Two recent stories from Iraq by freelance reporter James Palmer call attention to the plight of ordinary people there. -- In a front-page story published by the San Francisco Chronicle on the fourth anniversary of the war, Palmer quoted an Iraqi psychiatrist describing the massive trauma inflicted upon the civilian population: "No one knows what will result from living through this continuous trauma on a daily basis," said Dr. Said al-Hashimi, 54, a psychiatrist at Mustansiriya Medical School in Baghdad. -- Among the victims described in the article: -- 1) a 65-year-old housewife who "has suffered from severe depression and suicidal thoughts since viewing the corpse of her son, whose head was nearly torn off by gunfire late in 2003"; -- 2) a 27-year-old who "has endured chronic headaches, insomnia, loss of appetite and panic attacks after the slaying of her 55-year-old father by a Shiite militia in June"; -- 3) a 15-year-old who "has experienced flashbacks of a rocket destroying a building in her neighborhood" and "breaks down whenever she hears a loud noise"; -- 4) a 10-year-old who "stopped talking and refused to eat or drink" after his family moved when relatives received "a threatening letter with a bullet enclosed"; -- 5) a 7-year-old who "suffered an apparent nervous breakdown last year and stopped eating after the slaying of a close friend's father." -- In a piece he published ten days earlier, Palmer reported on "the trend of consulting fortunetellers [that] suggests Iraqis are continuing to lose confidence in their government and security forces as the country slides further into a chasm of violence and criminality." -- James Palmer first went to Iraq in the summer of 2005. -- He works as a freelance journalist with the Star-Ledger. -- Palmer grew up in Buffalo, N.Y., and worked on the docks and as an overseas English teacher before going back to school and earning his master's degree from Columbia University in 2001. -- He has contributed to the Christian Science Monitor, World Picture News, Newsday, the San Franciso Chronicle, the Toronto Star, the Pittsburgh Post-Gazette, and the Washington Times....
PROTESTERS PLEAD FOR PEACE
By James Palmer
** Civilian toll: Iraqis exhibit more mental health problems **
San Francisco Chronicle
March 19, 2007
[PHOTO CAPTION: An Iraqi boy awaits treatment in the emergency room at Yarmouk Hospital in Baghdad. A study of 10,000 primary school students found at least 70 percent suffered from trauma-related symptoms. Photo by James Palmer.]
BAGHDAD -- Iraqi psychiatrists are seeing what they call a disturbing spike in mental health disorders as the war passes its fourth anniversary -- a problem compounded by Iraq's lack of mental health workers, facilities, and services.
Several mental health care professionals suggest the number of untreated or under-treated people nationwide reaches into the millions, and the consequences could permanently harm generations.
"Iraqis are being traumatized every day," said Dr. Said al-Hashimi, 54, a psychiatrist who runs a private clinic and teaches at Mustansiriya Medical School in Baghdad. "No one knows what will result from living through this continuous trauma on a daily basis."
The government-run Ibn Rushd psychiatric center in the Iraqi capital provides examples of damaged people looking for help.
In a sparsely furnished office inside the hospital, Iraqis file in to describe their ailments to Dr. Haider Adel Ali, a somber 40-year-old psychiatrist.
Fanzia Jaafer, a 65-year-old housewife, has suffered from severe depression and suicidal thoughts since viewing the corpse of her son, whose head was nearly torn off by gunfire late in 2003.
Sundes al-Dulaimi, 27, said she has endured chronic headaches, insomnia, loss of appetite and panic attacks after the slaying of her 55-year-old father by a Shiite militia in June.
Zaman al-Keelany, 15, has experienced flashbacks of a rocket destroying a building in her neighborhood. The high school freshman said she has managed to continue her studies, but breaks down whenever she hears a loud noise.
Though no reliable research exists on the state of Iraqis' mental health, the preliminary results of a survey of 10,000 primary school students in the Shaab section of north Baghdad, conducted by the Iraqi Society of Psychiatrists and the World Health Organization, reveals widespread problems.
The study, not yet published, found at least 70 percent of students were suffering from trauma-related symptoms, according to Mohammed al-Aboudi, Iraq's national mental health adviser. Aboudi said those numbers appeared so high that the survey was redone -- only to come up with similar results.
Ten-year-old Ahmed al-Dulaimi (no relation to Sundes al-Dulaimi) is one of the young Iraqis struggling to function.
