland's citizenship law does confirm Nin Yaaban's theory that racists and tribalists are often the same people The exclusionary logic is the same.

SomaliPhilosopher;981755 wrote: I see you are a reader of Fanon huh? Please put that psychology to use and be the Somali fanon por favor Clearly neither of you are reading Fanon (who was married to a white woman, btw) correctly if you're spouting the views you are in this thread. Unfortunate.

Wadani;981751 wrote: How is trying to preserve the purity of ones ethnic group hatred for others? I don't follow this logic. Really? Even the term "miscegenation" is racially loaded, and the idea of ethnic/racial "purity" itself is highly problematic (there is no such thing as a pure ethnic group, anyway).

Wadani;981743 wrote: Well it depends what you mean by racism. I don't hate other races, I just have greater affinity and strong loyalty to my own people. "Miscegenation is an abomination" could be something straight out of a KKK manifesto, but that was your visceral response to seeing this video. Not sure how that's anything but racism and hatred for others, which is un-Somali and un-Islamic.

Hawdian, it's not that we didn't see that you posted "Kung Fu Fighting" twice before this third post, it's just not funny. And it won't get any funnier by continuing to post it. Mooge;981741 wrote: i fear our resident beauty safferz may be lured by these scrupulous foreign hungry men. Love is love There are a number of things I'd consider when seeing someone, but ethnic background is not particularly important to me. There are more important traits to look at and I don't think it makes sense to limit myself to Somali men exclusively.

Wadani;981734 wrote: As long as it aint happening in my fams i'm straight. To hell with the self-haters, let them do as they wish. So how do you rationalize your racism and intolerance?

Hawdian;981723 wrote: i remember an article about a micxed black and chinese girl being descriminated against i do hope that they get a better welcome back in china . This is what I mean, who said he's even from China apart from his ancestry? Maybe they'll have a nice life in Vancouver Wadani;981727 wrote: Miscegenation is an abomination.

Horta why are you guys analyzing this in terms of China's demographics, Chinese culture, etc? More likely is that these two are both Americans (or Canadians, or Brits or whatever), two people who met on their own terms - maybe at school, or at work - fell in love and decided to get married.

They look good together.

Reer baadiye

Clearly mentally ill

Alpha, you have to be delusional to interpret "Somaliland is not recognized internationally" as an insult, because it's a fact. The debate has always been whether it should or should not be recognized, but as far as it's current status, it is what it is. And you know as well as anyone that I have nothing invested in this debate, if anything I lean Somaliland more often than not.

Wadani;981472 wrote: It's not only about other people since it was ordained by God and will effect your relationship with him. But I do see what you're getting at. Let's put aside the fact that Hijab is a commandment from Illaahay (which you've already done)...we then would have to judge the merits of women covering/not covering in public based on the social effects that are borne out of each condition. The Quran is clear in explaining the functional purpose behind covering; namely so that Muslim women will be known (known as chaste/modest) and so that they will not be annoyed/harrased by this ubiquitious male gaze u speak of lol. But since we now live in a vapid and decadent society where vice has become virtue people do not value chastity and modesty and thus cannot see the utility in the hijab serving as a marker for such women (not always an accurate marker ofcourse). And as for it's second function, feminists suffer from a dissonance of sorts....they want to dress as they please and become sexually 'free', yet become filled with indignation when men (read men whom they are not lusting after lol) 'objectify' them as a result. Where does it say cover your hair in the Quran? Don't quote some desert Arab "scholarly" ruling on how women should dress, I'd like evidence that the hijab is a commandment from God. Alpha Blondy;981512 wrote: Saffz, this is for you, okay? :cool: Stop flirting with me Alpha :mad: I love that song though lol

I can't get over how absurd this decision is. How are Somalilanders who don't hold foreign passports (the vast majority) supposed to travel? Somaliland is not internationally recognized and its passport is useless, say what you will about the Somali passport but people are still able to travel with it, though often with some difficulties.

SomaliPhilosopher;981466 wrote: ^^^ you are hurting your case dee interesting blog post i came across http://www.linamalkawi.com/2009/07/why-are-women-required-to-wear-hijab.html Happy Eid y'all! Interesting read... I've wondered about this before, since I don't wear hijab or believe in what it symbolizes but I do cover during prayers. The difference to me is I don't feel sexualized by the hijab during prayer (someone can correct me on this, but I believe it's recommended that Muslim men cover their heads during salat as well, the idea is to humble yourself before God and dress modestly in His presence), but the hijab in everyday life is about your relations with other people (horizontal rather than vertical, as it would be with prayers/God), suppressing the female body and sexuality in public space because of the male gaze.

Alpha Blondy;981464 wrote: inabti, stop being a snob. you're not impressing anyone, ma garatay? No, why don't you stop being butthurt by the fact your school isn't even in the top 100 :mad:

Tallaabo;981450 wrote: They are only better due to the vast endowments and wealth they have:( But when you look at the value for money spend, the British institution with their meagre resources do much better;) Those were just a few obvious examples I gave to show how the list is distorted in the UK's favour, but even public universities like UC Berkeley are superior to UCL and Imperial :rolleyes: Ciid wanaagsan everyone

Tallaabo;981407 wrote: This table disagrees with you:p http://www.topuniversities.com/university-rankings/world-university-rankings/2013#sorting=rank+region=+country=+faculty=+stars=false+search= QS is a British company, and UK produced lists of the best universities of the world always overrate UK universities. UCL and Imperial College better than Stanford, Yale, Princeton, Penn, Columbia? LOL, no. SomaliPhilosopher;981410 wrote: I considered going to U of toronto....we could have been alumnus buds You should have

SomaliPhilosopher;981397 wrote: Why didn't you pm me dee, surely we can worked out some sort of arrangement :rolleyes: Well my undergrad days are long over, and I have no regrets about graduating from the Ivy of the North, University of Toronto

Alpha Blondy;981389 wrote: oo wayoow not, inabti? american universities are shit. we all know that..... ee naga daa xayeeysiiska, dee. American universities are the best in the world. On the other hand, only Oxbridge can compete with North American institutions. I actually wanted to go to Cambridge for undergrad but I didn't have that kind of money

Che -Guevara;981365 wrote: Safferz. It was the leadership and 'the planning for the day after' that set Ethiopians apart from Somalis. Right, the TPLF was a remarkably well organized grassroots movement.

Wadani;981360 wrote: The only difference is Gaddafi didn't bomb Benghazi...it was a complete and utter fabrication used by the West as a pretext towage an unjust war. Onthe other hand Hargaysa was literally bombed to the ground...no one denies this, whether pro or anti SNM. Go on youtube to see the aftermath of the air raids and the heavy shelling that took place in Hargaysa in 1988. +1, I don't use the term genocide myself, but the level of state violence unleashed on Hargeisa is undeniable. A lot of us here were directly affected by the bombing or lost close relatives in it, don't be a douche MM. And yes, Meles did receive support from Siyaad... Somalia aided rebels in Ethiopia/Eritrea in hopes of destabilizing the country from within, Ethiopia did the same with Somali rebel/insurgent groups. Interesting how the two turned out so differently, since both states collapsed in 1991.