De-Institutionalization in Iraq
furuhashi.1 at osu.edu
Mon May 19 05:01:13 MDT 2003
***** The New York Times
May 12, 2003, Monday, Late Edition - Final
SECTION: Section A; Page 1; Column 2; Foreign Desk
LENGTH: 1216 words
HEADLINE: AFTEREFFECTS: THE PSYCHIATRIC HOSPITAL;
In Baghdad's Anarchy, the Insane Went Free
BYLINE: By PATRICK E. TYLER
DATELINE: BAGHDAD, Iraq, May 11
The only mental patient left behind at the high security ward of Al
Rashad state hospital is a killer named Ali Sabah, a former math and
science teacher with jet black hair and dark, searching eyes.
He is off his medications, the door to the ward is wide open and
shards of glass lie everywhere as potential weapons. Yet on a recent
day he was calm until this reporter made a few notes. "Why is he
writing my name down?" he asked.
He stalks the looted corridors inside the 15-foot-high wall that once
provided maximum security to restrain 120 patients who were committed
for murder and rape while in the throes of mental disorder.
"I hate the world and the world hates me," he replied when asked why
he stayed while the others ran. Then he added, "I don't want the
monkey to see me and I don't want to see the monkey."
In another part of the hospital, the six women among the patients who
were raped by looters are receiving special attention from the
nursing staff. Some spend their days curled under blankets, others
have ventured out to squat in the light where there are no chairs,
but where cigarettes can be smoked. The nurses whisper that one rape
victim is pregnant.
For the staff, there is also the sad loss of Hanna Fatah, who had
been a patient here for 30 of her 70 years.
"When the marines opened the gates, Hanna wanted to leave," said
Sultan A. Sultan, her psychiatrist. She had no ability to judge the
danger and while wandering somewhere near the gate, she was killed by
a bullet that struck her forehead.
One of the tragedies of the war -- a preventable tragedy in the view
of many doctors and nurses -- occurred here. Iraq's only hospital
providing long-term care for chronic schizophrenia and other serious
disorders, Al Rashad was all but destroyed.
When American marines clashed with Saddam Hussein's irregulars trying
to block their advance into Baghdad, the marines came through the
gates here and knocked down the walls with their tanks. They set up a
command post in the nursing school.
Waves of looters came in with them, staff members said.
One of the oldest health institutions in Iraq, Al Rashad has long
been designated a civilian hospital. The director, Amir Abou Heelo,
told the Marine commander on April 8 that he was entering a
psychiatric facility, staff doctors said in interviews. But the
protest did little good.
"I am disappointed," said Dr. Raghad Sursan, a psychiatrist. "I am
mad, and if there is a word that is bigger than mad, I am that,
because the marines were there and could have done something to stop
The looters stripped everything once, then waited a week for repairs
to be made to doors and windows and came back and stripped the place
again, they said.
Of the more than 1,400 Iraqis institutionalized here at the beginning
of the year, 300 remain. The staff has been able to cope only because
the Geneva-based International Committee of the Red Cross, having
adopted this facility three years ago, raced emergency food and
medical supplies here as Baghdad was falling.
The complaint of the Iraqi psychiatric staff is that the marines
stood by as looters carried away every bed, basin, cooker,
air-conditioner, piece of furniture or thing of value.
The marines broke the door down on the maximum security wing, and in
no time the patients were gone, untethered from the antipsychotic
drugs that stabilized many of them.
One doctor said he was told by a Marine officer that the officer was
there to "liberate and then leave."
"This is the Iraqi version of de-institutionalization," said Dr.
Sursan, alluding to the mass de-institutionalization of mental
patients in the United States during the 1970's.
The Red Cross spent $1.5 million over the last three years bringing
the facility up almost to Western standards for compassionate care to
the mentally ill, said Olaf Rosset, the Norwegian physician who has
overseen the project from the beginning. Ghastly and putrid wards
were modernized, open sewers were closed, kitchens were rebuilt and,
Dr. Rosset said, the warehousing of patients gave way to a much more
humane approach of outdoor activities, picnics, poetry and art
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