Alter Ego

ALTER EGO is a film that we made quite some time ago but which is still very near to our hearts. It took us about 5 years to make the film, following the work of Dutch psychiatrist Joop de Jong in Guinea Bissau. During this time he is setting up a modern Mental Health policy, embedded in the developing Public Health structure of this former Portuguese colony.

Part 1 ("All is Wind") shows the situation De Jong met with when arriving at his post: a few beds in the worn-down city hospital where until shortly before the 'traditional' Portuguese kind of psychiatry was practiced (meaning: people were locked-up, chained, electro-shocked).

Since De Jong believes in modern psychiatry he starts to build a new open center ('no walls') for psychiatric patients, just outside the town of Bissau. This means quite a lot of reasoning with local authorities (the Minister of Health supporting him), ongoing education of the local medical personnel and a lot of organisational talent in a country with no real medical tradition, lack of building materials, transport problems, and so on. De Jong regularly goes - on his motorbike - to the rural areas, assessing the prevalence of mental disorders with the help of the nurses who are staffing the rural health centers, making contact with the traditional healers (who are always consulted by the local population first in case of psychosis, epilepsy, depression, etc.) and trying to understand their way of thinking and to possibly integrate them into the health structure of the country.

The traditional local belief is (as it turns out to be) that every disease is - somatic or psychological - the result of bewitching, of not complying with traditional rules and neglecting ceremonial mores.
De Jong tries to integrate (the recognition, referral and treatment of) psychiatric illnesses into the system of Public Health as the 'seventh disease'. At the time WHO had formulated 'six diseases', such as malaria, that should be recognised and treated by these rural medical workers as a filter for the referral system to regional and national hospitals.

Part 1 ends with the inauguration of the new clinic and the moving of the patients from the old hospital to the new Mental Health Center.

In part 2 ("Only one head I have, not two") we get to know about the proceedings in the new clinic, we get acquainted with some patients more intensely, we are present as the nurses get more and more responsibility in the treatment of the patients and so on.
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The doctor's trips to the rural areas are continued, his research comes to an end. He's writing his thesis. Meanwhile, his contacts with the traditional healers become tighter. In the end one sorcerer is willing to visit the clinic and help inaugurate a holy tree on the terrain of the clinic to be able to have traditional ceremonies go on in the clinic as well.

ALTER EGO is edited (it was praised for its 'American pace') as a series of letters of the doctor to friends back home.
The film had a theatrical distribution in The Netherlands and was aired on national TV 3 times and was screened at the Margaret Mead Film Festival 1987 quite successfully. The film is still used in the preparation of doctors and other people for their job in Africa.

ALTER EGO would not be outdated: I don't think a lot has changed in Africa in this respect.
Maybe it even has become worse...

Amsterdam, 2019
Joop van Wijk