She kept pacing tirelessly across the room where the inmates had gathered for an activity session. It was as if the regular rhythm of her moving feet helped lull the agitations of her mind. Mother Carolina told us that she would keep spitting all over the place and if rebuked, would promptly clear her throat and go on to repeat the spitting act with obvious defiance. But when she came and sat on the chair in front of Dr. Chitra, she appeared docile and co-operative. She wanted to go home , she kept repeating. Afterwards , she continued with her walking in the verandah and in the activity room, sitting for just a few moments and resuming again. She had complained to Chitra about aching legs without being able to make any cognizance of the association between her constant walking and the pain.
The rest , all twenty three of them, sat on chairs in a wide circle, some drowsy and nodding , some listless with blank stares, others with bent heads, drooping lips and sagging shoulders, as if grief and hopelessness were weighing them down. A few were of course abnormally perky, just waiting to be asked something for them to break into into a ceaseless disjointed narrative .
Mariamma(name changed) had been asked to take on the role of the class teacher during this activity session. With a piece of chalk , she was diligently writing down the names of all those seated there , on a slate. She then instructed them in a very authoritative tone, to say “present “, when she’d call out their names. All of them complied without a word, not once but several times, till the volunteer present there had to kindly but firmly coax her to get on with the class. When he tried suggesting what they should do, she was adamant that he shouldn’t interfere ,as the first hour was her period and she would be taking maths.
Mariamma had been a primary school teacher. Her body language and manner of speaking gave the impression that she must’ve been quite efficient in her job, may be a tard too much of a disciplinarian. For the past twenty years, she hasn’t been what we call “normal”. She has a younger sister who was apparently quite well off. Maraimma wasn’t exactly in indigent circumstances either. But she was not welcome in her sister’s house. So she has been spending her time in one institution or the other.
Here in Snehabhavan in Alapuzha, (Kerala), Mother Carolina, an elderly nun of the Visitation Order and two other much younger Sisters, take care of Mariamma and others like her with all the love and compassion that the most loving parent would extend to their vulnerable little children. It there is improvement in their condition, they are sent back to their relatives, so that others who are more in need of their care can be accommodated in this Home. Most of them are chronic cases of mental illnesses, some who have been under treatment , while some have been just left to themselves with gradual and complete deterioration of their faculties.
I had reached “Snehabhavan” with my friend Dr. Chitra Venkateswaran. Chitra is a psychiatrist who has spent quite some time in the Palliative Care Wing of the Calicut Medical College, tending to terminally ill patients both within the hospital premises and also visiting them at their residences as a part of the Home care programme. Now she is on the faculty of the Amrita Hospital at Ernakulam where she works for three days in a week on a salary . She spends the next two days providing free clinics at several places, counselling and prescribing appropriate medication for mentally ill patients, under the aegis of “Mehac” , a charitable Trust of which she is a Founder Member.
The sisters at Snehabhavan brought the patients to her one by one . She talked to them , assessing their behavioural patterns and changing the medication or modifying the dosage. Some of them had been brought to Snehbhavan after many , ,many years of illness.The families had given them up as lost cases , sometimes in sheer helplessness, their indingent circumstances making it impossible for them to seek medical help on a continued basis or buy medicines for the patient , week after week and year after year. Sometimes, where financial well being was not so much of an issue, the family had neglected them out of just plain disgust.
The abnormalities came in all shades of a wide spectrum.According to Dr. Chitra, medication may not be able to completely reverse the conditions of psychosis or scizophrenia or other cases of extreme mental disorders. But they did help to contain the disturbances and keep them calm enough to be able to help them lead a less chaotic day to day life, both for themselves and for the other members of the family , who were responsible for them.
To be continued…