Autism in Iraq

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Despite medical advances in diagnosing autism, the condition’s indecipherability makes it the black box of neurological, developmental disorders. It discriminates against no one, impacting an estimated one percent of the global population, including Arab countries reeling from the whiplash of economic malaise and war.

Nineteen years ago in Iraq, with the onset of the US occupation, institutional care – the backbone of Iraq’s health system — shattered.

Stunted, unrecovered and operating on a shoestring budget, practitioners lack the tools and clinical expertise to challenge the stereotypes mischaracterising Iraq’s autistic community of 72,000.

The ballpark figure is backed by research from the Baghdad University centre for education and psychological research. But Sheyma Ghassan al-Hashimi — mother to two autistic children — contends that the true figure could be as high as 150,000. Like other Iraqis, she believes that the spike in autism is associated with the observed increase of toxic environmental pollutants in post-occupation Iraq.

Dozens of privately-funded specialist care facilities exist, from Baghdad to the Kurdish Region of Iraq (KRI), with the exception of a single government-funded clinic in the capital.

Another taboo-fuelled practice has seen children with learning difficulties grounded inside their homes indefinitely — out of sight. Sheyma underlined that the practice is not exclusively practised by educationally deprived communities, adding that “affluent families, even physicians, are known for it.”

“Some families fail to understand that autism is not a problem in need of fixing. Still, I don’t blame them; they are without support.”

However, she was less forgiving of doctors fuelling drug dependency, due to their failure to caution families of the risks associated with risperidone. In an effort to prevent others from falling prey to profiteering hustlers, Sheyma and her husband launched Autistic Iraq, an Arab-language Instagram page documenting their journey, sharing tips and experiences, and challenging popular myths.

The content centres around Aya and Mohammed’s struggles and creative talents. Since going live in April 2020, the page has amassed a following of 20,000, beyond Iraq, in Oman, Jordan, the Emirates, and Saudi Arabia.

For the International Day of Disabled Persons, Sheyma said that the carers and families of autistic children had been invited by the state to attend “tokenistic festivities.”

“And you know what they gave us... a pack of crayons,” she said laughing in disbelief, while rhetorically asking “what else has the state provided?” Her extensive efforts to lobby the government — Iraqi premier, Mustafa al-Kadhimi in particular — urging him to establish a non-profit care centre, amounted to very little.

Commenting on his own experience as a father to an autistic adult, UK-based doctor, Ihsan Tarzi, said that “in Iraq giving birth to an autistic child is a serious affliction,” arguing that conventional wisdom denigrates the community as “mentally challenged and ret*d”.

Dr N added that neurological disorders did not feature in the medical syllabus at the Baghdad-based college of medicine from which she and Dr Tarzi graduated in the late 80s.

Autism was either the pink elephant in the room, or the only topic of conversation, Dr N said, underscoring society’s misplaced emphasis on prescription drugs and surgery to “cure” the condition.

The other fear she spoke of was Fatima’s inability to comprehend and observe religious rituals in a conservative society, and the inevitable risk of sexual harassment. “I decided that I needed to remove her from this environment to secure her future.”

Founder of the Mesopotamian-inspired, graphic novel, The Epics of Enkidu, Kuwait-based, Iraqi writer and comic artist, Ahmed al-Amin, decided that the protagonist of his work would be a neurodiverse individual. His autistic nephew was his muse, whose unmistakable sui generis inspired the novel. “His brain works so fast that the world around him looks so slow, and that’s why he acts differently,” Amin explained.

Despite the lack of care available in Iraq, Amin commended the resilience of the Baghdad-based, Al-Duha Centre for Speech and Development, which by some unexplainable miracle was able to restitute itself after its survival was threatened by the pandemic.

Aspiring paediatricians and students at the University of Dohuk, specialising in neurodisability told The New Arab that undiagnosed children are misplaced in mainstream schools, and subjected to discriminatory practices and bullying by peers and staff.

In more extreme cases, families mistreated autism as demonic possession, leading them into the hands of unqualified soothsayers and clerics, whose unorthodox methods are tantamount to child abuse.