Sunday, June 19, 2011

Being Hospitalised in Mumbai

This came from a victim of a century old private hospital in Mumbai.

I was in my teens when they first diagnosed me with OCD. Back then, I was living in quite a dysfunctional family. My parents were on the verge of getting divorced. I had a bad relationship with my mother. The doctors prescribed me different pills but there was no relief. Also, they were against any sorts of alternative treatment, which in fact might have proved more effective than the medication. After completing high school, I was under lots of parental pressure to join a medical college, which I did. I didn’t like to study medicine. So, after attending classes for about a week, I stopped going to college. Instead, I used to sit depressed on the railway platform and would return home after college timings. One month later my parents received a letter from the college authorities informing them of my poor attendance. Reading it my mother lost her temper and started to abuse me. I was in no mood for any more agony. So I started crying and begged her to leave me alone. But she didn’t stop. Following which I had a nervous breakdown. I was depressed and frustrated, but not to the point that I'd hurt myself or anybody else. My parents consulted a few psychiatrists. One of them was Dr. Daruwalla (name changed) in a century old asylum in Mumbai city. (Recently this hospital was exposed. MBR) At the first visit he seemed to be very polite and helping personality. Not like my regular shrink, who used to look down upon me. Dr. Daruwalla brainwashed my parents. He suggested that I be hospitalized urgently. They agreed. And as I was tired of taking the cocktail of prescription pills for OCD since my school days, which actually never cured me, I too agreed to the hospitalization. I was just hoping things would get better, not knowing how horrific the whole experience might turn out.
After entering the psychiatric ward at his private hospital, I was petrified by what I saw. The conditions inside were pathetic. Some patients chained to their beds were wriggling like fishes caught in a net. They were screaming, hurling abuses at the staff, while the ward boys simply teased them. Some patients quietly watched all this from their beds. Whereas, others seemed too drowsy even to watch the commotion. And this was in a hospital with a psychiatric facility which was touted as one of the oldest and the 'best' in Mumbai. The first night I was very scared, but dropped off as the meds started to have their sedative effect on me. The next day I was woken up by the noise of a young man wailing and screaming “Please, leave me! Somebody get me out of here”. I saw that a few ward boys were forcibly dragging him out of the ward, hitting him every time he screamed. After he was out, the whole ward was silent for about a minute. They probably took him to the shock room. As such, I'm a shy person so I didn't talk to other patients or the ward boys unless they initiated a conversation. For some time I observed the plight of the aggressive and frustrated patients, which was quite disturbing. It was evident by their emotions and talk that they were not there by their own choice. No relatives ever came to visit them. Some of them had been in this place for more than 6 months or a year! Though I was happy to know that my parents would not keep me here for more than a month or so, yet I realized it was too late to escape the 'treatment', and any refusal or retaliation would mean much worse treatment. Therefore, I tried to be submissive to the doctors and the staff. I didn't like it but then, that was the only way to avert any additional abuse.
During my stay they subjected me to around 15-20 ECTs. Each morning a ward boy would come to pick me up to take me to the ECT room. Inside the room I was told to lie down on the operating table. Then as the nurse put the oxygen mask on my face, the doctor would give me an intravenous injection in the forearm, and suddenly I'd pass out. When I’d wake up in the afternoon, I’d find myself on my bed in the ward. In addition to all this torture, they’d also give me high dosage of oral medications, which used to make me feel sleepy throughout the day. Each day, Dr. Daruwalla would visit the ward and only ask me one question, “Kaise ho?” My mind was too numb to even form a sentence. So I'd usually reply in one word, “Better”. Hearing which he'd move on to the next patient. Now, this continued for a couple of weeks after which I got extremely bored and started requesting him for a discharge. But he'd just say, “Yes, we will discharge you after the treatment is completed.” My dad used to take time out of his busy schedule and visit me nearly every day. After about a month, noticing that my condition has started to deteriorate; that I had put on weight, my speech got slurred, my memory had started to drastically decline; my dad requested Dr. Daruwalla for the discharge. But, he was reluctant to give it. On the contrary, he started demanding my parents to send me to some rehab center, situated somewhere in the outskirts of the city, for at least a year. My parents visited the center which was in a pitiful shape. They soon understood the true intentions of Dr. Daruwalla and decided to get me out of the hellish hospital as early as possible. After much effort, and paying around 150,000 Rupees as overall treatment costs, my father somehow managed to get my discharge. Soon after discharge my parents discussed about my condition with some other doctors. And it turned out that whatever treatment I received in the private asylum was totally unwarranted. It had only made my condition worse than before. Though, the staff at the institution didn't verbally or physically abuse me, but it was only because I conformed to all their unnecessary routines and treatments. Had I fought for my rights inside the hospital or for those of other patients, the hospitalization would have prolonged and it could have made my discharge more difficult. It was a terrible ordeal for me and my family. I regret trusting Dr. Daruwalla more than he deserves.

