In Tunisia, immolations by fire, weapon of despair

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A portrait of Mohamed Bouazizi is displayed on a building in Sidi-Bouzid, Tunisia, in December 2014.
A portrait of Mohamed Bouazizi is displayed on a building in Sidi-Bouzid, Tunisia, in December 2014. Zoubeir Souissi / Reuters

In the home of Abdelwaheb Jilani, who died in November at the age of 30, only a light bulb, hung on an electric wire which crosses the virgin walls, lights the house. His parents only have an identity photo for their son. “His head was too full of worries, he couldn’t take it anymore sighs his father. Beneficiary of “mechanism 16”, a system set up after the Tunisian revolution to provide part-time jobs to the unemployed, Abdelwaheb Jilani had not received his allowance for two years, without getting an explanation. “We saw that there were problems in his file, we tried to deal with it and his situation would be resolved”, said delegate Messaoud Charfi, who was appointed state representative in Jelma four months before the tragedy.

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One November afternoon, Abdelwaheb set off on foot in a field, four kilometers from this city in central Tunisia, to set himself on fire. “The women who picked olives tried to help him, but it was too late. He isolated himself to commit his act, because it was the third time he had attempted suicide “, tells Hammouda Harzali, a neighbor of the family. He wanted to help Abdelwaheb by giving him a cart to sell goods until he found a solution, but nothing worked. The cart is still parked a few meters from the house. “I saw him go every day to the municipality asking for his due and trying to understand his situation, remembers a neighbor. We always said to him: “In a month, it will be settled.” It is not true, no one helped him except the new delegate, who arrived too late. “

The second method of suicide

The case of Abdelwaheb Jilani is not unique in Tunisia. It recalls the painful story of Mohamed Bouazizi, whose fatal gesture, on December 17, 2010, had lit the fires of the first “Arab Spring”. Shortly after Abdelwaheb, another man attempted to immolate himself on the roof of Jelma municipality, in public this time. He was prevented from doing so by residents. In 2019, a dozen people killed themselves, according to the local press. Fire immolations are no longer the subject of official statistics since the last peak in 2016 (there were then up to 100 cases per year), but they have become the second method of suicide (between 15 and 20% of cases ) after the hanging, according to child psychiatrist Fatma Charfi, president of the technical committee to fight suicide at the Ministry of Health. A ratio constant since 2011 specifies Mme Charfi, who adds: “It didn’t exist before.

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Doctors and psychiatrists come together to explain the permanence of the phenomenon, which sometimes refers to the gesture of protest by Mohamed Bouazizi, sometimes to mental disorders, for a minority of those who take action. The majority of profiles, men between 25 and 35 years old, were in situations of social and economic precariousness, sources of a strong feeling of injustice. Such recurrence reveals the country’s inability to meet the expectations of the 2011 revolution, whether socio-economic (the unemployment rate is around 15%) or political. “The phenomenon continues because the effect of the revolution is still present”, analyzes Sami Ouanes, a former psychiatrist at Razi hospital in Tunis, who treated several patients who survived their immolation: There are still social protests, discontent and dissatisfaction with the transition process. “

In 2013, the self-immolation of Adel Khazri, 27, on Bourguiba avenue, in the heart of Tunis, led the authorities to ban the retail sale of petrol at petrol stations. An ineffective measure: Abdelwaheb Jilani was able to obtain a one-liter bottle of gasoline. Access to certain flammable fuels or liquids is still fairly easy compared to drugs, for example “, ahead Amen Allah Messadi, whose resuscitation service at Ben Arous hospital, in the suburbs of Tunis, is the only one in the country to specialize in burn victims. If he is at the forefront of the tragedies, Doctor Messadi no longer wishes to communicate the figures: The media have helped make this a sensational phenomenon ”, regrets there. ” Today we need to move forward and help the survivors moreAdds this doctor anesthetist who has many “Seen” these last years. He created an association in 2017 to help burn victims whose care is very expensive and patients take a long time to heal.

A bottle of gasoline at his feet

In the reconstructive surgery department of the Sahloul hospital in Sousse, 130 km south of Tunis, Doctor Nidhal Mahdi raises a sensitive issue, that of the last moments of the immolated while their family is at their bedside: “In most cases, people who self-immolate themselves still speak, even when they are burned, but they die soon after because of the edema that forms. Instead of intubating them directly to help them breathe, we give them a little time to talk to their families. Often they regret their gesture or just want to ask for forgiveness, it is very important for the family to hear these last words. “

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For those who survive, reconstruction is laborious, for lack of real psychological and social follow-up. In the town of Tebourba, 30 km west of Tunis, Adel Dridi, 35, almost lost the scar on his neck from his burn. Street vendor of fruits and vegetables, he set himself on fire in 2017 to protest his beating by the police. The conflict related to his illegal status. “I just wanted to end this humiliation”, says the young man, seated in the family home, cigarette in hand. Since then, Adel has healed physically, but he keeps within him an intact rage, that of not managing to live with dignity. He only survives.

He built his own grocery store across the street from home, without help but without legal authorization. On guard during the construction phase, he placed a bottle of gasoline at his feet, threatening anyone who tried to stop him from setting himself on fire again. “I have nothing to lose except my mother”, he said. Adel shows the interior of his grocery store, whose shelves are still empty. Her story is so familiar. It resembles that of Abdewaheb: early school leaving, unsuccessful attempts to integrate into society … “What makes me angry is that people protested in the streets after my immolation, but I got nothing, he grinds. I’m still at the same point, fighting for life.

Faced with this looming despair, and the permanent risk of relapse, many doctors are mobilizing to try to contain the disease as early as possible. Child psychiatrist Fatma Charfi has thus set up a suicide prevention system by training primary care medicine to identify cases. “There’s a collective consciousness that has improved today about suicide, She says. We come to go beyond the question of religious taboo to try to apprehend suicidal behavior as a sign of mental suffering

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