Country's lone psychiatrist sets sights on mental health reform in war-torn South Sudan

South Sudan’s sole licensed psychiatrist is on a mission to transform mental health care in the country of more than 12 million. In South Sudanese culture, mental illness is often believed to be caused by hostile possession of spirits, evil curses or punishment from God, and patients are regularly recommended to be kept chained to trees or posts by a non-licensed “medicine man.”

Among the educated, psychiatry is often looked down upon as a lesser field of medicine. The lack of funding, resources and support make the field unappealing to medical students seeking a career in health care.

"It’s not attractive in South Sudan," Dr. Atong Ayuel Longar, South Sudan’s only psychiatrist and an assistant professor in psychiatry at University of Juba, told FoxNews.com. "It's low paid and there’s a lot of work. There’s no private practice.”

Add to that the lack of respect the position garners from others in the country, and it makes it difficult to weed out serious candidates. According to Longar, there are 29 people calling themselves psychiatrists who have no clinical training or experience.

"Other doctors say when you are incompetent, you become a psychiatrist," Longar said. "It’s very hard when you get someone who’s brilliant in university to become a psychiatrist. When I graduated I was the first, best student.”

Faced with the choice between becoming an OB-GYN or psychiatrist, Longar went with where she felt her country needed her most. Her day begins with seeing up to 30 patients in clinic, and then includes making rounds in the psychiatric ward, teaching an educational session, setting mental health policies and formulating mental care protocols.

Longar and her staff of nurses and assistants struggle to find medications for their large number of patients, many of who are struggling with substance abuse disorders which is secondary to the trauma of the abuse they’re suffering from. Her hospital offers patients day therapy where they play music, create art, play soccer and recently began vocational therapy which includes carpentry, gardening and sewing.

Among the many challenges that Longar faces is the lack of resources for mental health care. Juba Teaching Hospital’s psychiatry department offers just 12 beds for patients who are kept locked up due to lack of security. Insufficient infrastructure and budget makes it difficult for Longar to shape policy for other health care professionals to follow when dealing with a mentally ill patient.

Longar is also spearheading a project called “Transforming the present, shaping the future,” which takes patients off the streets and gives them food, clothing and mental health care. Recently, the country’s health minister helped bathe and give haircuts to patients before outfitting them with clothes and addressing their mental health.

Through her work, Longar wants to see more sustainability in the country’s mental health care. A large part of that is making sure patients have the resources to continue medication, and that proper protocols are in place to ensure they receive adequate mental health care. Her goal is to replicate the project throughout the country, and address psychosis in children before they are placed in danger.

One patient serving as a testament to the success of the project went from being chained to a tree in the nude for years on the advice of a "medicine man," to achieving a healthy lifestyle, according to Longar. 

The project is part of a non-profit called Goats For the Old Goat, a charity started by Fox News contributor Ellen Ratner, which is focused on Goats, Education, Medicine and Sustainability in South Sudan. Goats are donated for psychiatric patients who care for the them and obtain milk from them to support their family. For more information and to donate, visit GoatsForTheOldGoat.com.^[1] 

References

1. ^{^} visit GoatsForTheOldGoat.com. (goatsfortheoldgoat.com)