Sunday, May 29, 2011

Check this out and add to the comments


Excerpts of an open letter to the Collector, Vadodara, from some groups there.

Subject:  Care of Destitute, Mentally Challenged Women in the District
This is to bring to your notice our struggles to access care for a destitute, mentally challenged woman in Vadodara City.
On May 20, 2011 we were approached by a compassionate citizen to look into the situation of this ‘Unknown Woman’ sitting on Old Padra Road (Rajvee Tower junction) since several weeks.  That day she was observed by this citizen without any lower garments and with what seemed to  her, like a massive growth in her genital area.  Because her own humanitarian sensibilities were extremely disturbed, she approached us.
That started the endless rounds for our team.  From May 20, our team approached/visited the following institutions:
  1. A home for such destitute women – we were told that before they could accept such women, they needed a Gynaec certificate and a Psychiatric Certificate.
  2. OP Road Police Station
  3. Mental Hospital, Kareli Baug
  4. Gynaec. Dept., SSG Hospital
  5. Psychaitry Dept., SSG Hospital
  6. Emergency Dept., SSG Hospital
  7. Magistrate’s Office at Nyay Mandir.
At almost every point, we encountered  a tendency to not accept responsibility and to shunt the woman out of the institution. The Mental Hospital/Psychiatry dept asserted that her Gynaec condition had to be treated first. The Gynaec. Dept stated that her third degree uterine proplapse was not an emergency and that her mental treatment had to be started first. The woman and our team were like ping pong balls.
Finally at 5 am morning, after a whole day and whole night effort,  on May 25, 2011, after shunting between the Magistrate’s office (twice), the Mental Hospital, (thrice), The Emergency Dept. (twice) and the Gynaec. Dept. (twice), we managed to get her transferred to the Psychiatry Dept.,  after admission and  referral from the Mental Hospital at 3.30 am. Our team and the poor disturbed woman had been on the road since 11 am on May 24. She is now admitted in Ward 14 under Psychiatric care.
Since yesterday, May 26, the Mental Hospital is threatening to withdraw the attendants that they had provided for the woman. The Psychiatry Dept. and the Gynaec. Dept.  in SSG Hospital will not keep patients without attendants.
Our expectation from you is that you direct the Mental hospital, as she is formally admitted there, to provide all care including attendants, till her treatment is complete.
This is the case of one woman. There are other women that our team has identified on Old Padra Road and near Khande Rao Market.
Our questions are as follows:
  1. Who’s responsibility is it to provide care for such women? Which institution’s? Care to be specified as compassionate competent care that respects the dignity and safety of such women.
  2. How can different departments shunt such women from their doorstep? Who will ensure that immediate care is provided until longer term solutions are arranged?
  3. Does the SSG Hospital have no provision for  single destitute  women who need treatment, if they are without an attendant?
  4. Can your office ensure a systematic identification of such women without infringing on their human rights and a system of care for them?
We are willing to work with you on this issue.

Woman without a past or a future

This came from a friend Sayyah in Maharashtra.

