In 1991, the de facto republic of Somaliland declared independence from Somalia, after a brutal four-year conflict during which tens of thousands died and even more became refugees. As the displaced return to their homeland, “the scope of the war’s psychological toll is just beginning to register,” writes Tyler Stiem in the Walrus. Stiem offers a brief glimpse into the only mental health facility in a country that has none of its own psychiatrists.
Aden Ismail is a Somali-Canadian doctor who has visited the hospital every year or so for the past decade, treating hundreds of patients during every visit. He estimates as much as two-thirds of the country experiences post-traumatic stress disorder. “Six or seven years ago, all of the patients suffered from acute mental illness,” Ismail tells Stiem. “Now I see more people like Mohamad. They’re hard to diagnose, because their symptoms are diffuse: anger, depression, malaise, insomnia. And it’s the tip of the iceberg.”