Imam Jamal Eloubra is troubled.
For 15 years he has provided
religious and spiritual guidance for his community at the mosque he manages in
the Beduin city of Rahat.
Just over a month ago, however, he embarked on
a course aimed at tackling the stigma attached to mental health disabilities in
Arab society and providing Muslim religious leaders with the tools to raise
awareness and offer practical medical advice to their communities.
be honest, in 15 years of being an imam, I have no idea if I ever dealt with a
mentally ill person,” admits Eloubra, a trained engineer who dons traditional
Beduin garb and a wide smile. “It’s a subject that is just not talked about in
my community. But now, after being part of this course, I’m going over in my
mind all the people that came to me for help in the past and wondering if they
were really sick and needed medical attention.”
We are in the Othman Ben
Affan mosque in Kafr Bara (not far from Rosh Ha’ayin) and Eloubra is among 25
Muslim religious leaders taking part in this six week course, run by the
American-Jewish Joint Distribution Committee’s Masira (journey) program, with
support from the Interior Ministry’s Department for Religious Communities, the
Health Ministry and the Tauber Foundation.
“After hearing some of this
information, I’m beginning to think that almost everyone in my town is mentally
ill,” jokes Eloubra, quickly turning serious again. “Our job as an imam is not
only to stand before our people in the mosque, but it is also for us to know how
to help all our community.”
This topic is especially acute, points out
Eloubra, “because most people in the Arab community are too ashamed to deal with
it at all. They are afraid to come forward and ask for help.”
course, which was proceeded by a similar one focusing on people with physical
disabilities and is part of Masira’s general outreach to people with
disabilities in Arab society here, is still being met with measured resistance
from community members who believe it’s just too complicated an issue to deal
“It’s a very taboo subject,” explains Soud Diab, of the Division
for Disability and Rehabilitation at JDCIsrael, who oversees the course. “We are
really going far in challenging attitudes and trying to change people’s
“When we ran the last course on physical disabilities, it was
much easier to get people interested in making a change, because we talked about
the charitable side of working with the disabled. With mental illness it’s
different, it’s not easy for people to accept; they have their ideology and it
this is really breaking their myths.
“Even today I’m still getting people
who are telling me not to deal with this subject,” says Diab, who claims she is
spurred to continue with the project because “I’ve met so many individuals who
suffer from this disability and there are almost no materials in Arabic, no
services in Arab villages and no help for the individuals or their families.
It’s really tough for them.”
Luckily, for Diab and the other JDC
organizers, their struggle for recognition has been encouraged by the support of
Dr. Ziad Abu Moch, the Interior Ministry’s director of Muslim affairs, who
describes this program as revolutionary in the Islamic community here and in the
Arab world in general.
“Arab society is afraid to deal with mental
illness; it is something that is hidden and there is a real lack of awareness
and confusion about this topic,” says Abu Moch, who is responsible for some 320
statesalaried imams that head mosques across the country.
success with the previous program for people with physical disabilities, we felt
that we had a responsibility to run a similar course about mental health
disabilities. At first we debated whether we should do it because we know this
is a very deep issue, but we realized that we do not have the right to neglect
one whole group of people.”
He says that the main barrier to
understanding mental illness is the Islamic belief in jinni – spirits from
another world who can sometimes be good, but most often are bad and are likely
to wreak havoc if left unchallenged.
“There is a lot of confusion on this
issue,” Abu Moch explains. “In Islam we believe in jinni; they are written about
in the Koran, and often people see mental illness as being caused by a jinn but
it is a scientific or medical condition that can be dealt with by
In this case, he theorizes, the Koran dictates that if a
person suffering from a medical disorder – this includes mental illnesses such
as schizophrenia, bipolar disorder or depression – he “must” seek
“Mental health disabilities are a disorder in the brain and
therefore people suffering from them must be treated by a doctor,” he says,
adding quickly, “it is fine for an imam to read sections of the Koran to help
the sick person spiritually, but this has to be done in conjunction with
providing medication too.”
