Tazmamart: Fort-Militaire-Secret du Maroc. Consequences d'un Internement du 18 AnneesBMJ 1994; 308 doi: http://dx.doi.org/10.1136/bmj.308.6936.1111 (Published 23 April 1994) Cite this as: BMJ 1994;308:1111
Evelyne van Ginneken, Ronald Rijnders Johannes Wier Foundation for Health and Human Rights, pp 118 ISBN 90-73550-10-6
Tazmamart tells a kind of Gothic horror story, one that is still unwinding. After unfair trials on charges of sedition, 59 former soldiers “disappeared” from Morocco's official prison system and were sent to a secret detention centre, Tazmamart, in the Atlas mountains. For 18 years they were held incommunicado and in almost complete darkness in small single cells which they never left. They were exposed to extremes of temperature, with poor food, little water, and no medical care. Thirty one died during this ordeal, and survivors' accounts suggest that at least 12 of these had pulmonary tuberculosis and 10 a terminal psychosis. One committed suicide a few months before release finally came for the rest in 1991.
These 28 men in their mid-40s, some weighing about 40kg, were taken for a month's intensive treatment by an army medical team, as if to make them more presentable. In April 1993 a medical mission from the Johannes Wier Foundation for Health and Human Rights in the Netherlands examined 21 of them, now back home. Most had continuing physical complaints, almost all had lost their teeth, and six had osteomalacia. Disturbed sleep, nightmares, irritability, and impaired concentration were still common after two years of freedom, as were social difficulties and financial hardship.
The team also established that the prison had comprised two separated wings of equal size. In one wing, where prisoners had structured their time with joint activities from their cells, including recitations from memory from the Koran, 24 survived. However, in the second wing, where this did not happen and there was always chaotic argument and tension, only four survived. The power of cooperative effort and solidarity in bolstering psychological and physical defences in even the most extreme situations was borne out in the Nazi concentration camps (see the work of Bruno Bettelheim and Primo Levi) and comes through in what I hear in daily clinical practice. This pivotal element in human processing of atrocious experience, the capacity to draw on social or religious ideals and institutions, cannot be encompassed in psychiatric formulations such as post-traumatic stress disorder.
The Moroccan government has maintained an implacable refusal to offer restitution to the living or the families of the dead. Indeed, release came only after Amnesty International published a list of those still believed alive, an event that may have forestalled plans for a mass execution. This, then, was a human rights victory of a sort - albeit a modest one when Amnesty International is still recording over 500 political prisoners in Morocco, including 150 prisoners of conscience; widespread ill treatment and torture of detainees; and the disappearance of unknown hundreds into other secret detention centres. The Johannes Wier Foundation is calling for the closure of these centres, whose existence continues to be denied - as was Tazmamart's for nearly two decades - by the Moroccan government. The foundation also notes that Moroccan doctors seem reluctant to take a stand on these issues. This is sadly true of the medical establishment in many countries with oppressive regimes and endemic human rights abuses.
The Moroccan authorities have been sufficiently sensitive to publicity about Tazmamart to monitor and threaten the 28 survivors and to obstruct the attempts of foreign human rights bodies to establish the full truth. For this reason the team entered as tourists and conducted the examinations covertly. Official concern about damage to Morocco's image will, however, doubtless be tempered by the knowledge that Western governments are rarely spotted scanning the human rights records of those with whom they do business. This too is the stuff of these horror stories.