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Iraq's Psychiatric Hospitals Confront Many Obstacles

Baghad's psychiatric hospitals are refurbished and admitting patients following last year's looting. But frequent bomb attacks in civilian areas make it difficult for patients to keep appointments.

Imagine walking into a hospital where you saw patients just a week ago and finding it stripped of everything except for a few sticks of furniture. That was the condition Ibn Rushd Psychiatric Hospital was in last April after looters swept through the Baghdad hospital, said Iraqi psychiatric consultant Numan Ali, M.D., in a telephone interview with Psychiatric News.

Numan Ali, M.D.: "Doctors worry every day driving to and from the hospital about whether a bomb will explode and kill them."

"They took valuable medical equipment and supplies, medications, patient charts, computers, and furniture," said Ali, who is also the secretary-general of the Iraqi Society of Psychiatrists.

When Ali and his colleagues arrived at the hospital after it was looted, they found just a few boxes of medications that hadn't been stolen. The International Committee of the Red Cross made it possible for them to care for patients by donating hygiene kits with soap and towels, safe drinking water, first-aid supplies, stoves, and canned food.

Last May a Japanese non-governmental organization (NGO) visited the hospital and asked what Ali and his staff needed."Within a short time, we had everything we asked for, and the hospital is completely refurbished," he said.

Japan also contributed $6 million to the reconstruction of mental health services in Iraq.

Ibn Rushd has 75 beds for short- and medium-stay patients, while Al Rashad has 1,000 beds for long-term patients, said Ali. Al Rashad was also looted and vandalized, and reportedly some women patients were raped. It has since been refurbished and is operating fully, although some 300 patients who left the premises last year haven't been accounted for, said Ali.

There are eight psychiatric consultants and eight psychiatric residents at Ibn Rushd, and at least 12 psychiatric consultants and 10 trainees at Al Rashad, Ali said. "The Ministry of Health is offering us new medicines and assistance, so conditions are better than last year."

He is pleased that psychiatrists and nurses are being paid triple what they were paid under Saddam Hussein, but added "we still deserve more."

The hospitals do not charge patients to stay there. There is a minimal fee of 500 dinars ($.35 U.S.) for a psychiatric evaluation and medication, said Ali.

He is seeing more cases of acute stress and posttraumatic stress disorders among Iraqis. Ali believes the cumulative effect of three wars, sanctions, deprivation, and torture under Saddam Hussein has caused severe damage to the Iraqi psyche.

Although the hospital receives some medications from the Ministry of Health, it doesn't receive the newer atypical antipsychotic drugs, said Ali.

He complained that the supplies of psychiatric drugs that NGOs have sent have expired within a few months.

In May the Middle Eastern office of Janssen Cilag offered to send Ali a large supply of Risperdal through an international relief organization. As of mid-October, he had not received the tablets and was anxious about their status. The International Red Cross Committee withdrew its staff after its building was bombed, Ali said sadly.

Corruption is still a problem in Iraq, and medications sometimes end up being sold on the black market. "The proper channel is the Ministry of Health to avoid corruption," said Ali, who is anxious about his own safety. "Doctors worry every day driving to and from the hospital about whether a bomb will explode and kill them."

To make matters worse, doctors are being kidnapped and held for ransom by criminals. "At least 20 of my colleagues have been kidnapped at gunpoint and held for ransom, which their families paid. One doctor hired bodyguards who were shot by the kidnappers," Ali said.

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