Remember ME - You Me and Dementia

August 13, 2009

INDIA: India's forgotten and abandoned patients

. LONDON, England / BBC News / South Asia / August 13, 2009 Eastern India's most prominent mental health institute, in the city of Ranchi, has recently published a list of 98 patients "abandoned" by their families. They were brought here for treatment and even though they are now stable, they are languishing because their families refuse to take them. The BBC's Geeta Pandey reports. A group of women stand in a hall, praying: "God, give us strength, to conquer our minds. Before we conquer others, let us conquer ourselves." Among the women is Laxmi Jaiswal. Her advanced age is etched in the lines of her face. "I've been here a very long time, at least 20 years," she tells me. Hospital records show that it is even longer than that - 23 years and two months. Laxmi has come to terms with her reality In the years that Laxmi has been incarcerated, she has not had a single visitor. She was initially diagnosed with schizophrenia. After she stabilised, several letters were sent to her address, but there has been no response from the family. She doesn't discuss her life with other inmates. "I keep it buried in my heart. If I were to tell anyone, will they be able to return me my family?" she asks. Gently nudged by Sister Celine, the supervisor of the hospital's female ward, she pours out her heart to me. "My brother-in-law brought me here. He didn't get along with my husband. I had children, whereas he didn't have any. He didn't like that. He snatched my children from me, and dumped me in this madhouse. My husband did not intervene," she says. 'No idea': Laxmi has spent a better part of her life in the institute, forgotten by her family and the outside world. "We had a large farm in Bihar and my husband used to sell tobacco. I have no idea where he is now or why he never came to see me. He must have taken a second wife, or maybe a third one." Laxmi is mother to five boys and six girls. "They must be all grown up now. I miss them," she says, tears clouding her eyes. Although abandoned by her family, Laxmi is yet to abandon hope. Recently, she told the hospital staff that one of her sons was living in Ranchi's Upper Bazar area. "It's a very congested area, we spent an entire day there, but the patient was unable to identify the house. She named a pond, then a market, then a by-lane, but we couldn't trace her home," Sister Celine says. "She's an old woman, she's been here far too long. It can happen to us. Even if you or I go somewhere after a long time, we may not be able to recognise the place," she says. In this 500-bed hospital, Laxmi and Agnes are among the 98 people on the list of abandoned patients. Clinical psychologist at the hospital Amul Ranjan Singh says the reason why families reject a patient is because in India there is a stigma attached to mental illness. 'Myth': Most people believe that once a person develops a mental illness, he or she can never be cured. "There's a myth that a mental health patient cannot do day-to-day activities or earn a livelihood. And a majority of our patients come from poor families who believe that these people won't be productive economically." Hospital staff say some patients are found wandering on the streets and are brought in by the police and there are no records of where they came from. Then, it all depends on what the patient remembers once he or she is stable. Sometimes, they are able to remember and give their details, but sometimes memory lapses result in mistakes. "Sometimes the families refuse, outright, to take the patient back. How do we tell a family that the patient is theirs if they refuse?" Sister Celine asks. 'Denial': For the patients though, coping with rejection can be a very painful affair. "They go into denial," says Dr Singh. "And there are two ways of denial - either they deny the existence of their family, or they deny their attitude towards them. "Specially the female patients never forget and they keep expecting that somebody will come for them. Males easily agree that probably there's nobody around who will come, and they say, I don't want to go back home. "Sometimes after a few months, you find the same patient roaming in front of the institute. Their families come and leave them here. This is pathetic. We take them back in and try to give them a life of dignity here," he says. The hospital's sprawling campus is divided into separate male and female wards - 150 places are reserved for women and the number of male patients is 350. The male ward has nearly three dozen "abandoned" patients. Here I meet Budhwa Munda, weaving cloth on a loom. He's 62 and has spent 36 years in the hospital. "He has grown old here," says caretaker Jehangir. Budhwa was brought to the hospital in 1973 by the police and letters sent to the authorities have gone unanswered. Budhwa doesn't talk at all, he speaks only with gestures if he needs anything, and Jehangir says they have no idea about his family. 'Take me home': Working on the loom alongside Budhwa is Ramji. He was brought to the hospital by his family when he was a boy. "When he came here, he had no facial hair. Today, he's greying, so you can make out how long he's been here," says Jehangir. At the time of his admission, his family wrote down a false address and no one has ever come to see him. Letters sent to the address have all come back. "Please take me home," Ramji appeals to me as soon as he sees me. "Send someone with me who will take me by the hand and put me on a bus. He can drop me home and come back. I'll return a year later." I'm perhaps the only visitor Ramji has had in a long time. Or maybe ever. He follows me around as I move on to speak to others. His desperation, and the hope in his eyes, is gut wrenching. For these abandoned men and women here, home's a far away place, a chimera, a mirage. And it will perhaps remain out of reach for most of them, forever. Laxmi, however, seems to have come to terms with her reality. "Since this is the place I have been mandated to live in, I will live here till the day I die. After that I will meet my maker." [rc] © BBC MMIX