Ibrahim Bangura grew up in a traditional Islamic family in Freetown, Sierra Leone. But religion did not shape his life. His childhood memories are wrapped in thick smoke of burned marijuana, kush, and other dangerous drugs that his older siblings smoked regularly in the room in which they grew up. Before too long, Ibrahim joined his brothers in the smoking habits.
Young man in a cloud of smoke. Photo Credit: Jakob Owens, Unsplash
“The habit of smoking grew in me to a point that if I did not take drugs, drink or smoke, I would not be able to think,” Ibrahim said in a recent interview with this reporter.
Smoking marijuana can make people feel euphoric, giggly, creative and relaxed, but there are also side effects of anxiety, confusion, delusions and hallucinations, high blood pressure, nausea and vomiting, panic, paranoia, psychosis and racing heartbeat, according to the healthline.com website.
When Ibrahim began failing in school, he doubled the amount of drugs hoping that it would boost his energy to perform better and get better grades. “I became addicted to an extent that I had to take drugs even when I went to school,” he said.
Northern Sierra Leone is a marijuana-growing hub
According to Skeku Kamara, the head of the Transnational Organized Crime Unit (TOCU), young men in the northern region of Sierra Leone are dominantly involved growing and the smuggling of marijuana for survival and occupation.
In 2015, TOCU officer Ismaila Samura warned that drug abuse poses a serious threat to national security. West Africa is a transit point for drugs from Latin America to markets in Western Europe.
TOCU is a unit within the Sierra Leone Police that investigates and prosecutes offenders who are involved in largescale drugs trafficking. But official data on drug trafficking, drug abuse and other drug-related crimes is extremely limited.
In 2019, at the age of 20, Ibrahim could no longer control his extreme rage and outbursts of violence caused by drug abuse. One particular drug that he calls “jah scotch” which is a mixture of butter scotch candy, kush and marijuana, made him lose complete control of himself. In his neighborhood, at upper Tengbeh Town, on the northern tip of the Freetown peninsula, people feared Ibrahim was cursed or possessed by demons.
Overwhelmed by stigmatization, marginalization, harassment, and shame, Ibrahim abandoned the home of his father, Sheikh, and settled in Waterloo, dozens of miles outside of Freetown.
One day he went back to his parents, got completely naked, and began chasing the neighbors and destroying their properties. “My father eventually captured me and gave me a sleeping pill. But when I woke up a few hours later I started destroying again. My father took me to the 34 Military Hospital where Dr. Fatorma gave me treatment and referred me to the Mental Health Coalition for counseling. I began seeing improvement with each day,” Ibrahim said.
Only 2 out of 100 severe mental health patients get treatment
Ibrahim is extremely lucky to have found mental health care and support. Dr. Emeka Nwefoh, who is a Mental Health Adviser for West and Central Africa, on behalf of the Christian Blind Mission (CMB),said that Sierra Leone has an estimated treatment gap of 98% for severe mental illness.
Nwefoh said that in West Africa mental illness is viewed as something that is brought upon oneself or as the result of supernatural activity. According to a 2009 study by Jones, El Masri et al published in The Lancet, about 88% of people with mental disorders in Sierra Leone had seen a traditional healer before accessing psychiatric care.
A 2012 World Health Organization (WHO) study stated that the majority of Sierra Leoneans believe that mentally ill people are evil, violent, lazy, stupid, and unable to marry or have children, and are unfit to vote. Mental illness is seen as either brought upon oneself as punishment for certain actions, or as being cursed by spells and witchcraft.
Traditional healers make mental illness worse
The Project Coordinator for the Mental Health Coalition of Sierra Leone, Edward Maunda Jah, said that “because of these beliefs, family members take the victims to traditional healers’ shrine, instead of asking clinical medical services as their first point of contact. This causes the patient to degenerate faster. This culture needs to change if we want to see improvement in mental illness,” Jah said.
Drugs and alcohol-induced psychosis prevalent among youths
In 2002 the Ministry of Health and Sanitation conducted a post-war mental health assessment and found that about 12% of the population suffered from severe mental illness. This rate is approximately 4 times higher than the estimated global prevalence of around 3% for severe mental illness.
While depression remains the most prevalent cause of mental health illness in Sierra Leone, the vast majority of youths suffer from drug and alcohol-induced psychosis.
“Drugs misuse and abuse of other substances, such as drinking and boiling of ‘pampas wata,’ coupled with the economic situation is a leading cause of mental issues among youth,” Jah explained.
