Memory

Sierra Leone’s history--some of it centuries old, some of it within recent memory--is still relevant and impacting each of us, even across time and an ocean. We speak with Dr. Ismail Rashid, a scholar and professor of African history who grew up in Freetown, Sierra Leone, to learn about three key events that have shaped the country, especially in terms of mental health and mental health care: the Atlantic slave trade, British colonialism, and the civil war.

Jon Lascher: Welcome to Unchain. I'm Jon Lascher, executive director of Partners In Health in Sierra Leone, and I'm excited to bring you the first episode of our podcast miniseries about mental health. Specifically, we're going to be talking about Sierra Leone's only dedicated mental health facility, which once had no choice but to rely on chains for patient and staff safety, and how it transformed into a dignified and well-resourced hospital.

We wanted to start with a reflection on Sierra Leone's history, some of it centuries old, some of it within recent memory, and all of it still relevant in impacting each of us, even across time and an ocean. There's a lot to unpack with any country's history, and Sierra Leone is no exception. We won't go through a complete and exhaustive timeline today. That's another podcast for another day, but amid the images and concepts that may swirl in your mind when you think about Sierra Leone, maybe blood diamonds, Ebola, child soldiers, the Amistad.

There a few things that you should know to begin to understand some of the factors that have impoverished Sierra Leone so dramatically. To learn more, we spoke with Dr. Ismail Rashid, a professor of history at Vassar College and an expert on African history. Professor Rashid also happens to be from Freetown, Sierra Leone's capital.

Dr. Ismail Rashid: One of the things that we know and one of the things that a lot of work has been done, uh, is slavery, enslavement and the quest for freedom, uh, as a process, uh, that has deeply traumatic implications in people

Jon Lascher: In order to understand Sierra Leone today, we must revisit the Atlantic slave trade. Dr. Rashid explains how that dark period of human history impacted not only Sierra Leone, but the rest of the world.

Dr. Ismail Rashid: So between 1500 to 1867, almost 390,000 people from all ethnicities were kidnapped, uh, captured, sold and enslaved from Sierra Leone to the Americas, 390,000 people. That's about 5% of Sierra Leone's population today. About 25,000, uh, of those enslaved people ended up in the United States. That's about 3% of the eventually, uh, about 12-plus million people, uh, who were enslaved in Africa, uh, and transported to the Americas.

Jon Lascher: Millions of people across Africa were kidnapped and taken to the Americas where they were enslaved, brutalized and treated worse than livestock. The slave trade, which was a policy of Europe and the Americas, continued unimpeded for centuries. Despite having ended over a century ago, slavery and unimaginable trauma, whereby families were ripped apart and humans were treated as chattel, echoes today. Sierra Leone endured the slave trade, and when it finally ended, the country welcomed freed slaves back within its borders.

Dr. Ismail Rashid: Sierra Leone first emerged as an area, as I said, to resettle free Africans. First the British said if we win or if we prevail, we would grant you freedom from enslavement. Well, we know the story, the British lost, and what happened was that the British took some of those, uh, freed and formerly enslaved Africans with them to British North America, which became Canada, uh, and for some time, uh, these free Africans were settled in Nova Scotia, uh, in, uh, New Brunswick, uh, two provinces in Canada. The place was very cold. They didn't get the, some of the land and the benefits that the British, uh, promised them, and they petitioned the British, uh, to be mo-, to be repatriated and resettled, uh, somewhere in Africa, and those groups came to Sierra Leone as part of the second groups of returnees.

Jon Lascher: They were settled in the aptly named Freetown. The now capital, located right on one of the few natural harbors in the world, had been the place where white Europeans forcibly removed, shackled and enslaved Africans, and it had become the place where many returned, carrying hopes of freedom and re-establishing their homes.

Dr. Ismail Rashid: What is important here in terms of thinking about those groups were the ideas that they came with. Uh, they came with ideas of freedom, uh, that were forged in the American Revolution. Uh, even those these were people who fought against the American Revolutionaries, they latched onto the ideas of freedom, and those ideas of freedom would shape, uh, the relationship between that emerging Krio population vis-a-vis the British, and would be a very integral and important part of the way Sierra Leone, uh, which is regarded as the land of freedom, uh, emerged and developed over time.

