ANNUAL REPORTS 1898 - 1978

"I had no idea of the large number of lunatics who are in Syria, but, when I began to study their deplorable condition, I found that there are more of these unfortunate sufferers than I ever anticipated. The governor of the District of El Metn told me that he found 20 insane in his district alone, who are bound hand and foot in iron chains, and as the Lebanon is divided into seven districts, we may count about 140 of these, not including the milder cases. In the rest of Syria and other places in the Orient, where there is no proper accommodation for them, the only refuges ... " More...

"A woman from Brumana became insane in consequence of a severe illness. Her relations having no other resource, went to a Maronite Priest, and asked him to come and cast the demon out of her. The old priest, whom Mr Waldmeier knew very well, came, and began to perform the exorcism in his priestly dress, carrying the censor and the big silver cross in his hands; these were the visible weapons which he would fight against the invisible Demons that possessed the poor woman. ..." More...

"Since issuing our first Annual Report of the Hospital, we are glad to be able to state that great progress has been made towards the achievement of our object. We mentioned that a large piece of ground had been purchased in a very desirable situation near Beirut, and that the completion of the building, which was already on the site, was in hand. This is now finished, and is called the "Administration Block. It forms a large square building, which will be used as..." More...

"The Hospital was opened for the reception of patients on 6th August, 1900. The difficulties experienced by our Medical Superintendent Dr Wolff in obtaining the Turkish diploma, delayed for a time the commencement of actual treatment. The new Institution has now been in full working order for about nine months only. Up to 31st March, 1901, 54 patients have been received, 38 men and 16 women. Of this number 9 have recovered and returned to their homes, whilst others ..." More...

"For the sake of economy, as well as from lack of funds, all kinds of mental patients were at first received in the two wards erected at the beginning (the American and Swiss Buildings;) but it was found that the noisy patients were so disturbing to the quiet ones that it was impossible to continue this method. We had indeed to refuse some patients brought to us, who were too dangerous to put with the quieter ones. We have, however, kept in touch with them, so that directly the new ward is ready we shall be able to take them in. Experience soon made evident the pressing need for the new building. At the close of our secretary's recent visit to Beyrout Mr Waldmeier used the words, "You see how much we need a new ward: do go home and get the money for this." On the same day at the agents, there was found a letter from the London office announcing that Mrs Bawn, of Philadelphia, had promised to erect a new cottage for male acute cases, as a memorial to her late husband, to be known as the Robert Wain Ryerss Memorial Ward. ..." More...

"We should add with regard to the priest mentioned above, that his cure has become the means of removing some of that opposition which we have had to encounter in the introduction of humane and modern methods of treatment. Some persons in positions of influence who began by cursing these efforts have begun to bless them. It should be born in mind that the "Holy Caves" brought in a certain profit to those who are concerned in them, but we are glad to think that a change is taking place in the feeling of the people in this matter, as is evident when the priests themselves are found bringing patients to the Hospital. ..." More...

"During the past year there have been admitted into the Hospital 93 patients - 35 males, 38 females. From the preceding year there remained in the wards 55 patients - 39 males, 16 females, making a total of 148 under our care during the year. Of this number, 82 patients have been discharged - 54 males, 28 females; and 3 have died in hospital - 2 males, 1 female. Of those discharged, there were recovered, 33 cases-22 males, 11 females; relieved, 25 cases - 17 males, 8 females; ..." More...

"Interest in the work on this side has been greatly advanced by the visit of Mr and Mrs Waldmeier to England last summer, at the invitation of the Committee. Mr Waldmeier had not been home since 1898, when he returned to Beyrout after his travels, to establish the Hospital. The Committee in inviting him thought it right that the Subscribers should hear from his own lips an account of the rise and progress of the Institution. He and Mrs Waldmeier were very warmly welcomed wherever they went. .." More...

"One of His Majesty's Commissioners in Lunacy for Scotland, Dr John Fraser, of Edinburgh, recently wrote: "The good work of the Lebanon Asylum has only to be known to command support." This gentleman has followed the progress of the Hospital from its foundation. ...
Among the more immediate needs of the Hospital at the present time, and one to which special attention is called in our reports from Syria, is an 'Isolation House'. Epidemics are not infrequently prevalent in the vicinity of Asfûriyeh, and at present there are no proper means of isolation for the use of our patients and staff in case of the appearance of infectious disease at the Hospital. We commend this matter to the generosity of our friends in Europe and America. Several friends have sent gifts in kind, to whom our grateful thanks are due, and one friend in Scotland (Miss Robertson) has kindly sent periodicals for the patients; more would be acceptable, especially illustrated ones.
There are always items which are needed in the work, and perhaps some friends would be inclined to contribute in this way: ..." More...

