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| Fire that Killed Chained Patients Throws Harsh Light on Mental Health Care in India DILSHIKA JAYAMAHA, -------------------------------------- (08-18) 00:25 PDT ERWADY, India (AP) -- The rusted iron chains that once shackled the woman are gone, but she is still bound by the horror of the fire that killed 28 other mental patients chained to stone pillars. The woman rocks slowly as she sits inside a thatched hut, wrapped in a dirty cotton sari. No one knows her name or where she came from, so she must remain in the asylum where she saw other patients die. The tragedy in this southern Indian village has drawn attention to the woeful plight of the nation's mentally ill. No one is certain how many of India's 1 billion people suffer from mental illness; it is clear many don't get adequate care. Only a few scorched pillars remain of the row of huts that once housed 46 patients in the Badshah asylum. All the survivors except the nameless, unclaimed woman -- who was unshackled before the fire reached her -- have been sent home. Until the Aug. 6 fire, Erwady was known only as the site of a 400-year-old Muslim shrine that some believed could heal mental disorders. It was also a village with about 16 small asylums for the mentally ill. The town of 10,000 is a mix of concrete houses and woven coconut thatched huts. Along its narrow alleys, goats dig through stinking piles of garbage. At another asylum, the Bismi Home for Women Mental Patients, a 30-year-old woman said what the nameless woman could not. "Please take me to a hospital," she pleaded through tears. "I promise to be good," said Bathmavathy, who like many people in Tamil Nadu state uses one name. According to Pakir, the man who runs the Bismi Home, the only treatment for patients is to "take them for prayers at the nearby mosque twice a day and one day they will be cured." The seven women he oversees bear the scars of shackles on their ankles. Pakir, who also uses one name, seems not to notice their emaciated frames and skin lesions. "If I don't beat them, I can't control them," he said. Berham Beebi, 50, sits on the asylum's dusty floor. She is bloated and her joints are elephantine. She says she eats soil. "Please, please, take us away. They are beating us. My genitals are injured," she said. Although the fire cast a harsh light on the treatment of the mentally ill, it was not the first sign of trouble: At least two reports detailing the desperate conditions of mental patients have been forwarded to state and federal health authorities in India since 1998. "This a crime against humanity," says I. Nazneen, principal of the Government Arts College for Women not far from Erwady. She has been lobbying the state for two years to address exploitation and cruelty toward mental patients -- appeals that have been waved off. S. Swamylal, chief of the state psychiatric hospital in Madurai, the main city near Erwady, says the government makes periodic visits to the thatched hut asylums to advise owners on hygiene and patient welfare. He notes that many Hindus and Muslims believe in the healing powers of places of worship rather than taking advantage of what medical care is available. "Enforcing the law takes time, especially because it involves religion. This incident may hasten the process," Swamylal said. Tamil Nadu's health secretary, Syed Munir Hoda, said many people prefer to stay in private asylums because of their religious beliefs. He said a psychiatrist was posted at a government clinic near Erwady last year, but few sought his advice. "This has been a bad experience, we must now move forward," Hoda said of the fire. For Erwady's mental patients, moving forward will not be easy. Many of their relatives and their caretakers believe the soil -- and even the chains -- are part of a mystical cure. Nurjehan, 52, has been chained to a tree at the Erwady shrine for five years. She growls softly as Muslim prayers come through loudspeakers. Her husband and their two daughters sleep beside her. "The chains will spring open when she is cured," her husband said. The state government, facing increasing criticism since the fire, has ordered the asylums in Erwady to close this month. It plans to transport remaining patients to government institutions, said C. Semmalai, Tamil Nadu's health minister. "It is the previous government's inaction that has led to this situation," he said, trying to shift blame. India's federal government has worked on developing community-based approaches to mental health care. But the $62 million program begun in 1997 hasn't reached enough people. There are non-governmental rehabilitation centers with better conditions. In Madurai, 55 people are housed at Shristi, a clean, pleasant facility where patients make greeting cards and other items for sale in nearby towns. The profits help run the home. The fire in Erwady also has reignited debate on conditions in government-run institutions. Water drips from the pipes at the Institute of Mental Health in Madras, the state capital. Sanitation facilities for its 1,600 inmates are abysmal. Some improvements to the old buildings have been made with private donations. Dozens of women, some filthy with mucus and dirt, sit around or plead for attention while children and adolescents, some naked, crouch or crawl nearby. It is Erwady without the chains or even the prayers. ----------------------------------------- On the Net: Aid organization site, www.aidindia.org. Disability site, www.disabilityindia.org ~~~~~~~~~~ Action Alert ~~~~~~~~~ NEWS RELEASE - August 28, 2001
"THEY WERE BROUGHT FOR CURE BUT WERE
KEPT CHAINED IN THEIR BEDS IN THATCHED HUTS."