Computer-savvy Ahmed, who enjoys playing soccer, stopped talking and refused to eat or drink when his family moved last year from their west Baghdad home to Fallujah for three months. They had moved after receiving a threatening letter with a bullet enclosed.
They have returned home and say Ahmed's condition is improving. But the boy is continuing psychiatric treatment at Ibn Rushd as an outpatient, and Ali has prescribed antidepressants while advising the boy's family to prevent him from watching violence on television.
"We're now finding an elevation of mental health disorders in children -- emotional, conduct, peer, attention deficit," Hashimi said. "A number are even resulting in suicide."
For some Iraqi doctors, the increase in the number of children traumatized by violence is apparent at the workplace and at home.
"I look into the eyes of children whose parents have been killed or are imprisoned every day," said Dr. Nadal al-Shamri, a pediatrician at the Medical City health complex in Baghdad. "The psychological trauma is so deeply ingrained in some children that they may never lead a normal life."
Al-Shamri said his 7-year-old son suffered an apparent nervous breakdown last year and stopped eating after the slaying of a close friend's father.
"It's difficult for me to eat after watching him cry," al-Shamri said.
During Saddam Hussein's 24-year reign, mental health was a forbidden topic, psychiatrists said. But today, things don't seem much better.
Iraqi psychiatrists, like most medical professionals here, are suffering from training and funding shortages. No psychotherapy or crisis centers exist, and Ibn Rushd is the only psychiatric hospital in the capital of 6 million people.
Patients at Ibn Rushd receive free treatment and medication, but those who can afford care at a private clinic pay roughly 5,000 Iraqi dinars -- nearly $4 -- for visits that usually last 30 minutes to an hour.
A shortage of prescription medication has resulted in a Health Ministry order limiting treatments to 10 days.
There is a similar shortage of psychiatrists, who have been among the professionals and intellectuals leaving Iraq in response to a campaign of intimidation.
Mental health adviser al-Aboudi, who also heads the Iraqi Society of Psychiatrists, estimates at least 140 of the country's 200 psychiatrists have been killed or have fled during the past four years.
Ali, who earns $300 monthly, is determined to remain, and he has the scars to prove his courage: two bullet wounds in his right arm from an assassination attempt in his clinic last year.
Remarking on Iraq's diminishing psychiatric resources, Ali said, "There is little interest from the government. We ask for training and assistance with (creating psychiatric) centers, but get nothing."
While consulting a string of patients one morning last month, Ali offered advice, prescriptions and, perhaps most important, compassion.
Jaafer, the housewife with suicidal thoughts, was cloaked in a traditional black abaya and clutched a white tissue in her right hand as she sat on a chair adjacent to Ali's desk and described the difficulties of coping with the killing of her 29-year-old son, Haider, more than three years ago. "Whenever I remember seeing his body at the morgue, I start to cry," said Jaafer, who complained of insomnia and losses of memory and appetite.
To make matters worse, Jaafer said, her family provides no support or sympathy. "They don't believe I'm really suffering," she said. "They just tell me to stop crying."
Ali looked down at his desk and paused for a moment to let Jaafer wipe the tears.
"We have all lost a dear one -- you should try to speak to other women who have lost their children," he said, before writing her a prescription for Valium.
That's about the best someone like Jaafer can hope for during a visit to the hospital. Anyone who wants or needs other psychiatric treatment "must go abroad," Ali said.
With no end to Iraq's troubles on the horizon, mental health professionals say the entire population eventually will require some type of healing. Hadoon Waleed, a psychology professor at Baghdad University, painted a grim picture when questioned about the future.
"Within five years of the falling of the regime, all Iraqis will be traumatized," he said. "We will all need treatment."
FOR THE SOOTHSAYERS, IRAQIS' MISFORTUNES MEAN GOOD BUSINESS
By James Palmer
** A once-illegal trade thrives as people lose faith in government **
Star-Ledger (Newark, NJ)
March 9, 2007
BAGHDAD -- When Mohammed Haman failed to return home one evening in January, his family knew something was wrong. But instead of reporting his disappearance to authorities, they did something that is becoming more common in Iraq: They consulted a fortuneteller.
On the day after he disappeared, Haman's family took one of his undershirts to a woman known to her clients simply as Madame Khulood.
In her central Baghdad home, Madame Khulood thoroughly inspected the garment and told Haman's family they would receive word about him within three days. She also advised them to sit tight.
The prediction proved accurate: Haman's family was contacted a few days later by a group of men who demanded $15,000 for his release. The family collected the money and paid the ransom, and Haman, a 55-year-old retired military officer, was returned safely to the embraces of his grateful relatives.
