Coronavirus

The Second Wave And Risks Of Rising Suicide Rates

A tribute to a young women who committed suicide during the pandemic in Liege, Belgium
A tribute to a young women who committed suicide during the pandemic in Liege, Belgium
Anne Sophie Goninet

PARIS — After first reckoning with the physical toll of COVID-19, the world also began to register the risk of rising rates of depression and isolation as the first wave of the virus forced hundreds of millions of people to stay confined at home for months at a time last spring. But now the second wave is raising the stakes, as mental health experts warn about the risk of an uptick in suicide.

Some parts of the world have already been experiencing "waves of suicides' such as Malawi, which reports a 57% increase between January and August in comparison with 2019, or India, as the pandemic put many out of a job and without financial resources. But according to a French study, with a second wave taking its toll on people's hopes and long-term economic effects, the worst is yet to come.

Hopes dashed: In Israel, the emotional first-aid hotline Eran received 837 suicidal calls during the country's second lockdown this autumn, a 49.5% increase compared with the first lockdown.

• While people were more preoccupied with surviving the virus threat during the first lockdown, they're experiencing more "emotional stress' during the second, especially because of the economic crisis; and many who had managed to cope during the first wave felt "their strength dwindled", Dr. Shiri Daniels, Eran's professional director, explained to Haaretz.

• "In the second lockdown we saw more loneliness, more depression and more reports of acute mental distress. The hope that we're coming out of the situation turned out to be an illusion," she told the Israeli newspaper.

• According to the service, the suicide calls stemming from economic distress rose from 4% to 15% between the first and second confinement and calls related to loneliness and personal relations increased from 26% to 35%.

Second wave's first weekend: England has imposed a second national lockdown this November and the impact on suicide prevention hotlines was immediate, with some reporting an increase in calls by almost one-third from the previous weekend, two days after the announcement of the new confinement, ITV News reports.

• 80% of callers to Papyrus, a national charity dedicated to the prevention of young suicide, mention the lockdown as well as the fear of isolation, financial problems and the uncertainty over the future as the source of their desperation.

• The charity had to extend its opening hours and increased its staff to answer the rising calls.

Accumulative effect: In France, the Fondation Jean Jaurès conducted a study, led by Michel Debout, a psychiatrist and professor of forensic medicine in Saint-Étienne, to measure the suicidal risks that the two lockdowns imposed by the country this year could generate. According to the report, the suicidal effects caused by crises tend to materialize several months, or even years later.

• After the 1929 stock market crash in the United States, the suicide rate only increased significantly in 1930-31; and for the 2008 financial crisis, European countries observed an uptick only one or two years later.

• "There is always a gap between the economic and social deconstruction and the reactions of the people who are the most affected on the individual and collective level," writes the French psychiatrist.

• It is therefore too soon for now to fully know the effects of the crisis on suicides and suicide attempts of the coronavirus pandemic, but the study reveals that among the French people surveyed who admitted they seriously considered taking their lives at some point this year, 11% of them considered it during the first lockdown and 17% after the end of the confinement, which confirms that "the crisis is ahead of us," the report says.

More prevention needed: Many aid organizations are calling for government actions to avert a looming mental health crisis, with more prevention to encourage people to seek and find help if they're having suicidal thoughts.

• "Everyone is cautiously talking about mental health and the lockdown and careful not to link suicide with lockdowns for fear of copycating. However 75% of people who die by suicide are not even known to mental health services," Ged Flynn, Chief Executive of Papyrus, told The Express. "We have to talk about it sensibly and openly."

• Fondation Jean Jaurès has a similar message, pushing local representatives to integrate suicide prevention in their health policy, with the help of professionals and charities. It also calls for the establishment of a global medico-psycho-social program for the thousands of unemployed, artisans and business leaders, who, according to its study, are more at risk.

Keep up with the world. Break out of the bubble.
Sign up to our expressly international daily newsletter!
Society

Harder Time: How Egypt Cuts Prisoner Communication With Loved Ones

Letters from inmates provide a crucial link with the outside world, and yet the process of sending and receiving them in Egyptian prisons is both arduous and arbitrary as an extra means of control.

Relatives speak with defendants during a trial in a Cairo court.

Nada Arafat

CAIRO – Abdelrahman ElGendy says letters were a crucial lifeline for him during the time he spent locked up in five different prisons between 2013 and 2020. "Letters were not only important, they literally saved my life," he says. "I was only living because I was looking forward to them from one visit to the next, and I would read them over until the paper became worn and torn."

Last month, the family of imprisoned software engineer and activist Alaa Abd El Fattah — who had been held in remand detention for over two years until his referral to emergency trial last week — announced it would take legal steps to ensure that Abd El Fattah is able to send letters to them following a period when prison authorities refused to allow him any correspondence.