Jon Lascher: But that freedom in many ways rang hollow, which brings us to our next piece of history, colonialism. Remember that British promise of freedom, the promise that was made to the enslaved Africans who fought for them during the American Revolution? As it turns out, the British had a rather selective memory.

Dr. Ismail Rashid: Initially, Sierra Leone started, uh, as a colony that would become a self-governing colony supported by the Sierra Leone Company, which was the company or the corporation behind the formation of the initial settlement. Between 1787 and 1808, because of a number of reasons, this colony was unable to be, remain free, to remain self-governing and to be able, uh, to become a settlement, a free settlement like Liberia, and it had to depend on British support to keep it afloat, and in 1808, the British eventually take, took over the colony. The foundation, the establishment and the meaning of freedom wasn't simply what one could call philanthropic or supportive of that population.

Jon Lascher: Thus began over 150 years of British colonial rule. The superpower had a strategic interest in Sierra Leone for its natural harbor, which was excellent for commerce and trade, among other things. But their colonial project didn't just come down to exploitation of natural resources and geopolitical maneuvering. It was also a psychological attack, an attack on the Africans living there, including the very people who had come there to be free. British colonialism was underlined by racism. They saw Africans as uncivilized, and forced those in Sierra Leone to convert to Christianity and adhere to British values. What's more, it wasn't just that the Africans lacked a civilizing force in their lives. It was that black people were less than white people. The aftershocks of this racist philosophy linger today.

Dr. Ismail Rashid: So the colony was not only a beacon for resettlement, it was also a beacon for trade, and most important, the colony was also a beacon, uh, for the projection of British values. The British believed that one of the ways in which you remedy slavery, especially slavery that was going on, still going on in the continent, uh, but also, uh, part of the damage that slavery had done towards, uh, Africans was that if you Christianize and you civilize, uh, Africans, that could have a transformative effect. It is similar to the rest of Africa because then Sierra Leone became part, uh, of a larger part of what was, uh, seen as the motives, the general motives for the British colonization of the continent, uh, British and European colonization of the continent. Uh, that is the three Gs or the three Cs, uh, the Europeans' drive, uh, for commerce, exploitation, the European drive, uh, to Christianize or to convert or to civilize, uh, Africans, uh, that is, to make, uh, Africans as much as possible in the image, uh, of, uh, Europe. So in that particular sense, Sierra Leone became, uh, part of that larger history of colonization. And in that second aspect, uh, of Sierra Leone becoming part of that larger history, uh, of colonialism, the British left in Sierra Leone a legacy of really a divided, uh, country.

Jon Lascher: The British colonized, exploited and terrorized Sierra Leone for hundreds of years. It wasn't until 1961 that Sierra Leone joined a growing list of African countries to demand their independence from European colonial powers. Newly independent countries scrambled to build economies on the skeletal remains of the exploitive systems left behind in the wake of colonialism. Political systems emerged primed for authoritarianism, mirroring the types of unjust and undemocratic systems instituted during colonialism.

To complicate matters, these newly independent African countries, in order to receive desperately needed capital, took loans from the very same countries that had colonized them. The loans did not come cheap and they did not come without conditions. Emerging economies and their new leaders dramatically restructured their economies and national budgets in the 1980s, moving millions of dollars out of social, health and education programs. All of this contributed to political unrest, economic stagnation, corruption, both in African countries, former colonizing countries, and the corporations that operated in both, and in Sierra Leone's case, it paved the way for civil war.

Dr. Ismail Rashid: Life was just very difficult, uh, for a lot of Sierra Leoneans, especially the young people or the youth who became the major, major combatants on both sides, uh, on, on different sides of the Sierra Leone, uh, conflict.

Jon Lascher: The war started in March of 1991, spearheaded by a group called the Revolutionary United Front. People dismissed the RUF at first as a rebel army, but within five to six years, it completely overran most of the country. The violence and cruelty that marked the decade-long war is notorious, and you can only imagine it had a major impact on Sierra Leonean psyche.

Dr. Ismail Rashid: It's very difficult for any group of people to live through violent event and to live through that violent event for so long. In Sierra Leone, the civil war lasted for over a decade. Whether it's in seeing your communities completely destroyed and overrun, whether it's in your loved ones being brutally killed, or whether it's seeing your limbs being hacked off or chopped off, uh, by insurgents, members of the Revolutionary United Front, or seeing in communities dead bodies litter the street, those are events that destabilizes people's sense of their, of themselves and their place.

