Skip to main content

Mental illness: Gujarat's vulnerable sections "forced" to approach quacks, private doctors

Counterview Desk
A recent scrutiny into the state of public health in Gujarat by a voluntary organisation, Sahaj, with the help of two dozen-odd activists and experts, has found that things are particulalry bad with regard to mental healthcare for the backward sections of society. Offering four case studies, it says, there is, in fact, "no public health system that deals with the issue of mental illnesses in the area which is particularly vulnerable because of extreme poverty, chronic health issues."
Suggesting that the Gujarat government infrastructure in the mental health sector is centred around major towns, the study says, it comprises four hospitals, one each in Ahmedabad (317 beds), Vadodara (300), Jamnagar (50) and Bhuj (16). Additionally, psychiatry departments of (government) teaching hospitals at Ahmedabad, Vadodara, Jamnagar, Surat, Rajkot and Bhavnagar provide additional 157 psychiatric beds.
At the district level, however, things are bad: "Honorary psychiatrists visit district hospitals 2-3 days in a week, with a mental health worker who maintains records. Currently, such services are available in six of the twenty five districts: Bharuch, Panchmahals, Sabarkantha, Junagadh, Mehsana and Banaskantha."
Offering four case studies from different areas of Maliya in Morbi district of Gujarat, the study, "Monitoring the Progress of Sustainable Development Goals in Gujarat: Situation Analysis for Selected Targets from SDG3 and SDG5" highlights difficulties in accessing these services. It says, people in "progressive" Gujarat do not have much knowledge about health services for mental health, forcing them to "approach the local ‘bapu’ or a traditional healer", who refers them to "private doctors in Gandhidham or Morbi."
It continues, "Some people do approach the community health centre (CHC) in Maliya but the doctor himself says that they are not equipped to deal with mental health issues. He says that he usually refers the cases to Morbi or Rajkot Civil Hospitals. Hence, people in the community are forced to go to private doctors in nearby towns."
The study notes, "When a person from this social and economic background approaches a private health service the financial burden on them is tremendous. Family incomes are not regular and the range for the expense on the treatment on mental illness is approximately Rs 2,000 to Rs 9,000, including travel to local towns. The situation forces them; they either borrow money or sell their land or sell their jewellery."
"In some cases the families when unable to mobilise money for the treatment, are at times forced to tie the patient to prevent harm to themselves or others around them", it adds. Text of the four case studies:

Case Study 1

Twenty four year old Farida lives in Zakariya village. He father died four months ago, her brother and mother keep very unwell as they are highly malnourished. There are unable to work on the salt pans, hence the mother and brother do stitching of bags for the storing of salt. They earn approximately Rs. 125 per day. The work is done for about 8 months in a year, the rest of the year, her brother works as a farm labourer and earns approximately Rs. 150 per day.
According to Farida’s brother, she is unable to do any work as she is suffering from mental illness and regular medicines need to be given to her to control her fits. It is necessary that she takes medicines regularly as otherwise her fits make it impossible for her to even sit. She listens to no one and is uncontrollable and shouts and screams.
The brother says that she was born like that but for many years she was never taken to any doctor as they were unaware of what should be done and no treatment was available. It was only recently that they took her to a ‘bapu’ in the block where it was suggested that Farida be taken to a hospital in Morbi.
Her treatment in Maniar Hospital in Morbi costs approximately Rs 1,200 every month and it is impossible to get medicines every month as the income of the family is not enough for basic subsistence let alone bear the cost of her medicines for mental health. The family does have a Mukhyamantri Amrutam card, but the illness that Farida suffers from is not covered in any of the hospitals.

Case Study 2

Fifty-year-old Amnaben of Nava Hanjiyasar has three daughters who are married and stay in their marital homes. She and her husband live alone in their house. Her husband used to work in the salt pans until recently he had a kidney operation. At present there is no earning member in the family as the husband cannot. Her initial symptoms of mental illness started about seven years ago.
According to her daughter, she initially got high fever and pain in the ear. She was taken to the Maliya CHC, but as there was no improvement in her health. Her daughter said that there are times when her mother runs away into the village in the middle of the night. Someone constantly has to be with her so that she does not run away, especially during the night. When she gets attacks she even tears the clothes that she is wearing.
Amnaben was taken to private hospitals in Maliya and Morbi. The doctors informed the family that “magaz ki nas me khoon nahi mil raha” (the nerves in his brains are not getting blood). The family feels that it is due to the constant heat in the salt pans that has affected her nervous system. They then took her to various private hospitals in Rajkot, Gandhidham and Ahmedabad. At present she is being treated by a private hospital in Ahmedabad.
Frequently people from the village go to the city to sell prawns and get the medicines for her from the city. The expenditure on Amnaben’s medicines and the treatment on an average is Rs. 60,000 per year. The family had initially borrowed money against the 12 bigha (3 acres) of land, which they have been unable to repay.
Presently they have to depend on the money that Amnaben’s husband’s brother gives. And have to constantly keep borrowing from ‘saga sambandhis’ or relatives. Her daughter said that Amnaben’s health has been better since the past 6 months, the attacks have reduced but have not disappeared.

