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.

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....

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.