Recovery

A decade-long study by the World Health Organization that followed 3,300 patients found that people with schizophrenia do far better in poorer nations such as India, Nigeria and Colombia than in Denmark, the U.K., and the U.S. Patients in poorer countries spent fewer days in hospitals, were more likely to be employed and were more socially connected. Between half and two-thirds became symptom-free compared to only about a third of patients from rich countries. This calls into question modern psychiatry's belief that schizophrenia is a organic brain disorder and best treated through medication and hospitalization. The researchers concluded that the stronger family ties in poorer countries have a major impact on recovery. In Dr. Vatwani's view, in addition to medication, an active family and village life contribute to recovery from schizophrenia. This is why he places such emphasis on reuniting patients with their families and communities.

Pushpa serves Shraddha by preparing food for patients and staff.

Pushpa  personifies how social context supports recovery. She suffered a psychotic break after the death of her mother ("my best friend") and wandered the streets of Borivli for six months. When she was found by Shraddha social workers, she was arguing with an internal voice as she lay in filth. Declining being reunited with an abusive family, she has remained at Shraddha for eight years. Pushpa (name and photo used with permission) has found her family here at Shraddha. She feels safe here and says, "They treat me with respect." 

Perceptions of Mental Illness in India

Understanding schizophrenia in the Indian context has been very eye-opening. Psychosis in the traditional Indian view is due to jada tona or black magic in which an individual is inhabited by a bhoot or spirit. What is interesting to me is that in India there seems to be so little fear of patients with schizophrenia compared the United States where the culture seems to believe that people experiencing delusions or hallucinations are dangerous. I haven't seen patients with schizophrenia at Shraddha that are agitated or out of control. On the contrary, they seem quiet, even timid. Perhaps because they aren't seen as a threat, people with mental illness seem more integrated into Indian society, especially in rural areas. Though it's difficult to generalize about a country as complex as India, there seems to be less stigma associated with serious mental illness here. Dr. Vatwani however, believes there is more stigma in urban areas than rural areas. Perhaps this is due to more easy access to Bollywood and Hollywood films that usually portray people with mental illness as psychotic killers.

Doc

Dr. Bharat Vatwani is the founder and guiding light of Shraddha. Starting in 1988 with a two-room tenement in Mumbai, Dr. Vatwani treated a few homeless mentally ill at a time. In 1997, the proceeds of an art exhibition of leading Indian artists and the contributions of several donors led to the opening of a 20 bed psychiatric facility in Mumbai. Unfortunately neighbors took Shraddha to court for housing "roadside, psychiatrically disturbing elements" that were perceived to be a threat to their community. In a landmark finding, the Mumbai High Court found that “mentally–ill, roadside destitutes are as much entitled to medical help as any physically indisposed person.”

In 2006, Dr. Vatwani was able to acquire 6.5 acres 90 kilometers southeast of Mumbai. The Karjat center provides a rehabilitation model that includes agriculture for up to 70 patients at a time. Over 1900 of the mentally ill homeless have been helped off the roads, treated, rehabilitated and reunited with their families throughout India.

In this clip Dr. Vatwani discusses how he was inspired to commit his life to serving homeless people with mental illness.

Reunion

Kamala returns home (photo used with permission).

Kamala's mother with grandchild.

The ultimate goal of Shraddha is reuniting patients recovered from schizophrenia with their families. Since 2006, over 1000 patients have been returned to their families. I've just returned from a road trip in Shraddha's ambulance through Maharashtra to northern Karnataka. I joined three social workers in reuniting three patients with their families. The last patient, Kamala, was a Banjara tribal woman who left her people seven years ago and was found psychotic on the streets of Mumbai three months ago by Shraddha social workers. In village after village around Aurad, the social workers asked Banjara people if they recognized Kamala or knew where to find her village. In the Banjara village of Bijalwadi Tanda, a woman called Kamala "Diwani" or Beloved, a common term in south India for those we call mentally ill. Deep in rural India down kilometers of brutal dirt track, we finally tracked down her home village of Nandi Bijalgau.

I was up front in the ambulance with social worker Vikram Shelar and driver Manaram Choudhary and had an excellent front row seat view of the extreme sport that is Indian driving. There were no seat belts. Glad we survived the road trip....

Life at Shraddha

A patient milks a cow (top); another prepares a paddy for planting rice.

Through the haze of jet lag and soggy monsoon heat, I am slowly adjusting to life at Shraddha. There are currently 42 men and 16 women who are patients at Shraddha. They have been found wandering the streets in florid psychosis in various parts of India: West Bengal, Uttar Pradesh, Jarkhand, Tamil Nadu, Maharastra, Rajasthan, Orissa, Haryana, Gujarat, Karnataka and Andhra Pradesh. Stabilized on medication, patients participate in the production of food and milk used to sustain Shraddha.

Posting here will be challenging given the very limited access to the internet at Shraddha or Karjat. I'm grateful to social worker Mansoor Rizvi for the use of his internet stick.

Inspiration

The mission of Shraddha is inspired by Anandwan (आनंदवन in Marathi), an ashram and community rehabilitation center for people with leprosy founded in 1948 by social activist Baba Amte (1918-2008). Influenced by Gandhi’s ideals of simplicity and truth and his fight against injustice, Amte was active in the Indian independence struggle and organized lawyers to defend the Indian freedom movement’s jailed leaders. He was arrested and imprisoned by British authorities in 1942. Baba Amte envisioned Anandwan, literally Forest of Joy, as a model of social and environmental justice. Using organic farming techniques and micro-water management, residents are self-sufficient in terms of basic subsistence through agriculture. Anandwan generates income to sustain the community through home-based, small-scale industry run by the residents. Anandwan today is spread over 200 hectares and has two hospitals, a university, an orphanage and schools for the blind and the deaf; more than 5,000 people are dependent on it for their livelihood.

Senate bills passed!

I got an email at 3:30 this morning from Olivia Seppi, a hard-working senator from the NMSU student senate. She wrote that she had pushed all 13 of her bills through tonight's final senate session of the semester. Of course, I'm especially excited about the passing of bills 226 and 227 which fund my work at Shraddha in Karjat, India. I'm very grateful to Olivia for the time and effort she put into getting my bills through the student senate. Grateful too for the support being offered by the Associated Students of NMSU.

The senate was still in session when Olivia wrote at 3:30 this morning. I hope she doesn't have a pressing academic deadline today. . . .

The journey begins

I got a ticket to India today, thanks to the efforts of Dr. Gary Lowe and Owen Cortner of Aggies Go Global, NMSU's initiative promoting international learning experience. Starting in June, I'll be volunteering at the Shraddha Rehabilitation Centre near Karjat in the state of Maharashtra. Shraddha is a unique farm that houses homeless men and women with schizophrenia and uses vegetable cultivation and dairy farming as part of the rehabilitative process. The farm, established in 2006 on 6 1/2 acres in the undulating grassy hills of Karjat, can house sixty men and women at any one time. Shraddha has helped more than 1200 men and women struggling with schizophrenia to get off of the roads and ultimately back with their families in far flung villages and towns throughout India.  You can check out their website here.

Oh, yeah, in Sanskrit, Shraddha (श्रद्धा) means faith.