The Wounds We Do Not See

BAGHDAD, Iraq, Nov. 10, 2006 — -- Visiting a psychiatric hospital in Baghdad is a shocking experience. Not, I should explain, because of the standard of care. Iraqi doctors are some of the best in the Middle East, and the supply of drugs appears sufficient.

What is shocking is the extent to which the war is now getting inside peoples' minds and cracking them open.

We went to the Ibn Rushud psychiatric hospital this week. Ibn Rushud is primarily for acute cases, with 60 beds for patients who usually stay only for a few days or weeks; it also treats a lot of outpatients.

The man in charge, Dr. Sha'alan al-Aboodi, took us round the wards, explaining that the patients who come in now exhibit far more extreme symptoms than he saw before the war.

We met one man who was trying to get a prescription filled -- for his brother, he told us. But it seemed clear he had some problems, too.

In the hallway he screamed abuse at the hospital managers for some reason that he couldn't explain.

Then he shouted: "I would rather be in hell than spend another day in Iraq."

We met a man who said he hadn't slept for two months since a bomb went off outside his house -- he pleaded pitifully with al-Aboodi to help him sleep.

In the garden outside the wards was a man who used to drive trucks from Baghdad to the Syrian border. He had witnessed six men beheaded in front of him by insurgents, and now every time he tries to sleep he sees some figure coming up to strangle him, which wakes him up and drives him to drink alcohol to try to banish the image.

The alcohol, however, only makes it worse.

Other patients who are put on drugs to reduce their anxiety and depression find themselves becoming addicted to these drugs because the war that they fear just goes on and on.

It should not be surprising that the relentless violence in Baghdad takes its toll on people's minds. Some patients doubtless already had mental problems that the additional stress of the war has made worse, and others appear to have been driven mad by the violence itself.

What's sad is that for those patients suffering from some form of post-traumatic stress, the most useful treatment -- some form of talking therapy -- is culturally taboo in Iraq.

Patients seek pills that will cure their problems quickly, and there is little market for therapists or the type of longer-term care that helps people get over extreme trauma.

We see images of the physically wounded on TV every day, but the mental wounds are deep, too, and often last much longer.