In the late 1980s, the people of northern Somalia rebelled against the government of General Mohammed Siad Barre. After four years of fighting, they separated from the rest of the country, forming the Republic of Somaliland.

The cost of their de facto independence was heavy. Tens of thousands of people were killed during the conflict, many during bombardments by the Somali Air Force. Half a million more fled across the Ethiopian border, settling in refugee camps. A struggle for control of the breakaway republic followed in the mid-1990s.

Rebuilding has been slow. The last camp was dismantled just a few years ago.

Today, as Somaliland thrives in the shadow of its troubled neighbours, the scope of the war’s psychological toll has only begun to register. As many as two-thirds of people over the age of 25 have suffered from post-traumatic stress disorder in some form. Abuse of khat, a plant-based amphetamine chewed all over the Horn of Africa, complicates this and other mental health issues.

There are no psychiatrists in Somaliland.

The patients at Hargeisa Mental Health Unit receive professional treatment for only one month per year, when a Somali-Canadian psychiatrist returns to the country on holiday. He provides free treatment and diagnosis.

What follows are portraits from Somaliland’s only mental health hospital.

See also Separation Anxiety: Caring for civil war survivors in Somaliland’s only mental health hospital in The Walrus.