While some see it as a desperate act by desperate people, the trend of consulting fortunetellers also suggests Iraqis are continuing to lose confidence in their government and security forces as the country slides further into a chasm of violence and criminality.
"We have no hope the government will help us," said Ali Abbas Hamidi, 44, Haman's cousin. "We believe more in our fortuneteller."
Fortunetellers say they confer with customers on issues ranging from kidnapped relatives and stolen cars to more universal subjects like romance and money. And in many cases, fortunetellers serve as a 911 emergency service for Iraqis who feel they have no one else to call.
Kadum Jassam, a 27-year-old truck driver, had never considered visiting a fortuneteller until late January, when his vehicle went missing and he felt he had no other recourse.
Jassam said a friend referred him to Sabbah Mohammed, a well-known soothsayer in the capital. Mohammed pointed his client directly toward his lost vehicle.
"He told me the traffic police had it, and he was right," Jassam said.
Fortunetelling for profit was forbidden under Saddam Hussein's iron-fisted dictatorship, and there are stories of the country's soothsayers being imprisoned for a week at a time and required to sign an oath forever renouncing the vocation upon their release.
Soothsaying still has many disbelievers and strong critics, but with the government more concerned about trying to contain sectarian warfare, and with democracy the ultimate goal, Iraq's fortunetellers have been free to ply their trade.
For Madame Khulood, the 53-year-old self-proclaimed seer who favors black velvet head scarves and white sandals over black socks, that translates into a simple but ostensibly sustainable living.
Though she makes house calls to the sick and elderly, Madame Khulood conducts most of her business inside a battered central Baghdad tenement building where cables and wires run haphazardly in every direction. Clients are directed to a sitting room in a modest second-floor apartment with blinding white walls and a large picture window.
She explained that a customer pays between 30,000 and 50,000 Iraqi dinars -- $23.50 to $39.25 -- on average for a session, which customarily lasts 30 minutes to an hour. These visits often include a strong dose of Turkish coffee served in a tiny ceramic cup, along with caramelized tangerines sprinkled with cinnamon. An appointment is required, and all new clients must have a recommendation from an established and trusted customer.
During good weeks, the Madame explained, she can see two customers a day. The bad times, however, can mean weeks without a single paying client, she said.
Not too far away, Sabbah Mohammed, 39, and his brother Ali, 21, run a much slicker and presumably more profitable business.
The brothers Mohammed operate two shops in a commercially vibrant district in central Baghdad where they sell stones, rings, chains, and beads that allegedly possess the ability do everything from stopping bleeding or curing jaundice to controlling a nemesis or defeating a rival.
The cost of jewelry ranges from $25 -- for a ruby-colored stone set in a ring that is supposed to alleviate anger -- to $2,500 for a so-called Yemeni stone that its owners assert will cure nearly any ailment.
If it's the personal touch you prefer, Ali and Sabbah charge up to 1 million Iraqi dinars -- about $780 -- to advise clients. A simple, one-time consultation costs about $31, a significant amount for the average Iraqi.
The brothers' business was bustling one recent afternoon.
A bespectacled, middle-age Iraqi man in a leather jacket sat on a cushioned bench and looked on inquisitively as Sabbah Mohammed fired off questions and, with each response, scribbled a series of seemingly unintelligible signs across a white sheet of paper.
"You spend money too carelessly," Sabbah Mohammed said after pausing a moment to study his conclusions.
"It's true," the man said solemnly to a group of spectators.
"But you will come into a large sum of money soon, and you and your family will get visas to travel away from the country," Sabbah Mohammed proclaimed.
"Yes," the man said earnestly, "God willing."
Roweda Jaleel, 26, and her 25-year-old sister, Zaineb, were leaning against a glass counter as Ali Mohammed prepared a reading of their futures.
"I ask him all of the time about marriage and my livelihood," said Roweda Jaleel, referring to her prospects for a husband and employment.
Unhindered by government oversight, the new fortunetellers of Iraq claim to possess paranormal powers but are cautious not to overstep their bounds. After all, they are aware this society is increasingly gripped by religious fervency and they might go too far.
For instance, Madame Khulood emphasized that she relies on the Quran and her faith to enhance and facilitate her clairvoyance. And Ali Mohammed said he cannot help his clients avoid any specific terrorist attacks because he is not capable of predicting when a person will die.
"That," he explained reverently, "only God can see."