According to the family, besides prison visits once a month, Abd El Fattah's letters are the only way they can gain assurance of his condition, and when his letters are denied, that in itself is an indicator that his treatment in detention is worsening. The numerous legal requests and official complaints by the family have been met only with silence by authorities.

While letters provide a crucial link between prisoners and the outside world, the process of sending and receiving them in Egyptian prisons is an arduous one as a result of arbitrary restrictions put in place by authorities.


Mada Masr spoke with a number of former prisoners about their relationship to letters during their incarceration and the way prison administrators constrained their right to send and receive correspondence.

Two letters per month

The law regulating Egypt's prisons and the Interior Ministry's prison bylaws stipulate that prisoners have a right to send out two letters per month and that prison administrators may allow more than two at their discretion. Prisoners are also legally entitled to receive letters.

Those sentenced to hard labor — a type of sentence that in practice usually entitles prisoners to fewer visits — are allowed to send one letter a week, and prisoners in remand detention technically have the right to exchange letters with family and friends at any time. However, in all cases, prison bylaws grant prison authorities the right to monitor, censor and refuse any correspondence sent and received , a power the Egyptian Initiative for Personal Rights deems a "violation to the personal freedom of prisoners, as it intrudes on their privacy."

A form of punishment

Prison authorities often restrict prisoner letters as a form of punishment, a measure that came under the spotlight when correspondence from Abd El Fattah to his family was arbitrarily cut off for an extended period last month.

Mohamed Fathy, a lawyer, says that Abd El Fattah's family pursued all possible legal procedures to push for allowing the exchange of letters with him, the last of which was a report submitted by the family to the Maadi District Court. This was preceded by an official notice through a court bailiff to the head of the Prisons Authority and telegraphs to the interior minister, Prisons Authority director and the superintendent of Maximum Security Wing 2 of Tora Prison Complex. Abd El Fattah's mother, Laila Soueif, also sent official requests to the superintendent on a daily basis.

Outside the gates of Tora Prison

Aside from the legal procedures, Soueif spent over a week waiting at the gates of Tora Prison Complex in the hope of receiving a letter from her son, a circumstance that gained particular urgency after Abd El Fattah signaled he was contemplating suicide during a detention renewal session in September.

This marked the second time that Abd El Fattah's family has embarked on a legal campaign in order to be granted their right to exchange letters with him. As the coronavirus pandemic first gripped the world in early 2020, the family went through a similar struggle after authorities halted all prison visitations as part of its COVID-19 restrictions.

During this period, letters became the principal form of communication between prisoners and the outside world. The Interior Ministry halted all prison visits from March until it reinstated them again in August 2020, though they were restricted to once a month.

Gendy, who was released from prison in January 2020, one month before the outbreak of the coronavirus in Egypt was officially announced, says that even in ordinary circumstances, letters were of vital importance since only direct family members are allowed visitation rights.

He says he used to give his family around 10 letters during every visit, addressed both to family and friends. "I used to keep an open letter to write to my mother about everything that was happening because the visitation time did not allow me to tell her all the details," he says.

Arbitrary restrictions

Even though the right to correspondence for prisoners is enshrined in the law, in reality, the process is an arduous one for both prisoners and their families due to the conditions of Egyptian prisons and arbitrary restrictions put in place by authorities, according to the accounts of several former prisoners.

It typically begins when the prison warden announces the visitation schedule for the following day. Prisoners hurry to pen letters before lights out, though some continue to write in the darkness. A prisoner who has a scheduled visit then gathers all the letters from his cellmates and hands them over to his visiting family members, who in turn give them to the rest of the prisoners' families outside, either in person or via WhatsApp if the family lives in another governorate.

In parallel, the families of prisoners who share a cell often create a WhatApp group to inform each other about visitation times. "Some families in nearby governorates send physical letters inside with the families that have scheduled visits. But those who live in remote governorates and who cannot afford to travel to the prison simply write letters and send pictures of them to the WhatsApp group," says Amgad Samir*, who was imprisoned for two years in Tora Prison Complex and was the facilitator for letter exchanges in his cell.

Marked in red

According to Samir, families would print out the letters sent via WhatsApp to deliver them to the prisoners, but the prison administration would sometimes not allow the entry of printed letters, so some families would volunteer to rewrite them by hand. "The sister of one of the detainees in Alexandria would rewrite dozens of letters in one day and would ask the children of some of the families to help her," Samir says. "Some families would send their letters with more than one person to make sure that at least one version made it inside."

Any letter being sent or received from prison is required to first be reviewed by the National Security Agency (NSA) officer stationed in the prison, who usually delegates a subordinate officer to read the letters before allowing them through or to "mark them in red," at which point the officer reads the letters himself to approve or deny them, according to Samir. After this screening phase is over, explains Samir, the officer hands over the letters to the mail facilitator, a designated prisoner, who then hands them out in the cell. "I would look at the faces of those who had letters sent to them, it was as if they had just been released," Samir says.

