One Man’s Death Points to Shortcomings in Morocco’s Mental Health Infrastructure

By Molly Mulroy

This article was published in Global Health Hub on February 7, 2017. Find it HERE

RABAT-SALÉ, MOROCCO – An orderly walks through the newly-built ward of the Ar Razi Hospital. Ar Razi is the only hospital in the country that offers services and facilities in mental health for the elderly, adolescents, and children. Developments in psychiatric health come at a critical time for Morocco, which only has an estimated one psychiatrist available per 100,000 Moroccans. Photo by Viviane Feldman.

CASABLANCA, Morocco — When Driss Joundy helped check his father into Casablanca’s Notre Dame Polyclinic, it was only to get a respite from the psychological problems that made it difficult for the older man to sleep. He didn’t know the horror that awaited.

The next morning, Driss was notified that his father, 77-year-old architect Rachid Joundy, had burned to death in an overnight fire in his room. Worse yet, he had been tied to his bed.

Morocco is far ahead of many countries in North Africa and the Middle East when it comes to mental health policy. Its first law on mental health dates from 1959, and patients have access to free-of-charge medications, consultations and hospital admissions. In contrast, Tunisia didn’t have a mental health policy until 1990, according to the World Health Organization, and Jordan developed its first mental health action plan only in 2008.

But Morocco still struggles with a shortage of psychiatrists, and experts say the rules are poorly enforced. Lawyers for Joundy’s family say the Notre Dame’s psychiatric unit had not been authorized by the Ministry of Health. Family members say an investigation after the fire in November 2015 found that the clinic lacked fire doors, smoke detectors and extinguishers.

They sued, and in summer a civil court found the clinic, its head doctor and the nurse on duty that night responsible for Rachid Joundy’s death. It ordered them to pay about $15,000 each to his wife, daughter and son, and about $3,000 each to the dead man’s siblings. 

The insurance company responsible for paying up is appealing. But Joundy’s family says it won’t be satisfied, even if the appeal is rejected. Family members also hope to see clinic owner Brahim Benbrahim lose his license, and face criminal charges. 

“We are fighting now …so this tragedy serves as an example for others,” said Joundy’s 30-year-old daughter Lamia. The best case scenario, she said, would be “that the clinic will not open again — not with this owner.”

Leila Slassi, a lawyer for the family said Benbrahim, previously Notre Dame’s head doctor, bought the clinic in 2015 and created the psychiatric unit.

“[It] has a psychiatric unit,” said Slassi, “with no authorization from the Ministry of Health.” 

Morocco’s minister of health, Houcine El Ouardi, says mental health is a top priority. But experts say regulations are poorly enforced. 

CASABLANCA, MOROCCO – Driss Joundy, 43, is the son of Rachid Joundy, an architect who was killed in a mental health clinic in 2015. Here, Driss describes the way his father was attached by his wrists and ankles. Photo by Viviane Feldman.

“I don’t think they do it. I don’t think anyone does it,” said Dr. Jallal Toufiq, a psychiatrist and director of the Ar Razi Psychiatric Hospital in Salé, Morocco. “Human beings tend to have good intentions, but they need also to be closely monitored. They need to know that you’re on their back in order to do a good job.”

Notre Dame is a large gray building on a street lined with other gray buildings in the largely commercial Sidi Blyout neighborhood. A former patient said it was organized in dormitory style with several rooms per floor, and that it was strictly run. 

Joundy often struggled mentally during the winter, said his nephew, Hicham Bensari, 39. “Usually, it was manifested by the fact that he couldn’t get sleep.”

He was advised to admit himself to a clinic to get some better rest, and Bensari said he chose Notre Dame because it wasn’t particularly expensive. But no one expected him to be tied to his bed. That is not allowed without a doctor’s order, and Joundy’s regular doctor testified at the trial that he had given no such order. 

His death has left Joundy’s wife of 48 years, Assia, and son Driss in the family apartment surrounded by family photos, and the broader family determined not to let others suffer the same kind of tragedy.

“That’s my husband,” Assia, says, cradling a portrait.  “It was a marriage of love.” 

RABAT-SALÉ, MOROCCO – Dr. Jallal Toufiq is the director of the Ar Razi University Psychiatric Hospital in Salé, Morocco. Despite the Ministry of Health’s attempts at reform, mental health illness in Morocco is still largely stigmatized. Photo by Viviane Feldman.
CASABLANCA, MOROCCO – Rachid Joundy, 77, was admitted for chronic insomnia to a private psychiatric clinic in downtown Casablanca on November 7, 2015. The following day his body was discovered by nurses. He had burned alive overnight, due to an alleged accidental fire. An autopsy reported he had been attached by his wrists and ankles. Joundy is survived by his wife and two children, who are attempting to seek justice in the Moroccan court system. The clinic, Notre Dame, is one of the several unauthorized facilities around Morocco that function outside of governmental health standards. Morocco continues to lag behind in mental health developments despite recent efforts by the Ministry of Health to fight stigmatization and increase public awareness. Photo by Viviane Feldman.

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