PROTEST HELD IN INDIA TO SPEAK OUT
ABOUT THE DEATHS IN ERVADI OF 28
PEOPLE WITH PSYCHIATRIC LABELS
INTERNATIONAL APPEAL FOR LETTERS TO
AUTHORITIES IS ISSUED BY INDIA ADVOCATES.
Support Coalition International received the below
report from India about a protest of the recent
deaths of 28 people held captive in a psychiatric
facility in Ervadi, India. There is a call for letters to
authorities. For more information, contact the
e-mail addresses in the forwarded alert, below:
<wamhc@vsnl.net>, <henri@pronet.net.in>
~~~~~~~~~~~~~~~
From: "BAPU" <wamhc@vsnl.net>
Subject: APPEAL TO THE INTERNATIONAL COMMUNITY
FROM BAPU TRUST, PUNE.
Date: Tue, 28 Aug 2001 17:11:38 -0700
~~~~~~~~~~~~~~~
Message from
Center for Advocacy in Mental Health
C/o Bapu Trust
7 Krishna House
Pune 411 042, Maharashtra, India
Tel: 6872672; 6359969
e-mail: <wamhc@vsnl.net>
~~~~~~~~~~~~~~~
Protest against the violations of human dignity at
Ervadi Mental Home, Tamil Nadu.
Held at Apte Prashala co-ordinated by Bapu Trust
and Schizophrenia Awareness Association, Pune, on
18th of August, Saturday, 2001, at 4.30 p.m.
~~~~~~~~~~~~~~~
Brief contents of the event:
Over 50 activists and concerned people and
organizations attended the meeting. Mrs Sadhana
Natu of Bapu Trust gave the context for the
meeting. Speakers were Bhargavi Davar (Bapu),
Manisha Gupte (MASUM) and Dr PT Lavatre (Supdt.
Yerawada Mental Health Institute, Pune).
Anil Vartak (SAA) and Mrs Bapat (SAA) spoke about
the stigmatizing nature of our society towards the
psychiatrically disabled. The activism of Tamil
Nadu groups, notably People's Watch was shared;
their study report and press release was
circulated. The various official lapses were
highlighted. Social attitudes and stigma was
discussed.
The role of closed-door mental hospitals in
maintaining the dignity of patients was
questioned. A signature campaign was taken out.
Letters are being sent to Maneka Gandhi, Dept of
Social Justice & Empowerment; Hon CJI, Mr Anand
and NHRC chief, Justice Verma. Press release was
handed over to the reporters who attended. Mr
Acharya from SAA expressed thanks for the
solidarity which brought everyone here.
The State Mental Health Authority, statutorily
mandated by the MHA 1987, is not implemented in
TN. The private trade in mental illness therefore
goes on unchecked. The issues of licensing, board
of visitors, minimum standards of care and
inspectorate, covered by the MHA, are completely
bypassed due to this non-implementation.
Community mental health programs, which promises
outreach, have not been implemented nor have they
met their goals in a majority of states, TN being
no exception.
Even though the Persons with Disabilities Act of
1995 provides the legal context for
non-discrimination and positive rights for
persons with psychiatric disabilities, in no
state in India has this constituency been granted
any benefits or welfare programs.
Other state judiciary such as the Supreme Court
and the High Courts of various states have
regularly issued recommendations regarding giving
proper care and treatment in mental hospitals.
However the apex court has never, in a normal
day, pulled up any private or state facility for
contempt of court when they default from the laid
out strictures, which they regularly do.
The case of the private trade and brokering of
psychiatrically disabled patients in Ervadi has
been known to officials of various cadres for
at least two years now.
The family and community is not necessarily
always caring, as this case bears out. The
prejudices that society has against various
marginalized groups (such as women) have also
worked against the inmates of this mental home.