Khaled Dawoud, a journalist and the former head of the Dostour Party who was released from prison in April after nearly one and a half years behind bars, says that prison authorities tightly restrict prison correspondence. "Everything in prison is cracked down upon: food, clothes and even letters," Dawoud says.

According to Dawoud, the NSA officer in Tora Liman Prison, another maximum security facility in the complex, would sometimes force prisoners to rewrite their letters after redacting sections describing things like prison conditions, for example, to avoid them making it into the press or being circulated on social media.

Disseminating information about prison conditions can even lead to further prosecution, as was the case with imprisoned attorney Mohamed Ramadan in December 2020, when he was rotated into another case by the State Security Prosecution after he was ordered released on charges of "sending letters from prison with the intention of destabilization."

Photo of three women speaking with imprisoned defendants at a Cairo court

Relatives speaking with defendants at a Cairo court

Stringer/APA Images/ZUMA

Fear of being forgotten

Banning letters is a form of punishment and pressure that authorities deploy arbitrarily against prisoners, according to lawyer former detainee Mahienour al-Massry, who has spent time in prisons. She tells Mada Masr that following the reinstatement of prison visitations in August 2020, after they had been halted amid the coronavirus outbreak, the National Security officer in Qanater Women's Prison told her she had to choose between visitations and letter correspondence, but that she couldn't have both. Massry refused the ultimatum, and after negotiating with the officer, was eventually granted "exceptional" approval for both under the condition that she only send two letters a month.

"Even though letter correspondence from prison is a legal right that is non-negotiable, there were always negotiations and struggles about sending and receiving them, about how many letters were allowed, and about their content," she says. "Prisoners inside for criminal offenses were in a different situation from political prisoners. The latter had a chance to talk and negotiate, whereas the former did not."

Massry recalls a situation when the NSA officer in Qanater took back some letters that she had initially been allowed to receive. "He said, 'I don't have a reason. This was an order from the National Security Agency. You could try next time, maybe they will go through.' They are moody like that," Masry says. The letters were returned to the family, who then delivered them to Mahienour in a subsequent visit without any objections from the officer. Another time, a letter was confiscated because it had the term "son of a bitch," which the officer deemed "foul language."

Looking for something to say

During an earlier stint in prison in 2016 in Damanhour, Massry did not receive any letters for a month. When she went to the officer to inquire after them, she found that he had a pile of letters addressed to her on his desk. She says the officer simply told her: "Sorry, I didn't have time to go through them all."

After the coronavirus outbreak in March 2020, letters to and from prison were banned for two months in Tora Prison Complex while visitations continued to be suspended until August. During this period the prison was overwhelmed with letters, as they were often the only form of communication with detainees. According to Dawoud, the National Security officer was unable to go through hundreds of letters a day, even with the help of another officer. After long negotiations, the officer finally approved the sending of letters to and from prison under the condition they did not exceed two passages.

Dawoud says that he used his letters to simply reassure his family with brief sentences. "Sometimes I couldn't find anything to say because on the one hand, I can't speak about prison conditions, otherwise the letter would be confiscated; and on the other hand I couldn't talk about personal issues," he says.

Despite that, the short letters were enough for Dawoud to check in on his father, who was battling cancer and eventually died. "One sentence was enough for me to know that he was okay. It was enough for me to be reassured," he says.

News about COVID-19

In certain cases, letters have taken on additional importance beyond allowing families and prisoners to check in on each other.

Samir says he was able to help out a foreign cellmate who was charged in a criminal case without the authorities ever informing his consulate or assigning him a lawyer. Samir was able to tell his wife about this prisoner in a letter, but he made sure to use coded language in order to evade surveillance.

Samir would also use coded language to pass on information about COVID-19 in prison that would otherwise be flagged and confiscated by the NSA officer. "We replaced the word 'corona' with 'mosquitoes.' I would write that someone had been bitten by mosquitoes yesterday, and my sister would understand what that meant," he says.

Using this simple code, Samir was able to communicate the prison's coronavirus situation to the outside world until the officer realized that someone was passing along information and pressured him to confess. "I had two choices: either lie and say that there was a mobile phone in the room, or tell him the truth. I told the truth," he says. As punishment, he was not permitted to exchange letters for a period before the officer finally allowed it again.

"The importance of letters does not just lie in their content," Gendy says. "They are also a testament that people outside still remember you, because the fear of being forgotten is every prisoner's worst nightmare."

*Pseudonym


Keep up with the world. Break out of the bubble.
Sign up to our expressly international daily newsletter!
THE LATEST
FOCUS
TRENDING TOPICS
MOST READ