Talking it through: Zimbabwean children who have lost their parents to Aids at a trauma counselling course in the school holidays, 2004. (Photo: Getty)
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Talking cure: Vikram Patel on The Life Scientific

Jim Al-Khalili spoke to the leading psychiatrist about treating depression in Zimbabwe, yet had to shoehorn in some clunky biographical details.

The Life Scientific
Radio 4

In The Life Scientific (Tuesdays, 9am), presenter Jim Al-Khalili talked to the pioneering psychiatrist Vikram Patel about the kinds of depression and psychosis suffered in developing countries compared to those in the west. Patel contends that they are the same. He estimates that 10 per cent of the global population – whether they live in a tin hut or a waterfront condo – will suffer from depression at some point and might benefit from the talking cure or medical intervention.

Of the 150,000 psychiatrists potentially needed in India (population 1.2 billion), only 4,000 are currently employed there. When Patel went to Zimbabwe, there were nine psychiatrists for ten million people. He trained local lay counsellors, encouraging them to work alongside traditional faith healers, who recognised depression as a form of distress called “thinking too much”. Was Patel just pushing the medicalisation of an already pragmatically accepted social condition? It didn’t sound like it. He said the same thing in a hundred different ways: “No matter where you are, depression responds to the same treatment.”

Given the potency of the subject, it was perhaps no surprise that each inquiry from Al-Khalili was overstuffed. It’s a Radio 4 idiom – the information-packed phrase posing as a question. Kirsty Young has to do it all the time on Desert Island Discs, sometimes condensing her guest’s crises in not one but several marriages into the few seconds leading up to asking about the fourth choice of song, while trying to sound not remotely engulfed by the biographical maelstrom.

At least she seems to do it when her subject is in the same room. When Al-Khalili abruptly announced, “Then you came over to study in Oxford as a Rhodes scholar, Vikram Patel, after which you spent several years in London training in psychiatry, but in the summer of 1993, you boarded a flight from Heathrow bound for Harare in Zimbabwe; what drew you there?” it sounded like the whole thing had been plopped-in later – by the producer, perhaps even pretending to be Jim in the edit. It was one of a few jagged moments that sent an ex­ceptional conversation into the realms of the abstract.

Antonia Quirke is an author and journalist. She is a presenter on The Film Programme and Pick of the Week (Radio 4) and Film 2015 and The One Show (BBC 1). She writes a column on radio for the New Statesman.

This article first appeared in the 12 March 2014 issue of the New Statesman, 4 years of austerity

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Inside Syria's unending siege, civilians, not soldiers, are the victims

In Aleppo, civilian strife is just another tool of war.

Maria is a young mother who lives in Aleppo. She missed her opportunity to flee when the Syrian-Turkish border was closed to all but the seriously injured in early 2015. With her two children – Fadi, aged five, and Sama, aged nine – she stayed in the city.

Maria’s husband was killed by a barrel bomb that fell on their neighbourhood in 2014. After that, she took the children and moved in with her husband’s family. Her married brother-in-law asked her to be his second wife. She accepted the offer for the sake of security. This year he, too, was killed when a bomb fell on his shop.

Speaking to her on Skype, I referred to Aleppo as a city under siege and she quickly corrected me. “The city is not under siege,” she said. “We are human beings under siege.” Maria clearly felt offended by my words. She moved the conversation on to the images of a young Syrian boy, sitting in an ambulance, which have appeared on newspaper front pages around the world – a symbol of the human suffering in Aleppo. “What can I say? His silence and shock reflected all the pain of Syrians.”

Tearfully, she described her living conditions. “There are two widows, with three children, who live all together with our old mother-in-law. The good people around us try to give us food and clothing.”

She added: “Before, I used to cook a big meal for me and my family-in-law every day. My late husband was well off.” The children don’t go to school but they get some lessons at home – Maria used to work as an Arabic language teacher at a high school in the city.

