Friday May 21, 2021
BY AMANDA SPERBER
PHOTOGRAPHY BY ABDIRAHMAN YUSUF
Rowda Olad
The capital of Somalia is the coastal city of Mogadishu, a thumping, humid, relentless town of battered but unbeaten people who have lived through an extraordinary amount of upheaval. Like the rest of the country, Mogadishu felt the collapse of any semblance of governance in the early 1990s. Since then it has been divided between war-lords, controlled overtly and covertly by the militant group Al-Shabaab, and destabilized by corrupt, violent politicians propped up by the international community and the United Nations.
When Rowda Olad, 36, a Somali-American, returned to Mogadishu in 2011 after her family fled nearly two decades prior, she was struck by the total absence of therapeutic services for this rattled country. At the time, Olad was a student at The Ohio State University (she chuckles, making a point to say the requisite “The”) and had been deciding whether to major in psychology or psychiatry. While in Somalia, she visited the only mental health clinic in Mogadishu. “There was no capacity,” she recalls. “There was a dire need.” The one psychiatrist there was doing his best, Olad says, but he was heavily medicating all his patients. Olad recalled that a lot of people were on large doses of sleeping pills.
Then and there, Olad decided to concentrate on psychology. “My friends and family used to discourage me to study psychology,” she remembers. “Everyone used to say, ‘What will you do with a psychology degree?’” She explains, “No one knows what talk therapy is.”
Olad knows that psychology can provide a healing path to develop habits for the sustainable behavior changes necessary to ease illnesses caused by trauma. This type of therapy might make life more comfortable in a way that medication alone cannot. “Even people with severe psychosis like bipolar and schizophrenia need a psychotherapist working with them,” she says.
And so, after returning to the States to obtain the necessary degrees and get some experience in Ohio at a clinic, Olad founded the first and only psychotherapy clinic in Somalia in late 2017. Maandeeq Mental Health Center and Training Institute now employs three therapists and has served more than 300 people. Some patients are paying clients who want to find out if there is a psychological diagnosis for their physical ailments—usually those people come after they have exhausted all other medical options. Maandeeq also has a partnership with the United Nations agency, the International Organization for Migration, and sees people who have returned to Somalia after attempting to move to Europe or the Gulf.
Olad at Liido Beach in Mogadishu.
“I use holistic therapy and an integrative approach where I address the mind and body as a whole,” Olad tells Vogue. “Most Somali clients complain about physical health when they are having mental health issues. They need culturally appropriate interventions.” Olad often uses cognitive behavioral therapy (CBT), which focuses on challenging mental distortions and changing unhealthy thought patterns.
The therapists that work at Maandeeq are Somalis who have gone to school in Turkey or Sudan and then returned to Mogadishu. Maandeeq has also contracted counselors from Kenya who do not speak Somali but can assist with preparing treatment plans and supervising group sessions.
Even just diagnosing a client can provide relief, Olad explains. People will come to her if they have been completely unable to sleep or if they are having debilitating back pain. Often in these instances, the patients have tried every other medical approach, and with Olad they will realize their physical agony is actually rooted in mental pain. Translating psychological terminology into Somali can be tricky, she says (for example, there’s no word for “bipolar” in Somali). To manage this, Olad will make PowerPoint presentations explaining to the patients what is happening in their brain. Most of Olad’s patients cannot afford counseling services and have splurged on the sessions to get a diagnosis. It can be frustrating, she notes, when a patient is unable to continue with treatment that is clearly helping them.
Olad meets with colleagues in Mogadishu’s Green Zone.
Besides one-on-one appointments, Maandeeq hosts casariya (a traditional Somali tea time), which are free group sessions with themes like “worry,” where men and women will meet for guided discussions. On October 14, 2017, the city was the site of one of the biggest terrorist attacks in world history when a bombing took the lives of at least 587 people—but because of lack of infrastructure to gather such information, the number could be much higher. On the one-year anniversary of the attack, Maandeeq hosted a psycho-education group session for Somali journalists. And now that Mogadishu is at the center of a political impasse and spats of armed clashes have threatened to return the country to civil war, Maandeeq has hosted a casariya for women to talk about their stresses.
“In Somalia today we see how a violent and painful past impacts not only individuals presently through many trauma responses, but also the collective through intergenerational trauma transmission,” says Angi Yoder-Maina, Ph.D., a peace-building practitioner who has spent 15 years designing trauma-informed approaches for communities in conflict across East Africa.
Maandeeq Mental Health Center and Training Institute now employs three therapists and has served more than 300 people.
Mogadishu sees some of the worst of the insecurity, with regular, nearly weekly reports of targeted murders and bombings, especially in upmarket hotels and restaurants, and armed clashes. Drivers on the roads that stretch into the city risk landmines. On top of this, unemployment in Somalia is astronomic, and the country is on the front lines of climate change, facing frequent shocks of extreme weather that overturn life’s rhythms.
“In developing countries and conflict or post-conflict settings, it’s not uncommon to find a general perception among communities that all mental health conditions require medication as means of treatment and management. This is not always the case,” explains Katy Wall, a regional mental health and psychosocial support technical advisor who works in East Africa with Save the Children, an international humanitarian organization.
Olad came up with Somali terminology for trauma, dhaawac yada qqrsoon, which translates to “hidden wounds,” helping clients understand what they might be experiencing.
“Somali people have experienced decades of traumatic events [but] they have a low suicide rate compared to developed countries,” Olad says. “Many people argue that Somalis are resilient. However, based on my clinical observation, people are dealing with invisible wounds that are impacting their daily interactions with others, how they behave, and how they think. Somali people need to heal from past traumatic events, and mental health should be a cross-cutting issue that reaches every level of society.”
Besides one on one appointments, Olad hosts casariya (a traditional Somali tea time), which are free group sessions with themes like “worry,” where men and women will meet for guided discussions.