It is becoming increasingly common to see homeless people all over the country, especially in Thimphu. Most are mentally ill. These people are abandoned by family, friends and the society at large because of their mental condition. It has been found that many people with mental problems admitted to the hospital are without proper care and often without an attendant. This concern is not just typical in urban areas. These people live without anyone’s support and some are quite often locked up under inhumane conditions without proper meals and shelter and totally alienated from the society.
Bhutan being a happiness-focused country with a small population, such problems should not arise. It is heart breaking to see our fellow citizens going through terrible times, living without food, shelter, and without any support. Some of them can be seen loitering in towns, sometimes being aggressive and threatening the lives of others as well as their own. Sometimes go begging without proper clothing.
There are a number of examples of people who have been suffering from mental illness and have no support. Recently, a person who used to be a health worker was found to be suffering from depression and he had no attendant to take care of him. At the initial stage, his neighbours supported him by providing him food. There is also a case of a 36-year-old lady from Mongar who is suffering from schizophrenia since she was 11 years old. Although she was treated several times in different hospitals, her disease relapsed many times and finally she was locked up and kept in a hut in a pathetic condition. She was not taken for further treatment because her mother could not bear the cost and the family members did not have time to take her to hospital nor let her stay with them. There are other such examples of the people who are silently suffering with similar conditions.
Recently, a man named Dawa was found loitering around Gelephu town, who looked hideous with long hair, dirty and stinky. He had been living in a drain. He was found eating from the garbage and drinking from the drains. No one cared about him for a long time. However, for Dawa, although late, help finally arrived. A social group that calls itself “All for One and One for All” (A11A) have taken a noble initiative by coming together to help him. The group with help of the health workers from Gelephu Hospital brought him to JDWNRH, Thimphu and arranged for an attendant who was paid for a month. After a month, the hospital discharged him as he had become quite stable. The group also tried to admit him to the rehabilitation centre in Serbithang. Dawa was finally sent to a rehabilitation center in Siliguri, India for further treatment with the help from JDWNRH management. The group mobilised funds from their members to pay for the treatment.
The situation here is that the small social working group like A11A cannot sustain or reach out to everyone who may require help without proper support and intervention from government. Mental illness is a leading cause of ill health, suicide and disability globally because of an appalling lack of interest from governments and NGOs. Many countries lack the basic legal framework to protect the people with mental disability. Although a lot is done in the medical sector for diseases like HIV/AIDS, malaria, disability, kidney diseases, TB, etc. there is surprisingly lesser attention and focus towards mental health. The people affected with mental disability are mostly and alarmingly among the young and middle-aged people ranging from 20-40 years of age, who form the economically active section of the society. These people as a result are bereft of the opportunity to equally fulfill their dreams and aspirations unlike healthy people. Instead, due to a lack of support for treatment and rehabilitation, these people become a burden to their own families.
It, therefore, has a significant impact in the intellectual and economic development of the society and the country as a whole.
If you visit psychiatric ward at the hospital, you will find different patients, some with their relatives/attendant helping them, some alone crying for help. Others are hungry and helpless. The hospital is concerned and offer help as much as it is able to, but it is often not enough as the hospital can only support to a certain extent to the patients brought to them. A proper system needs to be put in place in order to identify, report, treat, and to fully rehabilitate such patients and this has to be a mandate of the Government.
We do not want to have permanent mental home for such patients. However, it is possible to establish “half-way home” manage by mental health professionals where the patients are kept engaged and are taught some useful skill. Some countries even have a system where the relatives and friends who takes care of the patient are compensated by the government. Bhutan could adopt similar practices with proper monitoring system in place. A survey by the government might be useful in identifying the number of patients who are in need of such care.
It is high time our government learnt and followed other countries that have tackled such problems successfully.
Deepak Pokhrel is a member of the voluntary group called A11A ( All For One, One For All)