Yale Psychiatry fellow Ayana Jordan, MD, PhD, has spent four years researching the stigma of mental illness and substance use in West Africa. Her effort this year to help a former child soldier in the Sierra Leonean civil war avoid deportation from the United States is featured in a December 7 "New Yorker" story about the man.
Jordan wrote an affidavit and testified on behalf of Nelson Kargbo, a refugee from Sierra Leone stricken with mental illness who was forced into fighting for a rebel army during the country’s civil war when he was only 11.
Kargbo left West Africa and fled to Minnesota in 2000 when he was 15. He became a permanent U.S. resident four years later, and eventually a father. But he had trouble holding down a job, and he abused alcohol and drugs. He was in sporadic trouble with the law.
In August 2013, when he was 28, he was arrested for misdemeanor domestic assault and detained at a Minnesota prison. His name drew a “hit” by U.S. Immigration and Customs Enforcement as a security threat because he was a foreign national with a criminal record who once was arrested for making a “terroristic threat” during a fight with another man. He was ordered deported.
Jordan, who is from Pittsburgh, has studied mental health in Sierra Leone since 2011, when she was awarded a grant to work in the country’s war-torn Kono District for three months.
She spent time at a primary care clinic started by a medical school classmate that provided free treatment to people who did not have access to care, like child soldiers, amputated civilians, and rape victims.
Based on her experiences in Sierra Leone – she has returned three times since her first visit – Jordan was asked to testify in Kargbo’s case because he suffered from psychosis, a likely result of his drug use and the horrors he experienced as a young person at war.
He’d be highly stigmatized, seen as abnormal, feared, shunned, chased out of town.
Ayana Jordan, MD, PhD, Yale Psychiatry fellow
Jordan told the judge that Kargbo’s mental illness would progress if he returned to Sierra Leone. “He’d be highly stigmatized, seen as abnormal, feared, shunned, chased out of town,” she testified.
Mental illness is misunderstood in West Africa, Jordan told the judge. She has heard from some Sierra Leoneans that it can be “caught” when a cool breeze enters the room while someone is sleeping, through witchcraft and bad dreams, and by bathing at the wrong hour.
During her visits to West Africa, she has researched the link between mental illness, substance use, and the associated stigma in Kono and in Freetown, the capital.
She has given talks about her work, and that led to her being asked to write affidavits and twice serving as an expert witness for refugees with mental illness at risk of being deported to Sierra Leone, she said.
The work by Jordan and others to help Kargbo resulted in his being allowed to remain in the U.S. The judge determined conditions for mentally ill people in Sierra Leone violated the United Nations Convention Against Torture, and he was released from prison.
Jordan’s research in Sierra Leone stalled late last year due to the Ebola outbreak in West Africa, but she continues to help the people there by participating in a biweekly radio program that airs in the country and addresses an array of mental health issues.