Case Study 3

Sixty-year-old Jakkhabhai lives with his wife and one son and one daughter in Nanavada village. He has 6 sons and 3 daughters. He cannot work, his wife and youngest son work. His wife has 4 buffaloes which give milk and she sells the milk, going door to door. On an average she earns Rs 200 in day. The son herds the buffaloes of neighbours and earns Rs 200 per day.
Mumtazben, his wife, says that her husband has been mentally ill for almost 25 years. He does not even sleep and creates a ruckus in the house. At times he hits her and there have been instances when in his hysteria he has even tried to throttle her. In the night he leaves the home and goes around walking and at times banging on doors of neighbours. He talks to himself, randomly starts singing and abusing passersby.
In the initial years he was taken to Maniar Hospital in Morbi by Mumtazben. Later he was taken to a private hospital in Gandhidham which is almost 100 km from Maliya. He was admitted in the hospital for about a week, and then his health improved and was brought back to his village.
Since then he has been getting his treatment from Maniar Hospital. The medicines need to be administered every 15 to 20 days. The family tries to arrange money in whatever way they can as it becomes very difficult to handle Jakhabbhai if he does not get his medicines and has an attack.
Last when they had gone to Maniar Hospital, they were advised to give him injections to control his fits. But the son was asked to sign a consent form saying that if something happens to his father then the hospital will not be held responsible.
The son did not agree to the terms hence the doctor told him that he should go to Krishna Multi Speciality Hospital, but it would cost them at least Rs 500. The son did not have so much money, so he took his father back, buying only the medicines and not the injection.

Case Study 4

Six-year-old Krish lives with his mother, maternal grandparents and maternal uncle and aunt in Taragadhi village. His father left his mother, Savitaben when she was two months pregnant. Since then she lives with her parents.
Krish studies in class one. He is accompanied by his grandmother to school and she stays with him the entire time. He needs to be helped with all the tasks as he is unable to do any task independently. His mother says that he gets hysteria, from the age of 7 months.
From his birth he has been taken to various private hospitals in Morbi, Rajkot, Ahmedabad and Gandhidham. The doctors say that insufficient blood is reaching the brain and hence he has various mental issues.
Krish has 50 percent mental retardation as per his disability certificate, and has to get his medicines continuously from various private hospitals. He also has cerebral palsy, which is 70 percent and leads to movement disability affecting his vision, swallowing and speaking. His symptoms are poor coordination, stiff muscles and tremors and frequent seizures.
At present he is being treated in Krishna Hospital in Morbi. On an average his family has to spend Rs 8,000 a month on the medicines and travel for Krish’s treatment. Over the years they have spent around Rs. 3,00,000 on his treatment. Savitaben earns around Rs 3000 in a month by working in a local stationery shop.
Her parents work on local farms as daily wage labourers and they on an average earn Rs 6000 in a month. She has not availed any scheme as she is not aware of them (MA, Viklang Sahay Yojana etc.).
As Savitaben stays in her maternal home her name is not listed for any of the entitlements that she should be getting. She has to struggle hard to get the money. It is difficult for her to borrow from people as they are aware that her capacity to repay is very limited.

Comments

TRENDING

HSBC shareholders seek exit from funding Adani's 'contentious' Australian coalmine

By Our Representative  In a move that may embarrass India's top business house known to be close to Prime Minister Narendra Modi, shareholders of HSBC, a British multinational investment bank, the largest in Europe with total assets of US$2.715 trillion, are likely to decide at its AGM on May 28, 2021 a plan to exit coal financing related to the Adani Group, as it begins digging the Carmichael mega coal mine in Australia, reports Melbourne-based South Asia Times.

