When outgoing interim Iraqi Health Minister, Dr Khudair Abbas, embarked on the reconstruction of Iraq's collapsed health system last summer, he was shocked to find that there were only two psychiatric hospitals for a country of 24 million people.
According to Abbas, patients with mental health problems had been kept under prison-like conditions and many escaped when their institutions were looted and vandalized last year. Inhumane treatment of patients was symptomatic of Saddam Hussein's dictatorship which tortured and murdered thousands of citizens, said Abbas.
"[It is] not only the trauma of the past. We have to address the effect of the current conflict on the people," said Dr R. Srinivasa Murthy from WHO's Regional Office for the Eastern Mediterranean, who is responsible for mental health in the region.
In July 2003, WHO hosted an expert consultation in Cairo to discuss the mental health and rehabilitation of psychiatric services in post-conflict and complex emergencies in a number of countries, including Iraq. They found that these populations were traumatized by acute and chronic stress.
"Most of the population needs support to master the situation," Dr Murthy said, referring to countries like Iraq.
When Abbas became health minister in September 2003 he drafted a health needs assessment with the help of WHO and other international experts, including James K Haveman, a public administrator from the US, appointed by the Coalition Provisional Authority (CPA) to advise him. They singled out mental health, alongside infectious diseases and cancer treatment, as the three top priorities.
In February, Dr Abbas appointed Iraqi-born psychiatrist Sabah Sadik, who had been in exile in the UK for 25 years, as Iraq's National Advisor for mental health. An Iraqi Mental Health Council representing a wide range of disciplines was then formed and a draft Mental Health Act has been submitted to Iraq's Governing Council.
In May, 16 psychiatrists from across Iraq attended a WHO training workshop in Beirut, Lebanon, to review Iraq's mental health needs, update their own knowledge and discuss the proposed mental health reforms. The same month, the Iraqi health ministry prepared a one-year mental health plan financed by a US$ 6 million donation from Japan to focus on mental health services, training new staff and rebuilding a mental health infrastructure.
Iraqi psychiatrists have received training in Jordan, Kuwait, the US and the UK. …