It is not only an issue of people with
psychiatric disabilities or of their carers. It
is everybody's issue, everybody who cares about
the quality of life of human beings on this
planet. Therefore we must all respond to it.
We all have the power to change the system.
Hospitals can be caring places if only families
also participated fully in care instead of using
the hospitals as mere dumping grounds. Indian
hospitals have seen many stages of legislative
reform, and yet there are several problems about
the present law, which must be addressed.
Even for administrators who care, it is a battle
with the higher ups that want to maintain status
quo. Change must be brought about at all levels,
family, community, policy and law. The user voice
must be empowered and strengthened to be able to
take up this formidable task.
~~~~~~~~~~~~~~~
APPEAL:
Please read our letter of condemnation and send
off similar letters from your own organization,
locality or region to the concerned officials.
~~~~~~~~~~~~~~~
To: ALL CONCERNED OFFICIAL AUTHORITIES
FROM:
DATED:
In CONDEMNATION OF OFFICIAL LAPSES THAT LED TO
ERVADI TRAGEDY
At Badhusa Mental Health shelter in Ervadi,
Ramanathapuram 28 people were killed by a fire.
They were brought for cure but were kept chained
to their beds in thatched huts. When the fire
started they could not escape. The community did
not intervene and the owner has abdicated himself.
Every other year institutional abuses and
violation of rights of people with mental
disabilities in state run as well as private
facilities are brought to light. In the last
decade, we have heard about the wrongful
confinement of patients in jails who were kept in
highly deplorable conditions in very many states
of India, leading to several PILs; and about the
forced hysterectomies of girls with mental
disabilities in a state hospital.
The Mental Health Act of 1987 is not implemented
in many states, including Tamil Nadu where this
incident has happened. The State Mental Health
Authorities are non-functionaries in most states
and the licentiate and inspectorate do not exist.
The community mental health programs mandated by
the National Mental Health Policy is linked with
the PHC and have proved to be non-starters in
most states.
Even though 'mental illness' is considered to be
a disability, not even one state has opened up
facilities or social welfare benefits for this
group of disabled. The Disability Commissioners
are not even aware that psychiatric problems are
covered by the Persons With Disabilities Act -
Equal Opportunities Act, 1995. Private facilities
do not follow even the limited mandate of the
Mental Health Act.
Many residential facilities in India stand
blatantly in contempt of the Supreme Court
recommendations following the PILs.
We demand that:
1. States should implement the MHA and make the
slumbering authorities accountable
2. The psychiatrically disabled must be included
in all welfare schemes and benefits given through
the Persons With Disabilities Act
3. The various HC and SC rulings on institutional
care should be implemented and errant institutions
should be made accountable
4. Law should cover the rights of persons with
psychiatric disabilities with respect to care and
treatment
5. Justice should be served to the hapless
victims of the ERVADI tragedy by legal activism
against the state officials and the private
officials responsible for it.
~~~~~~~~~~~~~~~
Please send your letters to :
1. Ms Maneka Gandhi, Ministry of Social Justice
and Empowerment, Government of India, 25 Ashoka
Road, New Delhi-110001
2. Justice JS Verma, Chairman, National Human
Rights Commission, Sardar Patel Bhavan, Sansad
Marg, New Delhi 110 001
3. Honourable Chief Justice of India, Shri Anand,
Supreme Court of India, Bhagwandas Road, New Delhi
- 110 001
4. Chief Commission for Disabilities, Ministry of
Social Justice and Empowerment, Government of
India, 25, Ashoka Road, New Delhi- 110001
~~~~~~~~~~~~~~~
Please mark a copy of all your activities /
responses to <wamhc@vsnl.net> and
<henri@pronet.net.in>
Bhargavi Davar.
- end -
~~~~~~~~~~~~~~~
This action alert forwarded by:
Support Coalition International
454 Willamette, Suite 216
PO Box 11284
Eugene, OR 97440-3484 USA
email: office@MindFreedom.org
web: http://www.MindFreedom.org
phone: (541) 345-9106
toll free in USA: 1-877-MAD-PRIDE
fax: (541) 345-3737
Support Coalition International is a non-profit
federation of 100 grassroots groups united
to win human rights and humane alternatives
for people labeled with mental disabilities.
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