Life in chains: the plight of Somalia's mentally ill

Living in a tin shack by the roadside, Abdullahi is isolated, barely washed and poorly fed. For the last 17 years he has been chained up by his own family in Hargeisa, Somaliland.

by Jamal Osman
Thursday, October 10, 2013

Somalia film credits: Director/producer - Teresa Smith: Picture editor - Agnieszka Ligget: Camerman - Ahmed Farah: Field producer - Yassin Jama

He spends most of his days watching the world moving before him - placing his chest on a cemented floor, his elbows supporting his hands under his chin.

In all those years he's been there, Abdullahi watched children who were born during his chained-life become adults. The whole neighbourhood is built up. The sun rises and sets over him. His best companions are family-owned goats, who are free to move around.

'Evil spirits'

In Somalia, thousands of people who are mentally ill like Abdullahi face a similar fate. According to the UN, one in three Somalis suffers from some form of mental illness.

We can't trust him. For me the biggest worry is that he could go missing or be killed by the children.Yusuf Jama

Decades of war, poverty and unemployment are some of the reasons. There aren't enough doctors and nurses to treat such patients. Aid organisations are all over the country but there is very little interest in this sector.

Abdullahi's childhood was just like any other Somali boy growing up. He attended school and started working as a builder in his teens. He was dreaming of becoming a businessman until his life was put on hold at the age of 26.

"He used to love school," Abdullahi's mother, Nimo Yusuf, told me. "He loved and respected his parents. He'd call us 'Mummy and Daddy'. He still does, even now. He never swore or cursed."

Nimo remembers vividly the day he fell ill. She said: "One morning he left for work and came home in the evening saying he felt unwell. Then I recalled that people used to say that evil spirits could do this. And I thought they have done it to him. Since that day he's never been the same."

Traditional healers

Nimo is the family's breadwinner. She leaves in the morning to sell fruit and vegetables at the local market and comes back in the evening with some food for the family.

This very poor family tried to treat him – not through medical doctors but through traditional healers, known as Cilaaj. It is the most popular treatment for the mentally ill in Somalia.

Abdullahi was once taken to Sheikh Boon's Cilaaj in Hargeisa. This centre is moderate compared to others that use electrocution, beatings and other forms of practices as part of the treatment. Some patients die. It's a thriving industry, yet unregulated.

Abdullahi, if we unchain you, what do you think about that? Are you going to come with us?Maryan Hassan

The sheikh claims that many of his clients are from the diaspora community. Some travel to see him but also he regularly holds sessions through Skype.

A former maths teacher, he prescribes verses from the Quran for patients. They go into a room nearby where a group of men read the Quran loudly through cardboard tubes. Patients sniff foul smelling herbs to force the evil spirit or Jinn out of the patient's body.

"When we realise Jinn is inside the body of the patient we read the Quran until it runs away from the body of the patient," said, Sheikh Boon.

'Mad man'

But it didn't work on Abdullahi. He is still in his tin hut in all weathers. There is no protection whether it's hot, rainy or windy. His father Yusuf Jama, who is 83 years old, looks after him for most of the time.

"He's chained up all the time," Mr Jama told me. "We alternate the leg that will be chained: first, this leg and then the other. Also we have to tighten the screw because he can break the lock.

"We can't trust him. For me the biggest worry is that he could go missing or be killed by the children." 

Children from the neighbourhood shout "the mad man" as they pass by Abdullahi. Sometimes they throw rocks at him. His father is, at least, protecting him from these children. Abdullahi's brothers are around occasionally.

He asked his younger brother Abdulkarim if he could borrow his mobile phone so he could listen to music and the song Bulshayahay ma nabadbaa came on.

It is about a man who is returning to his country after being in exile. It brought tears to Abdullahi's eyes especially these lines (translated into English):

We have been apart for a while

I have longed for you like dry scalp craves for oil

Greetings O, people, greetings!

It was as if he was craving to be given the chance to come back into society.

We told Maryan Hassan, who is one of 20 psychiatric nurses in the whole country, about Abdullahi's desperate situation. She works at Macruuf Relief Organisation, a private mental health clinic.

'Free man'

Maryan agreed to assess Abdullahi and if possible offer him a free place for three months. We took her to Abdullahi's little hut. After greeting the family and asking about Abdullahi, she told him the good news.

"Abdullahi, if we unchain you, what do you think about that? Are you going to come with us?" she asked.

"Yes, I'm going to come with you," replied, Abdullahi.

Cutting the rusty chain took a long time but his brothers eventually managed to release him.

On arrival, he was quickly washed, given clean clothes, his nails cut and his head shaved. With kindness and a proper medical examination, Abdullahi looked different. He was given medication to treat psychosis.

As we were leaving, Maryan told Abdullahi: "Now you are a free man. When you wake up in the morning you have to brush your teeth, go to the toilet, you'll watch TV and take your medicine. Things have changed for you."

Abdullahi was lucky, but there are hundreds of thousands of mentally ill Somalis who are in desperate need of help. Abdullahi will be in the clinic for at least three months. We hope to see him well.