Photograph by Michael Christopher Brown, Magnum
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A patient rests outside the Brothers of Charity Sante Mental hospital building in Goma, Democratic Republic of Congo. Because of conflict in the country, many patients aren't able to make it to the facility to get help.
Photograph by Michael Christopher Brown, Magnum

Amid Chaos of War, a Hospital Offers Hope

A photographer discovers a home away from home for people suffering after years of conflict in the Democratic Republic of the Congo.

While working within the eastern region of the Democratic Republic of the Congo (DRC), I’ve often come across folks with psychiatric disorders. I wondered if there was a place for them to go—medical insurance isn’t often available and just getting to a hospital is almost impossible in remote, insecure regions.

On my last trip, I visited one of the places people can go: the Brothers of Charity Sante Mental Hospital in Goma, the largest city in the hotbed of an ongoing conflict that has killed millions since the mid-1990s.

The hospital specializes in psychiatric treatments. Several hundred people from in and around the province of North Kivu visit every month for treatment. When I went in June, there were 45 patients—20 women and 25 men—under the care of two psychologists and a handful of nurses, as many as the hospital can find and afford.

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A patient is brought into a treatment center.

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A patient gets a haircut in her room.

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The conflict around Goma and the DRC is a constant source of trauma and exacerbates the need for mental health care.

While in the hospital, I saw a patient come in with his brother-in-law. He paced around the waiting area with his shirt off, calling out to others in obvious frustration and anxiety. When his brother-in-law tried to calm him down, the patient bit him multiple times on the hand and face, causing deep gashes and spilling blood. Workers arrived to take the man away. He spat on them before he could be sedated.

The Brothers of Charity have been doing this kind of work here for over a century. Founded in 1803, the Catholic organization’s first Congolese hospital opened in 1911 in Lusambo, just after the end of King Leopold’s Congo Free State. The organization now runs a total of nine centers in DRC. The Goma hospital opened in 1995.

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A patient's brain waves are anaylzed in the hospital.

Brother Jacob Kazadi Nsumbu, who runs the Goma hospital, told me many of the patients don’t have families to support them—they’re abandoned due to a stigma on mental illness in the country. “Here in Congo, when you say you are going to the mental health center … people believe you must have done something wrong, that you are at fault,” he said. “Part of our job is to try and explain to the population that it is not only foolish people coming here, that anybody can come here and all are welcome and there is nothing wrong with getting treatment for a psychological problem.”

Overcoming the stigma is just the first challenge to getting care. There are dozens of rebel groups in the state around Goma, which makes it difficult for patients to reach the hospital or for the center to send out a mobile clinic. When patients leave the hospital, too, they’re often not able to find a place to pick up medication, and Nsumbu told me he sees a lot of relapses.

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During a church service, young patients are baptized.

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A patient sits on her bed in the hospital's women's ward.

As recently as 2013, the African Psychological Association listed only a handful of psychologists in the country. Nsumbu says the hospital has two psychiatrists and several nurses. Experts working in nonprofits and other aid organizations in the area say the hospital is one of the only options for mental health care in the area. And mental health in general is not a priority in the eastern DRC.

The same conflict that makes care hard to reach also makes it necessary. The hospital sees patients who are dealing with trauma from war. There are rape victims and patients who have turned to alcohol and drug abuse.

“The government doesn’t help us either financially or in terms of security; they do not help these people to get treatment, so many people are just forgotten,” Nsumbu said, adding that the hospital needs money to pay for medications, its staff, and to upgrade its facilities.

Sometimes NGOs send patients to the hospital and pay for the care. “But we really need much more support,” Nsumbu said. “A lot of people visit us and don’t do anything.”

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The hospital also has a school where patients can learn a trade. Here, students learn carpentry.

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The school's vocational training gives patients an opportunity to build jobs skills.

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Students learn to count money at the school.

When I’m working in the DRC, I often give something to my subjects to show my gratitude, whether it’s money, food, or rides. At the hospital, I donated the money to buy two sewing machines, one of which went to a patient who had been severely burned after having a seizure in her kitchen. She cried as she told me how her family had neglected her.

In addition to the hospital, the Brothers also run a neighboring school for children with mental disabilities. The school offers a vocational program, and many students find work after they leave. I learned of a young man who practiced making chairs in school and later sold 15 of them to the psychiatric center for $150—a lot of money for the average citizen of Goma. There are classes for tailoring and other crafts, too.

“This school was largely created to give these children dignity," said brother André Ngalula. "Some are neglected in their families, so many of these children come without knowing anything. Later they go back to their families and the families are often very grateful to us.”

I was nearly in tears every time I left the school and hospital. What struck me about these visits, though, was that while many patients were under sedation, many others excitedly came up to me wanting to speak English, to meet the visitor, and to show off the skills they had acquired. One patient played guitar and sang while others adamantly showed me their exercise routines, tumbling in the courtyard grass, proud of what they had learned from their supervisors. Here, despite the financial, social, and political complications, these folks are at least given a home away from home.

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Children take a break during classes at the school.

Michael Christopher Brown is represented by Magnum Photos. You can see more of his work here.