MK was found on the road in a village of Maharashtra and brought by a ‘good Samaritan’ to a Home for mentally ill destitute women in 2007. We would have liked to talk to her; that is what we do but it is not possible because this is a woman without a past or a future.
The Home has a visiting psychiatrist, resident nurses, psychiatric social workers and many times even a psychologist who look after the women rescued from the roads. The psychiatrist had diagnosed MK with Mental Retardation with Behavioral Problems… overly talkative, excessively cheerful, she did not seem to understand what was being told to her, her responses were inappropriate. She had grandiose ideas; she thought she was a police inspector! She reported that her family had blamed her for their misfortunes and had asked her to leave. The social workers sent her family letters and postcards at an address she gave but the Indian Postal Service sent those back, stamped with failure. We do not know anything more of her past.
At the Home, MK was feared for she had great tempers boiling inside. She did not make many close friends, preferring to be outdoors and engaged in hard, manual work rather than women’s work inside the cool shelters of home. She had the strength of many men, it is told, being large and strong in constitution, so she voluntarily participated in the construction work underway at the Home that was expanding to accommodate those like her; ‘mental’ women. She planted the gardens of the Home that have grown tall and straight today. However she was stubborn about her chores indoors or attending the prayer sessions, she fought with everyone, she did not like to socialize, rather she would talk to herself, do badbad, laugh inappropriately. She wanted to be married, a young woman like her, not yet 30. But a home for women has no men.
In fits of rage, she would try to run away from the Home. How could MK survive the rigours of the world outside the walls? The social workers had to track her down and then persuade her to come back. Sometimes she would be beyond persuasion. Then for her own good they would be obliged to bring her back anyway … but she was so strong, two-three men could not hold her down. Battle-weary, they found they could not handle her uncontrollable violence after two years. In January 2009, she was to be sent to the mental hospital , equipped to deal with violent cases like hers.
The court order, required to commit someone to a mental hospital, was followed through clearly. She was accompanied by a psychiatric social worker who recounted in front of the court that MK is psychiatrically ill and needs hospitalization. Two doctors, one the personal doctor of the patient from the Home, the other an external, neutral party, both though from the local Mental Hospital gave (almost similarly - worded) accounts as to her mental state. The district magistrate spoke to her in person and found her responses insensible. On January 23, 2009, under Section 20 and 22 of the Mental Health Act, MK was committed to the famous local Mental Hospital, situated half a kilometer away from the even-more-famous Jail for three months.
It is doubtful if anyone visited MK during her stay at the mental hospital, certainly not her psychiatrist or anyone from the Home. In the first week of March 2009, the Mental Hospital contacted the Home that MKs health was in critical condition and she would need to be shifted to the local General Hospital. A social worker and the nurse from the Home visited her before she could be shifted. She was sitting propped up in her bed, eyes dull but still cogent that she had visitors from the Home. She had partially healed scars on her arms. MK, the one with the strength of many men, seemed unable to support her own weight, as if her back would not hold her upright again.
Within the week, MK died in the care of the Mental Hopital.
Cause of death- unknown.
No death certificate has been issued.

Friday, April 1, 2011

Ajji's story

This story was shared by Ellen SS ...

Ajji had been living on the streets for about 20 years or so. She was recognized as somebody who needed treatment when she was eating food off a dustbin, but somebody found that her english speaking skills were terrific. She had been abandoned by her hubby and her children did not even bother to think of her. Her daughter who came to see her body after her death hardly had any remorse in her eyes even as she came to see her mother's body. Ajji’s hubby was a lecturer at a PUC college and made good money with private tuitions. When I came to this asylum as a volunteer, to my horror, this was worse than hell itself- anybody's nightmare. I was completely convinced that institutionalization only made people go from bad to worse.
No would never work here, nor in many places like this all over India. I was seriously aghast at the way these psychiatrists treat the very people who trust them so much and ruin their lives with their professional negativity and overmedication focussed on symptom treatment and nothing else. The doctor was only interested in making money and nothing else. Every week he collected huge amounts of money from nursing colleges; In return for the money, he forced ECT upon those clients who were outspoken and protested against the things he did on the pretext that they hadn't recovered. He did this so that the nurses-to-be in training would have an opportunity to understand how ECT was performed. These were demonstration rackets involving nursing colleges. Once I asked him what happened to the people who received ECT- This doctor replied in a matter of fact manner 'Well, their brains get fried'. The social workers said Ajji had been found wandering on the streets of xxxxx speaking perfect english and shouting abuses at strangers in impeccable cum absolutely grammatical English. She was brought here for treatment. When she was brought she was violent owing to the life she had led on the streets for more than a decade with no family to call her own. She was cleaned with strips of coconut barks dipped in coconut oil to remove the dirty grease that stuck to her skin. She was then caught hold of by the professional social workers here and given a hot water bath and some hot food to eat. Then she was asked to stay in a corner and shut up because people could not understand why she was so rude to the others in her speech. The great doctor failed to investigate why she became what she became and wouldn't have cared to find out either. When I spoke to her and tried cognitive behavior therapy, it did not work. How could therapies that were victim blaming and advocated a 'healthy adjustment to the environment' despite the fact that the environment had been thoroughly pathological, ever have a positive impact on clients. Did it address their lived realities? People kept teasing her and the mental patients in the asylum fought with her and earned her wrath.
Ajji spent all her time abusing the others who first abused her and as I could see she had every reason to be angry. The others always provoked her to entertain themselves. She complained about a horrible pain in her tummy. When she told the doctor about this he said 'you are a liar- you are only saying this to attract attention'. She endured the pain for about 4 months and then when it became terrible one day she refused to eat her food. There was just one asylum nurse for a hundred patients and her name was sister zzzzz. She addressed the patients with statements like 'you donkey - come and take this medicine and you monkey, eat your food. If you die I will be held responsible' etc. One fine day I heard Ajji had urinated and defecated when I was at the top floor observing the clients. Then I said to another woman client that we should take dettol and clean her up. When we went down with a bottle of dettol we found Ajji was lying on her back with her tummy completely swollen. It was a case of hernia and the intestine was protruding from the stomach a little. The doctor who was examining her said she would not live after he tapped various parts of her body. I told the chief doctor of the asylum over the phone that Ajji was dying and needed an ambulance if there were to be any hope of her reviving her.  He sent an ambulance. The previous night when the nurse reported that Ajji wasn't eating the same doctor had said, 'If you play all these dramas we shall have to force feed you with a tube which we will insert into your mouth or nose'. While she ate hesitantly, the hernia that had been ignored for quite sometime gave way, and a part of her intestine protruded out of her stomach by noon the next day. When the ambulance came finally and I was lifting Ajji and making her rest against my body in the van, the social workers kept quarelling with each other as to who should accompany Ajji to the hospital. 'It is not my business it is yours ' said each social worker to the other. On the way she was taken to some hospital which I don't remember and the doctor tapped Ajji's body and said she would not live. I was concerned even as I saw how dignified Ajji was even in her pain. She had tightly shut her eyes as though this were to be part of some bad dream- not once did the word 'pain' cross her lips.
When we finally reached the hospital and took her to the emergency ward I heard the sister with me give a call to the asylum chief on her mobile and say 'This woman will not live - shall I prepare the death certificate?’ The chief said that they were to make sure her body is not released to her relatives until they have paid all the money for the care they gave all these months. I was so angry: what was the care he had given her- abuses, scoldings, negation of her reality of pain, utter neglect of the hernia. And this is the man who comes out in public and talks about 'the legal rights of the mentally ill'.
What happenned to Ajji finally? She was on a ventilator for three whole days and cared nothing about her pain. All she asked me when I went to see her for three days even as she lay dying was 'Have you had your breakfast my child? You know i am supremely happy because my daughter has come to see me!!' and the next thing I knew was she said 'my children, my children, my children' even as she passed away. She was full of concern for a daughter who cared not what happened to her mother. Was she cared for in this institution run by xxx? No! She had only been retraumatized and forced to die of a mental cum physical torture. When she told the chief doctor that she had a stomach problem and loose motions he said 'Prove to me that you have loose motions by shitting on your plate and showing me the shit’.
This happens in such places, so don’t recommend asylum to anyone.

