Oped»
Nowhere to go
JUL 15 -
A few days ago, I had received a message from Sharada Sharma, an author and novelist. She said, “Jagannath, I wanted to tell you that I have managed to admit Maila in Aasha Deep, a treatment and rehab centre for the mentally ill. Although Maila’s problem, whom I used to encounter almost every day in my locality Chundevi is likely to be solved to some extent, I am aware that this does not solve the problems of so many homeless Mailas in the country, is not it?”
It was one of the few arresting messages I have been receiving since I started to write on mental health issues. It was an act of a responsible citizen. It will inspire other people to look after fellow humans who are on the street, homeless and mentally ill. Though individual acts of charity are not a sustainable solution, they help to create a basis for advocacy to draw social and state attention to take essential action.
Before deciding to admit Maila to Aasha Deep, Sharada Sharma had been doing the rounds of different organisations, government agencies and political leaders for the last two years. But she got no help to support a human being who is fighting with his destiny on the streets because of his ill mental condition. After reading her article published in Kantipur almost a month ago, I came to know about her determination to help the mentally challenged and homeless people in Kathmandu. In that article, she had questioned human sensitivity and the role of the state that isolates humans on the basis of illness.
In a recent conversation, Sharada Sharma told me, “There is no state for the people who are living with different mental health conditions.” She added, “In Nepal, there are 17,000 NGOs working in the health sector out of the total 27,000 NGOs registered with the government. But these 17,000 health NGOs are indifferent to the health and human rights concerns of mentally challenged and homeless people like Maila.”
In dealing with mental health in Nepal, there is a fundamental problem with the government. However, the Ministry of Health and Population in its recent five-year National Health Sector Programme (NHSP-II) has included mental health. It is yet to identify the intervention area and to develop the programme. This strategic paper states, “Mental health problems are clearly widespread, and may be associated with the legacy of conflict and with the very high rates of violence and suicide; but it is less clear what can be done that will be effective within the resources that are available.”
The paper adds, “Before committing to major expansion of mental health services, one or more scalable pilots will be implemented. The initial approach will focus on giving basic mental health training to health workers in the pilot districts, beginning to cover mental health issues in health education programmes and to integrate mental health within primary health care following the guidance issued by WHO.” It is a big question for the government how it should deal with the issues of mental health services in an emergency and the challenges of growing homelessness resulting from mental illness.
The case of Maila can give some insights for policy makers and politicians of this country in addressing mental health problems, poverty, social exclusion and human rights violations. According to Sharma, “Maila was born in Chundevi, close to Maharajgunj. His parents died when he was young. After his parents died, his two elder brothers migrated to other places leaving him alone. He left school and was not assisted to receive any skill oriented training. For some years, he did labour work around Chundevi. But for the last three years, when his mental health condition became chronic, he came to the streets. Though he was a member of the Chundevi community by birth, no one cared about him because of his ill mental health condition, and he has survived for the last three years by begging and sleeping on the street.”
Thanks Sharada Sharma, because of your kindness, Maila has been rescued from the street and is receiving treatment at Aasha Deep, a residential treatment and rehab centre of Maryknoll Nepal situated at Nayapati, Sundarijal, Kathmandu. It is the only quality home in the country where chronically mentally ill people can receive care and treatment. Since its inception, it has been supported by the Maryknoll Fathers and Brothers, US that pays for 60 percent of the centre’s expenditures.
Maryknoll was established in 1991 with the main aim of releasing all the chronically mentally ill patients locked in different jails like Central Jail in Kathmandu and Dhulikhel Jail in Kavre. These patients had been imprisoned for many years, solely for being mentally ill. There were no hospital facilities to accommodate them, and the families did not want them back due to the stigmatising, chronic and relapsing nature of their illness. Psychiatric treatment within the jail does not exist. The other two aims were to provide treatment and then to rehabilitate the mentally ill within their own families and communities.
Its executive director Prabhat Kiran Pradhan told me, “We are having a hard time generating resources to pay for the 40 percent of our expenditures. There is no guarantee that we will always be supported by the Maryknoll Fathers and Brothers. If they stop supporting us, we will sadly have to close down this rehab centre despite our unprecedented contribution and need to advocate mental health services in the country.” If Aasha Deep has to close down, it will be a disaster for the mental health sector.
Let’s hope Aasha Deep will function more effectively and Sharma will be able to generate the resources needed to treat Maila for some months. Once Maila becomes healthy, he has to return to the community. But he has no home, employment, family or education. The government has no programmes to protect and enhance the livelihood skills of such people. Where will Maila go? How will he face the social stigma of being mentally ill? How will he survive a normal life? And, finally, what about the other Mailas who are still on the streets in the absence of basic human care and treatment?
jagannathlc@gmail.com
Posted on: 2010-07-16 09:00
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