Koroma expressed concern over the provision of water and electricity in the hospital, and the drugs supply which he regarded as inadequate.

Dr Mandy Garber – a Sierra Leonean psychiatrist based in Pittsburgh visited the hospital and reported on what she saw.

The utilities were basic, food very sparse and owing to holes in the fence some of the inmates were chained to the bed.

Alpha Wurie, the Health and Sanitation Minister of Sierra Leone, visited the hospital on 3 September, removing and dismantling a set of chain restraints.

Partners In Health, an international non-governmental organisation, has helped modernise the hospital, updating the water and electricity supply and providing staff training.