Gross 'injustice' to children: Rs 5000 cr cut in education budget; 15 lakh schools shut down

Counterview Desk  More than 100 dignitaries, including educationists, academia, social activists, teachers’ union, civil society organisations (CSOs), various networks and people working on child rights, in a letter to Union Finance Minister Nirmala Sitharaman have sought reversal of reduction in allocation for education in the Union Budget 2021-22, even as demanding substantial increase in it.

Communal rhetoric? Hindutva preached by RSS-BJP is 'monolithic', not Hinduism

By Prem Verma*  I am a devout Hindu but not a believer of RSS Hindutva form of Hinduism which brings about hatred of other religions. My Hindu religion has not taught me to look down on other religions and neither has it instilled in me to go about converting others to my religion because my religion is superior.

Buddhist shrines massively destroyed by Brahmanical rulers in "pre-Islamic" era: Historian DN Jha's survey

Nalanda mahavihara By Our Representative Prominent historian DN Jha, an expert in India's ancient and medieval past, in his new book , "Against the Grain: Notes on Identity, Intolerance and History", in a sharp critique of "Hindutva ideologues", who look at the ancient period of Indian history as "a golden age marked by social harmony, devoid of any religious violence", has said, "Demolition and desecration of rival religious establishments, and the appropriation of their idols, was not uncommon in India before the advent of Islam".

Ciminalising 'tool' created, name: Gujarat Land Grabbing Prohibition Act 2020

By Varsha Bhagat-Ganguly, Rejitha Nair* The year 2021 in Gujarat opened its account with 647 alleged land grabbing cases under investigation, 16 FIRs filed against 34 land grabbers within 35 days of Gujarat Land Grabbing Prohibition Act 2020 (GLGPA), as informed by the Additional Chief Secretary (Home), Gujarat State, in a press conference on January 22, 2021. He further informed that of 647 alleged cases, 605 applications of land grabbing were received by different collectors who have initiated suo moto proceedings in 42 cases. The total land in these cases is estimated to be around 1.35 lakh square metre, worth Rs 220 crore as per jantri rates (ready reckoner of land prices in different parts of the state). By March 15, 2021, at least six even cases are before the Gujarat High Court. Of about 11 cases reported in the daily newspapers, in three cases, grabbing of government land is charged, and the rest are land disputes between two individuals. The promptness of the district collect

Swami Vivekananda's views on caste and sexuality were 'painfully' regressive

By Bhaskar Sur* Swami Vivekananda now belongs more to the modern Hindu mythology than reality. It makes a daunting job to discover the real human being who knew unemployment, humiliation of losing a teaching job for 'incompetence', longed in vain for the bliss of a happy conjugal life only to suffer the consequent frustration.

RSS love for 'killer' Myanmar junta behind Indian military presence at Tatmadaw Day?

By Shamsul Islam*  If a shameful act means an action which is criminal and nauseating, it would be an understatement to describe the attitude of the present RSS-BJP rulers of India towards the demolition of democracy and large-scale killing of the people of Myanmar by the military ( tatmadaw ) junta which took power through a coup on February 1, 2021 after renegading the election results in which the party of Aung San Suu Kyi, National League for Democracy, was a clear winner.

Chhattisgarh’s Apra riverfront imitates Sabarmati: 'Devaluing' water, environment

Sabarmati riverfront By Mansee Bal Bhargava*  This year’s #WorldWaterDay (March 22) focus was on ‘Valuing Water’. My school friend, Pragati Tiwari from Bilaspur, Chhattisgarh, called that day knowing my interest in water matters. We were remembering our childhood days as how we used to play on the banks and the bed of the Arpa Nadi (River) during the summer holidays and as how the river would swell like Anaconda to flow happily during the monsoon.

Bihar massacre on Holi day: Brahminical, casteist mindset behind 'uneasy' silence

Bihar chief minister Nitish Kumar By Vidya Bhushan Rawat*  Several people were killed in Bihar amidst Holi festivities, but not much response has come in from the media. The silence of the government and the society as a whole is also appalling. We seek to romanticise these festivals, yet we forget that every year they take so many lives. This despite the fact that Holi appears to be the best time for 'avenging things'.

India's draft migrants policy: Whither concern on job restrictions imposed by states?

By Anil Kumar*  India’s Niti Aayog has prepared a Draft Migration Policy. The draft policy acknowledges migration as an integral part of development, and it calls for positive government interventions that facilitate internal migration. With a rights-based solution to migration, the draft states that the policy should “enhance the agency and capability of the community and thereby remove aspects that come in the way of an individual’s own natural ability to thrive”.