Remember ME - You Me and Dementia

April 11, 2012

SAUDI ARABIA: The stigma of mental health

JEDDAH, Saudi Arabia / Arab News / Life & Style / April 11, 2012

‘Zelal’ A film by Marianne Khoury & Mustapha Hasnaoui

By Lisa Kaaki

Cairo based, Marianne Khoury is a filmmaker and a woman, and that comes at a price. But Marianne is obsessive and passionate about her work. Her late uncle, Youssef Chahine, even said she was “crazy,” but he meant it in the creative sense.
Although her father was a film distributor and her uncle was one of the most famous Egyptian film directors, Marianne did not enter the film industry straight away. She first studied economics at the American University in Cairo, then at Oxford. She even worked in a bank. However, after two years, she finally acknowledged that the cinema world was indeed embedded in her genes.
In 1982, her uncle named her executive producer of “Goodbye Bonaparte,” and she became one of his closest collaborators for more than 20 years. But Marianne, unlike her uncle who made mainly movies, prefers documentaries. She directed “The Times of Laura,” released in 1999, followed by “Women Who Loved Cinema” in 2002. Both films won critical recognition.
Screenshot from the movie Zelal. 

Behind her infectious smile and good humor, Marianne Khoury nurtures a passion for controversial issues, particularly marginalization and social exclusion. She vows a marked preference for character-driven movies and admits that her desire to know more about mental illnesses was the reason behind “Zelal” (Shadows), one of the very first Arab docudramas about the secluded life inside two of Cairo’s mental hospitals, El Khanka and Abbaseya.
The film opens with a distraught father accompanying his mentally disturbed son to the hospital’s outpatient clinic. The father breaks down when the psychiatrist asks him if his son is a policeman. He replies that his son used to be a policeman, choking with grief over what his son has become. The scene showing the father talking about his son’s behavior, caused by schizophrenia, is heart wrenching. This middle-aged father who still cannot come to terms with his son’s mental illness is not alone.
In the Middle East, as in other countries across the world, there is a constant refusal to admit to the presence of a mental health problem and to search for a treatment. It is relatively rare for Gulf nationals to be treated in their home country. The stigma associated with mental health remains so strong that even when a patient’s mental illness has been duly recognized, the family will request that the treatment is provided abroad and not in the patient’s home country.
The stigmatization of mental health in the Middle East constitutes a huge and enduring obstacle to receiving a proper treatment. It has been estimated that at least 60 percent of the population in the Middle East suffers from mental problems; however, most of the people suffering from mental illness feel too ashamed to seek medical help.
If there is a tendency in the Middle East to equate mental disorder with insanity, Marianne Khoury likes to recall that during the Middle Ages, a time when the mentally ill in the West were treated with extreme cruelty, the Arabs were far more tolerant. They even gave individual treatments according to the type of mental disorder.
Mental hospitals were first built in the Levant and in Egypt. In the ninth and 10th century, El Razi and Avicenna were the first to write about mental illnesses and to diagnose “insanity” as a disease of the mind or the brain that alters its functions.
Moreover, during the 14th century, the Qalaoon Hospital in Cairo was reputed for its mental illness ward. This hospital treated poor people who suffered from mental illness and were rarely isolated from the rest of the patients. However, in the following centuries, there was a gradual backslide in the care of the mentally ill.
For the very first time, cameras film the way of life inside Abbaseya and El Khanka. The viewer is literally faced for 90 minutes with patients, first seen in the daily clinic, then inside the hospital and finally outside. Zelal gives a voice to all the men and women of all ages that society never hears, because they are silenced within the hidden walls of mental institutions.
The docudrama, winner of FIPRESCI/Best Documentary, should be viewed by all health professionals and medical students throughout the Middle East as well as the public at large.
Family, friends and society still play an important role in stigmatizing mental illness. Zelal launches a strong appeal for more tolerance. Mental illness should be treated just like any other illness; instead of fearing or even trying to hide it, one should face up the challenge of finding the appropriate treatment. A number of mental illnesses can be cured if they are treated properly and in time.
At a recent showing of Zelal at the American University in Cairo, Marianne Khoury raised the hope that this film would create a better understanding of mental illness and also bring about positive changes in the way it is perceived and treated. The time is long due to break the stigma, which still seals the fate of millions of mental health patients around the world. 
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