The true meaning of asylum by Barbara Nadel

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Sad news from İstanbul. The old sanatorium on the island of Heybeliada burnt down last Sunday. Heybeliada is the second largest of the Princes Islands which are a group of green and pleasant islands in the Sea of Marmara, south of İstanbul. The old sanatorium or the ‘tuberculosis hospital’ as it was known was a famous local landmark and, despite being empty and unused for several years, was still thought of with affection by ex-patients and local people. There were very good reasons for this.

As some of you will know, I worked in a hospital myself for many years. My hospital was a psychiatric institution and like Heybeliada, it was old. When I worked there it was designated for closure and many of our patients were in the process of being moved out into the community. Not all of them, especially the elderly people, always wanted to go. My hospital was run down and not even very comfortable when I was working there. But it had been so once and this was what the older patients remembered and why, in reality, they didn’t want to leave. Basically, at one time, a real therapeutic environment had been created, a true ‘asylum’ where those who were sick could take time and space to recover.

Under the directorship of a doctor called Tevfik İsmail Gokce, Heybeliada also became just such a beacon for those who suffered from tuberculosis and other afflictions of the lungs. Patients were provided with excellent food, plenty of fresh air, companionship and conversation as well as stimulating cultural activities like musical concerts and film shows. Artisans were even employed at one time to give those patients about to be discharged some practical skills and work experience. Life after hospital for those who had been diagnosed with tuberculosis was tough, just as it was and remains for those diagnosed with a mental health problem today.

Heaven forbid that we should return to the abuses that often existed within large institutions – particularly those designed for people with mental health problems. But I do believe that there is still a place for designated therapeutic environments where people may escape, for a while, the cut and thrust of everyday life. After all, to be sick is surely quite enough to cope with, without having to deal with employment hassles, domestic worries and the hell that can be modern life. I do believe that wherever possible patients should be cared for within the community and this is what most of them do want now, whatever their condition. But wouldn’t it be nice if there were some real, peaceful and therapeutic asylums out there for us when we feel we just can’t take any more? Places that would take you in, feed you, let you rest, stimulate your mind if you wanted and just give you some space?

Of course there are private facilities that provide just such a service but their fees put them out of the reach of most of us. The true meaning of asylum is a ‘place of safety’ and that is what Heybeliada and places like it were. So a sad passing but one which will not be forgotten. Because whatever may happen to a great hospital and all of its equipment and administrative apparatus, the one thing that remains for a long time afterwards are its patients. And they do remember and they make sure that the rest of us know about it too.

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