“Pampas wata” is the liquid resulting from boiling Pampers (disposable diapers) or sanitary pads, a trend started in Indonesia in 2018. The Indonesian National Drug Agency (BNN) explained that the chemicals in the sanitary pads give those who drink it a feeling of “flying” and hallucinations. The phenomena reached Sierra Leone in 2019.
Lack of treatment facilities increases the number and severity of mental illness
“Most consumers of drugs are young people between 18 and 35 years old. They end up developing mental complications and other health issues like Hepatitis B, with other organ disease, most of whom die during their youthful age,” said Dr. Edward Nahim, who served as the Sierra Leone’s only psychiatrist for over three decades.
Nahim, a government Consultant Psychiatrist, identified unemployment as a major factor leading to stress and frustration, and ultimately these vulnerable youth fall to drug abuse.
“Most youths find it extremely difficult to access treatment facilities which could be one of the contributing factors for increased in mental illness and severity. Mental health issues could be cured or minimized if detected at an early stage,”Nahim said.
A 2012 World Health Organization report estimated that 715,000 people were suffering from mental disorders in Sierra Leone, with only 2,000 receiving treatment. That is less than 0.3%.
Psychiatrist-in-charge at the Sierra Leone Psychiatric Teaching Hospital (SLPTH) Kissy, Dr. Abdul Jalloh said that most of his patients are between 16 and 35 years old based on the past five years records.
He explained that mental illness can be triggered by risk factors such as drugs abuse, chemical imbalance in the brain, or hereditary complications. Also, stressful events, such as the civil war, the Ebola crisis, the mudslide of 2017, and the current COVID-19 pandemic could trigger mental complications.
Policies on harmful drugs should be enforced
According to a WHO 2012 report, there is a high rate of production and consumption of alcohol and illicit drugs in Sierra Leone. Sierra Leoneans consumed on average 9.7 liters of alcohol per capita in 2005, compared to 6.2 liters per capita for the rest of the WHO African region.
Dr. Jalloh warned that if the current trend continues, Sierra Leone’s future is in danger.
“Harmful drugs have a devastating effect on young people. Drugs are easily accessible and are cheap, and the youth can easily afford to get them,” Jalloh said.
To curb the surge of mental disease in youth, Dr. Jalloh said, the government needs to introduce stringent policies on prohibited drugs and increase taxes on the sale and production of alcohol, and the government should enforce the policies.
The “pusher boys” of Freetown
Ahmadd K. [real name protected] is known as a ‘pusher boy’ from Calaba Town, eastend Freetown, who sells drugs for a profit. Ahmadd dropped out of school at 15, when he abandoned the dream of becoming an auto mechanic and chased fast cash dealing drugs.
“I started working at the Kissy-Targrin estuary terminal to escort market people coming from the Lungi Airport for 500 or 1,000 Leones, though some people paid more generously,” Ahmadd said. “I worked as an escort boy till I gathered enough capital to start my kush [drug] business,” he said. I started smoking because of the stress and economic hardship and selling kush is my only means of surviving.”
Kush is a synthetic drug containing of a mixture of harmful chemicals, which are much more dangerous than regular marijuana.
Ahmadd said that he usually buys small-size plastic bags of drugs for 150,000 Leones (about 15 US dollars). He then re-packages them into smaller portions which he sells for 5,000 Leones each.
The large-sized plastic packs, also known as “house size,” cost Le 5 million Leones. If he successfully pushes a “house size” to his clients, he will pocket a net profit of 3 million Leones. Sierra Leone’s minimum wage is 600,000 Leones per month.
Six out of 10 male patients admitted at his hospital present mental illness caused by drug abuse, accounting for 60% out of more than 130 patients admitted as of November 2020.
Mental Health is not a priority for Sierra Leone’s government
In April 2001, the African Union countries set a target of allocating at least 15% of their annual budget to improve the health sector. But Dr. Jalloh said that there is no official budget line dedicated to mental health.
According to the Ministry of Health and Sanitation, as of 2017 the Sierra Leone government allocated just 7.3% of its budget to health. And, according to Dr. Emeka Nwefoh, Sierra Leone has only two psychiatrists to serve the more than seven million population.
“Almost 50% of the healthcare staff have not been absorbed onto the payroll system,” Jalloh said, stating that the government should adhere to the Abuja Declaration of 2001 and to provide a budget line for the mental health sector.
By George M.O. Williams
21/12/2020. ISSUE NO: 7969