damage to the infrastructure: health care
visit to a psychiatric hospital [excerpt]
Berta Joubert, M.D.
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In some cases, particularly when the patient is extremely depressed, agitated, or violent, the doctors resort to electroconvulsive therapy, which they have to administer in a very primitive way, without the drugs needed to counter the violent convulsions. Regardless of one’s position on the use of ECT, the fact remains that it is still a form of therapy available in most countries. A general protocol exists to administer it in order to reap maximum benefits with the least amount of discomfort for the patient. The basis for its use is that it has produced significant improvement in patients with various severe mental symptoms—in particular, profound depression. Most often it is used when medications are not advisable. Part of the protocol is premedication first, with a short-acting anesthetic to sedate the patient, and then a muscle relaxant to prevent any violent convulsion and therefore a concomitant fracture. Oxygen is also administered, since the relaxant suppresses normal respiratory movement.
It is hard to fathom how ECT can be administered under the current situation in Iraq. The premedication or oxygen is often not available. Only an old-model ECT machine was available at the Ibn Rashid Hospital, and the physicians had to do their best. They have to weigh the psychological pain suffered by the patients against the consequences of the lack of premedications, which can be the pain of a fracture or the agonizing sensation that they cannot breathe.
One psychiatrist told me that sometimes, when the patient’s relatives see their loved ones undergoing this treatment, they take them home. It is difficult to imagine the psychological pain these patients and their relatives go through. Patients with mental illnesses can be very vulnerable to other forces if they are not treated. Depending on the illness, they can become very careless and neglect their personal hygiene, health, and nutrition. Under the current conditions in Iraq, this neglect can be very dangerous for the overall health of the patient.
excerpt from CHALLENGE TO GENOCIDE
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