Monday, March 7, 2011

Bharthi ajji's story

A friend, Allus-J, from Bangalore shared this story:

As part of her Ph. D., she was volunteering with a closed door facility in B'lore. I mean a mental asylum. There she was able to work only 15 days. Then she bolted out of horror and grief.

Bharthi Ajji was incarcerated there, said to be 'schizophrenic'. A-J found her clutching her stomach with severe pain. The hernia had started to show through the navel. She insisted with the ruling doctors that Bharthi Ajji needed emergency care. The doctors neglected this until she could bear it no more and was literally collapsing. A-J was shocked that the attendants in the asylum were not willing to accompany Bharthi Ajji. A-J herself accompanied her. But it was too late. Ajji was admitted in the hospital, many days too late, and died in the hospital.

How people die in such facilities is an untold story.

Thursday, February 3, 2011

Zubin's story

It was a heavy monsoon day and the city was flooded. Even though it was only 4 in the afternoon, the sky was gloomy, and the low chassis buses skimmed through knee deep water. Not many people in the bus today, as I boarded. I headed for a popular, crowded dosa-idli joint in South Ex and waited for my anonymous friend to arrive. I tried my best to be comfortable, with my shirt and trousers hanging on me, wet with the heavy shower.
A tall, heavyset young man wandered towards me, his clean shaven face honest and smiling, his hand extended. “Zubin”, he said, introducing himself. I said my most improbable name, and he laughed.
His story...
He had loving parents, and both were busy working, until he became depressed. He could not take the pressure of studies in the elite MBA school. In the second year he cracked up. They brought him back and put him in an institution. Matter of factly, he narrated the many times his parents put him away in the institution. He said this quietly, without judgment or remorse or any expression of anger towards his parents. He seemed okay with that or he was not telling. His hands were trembling and shaking without any relief. He was many times what I had imagined to have been his pre-meds size.
He talked mildly about being sexually abused in a popular lock up facility in Mumbai. His voice fell and he went still. His eyes were downcast. His shoulders stooped. But his voice was non judgmental.
He talked about friends inside the also popular lock up facility in New Delhi: One of them was a writer. Her brother had migrated to the US, and had incarcerated both his mom and his sister. Zubin was sad about this and wanted to do something. He had checked with lawyers. They said to file habeas corpus. He didn’t know if his parents would allow that. Another one was there because his family could not take his spiritual pursuits. This other man was about 55 years of age, and Zubin felt that was the correct age for thinking about God. However that man’s family had disinherited him and put him away.
Zubin needed to talk to someone about this. So that's why we met. Story over, he got up to leave.
Sadly, I watched Zubin walk away. Never heard from him after that. He didn’t respond to my emails. Hope he is okay.