"The occupation of insane men and women in an asylum is one of the most important means for physical and mental improvement, and many doctors say that it should be a leading feature in the management of every asylum according to the inclination and physical condition of the patient. Dr Tucker, of New York, tells of a patient who said, 'If we work, we are free from delusions and regret, and feel more hopeful and cheerful.' I have experienced at Asfûriyeh that patients who are doing some work in the open air eat and sleep better, but it is a great exertion until ..." More...

"Look again at the map, and ask yourselves; Could there have been chosen a better site for the Lebanon Hospital for the Insane, than Asfûriyeh, near Beyrout? To quote the words in one of our reports, 'The work is essentially more than a Hospital for the Insane, it is a splendid object lesson to the natives, giving them a true picture of what Christianity is and does.' This object lesson is not confined to the peoples resident in the neighbourhood, but is carried to distant countries far beyond Egypt by those who pass along the trade routes to Damascus, Bagdad, and even along the Haj road from Damascus to Mecca. After centuries of conflicts and invasions, the whole country of Syria was conquered by the Turks in 1516, and has continued under their rule ever since. But from the time of the massacre of the Christians by the Druses, in Damascus and the Lebanon in ..." More...

"The religious persuasions of the patients admitted are shown in Table IX and I have frequently remarked that Mohammedan patients and their relatives appear at anyrate to show the most gratitude for what has been done to them. The son of one Mohammedan woman although not in the best circumastances volunteered to become an annual subscriber for a small amount in token of his appreciation of what had been done for his mother." More...

"Twenty patients: viz. 9 men and 11 women have been discharged perfectly cured; 38 patients, viz. 19 men and 19 women have been discharged in such a condition that they were quite capable of resuming their position in society, but whose disease prevents me from claiming them as cured owing to the liabilityof future recurrence; 24 patients, viz. 15 men and 9 women were dicharged for various reasons, such as permenent mental weakness, desire of the relatives to try the patient at home, etc., all of which prevent me considering them as benefited from the purely medical point of view. However, I can confidently say that from this number who have been admitted in states of excitement or in a degraded condition, many have left calm and ordely; so at least it can be claimed that they can be managed at home and do not now urgently require asylum care, as was the case on admission." More...

"This term is unfortunate for several reasons: The hospital being a voluntary one, patients relatives have absolute right to demand the discharge of their patient whenever they think fit. To give an example; A young lad, brought here in a state of great mental excitement was removed from the hospital by his father only a week after admission, to be taken to the convent Kosheyeh in order that the devil of which he was supposed to be possessed could be cast out." More...

"Many cases have required constant individual supervision on account of the (volume) violence of their excitement or for suicidal tendencies. Destruction of clothing and property such as chairs, window glasses, linen and bedding has been in excess of former years. Several patients have required artificial feeding for varying periods - one young Armenian student who became ill suddenly but is now on the way to recovery had to be fed artificially for over two months." More...

"About the commencement of the war J am aware that it was questioned whether J should remain as director of the hospital and also that J have to thank certain jealous confreres for their activity in this direction. Those petty intrigues however were diverted by those in actual authority and matters went on quietly till last spring when Ali Munif Bey, the Lebanese Governor was looking about for accomodation for sick patients. A certain doctor seeking to ingratiate himself with the governing powers and for self interest, directed the attention of the governeor to Asfouriyeh. He inspected the hospital in company with this doctor with a view to filling what accomodation there might be vacant with infirm patients." More...

"I have to report with regret a great increase in the number of deaths which occured in the hospital during the year. Many patients were admitted in an extremely feeble condition so that their powers of resistance were reduced to a minimum. Two patients were admitted in a moribund condition and died a few hours after admission from starvation and a female who was brought here practically naked on the back of a porter, died at the gate before admission. The majority of the patients admitted were insufficiently clothed and practically all were covered with vermin." More...

"Now that the hard years are over and there is every hope of a brilliant future, perhaps a few suggestions as to expansion and improvement will not be out of place. I think that what the Hospital needs most and which I have already mentioned is a proper installation for electric light. The laundry and the stable will have to be improved, and a disinfecting apparatus is greatly needed for the Hospital." More...

"Table IX, which shows the Religious Persuasions of the patients, indicates fairly clearly that there is little religious prejudice shown against this hospital. This is rather remarkable in a land where secterian bigotry is fairly pronounced." More...

