The Kingdom of Bahrain is an archipelago of 33 islands, located in the Arabian Gulf, covering 2400 km2. The main island, Manama, is the nation's capital. The total population stands at 742 562, 62.3% of whom are local Bahrainis and the remaining 37.7% expatriates (Central Statistics Organisation Directorate, 1991). Bahrain first entered the historical stage around 3000 bc, and for almost 2000 years was the centre of the old Dilmun civilisation (Bibby, 1969). Dilmun was perceived as a sacred land by the Sumerians and Babylonians; it was a burial ground for their dead, and Bahrain has over 100 000 burial mounds each containing 200–250 bodies. In the old Babylonian epic of Gilgamesh, which antedates Homer's Iliad, Dilmun is described as a paradise where the worthy enjoy eternal life (Clarke, 1981).
Al-Haddad & Al-Offi (1996) provide a history of Bahraini psychiatric services. Before 1930, no institution cared for psychiatric patients in Bahrain. Left to look after an ailing relative, families often devised their own form of therapy. One of the most common remedies was conducting a Zar ceremony, which was thought to help rid a person of the demons or jin believed to be responsible for mental ailments. Other forms of treatment included reciting verses from the Holy Quran, as well as cautery applied on either the occipital or parietal regions of the head.
In 1930, Charles Belgrave, the English counsel to Bahrain's ruler, suggested the creation of a place for local ‘lunatics’ which would safely put them under the direct supervision of the Municipal Council. In 1932 a small house was rented in the capital to host 14 patients (12 male, 2 female). The residence was named the ‘Mad House’ and psychiatric patients were looked after by ‘attendants’ (who were essentially labourers rather than nursing staff). The Municipal Council continued supervision of the asylum until 1948, when responsibility was transferred to the Department of Health. A report by Dr Snow, chief of the Department of Health at the time, illustrates improvements to the asylum; the building was refurbished and newly painted with pleasant colours, and patients were encouraged to spend more time outside their cells.