“Because we have so few professional resources, people are used to understanding mental illness in their own way and most would never even think of coming to a hospital for psychiatric treatment,” says Stephen Sevalie, who this year became the country’s second psychiatrist, working for the Sierra Leone armed forces.

For those working in the mental health sector, this is not the way things were supposed to be. In the years after the decade-long civil war which, according to the UN, led to the deaths of more than 70,000 people and to hundreds of thousands being maimed by amputation, international charities poured into Sierra Leone with promises to heal its emotional wounds.

At the Kailahun district hospital, there are signs that changes to the mental health system are at last being institutionalised.