"Imagine first of all this vast extent of territory which has been grossly misruled for centuries; money stripped from the country to the central authority (Constantinople) and no return made, or held by the avaricious few. A people bright intelligent and frugal, but down trodden, utterly uneducated, separated from one another as wide as the poles by religious secterian fanaticism, shown the very worst that Europe can show except by a few missionaries. In a word every man's hand is out against his neighbours. There is not an industry in the country worthy of the name, and what the land yields cannot be attributed to any remarkable energy on the part of man. Is it any wonder therefore that there is not a philanthropic institution in the country? Poor Law! The law for the poor is If you can't get money somehow or anyhow, heaven help you!" More...

"The Beyrout Dorcas Society has kindly presented us with a considerable stock of clothing for the poor patients. Recognizing the very inefficient means of lighting the hospital has at our disposal, the London Committee has provided the necessary funds for an Electric Lighting and Power Plant which is now in course of installation." More...

"It will be noted that 19 patients; 18 men and 1 woman are classified as not insane. Some of these are criminals sent for examination by the government when the extent of their responsibility is in question. Others are accounted for by feverish conditions, hysterical outbursts and the like, which might never have required admission to this hospital, had careful observation been adopted and sudden conclusions avoided. After all, perhaps it is in the interests of the patients themselves, that they are brought here quickly, for we have far too often occaision to remark, by the bruised and generally knocked about condition of excited patients brough for admission to the hospital, that compassion and what should be prompted by it are by no means lavishly extended to these unfortunates. A policeman, for example, would just as soon think of withholding his riding whip from a troublesome lunatic as he would from applying it to a donkey." More...

"21 patients left the Hospital for various reasons-for example, removed by friends with a view to seeing whether a change would be helpful, or the patient had become sufficiently calm that home treatment was again possible ; 26 chronic patients were transferred to Damascus by order of the Damascus Government. Such cases cannot be classified from the standpoint of their mental disorder as other than 'Not Improved,' ..." More...

                                          M   F   T
    
        Armenian Orthodox                 1   -   1
        Armenian Protestant               1   1   2
        Buddhist                          1   -   1
        Druse                             1   3   4
        Fetish Worshippers                1   -   1
        Gregorians                        2   1   3
        Isrealites                        3   4   7
        Greek Catholics                   4   1   5
        Greek Orthodox                   13   7  20
        Maronites                        18  15  33
        Protestants                       3   3   6
        Moslems                          33   6  39
        Roman Catholics                  14   3  17
        Syrian Catholics                  1   1   2

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"I have just finished the course of instruction on Mental Disease to the medical students of the graduation class of the American University Beyrout and the Matron has also given six lectures on mental nursing to the senior nurses of the American Hospital. The Board of Trustees of the American University has accepted the recommendation of the Faculty of the University that I be given the title of Clinical Professor of Psychiatry. Arrangements are at present being made whereby one or more graduating students will live in this hospital and receive postgraduate training in Mental Diseases. This should be very helpful both to the students and to the work of the hospital." More...

"It has become evident that if the work is to go forward, or even to remain at its present vigorous level, new supporters will have to be found. Wonderful though the total collected in patients' payments now is - and we congratulate the Director on his achievements in this direction, as well as in his more medical work - a good reason prevents its becoming entirely self-supporting. From the beginning it has received a large proportion of the poorest and most needy, who could not pay. ..." More...

"I was able, on the occasion of my last visit, to see for myself that the different departments of the asylum of Asfuriyeh are maintained under the best of conditions, both in regard to cleanliness and to the treatment of the patients. Moreover, the excellent management of this institution could not leave its object in any doubt, in view of the fact that during the whole time of our connection with it, it has never been possible to bring any complaint about the care of the pauper patients who have been sent to it by my Department. ..." (Dr. Talhouk, Ministry of Health) More...

"We are having to possess our souls in patience until the engineer returns to Beirût from the Hauran, which he has promised to do this summer. But those on the spot have little doubt that he will reach ample water supplies when he recommences drilling at Asfuriyeh, since all his other bore-holes in the district have had the desired result. Our farming and horticultural schemes are held up until the big water supply comes, but they are not forgotten." More...

"This is the thirtieth anniversary of the Hospital, and therefore a backward glance may perhaps be permitted before the work of the year is recorded. It was on August 6, 1900, that announcement was made, amidst the lively interest of the whole countryside, that the Hospital was open for patients, and by August 20th ten men and five women were in residence ..." More...

"Another piece of co-operation on which we set much store is that with the 'Friends of Armenia.' Following Commander Corhyn's words at our Annual Meeting at St. Martin's-in-the-Fields last year, we have had some contact with this Society, with the result that they have made a grant for the treatment of Armenian patients at Asfuriyeh and propose to hand over any further money received for this purpose, in response to a special appeal. This is a generous step when one considers the many claims of Armenians upon this devoted and enterprising Society ..." More...

