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Healing the psychological scars crippling Liberia in the wake of civil war

March 24, 2014 at 6:32 PM EDT
After 14 years of civil war, more than 40 percent of Liberians suffer from post-traumatic stress disorder. But most have nowhere to turn; the cash-strapped West African nation has only one psychiatrist for 4 million people. Special correspondent Molly Knight Raskin reports on one man’s devotion to healing these national psychological scars. Video shot by Ben Niles of Plow Productions

GWEN IFILL: Now we turn to the West African nation of Liberia.

Special correspondent Molly Knight Raskin reports on a program aimed at healing the psychological scars from the country’s prolonged civil war.

She filed this report from the town of Ganta.

MOLLY KNIGHT RASKIN: It’s Sunday evening in Ganta, a bustling city in northern Liberia, and it’s time for a weekly radio show that’s become a surprise hit across the vast region on the border of Guinea.

AARON DEBAH: Once again, you are listening to the “Hour of Mental Health” discussing live issues, people who have been affected these problems.

MOLLY KNIGHT RASKIN: The creator of the “Hour of Mental Health” radio show, the first of its kind in Liberia, is 32-year-old year-old Aaron Debah, a registered nurse and teacher at a local medical college.

AARON DEBAH: Many times, when people are depressed, they get so agitated at times, they get vexed very quickly.

MOLLY KNIGHT RASKIN: Debah earns his living teaching psychiatric nursing, but the job he’s most proud of is one that is not paid and consumes most of his waking hours.

Debah is a certified mental health clinician, a tough job in a postwar country. But for Debah, it’s especially taxing; he’s the only mental health worker in a region of Liberia that’s home to half-a-million people. In 2011, Debah graduated from a program created by the Atlanta-based Carter Center in response to a mental health crisis in Liberia.

Studies found more than 40 percent of Liberians suffer from post-traumatic stress disorder related to the country’s 14-year civil war. And they have nowhere to turn. Liberia has only one psychiatrist for four million people. It’s a staggering statistic, but experts say it’s not unique to Liberia.

SEAN MAYBERRY, StrongMinds: Ninety percent of the population in the developing world doesn’t have access to mental health services, 90 percent. And that translates into hundreds of millions of people.

MOLLY KNIGHT RASKIN: Sean Mayberry is the founder of StrongMinds, an organization that’s treating people with mental illness in Uganda.

SEAN MAYBERRY: The barriers to mental health in the developing world include the lack of financial resources that are invested, the lack of training of the medical personnel themselves, the lack of available medications, and certainly the stigma that is in existence in the communities towards mental illness itself.

MOLLY KNIGHT RASKIN: Despite these barriers, organizations like StrongMinds and the Carter Center are tackling mental illness in developing countries by training local nurses and physician’s assistants in short, but intensive programs.

To date, the Carter Center has graduated more than 100 mental health clinicians, who now work in all of Liberia’s 15 counties. Here in Nimba County, and all over Liberia, health workers are struggling with major issues like malaria, HIV, and infant and maternal mortality.

But in a country still struggling after 14 years of civil war, mental illness is crippling the recovery process. Most of Aaron Debah’s patients are referred to him by Ganta Methodist Hospital, but its budget has been cut by more than half since last summer, when Liberia’s cash-strapped government decided to partially defund several faith-based health organizations.

Now the hospital is on the verge of collapse. There’s almost no functional medical equipment and an acute drug shortage. The administration can’t afford to rehire Aaron Debah, who was once on the nursing staff, so for now he’s volunteering his own time to counsel patients.

One of them is 45-year-old Vahsee Payee, a father of three who suffers from depression and epilepsy. Debah treated him with medication and counseling three years ago and saw a dramatic improvement in his health. Today, however, the medication is no longer available and Payee’s symptoms are getting worse.

AARON DEBAH: Vahsee, so how are you coming along?

MAN: Oh, thank God. I try living, but still need some help. But the thing is, it’s a continual process. So, when you stop the medicine, you embarrass yourself. But when it’s constant, I feel fine.

MOLLY KNIGHT RASKIN: Without access to the drugs Payee needs, Debah can only offer him words.

AARON DEBAH: We still hope that things will be fine. So, until we can get a supply of drugs, we will just keep working together.

MOLLY KNIGHT RASKIN: Another patient who needs medication is this mother of four, who suffers from bipolar disorder. Last year, Debah was able to stabilize her with psychotropic drugs. But the supply has run out and she has relapsed. During this visit, Debah tries to reassure her husband.

AARON DEBAH: For every day I come, I always see you around and talking to her little by little. Even though the medicine has helped her, talking is also helpful.

MOLLY KNIGHT RASKIN: Without medication, Debah relies mostly on psychotherapy and psychosocial support.

AARON DEBAH: We treat people using basic counseling. We talk with some family members to understand the problems the loved ones are faced with, and, after, we begin to work along. I think those are some basic ways in which we are making some impact.

MOLLY KNIGHT RASKIN: It’s this level of one-on-one care that Debah is known for. During his radio show, he invites anyone affected by mental illness to call his personal cell phone. He makes house calls, even if it means walking an hour to a nearby village. Debah says he never turns anyone away, particularly those who have been affected by the war.

AARON DEBAH: When I think of my own stories, about my own life, going through the course of war, I mean, I feel challenged to help these people work along.

MOLLY KNIGHT RASKIN: When Debah was a child, he and his family were forced out of their home by rebel soldiers and spent many years hiding in the bush to escape the violence. Today, Debah sees many patients who experienced similar trauma.

One of them is 29-nine-year-old Mike Otis Myers. Myers was abducted during the war and recruited as a child soldier. Today, he suffers from post-traumatic stress disorder.

MAN: When I think about the past, I cry sometimes. I cry and cry, cry, cry. And that — it can’t help me.

AARON DEBAH: What I feel is that, if you have the means of sharing it to somebody who is concerned, in time to come, change can come.

MOLLY KNIGHT RASKIN: Since Myers began counseling sessions with Debah, he’s re-enrolled in school for the first time since the war and says he’s determined to complete his education and enter the work force. Like so many Liberians, Debah takes even the smallest amount of progress as a positive sign.

AARON DEBAH: For me, I feel ever hopeful. I feel more energized. I feel motivated to do what I’m doing. Even though the challenges are so great, but I know change will come.

MOLLY KNIGHT RASKIN: Until then, Debah says he will continue volunteering his time, and using his voice, to advocate for the mentally ill in his community, even if he has to go at it alone.