Sakiina Smith Haaruun a mental health practitioner who is currently managing the first mental home for black women in Birmingham England called Harriet Turman House describe patients in Campana psychiatric unit as the forgotten citizens of the Gambia. In an encounter with the author, Sakiina Smith Haaruun stated that as a mental health practitioner which ever country she visited, her interest continues to be for the development of quality mental health services, for people who are experiencing severe and enduring mental ill health here produce to the readership her frank opinion on the state of mental health in the Gambia. I am aware she continues that in developing countries, systems are not always in place, however, I was totally traumatize when I visited the Campana mental health hospital. In my mind, I knew that the hospital will not be set or being managed in the ways and conditions I am used to working in Birmingham, but no way was I prepared for what I encountered. On approach to the hospital with my colleague, I requested to meet with the Medical Director for the purpose of sharing ideas and development for the care of mental ill.Shortly after a man in a white gown approached us and escort us to his office: at this point I need to explain to you the layout of this office. It consisted of an old battered table, one broken down chair, battered filing cabinet and a cupboard, I belief for storing medication. I introduced myself stating my professional background and the purpose of my visit. I explained my present project development which is the first mental home in Birmingham, England. I was informed by the nurse that the hospital have the capacity to cater for 50 but as the only mental hospital in the Gambia, there was a total number of 109 patients which was over 100 percent excess of its maximum intake. I could not imagine how this could be possible with sleeping arrangements and other therapeutic activities. I lost for words when the nurse told me there was no consultant psychiatrist, no Doctors/ General Practitioner attached to work with the team at the hospital, and that the overall management was done by 3 nurses with a handful of nursing aids. I felt that I did not want to hear anymore neither did I want to see what the wards looks like, but my curiosity won over. As I walked along the corridor I knew, I should not go any further but I continued. It's really difficult to explain to the media what I actually encountered with my own eyes. The picture of degradation, dehumanization, unhealthiness and overcrowding is imprinted my mind and this is something that I will never forget. There are dormitories that supposed to have the capacity of 8 individuals which is double to 16 individuals. The bedding and linens were dirty and scanty. Dressing and bandages were filthy. People in general were just contained behind the walls away from the society/ communities on the whole. The fact that there is no structure, no policy frame work and no mental health act for the present day care is not surprising as mental illness is a taboo amongst black people irrespective of where they are living. The Gambia is certainly an example of how much fear there is around the area of mental illness. My starting point for caring for those with mental illness is 'there for the grace of God go I' and in the eventuality of an individual developing mental illness, the question is how would I like to be cared for and in what environment would I like to be nursed. The fact that someone is experiencing major disturbance, confusion, distress, anxiety, frustration and depression is compounded by unhealthy overcrowding environment. By this I mean if Iam experiencing any of the above illness I would want to be in an nurturing, caring, healthy, therapeutic environment/ community. I am not for one minute saying the nurses are not caring and nurturing individuals but the lack resources inhibits their skills and ability to effectively care for the people. I wholeheartedly commend their continuous effort to manage in such disheartening conditions. I have been working in the mental health system since 1971 and I see myself as an effective care/ manager but must say I could not and would not work under such conditions, so once again maximum respect to 3 nurses who are working flat out to manage mental health patients of the Gambian population. Mental illness is worldwide. We should not be afraid to recognize that this can happen to us at any given time. The stresses of life is such that without care and support this area of nursing will continue to rise. The statistics in medical science shows that one in four individual within any given population will experience some form of mental illness in their lives: therefore this is not to be swept away. The reality is that this is not going away it is already prevalent and it's numbers will rise, and it is going to stay. ---------------------------------------------------------------------------- To unsubscribe/subscribe or view archives of postings, go to the Gambia-L Web interface at: http://maelstrom.stjohns.edu/archives/gambia-l.html You may also send subscription requests to [log in to unmask] if you have problems accessing the web interface and remember to write your full name and e-mail address. ----------------------------------------------------------------------------