"Mention may also be made here of the training in mental nursing of the staff of nurses, who have been in the service of the Hospital during these years, and also of its more recently extended activities in the training in mental diseases given to the Medical Students of the American University of Beirût, who are now or will regularly become the medical practitioners of the Near East." More...

"The Director of Public Assistance, Beirût, intimated to me that the local government had decided to reduce the hospital fees paid to the various hospitals in Beirût for patients maintained by the Assistance Publique and that he thought this Hospital should accept a reduction of two piastres per patient a day. After I had made certain representations to him, he decided to accept a reduction of only one piastre per patient a day ..." More...

"In the portion now under the French mandate the Turks used to have a small hospital for mental patients (at Damascus), but it was so badly managed that during the War Turkish doctors condemned it. The patients were turned out and placed in a mosque. But the Turkish Governor had them sent to us, and I may say that on arrival they presented a real problem. In a filthy condition, suffering from an infectious form of dysentery, these poor unfortunates greatly troubled us for some time." More...

"On November 9th the ceremony of naming and dedicating two houses, in honour respectively of the Founder (Theophilus Waldmeier) and of Dr. Watson Smith, took place, details of which will be found in Dr. Miller's report. Mrs. Waldmeier herself was present on this occasion, to share in the recognition of her husband's great work and to see the improvements that have occurred since she and her husband left twenty years ago. A touch of gaiety was added to the occasion by the presence of some forty musicians of the French military band of the Levant, kindly lent by General Huntzinger." More...

"Then we come to 'Dementia Paralytica,' over here more often called General Paralysis-a truly fell disease, an essential precursor of which is syphilis. Until ten years ago, when treatment by induced malaria was introduced, this form of mental disorder invariably ran a fatal course, seldom lasting as much as four years. Judged by its prevalence among the admissions (7 per cent of the men and 5 per cent of the women), it would seem not to have a particularly heavy incidence at the Lebanon Hospital, although on the other hand I note that no less than 37 per cent of the male deaths were due to General Paralysis. In this connection it is noteworthy that among the deaths there are three cases of malignant malaria, a disease from which our own country is practically free: ..." More...

"Great changes are taking place in this land. During the next three years, Syria becomes an independent country, and a similar treaty recognizing the independence of the Lebanon has just been signed. The constitution of 1929 is to be restored, and a change of Government has already followed. Such changes are not expected to affect the status of the Hospital in the near future. The Hospital still caters mainly for the poor and needy, as it has always done since its inception." More...

"The next item is that a cinema film of the Hospital has just arrived in this country. Unfortunately, it has proved impossible for it to be shown in this hall this afternoon, as we had hoped, but we look forward to being able to show it in London and elsewhere later on, and shall be glad to hear of possible openings for it in the autumn. As you pass out, you will see there is a plate on the table at the door, and we should be glad if you would regard it with a kindly eye. ..." (From the annual general meeting in London, 1938) More...

"Early in the year, the Government of this Republic decided to put into operation an Ottoman Law of 1876, governing the reception of patients into mental hospitals. A copy of this law is appended to this report. The regulations contained therein are admittedly out of date, and are not operative in this form in Turkey to-day. A promise has been made that the law will be modified to meet modern needs, and upon representations made at the time, permission was obtained, for the present, to admit all private and free patients as urgent cases. Otherwise the necessary steps have been taken to conform to the law." More...

"A third point is that since hostilities began on 3rd September, 1939, 122 cases have been cared for at the request of the Military Authorities. Most of these cases remain with us a comparatively short time and are then repatriated, many of them being discharged from this hospital under the heading No Change. These are the mentally deficient and the emotionally and morally unstable individuals, classed under the diagnosis of 'Psychopaths,' who are such a trial to military authorities in every country. Like so many drug addicts they are 'half mad, half bad, unhappy misfits of life.'" More...

"The fighting came within a few miles of the Hospital, the noise was terrific and the bombing fairly heavy. But the place itself, with 339 patients in residence, remained unscathed, and we are told that the patients were perfectly calm, thinking this just a rather noisy Moslem fete! It escaped in another remarkable way. As the battle reached its climax around Beirût, a military order was received for complete evacuation of the premises within four hours. But before this time-limit expired-and where could these 339 unfortunate mental patients have gone? - the 'Cease Fire' sounded. Truly, its preservation amid so many dangers has been wonderful ..." More...