The household’s other widow, Safaa, joined our conversation. “Since the first day of Eid ul-Fitr [the festival that marks the end of Ramadan, this year on 6 July], the siege began in Aleppo. There was no food or water. Children cried and could not sleep because of hunger.”

Safaa made food from pulses that she had managed to save, particularly lentils. As the area around the city is rich in olives and well known for producing za’atar herbs, the extended family depended on reserves of these for nutrition. “Al-za’atar al-akhdar [a dish of the herb, olive oil and a few other basic ingredients] has saved the reputation of Aleppo and its people,” Safaa joked, and both women laughed.

Then, suddenly, the Skype connection was lost and they both disappeared.

Another Aleppo native to whom I spoke, Ayham, described his desperation as he finished his engineering degree before fleeing Syria. “I am my mother’s only son, so I didn’t want to do military service, and I left, as I felt so insecure,” he told me. He had been living in Shahbaa, a neighbourhood controlled by Bashar al-Assad’s regime, while completing one application after another to study abroad. Eventually he was successful and he has now made it to a university in Europe.

Ayham’s parents were pushing him to leave because they knew that he was part of an underground anti-Assad protest movement. “There are two Aleppos,” he explained. “One is free and the other is controlled by Assad’s regime. Both are very unsafe . . . Living hungry was easier than living under threat.”

There are roughly two million people in the city, most of them women and children. Since the second day of the siege, there have been no fruit or vegetables available and only a few bakeries are producing bread. Compounding the starvation, the bombing has been intense, hitting hospitals, ambulances, blood banks and the Syrian Civil Defence base. Assad’s regime is targeting vital resources for civilians.
Even after rebel forces, in co-operation with the Islamist faction Jaish al-Fateh, managed partly to break the siege and open a new road into the south of the city through the Ramoussa area, they could not bring in enough food. The little that made it inside immediately sent prices soaring. Civilians could not use this road to escape – jets were targeting the routes in and out.

The eastern areas of Aleppo, which are still under the opposition’s control, are also still without aid, because of how risky it is to get there. All the talk coming out of the city today is about decisive battles between Assad’s forces and the rebels in the southern quarters. Civilians put the recent air strikes down to these conflicts – it has long been believed that when the regime loses ground, it intensifies its bombing as revenge, and to send a message to those who continue to resist.

People in Aleppo and the north-eastern territories of Syria are suffering and dying. They have no other choice. It seems that both Isis and the Assad regime are trying as hard as they can to destroy Syrian civilians, whether through direct attacks or by gradual starvation.

There is little information available, as both sides attempt to prevent the media from documenting life under siege. Isis accuses journalists of being agents of Assad, while the regime portrays reporters as terrorists. Pro-Assad social media accounts have alleged that Mahmoud Raslan, who took the footage of the boy in the ambulance, has links with terrorism. The same channels have yet to say much about Raslan’s subject – Omran Daqneesh, the five-year-old whom he showed, bloodied and stunned, after the boy was pulled from the rubble caused by multiple air strikes. Omran’s ten-year-old brother, Ali, has since died from injuries sustained in another attack.

After four hours, I heard back from Maria. She apologised for losing the connection and asked me not to worry about her. “All of us are fine. We did not die yet,” she said. Her daughter, Sama, has not been to school since last year, she told me, and now studies only Arabic poetry. They have no books, so she depends on the verses that Maria knows by heart. Sama misses her school and her friends, and though she remembers their faces she has forgotten their names.

Maria has made a doll for her out of scraps of fabric and they call it Salwa. Together, they sing Syrian folk songs for the doll, in particular one that goes: “Hey Salwa, why are you crying? I need a friend.” Maria is resigned. As she says, “We are back in the Stone Age.” 

K S is a Syrian journalist, based in Sweden since 2014

This article first appeared in the 25 August 2016 issue of the New Statesman, Cameron: the legacy of a loser