Thursday, June 5, 2008

City of Rest

By Ibrahim Jaffa Condeh and Kevin Hill

Faith-based addiction and mental health facility City of Rest has been granted approval from the Ministry of Lands, Country Planning and the Environment to use three acres of government land to build a new healing centre in Grafton in the eastern part of Freetown.

Mission Direct, a UK-based religious NGO has made City of Rest part of their main program for this year. The group will be funding and building the new facility and expect to begin construction November of this year.

City of Rest’s current home on Fort Street houses 40 residential ‘guests’ who receive treatment for drug addiction and mental illness through prayer, biblical counseling and an opportunity for “renewal of the mind”.

City of Rest began as an NGO in 1985 to deal with drug addicted youth. The residential program began in 1994 with only 6 guests. The home now houses 40 people: 30 men and 10 women, with seven staff members and volunteers.

The home does not charge an admission fee, but does require all residents to pay Le120,000 ($40US) per month to cover feeding costs. The guests receive three meals a day and stay as long as is required, as long as they can pay the cost of food. Those who cannot pay are not allowed to stay at City of Rest.

The facility does not receive core funding from government or NGOs, but are able to maintain operations through donations from church groups and individuals.

City of Rest is receiving assistance from Mission Direct and German NGO Hilfe fur Bruder, or help for brothers, who funded the purchase of the three acre plot of land for the new building in Grafton.

For Pastor Ngobeh, the major reason people come to City of Rest is that they have lost their sense of love, patience and perseverance. It is hoped that through counselling and prayer the patients’ addiction and mental health issues can be ‘cured’. “Encouragement can even heal them”, he said.

Pastor Ngobeh believes that the faith-based approach to addiction and mental illness works, because “no situation is above God almighty. If God is not backing you, it doesn’t matter what you do.”

According to City of Rest’s psychiatric consultant, Heleen van den Brink, the counselling process can be effective in treating the guests. The centre deals with drug addiction as well as mental health issues like schizophrenia, psychosis, trauma, depression and anxiety. The home has 21 residents with drug addiction issues and 19 people with serious chronic mental health disorders.

“Often people come in with both addiction and mental health problems. Someone who is bi-polar might use drugs to stabilize themselves, or self-medicate,” she said.

Van den Brink said that the Western model of mental healthcare is very medical and pharmaceutical. In contrast, the religious-counselling method that City of God uses is very social and provides therapy for the guests through structure, familiar faces, regular meals, a safe place to live, an accepting community and love.

“Many of the guests have gone through major rejection. Outside, no one listens. Here, someone pays attention. As a faith-based organization we see God working in peoples’ lives”, she said.

City of Rest does not treat mentally ill residents with medication, unless previously prescribed by a doctor. The home relies solely on counseling and prayer to manage serious chronic mental illnesses.

City of Rest allows guests to stay as long as they need to, providing they can pay for their food costs, if they respond to the counselling and religious teachings. When a resident wants to leave, he or she must complete an assessment test. “If you do not complete the assessment test, you can’t leave”, Ngobeh said. The parents of guests can also withdraw their children if necessary.

Some of the residents are also suffering from the long lasting effects of war. Wilfred, a guest at City of Rest from Liberia, was conscripted into Charles Taylor’s army and forced to use copious amounts of drugs. The effects of the war and the subsequent addiction issues have left him traumatized.

City of Rest uses the ‘cold turkey’ method of detoxifying drug addicted residents. When a drug addicted person comes to stay at the home they are forced to go through the ‘detox’ process without help. Pastor Ngobeh jokingly says that these guests complain that “this is not the City of Rest, this is the city of torture!”

Some of the residents, those described by Pastor Ngobeh as “aggressive”, are chained around their waist and down to their ankle so that they will not run away or harm people.

If City of Rest does have a problem with one of its guests, Pastor Ngobeh calls on Consultant Psychiatrist of the Sierra Leone Mental Hospital, Dr. Edward Nahim, who is the only psychiatrist in the nation. “When they become very aggressive, we call him,” said the pastor.

According to Dr. Nahim, the City of Rest plays a positive role in providing mental health care in Sierra Leone and he actively supports the organization. “Anytime there is a problem with their mental patients I’ll go out on an emergency call. They are doing quite a good job. Many patients may not like the stigma of being admitted to a psychiatric hospital. We need many of such institutions. We don’t have the personnel in this country”.

Kangbai, a guest at City of Rest, has had a positive experience during his stay. “I’m bi-polar. I’m not taking medication. I’m coping.” Another resident, Francis, said that she is using the counselling and religious teachings to “change my life, my behaviour, to stop smoking and drinking. Next week I will take the test (to leave the home).” Mohamed, suffering from addiction issues, has been at the home for four months. He said that he was happy to have found himself at City of Rest, "It has changed my life.”

City of Rest faces its own challenges including being short of staff and not having a qualified psychiatrist. They require the help of psychiatric nurses and are actively seeking qualified volunteers to help.

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