"A matter of regret this year is the withdrawal of all 'incurable' cases among those sent by the Lebanese Government. The reasons for this are mainly financial, but also due to the great pressure on the reduced number of beds available. During the last week of the year seventy-five Government cases were removed to the 'Monastery-Asylum' of Dair-al-Salib, near Beirût. This interesting place was founded a few years ago by the Rev. Yacoub Haddad, a Maronite priest, as a home for aged and sick priests. ..." More...

"No report could be written without at least referring to the appointment of the first Lebanese Minister to the Court of St. James's, a historic event. In Mr. Camille Chamoun we are extremely fortunate in having as Minister someone who not only knew Asfuriyeh officially during his time as a Cabinet Minister in Lebanon, but who has a family interest in it as well. For it was his father who persuaded the owner to sell the original estate to Theophilus Waldmeier for this 'First Home for the Insane in Bible Lands.' And this was by no means done in a day!" More...

"At the close of 1945, 243 patients remained (142 men, 101 women). Of the 401 admitted, 164 were private cases, 138 government cases, 43 French military, 17 from UNRWA, 15 from the Polish Delegation and 24 free. The average age on admission was 32.5 years. 83 were in an exhausted state. 110 of the 401 recovered (the largest groups being 42 cases of mania, 22 schizophrenia, 17 exhaustion psychosis, 16 delirium tremens). Figures are given of the results of Cardiozol Shock Therapy during the year." More...

"A minute in May records that at the end of 1945 'the increase in the scale of patients' fees had enabled the Hospital to keep pace with the abnormal expenditure' (then, as now, about i,ooo per cent of normal). There came a moment, however, when the process of raising fees to meet prevalent costs began to fail, and the number of patients in residence, both Government and private, fell. In a hospital of this kind, where the only 'long stoppers' now are those without home or money, and where about one quarter of the patients complete their treatment within three months, the cessation of new admissions may bring such a rapid decrease in numbers even in a few months as perhaps to halve the size of the Hospital. This is more or less what happened. ..." More...

"'Our Daily Bread.' In this year 1947, with its world shortages, most countries have been brought face to face with humanity's stark basic needs-food, warmth and clothing. The word bread, in particular, has taken on a new meaning. In the affairs of the Lebanon Hospital, the same thing has happened. We are positively in need of money to provide bread for our patients in the coming year! This is what our large deficit means, for it is because food is so dear that we lack the means to buy other necessities...." More...

"When one reflects that in February 1948 there were only enough funds in Beirût to carry on the Hospital for four months, and little more in London - using up all the accumulated investments - than would be required to keep it going for another eighteen months, one must be profoundly thankful for the more favourable turn in the finances which set in about April, thanks to the efforts of a great many people, and which has been well maintained since. And here let gratitude be expressed to the Lebanese Government, who on March 23rd made a second large grant to the Hospital; this time through the wife of the Prime Minister, Mme. Riad-es-Solh, who called at Asfuriyeh and handed to Mrs. Robertson a cheque for LL.25,000 (£2,831) on behalf of the Government. ..." More...

"The problem of providing adequate linen and bedding for the patients is an ever-recurring one, but we have not shirked it. Material, received from England or purchased locally, has been made up into sheets in our own sewing room, and the mattress situation has been partially relieved by the purchase of Dunlopillo mattresses for Philadelphia and American Houses out of the proceeds of a legacy left us by an American benefactor. These mattresses have proved very suitable for their purpose, and the coverings for them have been made in our own sewing room. The male attendants have yet to be put into a satisfactory uniform, though the senior ones have been provided with white overalls, and an attempt has been made to provide a khaki overall for the more junior. We have so far been hampered by lack of funds from equipping the male staff with a smart and workmanlike uniform, and there is no doubt that this is one of our imperative needs." More...

"Our celebrations in October were a time of much activity. For a fortnight previously the hospital kept open house to journalists, 34 of whom came to inspect the buildings and treatment. The Prime Minister and other prominent people came to a dinner party, the hospital Social Club gave an entertainment, the patients had a party and the climax came on October 21st when the President of the Republic, Bechara el Khoury, opened the newly extended Admission Unit, now called Glockler House in memory of the long service given to Asfuriyeh by our present Executive Committee Chairman, Mr. H. W. Glockler, and his father before him. ..." More...

"We were proud and glad that, as mentioned in Dr. Ford Robertson's report, five of the first group of Student-Nurses (Mohammed Kazrna, Najia Mattar, John Ashkar, Michel Dahduh, and Leila Mattar) obtained the Asfuriyeh Certificate m Psychiatric Nursing in August, after three years' training. The examination papers were drawn up in co-operation with the Matron and Sister Tutor of the American University, and Dr. Itani, Psychiatrist to the Municipality of Beirut, attended the sittings. Certificates were presented to the successful candidates at a Graduation Ceremony ..." More...