Jon Lascher: Which brings us back to our theme, mental health. Mental health conditions are often biological in nature, but we can't ignore the role history plays in shaping each and every one of us. In Sierra Leone, that history includes slavery, colonialism and civil war, and has produced within an entire population a complicated mixture of trauma and an absence of robust social programs and dire poverty resilience.

Dr. Ismail Rashid: So whether or not you're Mendes, Temne, Loko, Limba, Susu, Mandingo or Krio, all of those people can leave imprint on their society, uh, and their mentalities on how they think about that war, and their mental health and about how they relate to, uh, other folks. One of the consequences of slavery that has a deep mental health implication is slavery, of how people see themselves and their self in relationship to, uh, other, and the legacy of slavery as was seen, the legacy of enslavement, and the impact of race and racism as was seen across the world is deep and it occasionally explodes. And if you're a person of African descent, if you're a black person traveling around the world, that stigma of slavery and enslavement travels with you, and you are in situations where those encounters impact on you and your mental health. That's the first point.

The second point is on colonialism, and here I would want to bring in, uh, a well-known, uh, psychiatrist and psychoanalyst that I'm sure you are familiar with. Frantz Fanon says the colonial condition is a nervous condition. Uh, that is, colonialism, uh, just like the process of enslavement and slavery, creates conditions of nervousness and trauma in people who are colonized. Colonization is a violent event. Resisting against colonization has considerable violence. Violence destabilizes people, not only, uh, physically, but it also destabilizes them mentally, spiritually. So it's not a shock or a surprise that, especially in the most recent time, during the Sierra Leone wa-, civil war and after the Sierra Leone civil war, we saw an uptick of mental cases, uh, or mental issues in the, uh, in individuals and in the society at large. But I want to balance, uh, the, this reflection about trauma, the impact, uh, of trauma with resilience, uh, because sometimes we talk about, uh, meant trauma, uh, I think that trauma even as it leaves its imprint on people, on the landscape and on culture, uh, is something that damages a society, uh, in perpetuity.

Uh, we should also think about the ways in which people in different ways, not only through biomedicine, uh, but through cultural rituals, uh, through the way they organize society, through the way they relate, uh, to people or reconfigure their relationship, uh, with people, are able to reconstitute or make themselves whole in new ways, make their communities whole in new ways, and also try to make their countries or their nations whole in new ways. So one of the things that's, uh, been remarkable, uh, about many African societies, but Sierra Leone specifically, is the way in which we came out of the civil war, uh, uh, with all of the problems that had gone on, uh, to be able to contain, minimize, and put some of that violent genie, some of those violent genie back into the bottle, uh, and try to move on and reconstitute life, uh, that is meaningful.

Jon Lascher: After disasters, whether it be a civil war, an earthquake, or an Ebola outbreak, we often speak of people's resilience in the face of unfathomable loss and suffering, that we should be careful here. While Sierra Leoneans as a whole could be described as resilient, their resilience is born out of necessity. They must be resilient in the face of billions of dollars in wealth being extracted from the country. Resilience as a character trait does not prevent or treat illness, it does not put food on the table when you're impoverished, and it doesn't train doctors and nurses, nor does it stock pharmacy shelves with needed medications. Kissy Mental Hospital, now known as Sierra Leone Psychiatric Teaching Hospital, has its own history of trauma and resilience, wrapped up in all of the history we've just discussed.

Join us for our next episode as we explore how this hospital reflects Sierra Leone's past and is beginning to represent its future.

Anneiro Braima: You come in an environment where you feel as if you are a slave, you are shackled, you, you, you, you, you, you feel you've been condemned by your relative.

Jon Lascher: Continue to learn and explore more stories from Sierra Leone and PIH by visiting pih.org. Follow Unchain on Spotify, subscribe on Apple Podcasts and Google Podcasts, or find us on YouTube under Partners In Health. Look for us at Partners In Health on Instagram or PIH on Twitter, and DM us with your comments or questions. Thank you for listening to Unchain. We'll meet you here next week.