Healing Iraqis: The Challenges of Providing Mental Health Care in Iraq

[Image from doctorswithoutborders.org] [Image from doctorswithoutborders.org]

Healing Iraqis: The Challenges of Providing Mental Health Care in Iraq

By : Jadaliyya Reports

[The following report was issued by Doctors Without Borders on 30 April 2013.]  

Healing Iraqis: The Challenges of Providing Mental Health Care in Iraq

Introduction 

Mental health disorders and emotional distress are as debilitating and agonizing as physical health problems. According to The World Health Organisation, mental health disorders are the fourth leading cause of ill health in Iraqis over the age of 5 years. There is little doubt that years of political and social repression, punctuated by wars, and followed by a post-war period characterised by interrupted and insufficient basic services have taken their toll on the Iraqi people.

Few people in Iraq have remained untouched by the trauma associated with years of unrest and instability.

“I almost had a nervous breakdown. I hit everything that I see in my way. I get angry and hit things. I’m worried that my children will get sick. I witnessed an explosion four years ago and I still have shrapnel in my head from the incident. Six years ago I was imprisoned in Abu Ghraib for a year and a half. I became an angry person, I would get irritated so easily and always felt miserable. After the first session of counseling I felt that I had been helped. The problem is I’m always worried about the cost of living since I don’t have enough money… and I’m always afraid and worried that something bad could happen to my family”. -- 47 years old male, married with 10 children. First session.

Societies which have experienced years of suffering and social upheaval due to long periods of violent conflict not only face high levels of emotional distress, but have great need of a healthy, productive population to rebuild their country. However, as mental health problems are often less visible than physical ill health, and often less understood by most in the community, mental health care is frequently significantly less resourced than physical health care.

In 2009, Médecins Sans Frontières (MSF) in collaboration with the Iraqi Ministry of Health (IMoH) launched a program aimed at opening up access to psychological counselling, and at catalyzing the integration of mental health care as a crucial component of the Iraqi health system. The project focussed on nonpharmaceutical approaches to address the anxiety and depressive disorders, which research shows are the most common of the mental health disorders experienced by the Iraqi population, and which are considered highly amenable to psychological counselling approaches.

Over the past 4 years, MSF and the IMoH have introduced psychological counselling services in two hospitals in Baghdad and one in Fallujah. The intention is for the model of care to be replicated in other health care facilities throughout Iraq and particularly, consistent with current worldwide approaches to mental health care, to integrate psychological counselling into community-based primary health care services. As in many countries with under-developed mental health care services there is also an urgent need to increase public awareness of mental health issues and encourage those in need of care to seek assistance. Raising awareness can also help reduce the stigma associated with mental health disorders by the public, other medical professions and at the political level. 

“I came here for the first time, to overcome the situation I’m in. I always have negative thoughts and when anyone starts talking to me I suddenly can’t stop crying. I witnessed several explosions go off in front of my house and have had my homes searched by the police several times. These experiences affected my life and my work so much. I tried to talk to my family, but they didn’t understand me and didn’t listen to me. They say I’m crazy. That’s why I came here I want someone to listen to me. I left my work and now I’m a house wife, I don’t like socializing with the family at all.” -- 27 years old female. Married. House wife. First session.

The Iraqi MoH is committed to addressing the issue on a broad scale, but much more work needs to be done to improve and replicate services, increase community awareness about services, and reduce the stigma associated with mental health.

[Click here to download the full report.] 

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Past is Present: Settler Colonialism Matters!

On 5-6 March 2011, the Palestine Society at the School of Oriental and African Studies (SOAS) in London will hold its seventh annual conference, "Past is Present: Settler Colonialism in Palestine." This year`s conference aims to understand Zionism as a settler colonial project which has, for more than a century, subjected Palestine and Palestinians to a structural and violent form of destruction, dispossession, land appropriation and erasure in the pursuit of a new Jewish Israeli society. By organizing this conference, we hope to reclaim and revive the settler colonial paradigm and to outline its potential to inform and guide political strategy and mobilization.

