Between the realization that suicide is ‘haram’ (religiously forbidden), a lack of resources and the recognizable dark place which no light seems to be at the end of the tunnel – a clinically depressed Egyptian citizen has nowhere concrete to go to for help.
Zamalek is an affluent area in Cairo, with a reputed expat community and lush hotels thus vouching for the elevated lifestyle of its residents. Its most iconic feature? Doubtlessly, the Cairo Tower.
Earlier last month, between happy selfie-takers and individuals enjoying the night breeze on one the tallest structures of Cairo, a hooded figure was spotted casually looking around himself for a few minutes before seizing the opportunity to jump over the iron fencing of the tower’s rail to which he momentarily grips. A man lunges towards him, trying to capture the front of the hooded figure’s shirt but to no avail. The young man lets go of the railing – the only thing keeping him supported – into thin air.
In no more than mere seconds, Nader Mohamed Gameel has let go, and falls to his intended death.
He was 24 years old.
The video of this moment spread like wildfire across the internet in the following days. And Nader, whose cries for help were overlooked before, became the most trending topic on social media. The tragic incident gained even more momentum and attention due to the fact that it occurred at one of Cairo’s supposedly more ‘happiest’ and ‘attractive places’, the Cairo Tower, where couples and families often go to enjoy panoramic views of the Egyptian capital.
Nader’s suicide generated heated and polarized reactions across Egypt; it also reignited the conversation about mental health, its stigma, and most of all, the availability of treatment for those who are struggling.
Suicide in Egypt – a brief overview
According to the World Health Organization’s 2018 statistics, Egypt has one of the lowest suicide rates worldwide, with around 4 per 100,000.
It is due to its uncommon nature that whenever a case of suicide does occur, it quickly makes Egyptian headlines, with one the most common cases of suicide involving trains. This public decision can often be misunderstood or hard to grasp in a country where the topic is a societal taboo.
“Most of these suicides are a statement against an oppressive system, and the stories express a suffering that is of the collective, that is related to life circumstances out of the person’s hands,” explains Mona El-Shimi, a Cairo-based psychologist and drama practitioner, specializing in stress, anger and trauma management as well as non-violent communication. She highlights that the choice to carry it out publicly could also be based on impulse as opposed to planning.
But Nader was not the first person to commit suicide in a public space, yet, his case was furiously debated, a reality that El-Shimi believes is related to the fact that Nader, as a young, clever, and capable young man, had an unusual profile for suicide tendencies. Additionally, “his story represents many youth who depleted by mainstream education and not rewarded or given purpose in return.”
Last year, Egypt’s Cairo Metro Spokesman Ahmed Abdel Hady sparked controversy when he commented that the tracks were not suitable to psychologically distressed individuals with suicidal tendencies, highlighting the cavalier attitude often taken on the matter.
Moreover, given that committing suicide is considered a religious sin for the country’s Copts and Muslims, many families do not report suicide deaths as such, which makes it hard to be certain of the number of suicides per year in Egypt.
Suicide among young adults and high-school students is often attributed to pressures from achieving certain academic results in their final exams to navigating their first years into adulthood without supportive environments.
In the last few years, there has been a more concentrated focus on mental health issues. However, the reach of short-lived ‘online’ campaigns is relative and often goes unnoticed, while private services to treat severe psychological issues can be costly, with private therapy sessions costing between EGP 150 to EGP 1800 per session.
“There are some promising examples like the public clinic in Abaseya “El Waha” – and the public clinic in Qasr Eini. The same professional doctors who work there for negligible fees are established doctors with big names in their private practice,” says El-Shimi.
“Other public services are questionable and it’s really a matter of luck regarding the doctors, how ethical and professional they are, because there is no ethical board and not enough monitoring and evaluation.”
In the face of the suicide, various hotlines and numbers do spring up on social media, but many of these do not even work.
What are the existing ways to seek assistance for suicidal tendencies?
Despite being flashed everywhere, Befrienders’ hotline numbers 762 2381/ 762 1602/3, which are also listed on Suicide.org, do not work. This is also sometimes the case for 08008880700 which is the Ministry of Health and Population’s hotline for mental health and addiction support services.
However, one number that does work from the Ministry of Health is 0220816831. Upon calling, a person inquires about the nature of the mental health issue and directs the caller to the nearest mental health facility.
For example, when Egyptian Streets called the number as a test, the employee at the Ministry redirected us to the Abbasseya Mental Health hospital where a doctor could open a patient’s case for as little as EGP 1. All that is needed for the consultation is the national identification card. One can also call the hospital directly at 01154898506.
Nonetheless, despite the availability of some mental health assistance, it doesn’t seem that there is an immediate hotline a person can call immediately for assistance.
There are some online initiatives, of varying costs and types of services, that do provide help in Arabic and English.
Takestep is a website which enables users to book and pay for their sessions online prior to having the consultation on the phone. Whilst at Shezlong, a user is free to choose their therapist, pay online, and communicate with a therapist online.
In terms of information, Nafsy.net breaks down and informs users about the varying mental health disorders that exist, as well as providing explanations on medication, in Arabic.
This is also true for Mesh Lewa7dak (You’re not alone), an online initiative both on social media and on its own website, dedicated to lessening stigma on mental health issues and misconceptions.
In pure anonymity or, with the identity revealed, a user can also post their problems and difficulties online, in Arabic on Hellooha, on forums where a member would give advice but this is solution comes with its limitations as it is unclear whether those giving advice have received training or not.
Finally, an international website which can be considered in times of distress and which is managed by listeners and volunteers is 7cups.
Why suicide prevention specifically and the need for a hotline
Still, with more and more mental health issues coming to the surface, debates run deep about the best way to tackle a severely distressed individual in Egypt.
According to a 2018 report by the World Health Organization, titled ‘Preventing suicide: A resource for establishing a crisis line’, some of those who do harbor suicidal thoughts or inclinations lack caring connections, a feeling of belonging and may be victims of isolation.
Moreover, the report found that the majority of individuals who are at risk of taking their own lives avoid seeking help from face-to-face services, and even fail to share these ruminations with therapists.
“The confidential services offered by crisis lines may help overcome the barrier of stigma surrounding suicide and mental health problems that could prevent a person from seeking help in other ways. Consequently, crisis lines often engage with persons who are not otherwise receiving help for their suicidal thoughts, ” the report states.
Such stigma, heightened in Egypt’s overall strongly conservative currents, would make it even more difficult to find suicide prevention assistance if not anonymous, immediate, confidential and non-judgmental.
Accessing support, at the right time of heightened distress, can prevent suicide. If those who are most affected in Egypt can manage to find and reach out for help in the moment they are most triggered and distressed, they would be able to be saved.
In a moment where one is reluctant to reach out to strangers, experts recommend for those distressed to ask for help from those they are closest to.
“Call a trusted friend or family member and talk things through if possible. If they [the triggered individual] doesn’t feel like opening up to this person, [they can] just be in their company,” recommends El-Shimi.
“Being lonesome in one’s own dark mind prison is a slippery slope, and often it just needs the presence of another to break it.”