Sierra Leone has a population of over 8 million people, but only has one mental health facility, three psychiatrists, and no in-country practicing adult neurologists. The Sierra Leone Psychiatric Teaching Hospital (SLPTH), formerly the Kissy Lunatic Asylum, is the oldest psychiatric hospital in sub-Saharan Africa. Recently, SLPTH has transformed to provide more accessible and patient-centered care to the community, becoming chain free in 2018. With support from the Ministry of Health and Sanitation (MOHS) and Partners in Health (PIH), received accreditation for the country’s first psychiatry residency program in 2022.

My project consisted of conversations with SLPTH residents on subjects of mutual interest with the hope of gaining valuable insights into the experiences of SLPTH residents while cultural and medical exchange through bidirectional conversations between SLPTH and UCSF residents. The project design was a series of six one-hour long conversations with groups of 2 to 4 SLPTH residents. Agreed upon discussion topics included residency training in Sierra Leone and personal journey into medicine, experience of being a mental health care provider, obstacles to providing care, and community needs and access to services. We also held a session with a UCSF Neurology resident for SLPTH residents to learn more about common neuropsychiatric conditions in the U.S. and how they are treated. Through this project, I was able to investigate the field of global health narrative medicine by utilizing the power of virtual connectivity. Sharing a virtual room with the SLPTH residents and getting to know their lives, goals, and experiences as healthcare professionals taught me many invaluable lessons about medicine and global health research.

Establishing a positive working environment and collaborative atmosphere from the outset of planning was crucial to producing a mutually beneficial project that all parties were comfortable with. This also meant giving the project proposal some leeway and adding viewpoints that would be more beneficial for the SLPTH residents to learn from, like those of the UCSF Neurology residents. When attempting to coordinate across different schedules and time zones, it was important to be adaptable and have contingency plans for technical difficulties and scheduling conflicts.

Developing a good rapport and deep connections with the residents over time was very fulfilling. It was inspiring to learn about the residents’ commitment to their community and the work they are doing to increase quality and accessibility to care and to decrease stigma surrounding mental illness. Topics discussed included the residents' personal journey to medicine, community perspectives on mental illness, commonly encountered neuropsychiatric conditions, obstacles to seeking care, and future aspirations for mental health care in Sierra Leone. The writing process has been equally meaningful and a great method of personal reflection that I look forward to sharing with the SLPTH residents. Throughout this project, I have gained knowledge about myself, other people, and the power of purposeful conversation to broaden perspectives and exchange ideas. Ultimately, I hope the final product elevates the perspectives of others and highlights the value of knowledge exchange amongst medical professionals from different backgrounds, even when occurring virtually.