The Israeli-Palestinian conflict is often described as unique and exceptional with little resemblance to other historical or ongoing colonial conflicts. Yet, for Zionism, like other settler colonial projects such as the British colonization of Ireland or European settlement of North America, South Africa or Australia, the imperative is to control the land and its resources -- and to displace the original inhabitants. Indeed, as conference keynote speaker Patrick Wolfe, one of the foremost scholars on settler colonialism and professor at La Trobe University in Victoria, Australia, argues, "the logic of this project, a sustained institutional tendency to eliminate the Indigenous population, informs a range of historical practices that might otherwise appear distinct--invasion is a structure not an event."[i]

Therefore, the classification of the Zionist movement as a settler colonial project, and the Israeli state as its manifestation, is not merely intended as a statement on the historical origins of Israel, nor as a rhetorical or polemical device. Rather, the aim is to highlight Zionism`s structural continuities and the ideology which informs Israeli policies and practices in Palestine and toward Palestinians everywhere. Thus, the Nakba -- whether viewed as a spontaneous, violent episode in war, or the implementation of a preconceived master plan -- should be understood as both the precondition for the creation of Israel and the logical outcome of Zionist settlement in Palestine.

Moreover, it is this same logic that sustains the continuation of the Nakba today. As remarked by Benny Morris, “had he [David Ben Gurion] carried out full expulsion--rather than partial--he would have stabilised the State of Israel for generations.”[ii] Yet, plagued by an “instability”--defined by the very existence of the Palestinian nation--Israel continues its daily state practices in its quest to fulfill Zionism’s logic to maximize the amount of land under its control with the minimum number of Palestinians on it. These practices take a painful array of manifestations: aerial and maritime bombardment, massacre and invasion, house demolitions, land theft, identity card confiscation, racist laws and loyalty tests, the wall, the siege on Gaza, cultural appropriation, and the dependence on willing (or unwilling) native collaboration and security arrangements, all with the continued support and backing of imperial power. 

Despite these enduring practices however, the settler colonial paradigm has largely fallen into disuse. As a paradigm, it once served as a primary ideological and political framework for all Palestinian political factions and trends, and informed the intellectual work of committed academics and revolutionary scholars, both Palestinians and Jews.

The conference thus asks where and why the settler colonial paradigm was lost, both in scholarship on Palestine and in politics; how do current analyses and theoretical trends that have arisen in its place address present and historical realities? While acknowledging the creativity of these new interpretations, we must nonetheless ask: when exactly did Palestinian natives find themselves in a "post-colonial" condition? When did the ongoing struggle over land become a "post-conflict" situation? When did Israel become a "post-Zionist" society? And when did the fortification of Palestinian ghettos and reservations become "state-building"?

In outlining settler colonialism as a central paradigm from which to understand Palestine, this conference re-invigorates it as a tool by which to analyze the present situation. In doing so, it contests solutions which accommodate Zionism, and more significantly, builds settler colonialism as a political analysis that can embolden and inform a strategy of active, mutual, and principled Palestinian alignment with the Arab struggle for self-determination, and indigenous struggles in the US, Latin America, Oceania, and elsewhere.

Such an alignment would expand the tools available to Palestinians and their solidarity movement, and reconnect the struggle to its own history of anti-colonial internationalism. At its core, this internationalism asserts that the Palestinian struggle against Zionist settler colonialism can only be won when it is embedded within, and empowered by, the broader Arab movement for emancipation and the indigenous, anti-racist and anti-colonial movement--from Arizona to Auckland.

SOAS Palestine Society invites everyone to join us at what promises to be a significant intervention in Palestine activism and scholarship.

For over 30 years, SOAS Palestine Society has heightened awareness and understanding of the Palestinian people, their rights, culture, and struggle for self-determination, amongst students, faculty, staff, and the broader public. SOAS Palestine society aims to continuously push the frontiers of discourse in an effort to make provocative arguments and to stimulate debate and organizing for justice in Palestine through relevant conferences, and events ranging from the intellectual and political impact of Edward Said`s life and work (2004), international law and the Palestine question (2005), the economy of Palestine and its occupation (2006), the one state (2007), 60 Years of Nakba, 60 Years of Resistance (2009), and most recently, the Left in Palestine (2010).

For more information on the SOAS Palestine Society 7th annual conference, Past is Present: Settler Colonialism in Palestine: www.soaspalsoc.org

SOAS Palestine Society Organizing Collective is a group of committed students that has undertaken to organize annual academic conferences on Palestine since 2003.

 


[i] Patrick Wolfe, Settler Colonialism and the Transformation of Anthropology: The Politics and Poetics of an Ethnographic Event, Cassell, London, p. 163

[ii] Interview with Benny Morris, Survival of the Fittest, Haaretz, 9. January 2004, http://cosmos.ucc.ie/cs1064/jabowen/IPSC/php/art.php?aid=5412