"In June, Miss A. S. Worden was warmly welcomed by many of our attendants who remembered her. She has become a very competent nurse and a special word of appreciation is merited for her skilful organisation and handling of the insulin wards and treatment room staff.
Miss P. Cooper was welcomed as our first full-time Sister Tutor and settled down and found her feet as a teacher in a completely new sphere. Her conscientiousness, patience and calmness with the student nurses is being much appreciated." More...

Beirut Executive Committee, 1954 - Standing: Professor S. Himadeh, Dr. J.J. Mcdonald, E. P. Southby, J. D. Knight, Dr. W. M. Ford Robertson, G. Rayes, H. C. Lees, Dr. J. Hitti. Seated : W. F. Gosling, Mrs. E. Cortas, K. Joly, Saeb Salaam, Sir E. Chapman-Andrews, H. W. Glockler, Dr. A. Khairallah, R. J. D. Belgrave. More...

"Regarding the much desired goal of teaching nursing to our attendants in the Arabic language, progress is still unfortunately slow and Dr. Drooby has not been able to begin lectures as there have been unforeseen difficulties. Later in the year we decided to accept only literate attendants and formed a Selection Committee of four, including Matron, a doctor and the Staff Warden. This has worked effectively. Extra-mural aspects have seen a further increase for, in addition to the usual intensive three months' course of lectures and demonstrations to the nurses of the American University Hospital, their Matron Miss Moser, asked if we would accept all her students for two months' internship each from September until June. This we arranged most willingly, and up to the present it is proving satisfactory." More...

"The departments of the Hospital which were referred to at last year's Annual General Meeting as being 'old fashioned' and in need of renovation are being re-arranged, re-decorated, and partially re-furnished. The elevation of the living conditions of this section of the resident population of tne Hospital is having a good moral effect on all members of the community. The general up-grading of the level of patient care in the Hospital is being greatly assisted by the activities and achievements of the Central Administrative Department." More...

"As our experience with these drugs increases, we have been taking more and more precautions and have been keeping the patients undergoing these treatments under closer supervision. So far we have been completely free from unpleasant experiences in their use. On five occasions we have had severe circulatory collapse (without complications) following electro convulsive therapy. Every one of the cases had been on Serpasil therapy. It is a standing order now in this hospital to, suspend serpasil for a week prior to using E.C.T. The list of stabilizers seems to be ever increasing. We have been asked to experiment with several of the products quite early during their experimental phase." More...

"In November Asian 'flu hit us with full force, and at one time we had around sixteen personnel down with it, and found we had to open Brigstocke House as a sick bay. Our water situation was quite drastic at this time. The weekly bathing of patients was carried out by means of a trickle of water going into a bucket on a primus stove, and economically showered over each patient. It was also extremely difficult keeping up teaching standards in hygiene to new students.
The religious Services have continued as usual. Our own student nurses conducted the nondenominational service in Arabic for the patients each Sunday morning, and Mrs. Manugian with unerring faithfulness has continued to be pianist at these services. Miss Cooper continued to arrange the Wednesday evening service for staff until the time of her departure, then Miss Cory took over, assisted by Mrs. Wakim.
With the gradual reduction of the European staff the upgrading of the local personnel must be steadily established. The year has brought its disappointments and setbacks, but our eyes are now focused on the not too distant future, when the dream of those who laid the foundations of the School will be realised : for this Hospital to become a training centre for psychiatric nurses, run by well-trained Lebanese staff." More...

"X-Ray Technician: Before the opening of the new X-ray Department much previous thought was given to whom should be chosen to train as Technician. Finally, Mr Massad Mattar, a graduate nurse of 1955 who had shown a great interest during his nursing career in all electrical equipment used for diagnostic purposes, was sent to the A.U.B. on a special course, and has made satisfactory progress since the Department was opened.
X-Ray Department: An X-Ray Department consisting of waiting room. X-ray room and film developing room has been constructed in the basement of Philadelphia House, the X-ray installation being made possible by the generous donation of 10.000 L.L. by Tapline, in 1957. Doctors' Consultation Rooms: Separate doctors' consultation rooms have been provided in a number of the wards. Improvised sluice rooms have been provided in six of the wards." More...

