Working at the psychiatric hospital in Sale is difficult to describe in part because there were so many different entities and organizations involved. As I’ve previously described, the details and arrangements of my traveling were made by UBELONG, a US-based social enterprise that connects volunteers with boots-on-the-ground non-profits globally. However, once I arrived in Morocco, my host family and project placement was organized by Thaqafat, a Moroccan NGO that fosters cross-cultural exchange.
Still with me?
Here's where things start to get tricky.
Thaqafat, helped place me in the psychiatric hospital project through the non-profit organization, L’Association SILA. Founded in 2010, SILA is a non-profit association that aims to advocate for the rights of people with mental disabilities by ameliorating the living conditions of patients, improving hospital stays and providing development and training opportunities for hospital staff.
Since its inception, SILA has completed several projects:
Redevelopment of clinic restrooms
Organization and facilitation of workshops for patients (e.g., plastic arts, baking, storytelling and pottery)
Organization of yoga sessions for hospital staff
Construction and development of a center for physical therapy
Creation of a center for adult day and geriatric psychiatry care
Organized by a board of directors and managed by a small staff, SILA operates at the frontlines of providing quality care, working within Hôpital Ar-Razi in Salé, Morocco.
Hôpital Ar-Razi
Hôpital Ar-Razi is the brick and mortar facility that I commuted to every day. Morocco’s largest and most well respected psychiatric hospital, it is also one of the leading psychiatric hospitals in all of Africa. Patients come from a variety of backgrounds and may include young autistic children, young adults recovering from substance use disorder, adults suffering from various mental health disorders and geriatric patients with dementia.
In 2012, Morocco’s Minister of Health announced that mental health care would be a priority under Morocco’s 2012-2016 National Health Action Plan. Currently, there are about 300 psychologists working in Morocco (a ratio of one psychologist per 100,000 people). Yet, mental health disorders represent the second leading cause of morbidity and mortality in developing countries (after non-communicable diseases). Despite major progress in identifying the need for mental health services, stigma and accessibility still limit opportunities for care.
The hospital led by Pr. Jalla Toufiq is comprised of 10 units:
Men’s unit: clinic and service
Women’s unit: clinic and service
Toxicology center
Pediopsychiatric center (for children under the age of 16)
Geriatric day center and adult aftercare center
Consultation center
Center for adolescents
University students also rotate through the units as part of their “stage” (internship) requirement. I frequently worked with students one or two weeks at a time. In fact, people often asked me if I was completing my “stage” at the hospital. Sometimes it was easier to respond yes than explain my unusual role as a volunteer.
Center for Geriatric Care
In 2013, L’Hôpital Ar-Razi, L’Association SILA and King Mohammed V inaugurated Morocco’s first center specializing in geriatric care. The center provides theory and evidence-based alternative care to patients during the weekdays. This alternative care model aims to provide a safe and stable environment where a diverse curriculum allows patients to socialize while learning occupational or cognitive skills.
This alternative care center is where I volunteered! It should be noted that this day center provides care for both geriatric patients with mental health problems and stable adults who have been diagnosed with a mental health disorder. Usually these two groups have separate programs that cater to their respective needs. Within each group, however, patients exhibit different needs. For example, most of the geriatric patients have varying degrees of dementia. However, there are some older adults who are very cognitively apt, but suffer from severe depression. There may also be patients who attend the center due to physical handicaps (Parkinson’s Disease, alogia, etc.) In the adult group, most patients have received a diagnosis of schizophrenia (paranoid, catatonic, disorganized), but some patients have bi-polar or anxiety disorders. Some of these patients have severe cognitive delays while others are very sharp. Adult patient age ranges from mid-twenties to mid-fifties while the geriatric patients are over 50.
Because the center accommodates a diverse range of patients, I had some liberty to design and coordinate activities. In my next post, I’ll discuss the program I developed, some of the pitfalls of having too much free reign, getting used to the Moroccan work ethic and what it was like to work with psychiatric patients in another language.