During the 40-hour course, which has included
a lecture from a Muslim psychiatrist on how mental illness fits with Islamic
philosophy and a session on understanding the country’s mental health disability
laws, state benefits and rights, the imams are encouraged to research Islamic
texts, including the Koran and the Hadith to find references to mental illness
and come up with practical solutions to problems such as what is the definition
of a mentally ill person, can people with mental health disabilities get married
or how to deal with post-partum depression in new mothers.
“An imam is
the key person in Muslim society,” explains Abu Moch. “He is a person who has
won a place to be influential in his community and the people around him see the
imam as a very important person; he is both a religious and social leader... he
is the person that will be able to raise awareness to this issue and bring a
better understanding of this subject, which almost no one talks
WHILE IT is still too early to assess how influential this course
will be, it is clear that after only a few sessions the religious leaders who
gather here each week are talking about mental illness and taking it very
Even with this measured success, however, both Diab and Abu
Moch are bitterly aware that the challenges lie far beyond religion. The two
point out that almost no statistics exist to suggest how many Arabs suffer from
mental illness and both say that services to help those who are so clearly
hidden are even scarcer.
According to Avital Sandler-Loeff, area head of
the Division for Disability and Rehabilitation at JDC-Israel, who runs the
entire Masira project, even though the Law for Mental Health Rehabilitation was
passed a decade ago and provides some “very advanced” services, only very few
Arabs come forward to claim their rights.
They are put off by religious
concerns and cultural fears that doing so will bring shame to their family’s
honor. They prefer to keep quiet about relatives with mental health
disabilities, she says.
Sandler-Loeff’s observations are backed up by a
study on adults with disabilities carried out last year by the
Among its findings were that onethird of
those receiving disability allowances from the National Insurance Institute
suffer from mental illnesses, but very few of those claiming benefits are from
Arab towns or neighborhoods.
In addition, while 66 percent of those
hospitalized in psychiatric wards each year were from Jewish neighborhoods, only
8% were Arabs and of those receiving outpatient treatment, 70% were Jews and
only 2% were Arabs.
The report also revealed that of those receiving
treatment in government- run mental health clinics 7% were Arabs while 67% were
Sandler-Loeff is quick to comment that lack of mental health
services in Arab neighborhoods, towns and villages, as well as limited
accessibility to information in Arabic plays a part explaining these figures,
but mostly she says it’s due to lack of awareness.
She says that if there
is more demand, the services will be created according to the law. Masira’s next
project is to create a center in Tira that will provide the population with
mental health services and treatments.
ON THE day I visit the course, the
imams are receiving a lecture from Dr. Khaled Abu Asbah, director of the
Masar Institute for Research Planning and Social Consulting. He is working with
them on how to put what they have learned so far into practical use and
encouraging them to create projects that will reach out to those suffering from
mental health disabilities.
He is also giving advice on how to find
appropriate government services for those with disabilities.
who recently completed a book on attitudes toward mental health issues in the
Arab world, says that “in general there is very little recognition of mental
illness, even though the richer states in the Gulf are starting to take an
interest. Poorer countries such as Egypt, Jordan, Morocco and in the Arab
community here are not aware of the problems at all.
“My role here is to
give [the imams] the tools so they can help those in their communities who
suffer from mental illness. They need to know what the rights are for the
disabled, especially to let the families know they will not lose any of their
social welfare benefits. I will also help the imams understand how Shari’a law,
the Hadith and the Koran all fit in with this topic.”
Lod Imam Adel
Elfar, however, is not convinced. “I still have no idea how to identify mental
illness,” exclaims the 44-year-old father of seven, who is dressed more like a
businessman. “I’m just not sure exactly what it is and I certainly don’t feel
ready to tackle it in my community.”
Elfar says that Lod, which has made
headlines recently for a spate of socalled honor killings and other violent
crimes, lacks the services to properly treat people with mental illnesses, even
if there were those brave enough to come forward and ask for help.
is a lot of violence in our community and I know that people are traumatized,”
he says. “I want to help them but I just don’t know how.
lacking the proper tools and right now I can only provide them support in a
“I am starting to think, however, about all those people
who have come to me in the past or those that society has labeled as ‘crazy’ and
wondering if they were really suffering from mental health disabilities. I know
this course has been helpful, but now I feel I like I have more questions than
answers... I will just have to spend more time reading and learning about this