The only mental patient left behind at the high security ward of Al Rashad state hospital is a killer named Ali Sabah, a former math and science teacher with jet black hair and dark, searching eyes.
He is off his medications, the door to the ward is wide open and shards of glass lie everywhere as potential weapons. Yet on a recent day he was calm until this reporter made a few notes. "Why is he writing my name down?" he asked.
He stalks the looted corridors inside the 15-foot-high wall that once provided maximum security to restrain 120 patients who were committed for murder and rape while in the throes of mental disorder.
"I hate the world and the world hates me," he replied when asked why he stayed while the others ran. Then he added, "I don't want the monkey to see me and I don't want to see the monkey."
In another part of the hospital, the six women among the patients who were raped by looters are receiving special attention from the nursing staff. Some spend their days curled under blankets, others have ventured out to squat in the light where there are no chairs, but where cigarettes can be smoked. The nurses whisper that one rape victim is pregnant.
For the staff, there is also the sad loss of Hanna Fatah, who had been a patient here for 30 of her 70 years.
"When the marines opened the gates, Hanna wanted to leave," said Sultan A. Sultan, her psychiatrist. She had no ability to judge the danger and while wandering somewhere near the gate, she was killed by a bullet that struck her forehead.
One of the tragedies of the war -- a preventable tragedy in the view of many doctors and nurses -- occurred here. Iraq's only hospital providing long-term care for chronic schizophrenia and other serious disorders, Al Rashad was all but destroyed.
When American marines clashed with Saddam Hussein's irregulars trying to block their advance into Baghdad, the marines came through the gates here and knocked down the walls with their tanks. They set up a command post in the nursing school.
Waves of looters came in with them, staff members said.
One of the oldest health institutions in Iraq, Al Rashad has long been designated a civilian hospital. The director, Amir Abou Heelo, told the Marine commander on April 8 that he was entering a psychiatric facility, staff doctors said in interviews. But the protest did little good.
"I am disappointed," said Dr. Raghad Sursan, a psychiatrist. "I am mad, and if there is a word that is bigger than mad, I am that, because the marines were there and could have done something to stop it."
The looters stripped everything once, then waited a week for repairs to be made to doors and windows and came back and stripped the place again, they said.
Of the more than 1,400 Iraqis institutionalized here at the beginning of the year, 300 remain. The staff has been able to cope only because the Geneva-based International Committee of the Red Cross, having adopted this facility three years ago, raced emergency food and medical supplies here as Baghdad was falling.
The complaint of the Iraqi psychiatric staff is that the marines stood by as looters carried away every bed, basin, cooker, air-conditioner, piece of furniture or thing of value.
The marines broke the door down on the maximum security wing, and in no time the patients were gone, untethered from the antipsychotic drugs that stabilized many of them.
One doctor said he was told by a Marine officer that the officer was there to "liberate and then leave."
"This is the Iraqi version of de-institutionalization," said Dr. Sursan, alluding to the mass de-institutionalization of mental patients in the United States during the 1970's.
The Red Cross spent $1.5 million over the last three years bringing the facility up almost to Western standards for compassionate care to the mentally ill, said Olaf Rosset, the Norwegian physician who has overseen the project from the beginning. Ghastly and putrid wards were modernized, open sewers were closed, kitchens were rebuilt and, Dr. Rosset said, the warehousing of patients gave way to a much more humane approach of outdoor activities, picnics, poetry and art contests.... ***** -- Yoshie
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