"Drug Addicts: A total of 245 admissions were recorded during this year. Their distribution offers the following pattern: The management of these addicts consisted of immediate withdrawal of the drug (except for Morphine) which was carried out safely under chlorpromazine narcosis. The abstinence symptoms were easily controlled. The majority of patients were discharged as 'relieved' only. The drug addicts are mostly psychopathic personalities and poorly motivated to discontinue their drugs; so no psychotherapy was possible." More...

"There has been a regular increase in demand for psychiatric services and help. Because of this, although the Clinics in Tripoli and Sidon are financial liabilities, we have continued our service. Similarly, the prisons mental health service is given by us completely free of charge. We feel satisfied that Asfuriyeh is true to its Mission of Service and the Authorities are appreciative of such high quality service given freely." More...

"In the group of schizophrenias we have found useful to compare the results obtained with the newer phenothiazine derivatives e.g. thio-pro-perazine (majeptil) and prochlorperazine (stematil), with chlerpromazine (largactil). In both groups electro Convulsive Therapies were adde to the treatment on certin occaisions. The gross results were comparable with each other and the difference obtained was not statistically significant." More...

"3. Research: As referred to in my previous report, within 63 years, an institution gathers considerable yseful data. This year we have started clarifying all the relevant information on punch cards. We are intending to study the Geographical distribution of the various types of mental illness in Lebanon. This may open the way for other studies at a later date." More...

"Webster House. This ward used to be that of male and female prisoners. It has been altered to accomodate male prisoners only. Partitions were removed, the whole interior was white-washed and new cupboards for the kitchen were made. The office space was changed, and the building divided into two sections: Ward One, for mental patients, and Ward Two for drug addicts. Before this alteration was made, the maximum capacity of Webster House was 89 beds; it has now become 94." More...

"The Syndicate of the Asfouriyeh workers is going through its growing pains. There has been, and will continue to be a growing spirit of partnership between the Syndicate and the Hospital authorities to promote best interests of the patients and staff alike." More...

"The procedure for diminishing the salaries and wages item has been much more tempestuous and socially disturbing. It has been used as an excuse for fishing in troubled waters. To help those who wanted to resign, the hospital paid them their full indemnities although legally they were not entitled to do so. At present the salaries item of our budget is still too high and is likely to get higher in view of the anticipated government regulation for a further increase in salaries and wages." More...

"All these productive programs suffered seriously by virtue of the series of social unrest by some of the workers which had started in 1965 and continued at intervals all through 1966. The strike was only a partial success and all through we were in complete mastery of the situation. However, the total discipline of the Hospital was badly shaken and the hospital routine got out of gear." More...

"The London and Beirut Committees have been very conscious of the urgency in taking immediate actions concerning the future policy of the Hospital. In fact events were progressing satisfactorily for the change of site of Asfourieh when the Middle East war on June 5th 1967 came to give another serious blow to the already generalised lack of economic confidence which had resulted in the crash of if Intra Bank in 1966.Just before the closing of the year there has been determined effort to safeguard the mission for which Asfourieh was created." More...

"Asfouriyeh Ladies Guild. The Ladies Guild once again have been most generous, providing us with stoves, blankets, shoes, sheeting and dress material. They held their annual cake sale in December at the British Ambassador's Residence. As usual all were asked to bring a gift suitable for a male or demale patient. This was very a very successful morning, we had sifficient gifts to give every patient something for Christmas plus either sweets or Cigarettes." More...

"5. The Future
Now that it has been accepted as policy that the hospital will remain on its present site for the foreseeable future, every effort will be made in the year ahead and in future years to use such resources as ma[n]y be available to preserve the fabric and services of the wards and departments until such time as teh financial position will permit major renewals or replacement by new buildings." More...

"Introduction of National Health Scheme
At National level it was decided to introduce the National Health Scheme as a further stage of the Socia Security Law. Decree No 13959 of 26th September 1963. As a result from 1st November 1970 approximately 600000 employees becane contributors to the National Health Fund paying 1½% of their salaries monthly to which their employers add 5½%. The figure of £829 (LL6442) appears under this heading in the accounts of the committees liability as an employer for the two months Novemver and December 1970." More...

"In last years report, reference was made to the concern caused by the condition of the ageing stem boiler on which the hospital was dependant for both steam heating and domestic hotwater supplies. The Committee is deeply grateful to Messrs. Tapline and the Ladies Guild for donations of LL2000 (£2516) and LL 1500 (£1887), repectively, which met the cost of the installation of a new hotwater boiler and four calorifiers." More...

"The slow demand for beds for National Health Fund patients continues. 22 cases were treated in 1972 producing an income of LL 10598, as compared with 5 cases and an income of LL 1680 in 1971." More...

