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Mental institute in Iraq struggles to meet needs

"[Former Iraqi president] Saddam used to beat us and then [US President George W.] Bush sent his army to beat us and now my father beats me -- I just can't take it any more."

an Iraqi patient at the al-Rashad mental institute

During the US-led invasion of Baghdad, looters laid waste to Iraq's largest mental health facility, causing nearly all 800 patients to flee into the anarchy and chaos that gripped the capital.

Three years of violence, insecurity and unrest later, nearly all of them have returned to the al-Rashad mental institute, along with hundreds of new patients struggling to deal with the trauma of post-invasion Iraq.

"Saddam used to beat us and then [US President George W.] Bush sent his army to beat us and now my father beats me -- I just can't take it any more," said one patient to Ali Farhan, director of the institute, after his father brought him in for violent and unstable behavior.

"After three years of invasion in Iraq, the entire country needs therapy," Farhan said.

"The situation is becoming unbearable, the scenes of bloodshed in the street during the day and on television during the night are making people go insane," he said.

The institute, near the sprawling Shiite suburb of Sadr City, tries to filter out the daily background violence of Baghdad as much as possible.

Televisions in the wards, fixed behind wire cages, broadcast only Arabic and Iraqi music.

"We do not broadcast news because all the violence in the country doesn't help the healing process," Farhan said.

Founded in 1950, al-Rashad is the largest mental health facility of its type in the country and was originally established for paranoid schizophrenics who could no longer function in society.

After the fall of the old regime, and as the US military looked on, the hospital was looted, four women were raped inside its walls and it lost all its patients.

They soon came back, however, and over the next three years, were joined by groups of newcomers.

"Most Iraqis are depressed," said Farhan. "They got that way through Saddam's bloody regime and now the depression is changing into nervous breakdowns with the daily suffering."

The rambling compound is divided into two wings, one for men and the other for women, with a large garden in between where the 1,000 patients can stroll around.

Inside the barracks-like wards stretch long white-tiled corridors that are as clean as they are stark. Patients sit in corners puffing on cigarettes or staring emptily out the barred windows of their rooms.

Bashir Fadel, one of eight doctors caring for all the patients, said that the institute receives two kinds of patients: Some just have psychological problems, while others are deeply unstable.

"Those with psychological problems are easy to deal with, but those who are mentally unstable are more difficult," he said, linking most people's problems to the daily violence they encounter.

A four-month-long study by the Association of Psychologists in Iraq published in February found that 92 percent of 1,000 children surveyed suffer learning problems directly linked to the climate of fear and insecurity.

Getting treatment, however, is difficult, especially since the popular perception of psychology in Iraq, like many places around the world, is that it is just for treating the insane.

"Many patients don't come to the hospital," said Fadel. "Most of the families take their sons to the sheikhs and traditional healers to be cured -- they think a spell has hit them."

It is also difficult for the institute to cite successes. A doctor can pronounce a patient "cured" only to find that the family will not take them back, sometimes because of the stigma, other times for monetary reasons.

Like many other institutions in Iraqi society, al-Rashad is struggling to make ends meet and is overburdened by an ever-swelling number of patients. The same atmosphere of insecurity that sends people to the institute is keeping away foreign aid.

"The International Committee of the Red Cross used to help us but when their headquarters was bombed in 2003, we were left alone," Dr Raghed Issa said.
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