Friday 22nd February

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The first day of our first ever Introductory ACT workshop in Makeni got underway this morning. Makeni is Sierra Leone’s 4th largest city. It has very few buildings that are higher than two stories. The streets are wide, dusty and bumpy. Ernest Bai Koroma (Sierra Leone’s president) comes from the city, and this is often cited as the reason why the city enjoys electricity 24 hours a day.

The venue for today’s workshop was what can only be described as a ‘garage’: motorbikes stacked against one wall and chairs set up across the rest of the room with some additional chairs across the front for the facilitators to sit at. There were several windows with no glass and the front of the building was open.

Some attendees had come very long distances to make it to Makeni. It was wonderful to meet new people and hear about the important work that they have been doing with NGOs working to support physical health needs, victims of sexual, physical and emotional abuse and trauma. Amongst the 30 participants in the workshop there was a prison officer. Many of the people that he works with have yet to be convicted of a crime. Suspects in legal cases in Sierra Leone tend to remain on remand for a long time – the wheels of justice can turn slowly.

Pious did a great job of introducing the workshop, making us feel so welcome and creating a context for the day. His boss Betty was there, which was an honour for the group. She helped us to open the proceedings after the obligatory celebration involving songs and prayer. The undoubted highlight from today’s workshop was getting the opportunity to see Hannah Bockarie in full flow as she assisted with the facilitation of the workshop. She supported both Beate and myself with different exercises that we were involving the attendees in. She has attended many workshops now, and has served her apprenticeship well. Hannah has a great understanding of the ACT principles and she has the benefit of seeing these principles through the cultural lens of Sierra Leone.

Today was a coming of age performance for Hannah. It was fascinating to compare the reserved respect that the attendees afforded the attempts that myself and Beate make to communicate our points to the group. Hannah would follow it up with her description of the relevant processes in Krio (the lingua franca of Sierra Leone that is spoken by 97% of the population). Although all attendees understand and speak English, the local Krio seems to engage them to a much greater extent. They respond enthusiastically to Hannah’s checking in with the group to determine if they understand a particular point: ‘Not so?!’ and ‘Put the hand up if you don’t agree!’. It was a powerful performance from Hannah, and both Beate and myself are hugely proud of how well she has developed as a trainor. Today we saw the future, and it looks very bright. We managed to videotape some of the sections of the workshop that Hannah facilitated. I hope to upload these to the blog at some point when I return.

The heat today was stifling. Despite the high temperatures, the energy in the room remained good. There was so much sharing from the group today. They were keen to volunteer examples of problems that their clients have been experiencing. There was lots of animation, and the level of interaction with the facilitators was excellent. The workshop content included: introducing the group to mindfulness exercise; learning about their work and the meaning and values that drives this work;  contextualising the ACT approach (a pragmatic approach that aims to increase distress tolerance by promoting a non-judgemental acceptance of distress and an active willingness to tolerate distress and still do what is important to you); the difference between moving away from suffering and moving towards valued life directions; introduction to the Matrix as a way of formulating cases that they are working with; some role play in pairs allowing the attendees to explore these themes from the perspectives of clients and from the perspective of a therapist.

In the audience today we had three graduates of the Mental Health certificate programme for nurses that Heather Weaver had told us about on Monday night when we met with her and Tom for dinner. These folk contributed well to the workshop. It was great to strike up a conversation with one of them (named Abdul) during one of the breaks. He works in the local psychiatric hospital. We spoke about our respective work with individuals presenting with psychosis. He said that there is no talking therapy available for individuals with psychosis. Nor is there any atypical antipsychotic medication. Instead patients are treated with older neuroleptic medications such as Chlorpromazine or Haloperidol. Abdul said that the side-effects of these medications tend to be quite severe. Abdul seemed to be enjoying getting an opportunity to learn some therapy skills that he can apply in his work. I hope to stay in touch with Abdul to learn about how his work develops in the future.

After a very constructive start to the workshop, we are looking forward to continuing tomorrow!

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