"Further to my last report to this assembly, we have continued the plans of the new hospital. The consultant architects from Great Britain and the Lebanese team of architects and engineers have been cooperating with the nursing, administrative and medical members of the hospital in adopting the original British 'standard plan' to suit the requirements of the Middle East. Some of the requirements have been addtition of balconies. Another basic alteration was the need for different type of accomodation for the first, second and third class patients.Even some consideration was given for special cultural requirements in the accomodation." More...

"During the year we have been subjected to constant danger by shells and bullets of all makes and sizes. Several of our staff of all ranks have been kidnapped. Fortunately we have no lost any of them. We have had to take serious risks to supply the hospital with food, fuel and cash. The dangers of travel depeleted our staff at times by 60%. We had to improvise and give free board and lodging in the hospital to many of our employees." More...

"Inconvenience to staff. I am duty bound to record that I believe we did enjoy the benevolent protection of the para-Military Organizations in our area. Our relations with them remained close, sincere and cooperative. At times we had to go out of our way to help them in various ways, but time has proved that we were right in making periodic sacrifices and the wisdom that we showed in our decisions in certain difficult situations. The few serious incidents we had were essentially individual acts such as:
(1) The removal of certain prisoners by their armed relatives. Some of them reached home. A few were found dead. A few others we have not been able to trace.
(2) Kidnapping of nine male students and three staff members. They were all released.
(3) Kidnapping of a female student nurse. Our latest non-confirmed information is that she is in a convent somewhere near Jounieh. More...

"Im Jahre 1896 wurde zi Beirut in Syrien von Herrn Missionar Theophil Waldmeier, dem Gründer und langjährigen Leiter der blühenden Missionsanstalt Brumana aud dem Libanon, eine aus Missionaren, Predigern, Aerzten und Kaufleuten bestehende kleine Gesellschaft ins Leben gerufen, welche sich die Aufgabe setzte, einen Zufluchts- und Bersorgungsort zu schaffen für die gänzlich vernachlässigten und vielfach in unmenschlichter Weise mißhandelten und gemarterten Irren, Epileptischen und Blödsinnigen in Syrien und Palästina." More...

"Gefesselt an die Wand mitt schweren Ketten,
Verzehret von des Wahnsinns fieberbrande,
So schmachten, qualdurchglüht, im Morgenlande
Die Irren auf den dumpfen Marterstätten.

O schrecklich Los, –– wenn wir nicht Liebe hätten,
Und Christenpflich, zu sprengen diese Bande,
Zu tilgen unsrer Zeiten Schmach und Schande,
Aus Todespein die Brüder zu erretten!" More...

"Trotzdem sich bei dem über siebzigjährigen Herrn Waldmeier das Alter mehr bemerklich macht, läßt ihm die Sorge um den weitern Ausbau und die gründliche Fundirung seiner Anstalt weder Ruh noch Rast. Mit unendlicher Mühe hat er, sozusagen allein, im letzten Jahre den Bau des neuen Isolirhauses für unruhige Männer ausgeführt und vollendet. Es hatte zu diesem Zwecke eine amerikanische Dame eine Gabe von 25,000 Fr. gestiftet, und es erhielt deshalb das Haus zu ehren des verstorbenen Gemahls dieser Dame den Namen "Robert Waln Ryerss Memorial Ward"." More...

"Unsere Anstalt wurde im Jahr 1900 am 4. August eröffnet. Im ersten Jahr hatten wir 32 Kranke, im zweiten 39, im dritten 43, und so steig die Zahl bis jetzt auf 76 Kranke. Während dieser sechs verflossenen Jahre haben wir 475 Geisteskranke behandelt, von welchen 130 als geheilt entlassen werden konnten, 100 wurden gebessert von den übrigen sind noch einige in der Anstalt, andrer wurden als unheilbar entlassen und der Rest fiel dem Tode anheim." More...

"The most approved method of construction of asylums is the 'Cottage System' affording more quiet and privacy and better attention than can he had in one large building. The American Cottage was built to accommodate twenty patients. The good results of the work are already apparent in that a number of patients have been discharged as either 'permanently cured' or "improved.' If it had not been for this asylum these unfortunate ones would probably have been sent to the cave of Kuzheya, or other similar place, to undergo the tortures and horrible cruelties practiced on the insane by the superstitious Maronite priests in order to drive out or exorcise the evil spirits that are supposed to inhabit the bodies of the unfortunate sufferers: such treatment resulting almost inevitably in permanent mental derangement and death. A description of this cave and the brutal treatment prescribed for the insane who are sent there is found in one of Theophilius Waldmeier's earlier letters." More...