Sometimes in life, one comes across people who change, the very way you perceive life and the world around you. They bring you closer to an ignored reality, introduce you to a different facet of life and change the way you have been looking at things. Undeniably, one can never be the same again after that. When I visited San Ker a rehabilitation center for the mentally challenged and addicts in Mawroh Shillong I was not, in the least, prepared for what I was in store for. However, there inside those unfriendly gates and walls was a different world and I wondered many a times after my visits there, which side is the rational or the sane world really?
In this quiet, serene and isolated area, just on, the outskirts of the city a different world existed since the early nineties; here a group of dedicated doctors and assistants lead by Doctor Sandy Syiem has been trying against all odds to create a sane atmosphere for the mentally challenged, the addicts and other patients with similar ailments. Outcaste by our so-called reasonable world, these people get acceptance nowhere. They find their equilibrium hereï¿½ in the tranquil, serene ambience of San Ker.
As my friend Wanda and I approached the gates, I was taken aback to see my face on the other sideï¿½ glaring back at me. For a second I did not realize what was it, how could I be on the other side I thought. Well, the management had installed looking glass on the upper edge of the gates so that if anyone peeps in they see themselves. Later Dr Syiem informed me, it was meant to do just that, to make us feel that it could be us on the other side. Certainly, it had me pondering for a while. Inside, I found no patient chained to the bed and looking blankly into nothingness, as is the projected image of such places all over the country. Remember the case in south India where nearly 27 patients, charred to death in an inferno, as they could not get to safety, being chained to the bed! What struck me the most was the humane atmosphere inside. There was no sterile look, no unfriendly nurses moving around or doctors doing the rounds with a half-baked smile and approach-me-not attitude. No dark or dingy corners or isolated wards, it looked like a social community center where people have collected to perform different activities in separate divided groups. A sense of participation prevailed among the inmates. Some were playing badminton, some football while some, sitting around and watching and a few, just gossiping and chatting. However, amongst them were attendants too, keeping a vigil over them, while participating in the activities. I should say initially I was slightly nervous as I entered the gates and a little vary about the kind of reaction we would get once inside the inmates area, having the misconception that we all have regarding mentally ill patients. In fact I was pleasantly surprisedï¿½ as me, my friend, accompanied by doctor Rica and Daaihun the in-charge, entered the gates we were graciously wished by one of the inmates. When I turned to look at her she looked me straight in the eye, I smiled she returned the smile and for that moment in time I knew she reached me as I did her. She was a woman in her mid fifties, with perfect accentuated English and graying hair, which she wanted to color into burgundy I found out later on. Just right for her complexion, I thought.
Naturally, we did stir up the atmosphere and generated inquisitiveness amongst the inmates; and I thought my worst fears had come true when someone, just caught hold of my hand. However, as I turned, I saw it was one of the inmates, she was smiling and saying something, I realized she meant no harm. She said she had seen me somewhere and was sure she knew me. I smiled at her and assured her that perhaps she is right. A woman in her mid thirties with a child, back at home she seemed to be eternally confused, regarding whom to listen to, the doctor or her Guruji who she thought, knew better. Well I tried to explained to her in my own way that Guruji was meant for spiritual problems while the doctors were here for her physical ailments and she should listen to them as they were technically qualified for thatï¿½ I wonder if she did follow my advice but she did thank me promptly for that. Amidst them was also a girl who was saying something I could not understand. Upon inquiring the Doctor informed me that she was annoyed as we did not pay attention to her. Well, I just nodded to whatever she had to say, not understanding a word of what she had said. After a while she walked away brandishing her hand in the air in an expressive mode, obviously she looked happy. However, the face that disturbed me the most was the face of an old woman, a widow, graying hair, eyes tormented with tears and anguishï¿½ shaking from side to side in short quick vacillating movement. She was worried about her son and repeating ï¿½my sonï¿½ my sonï¿½. Later I found out about her son; mentally challenged like his mother, lives with some distant relatives who ill-treat him. Through her eyes, I felt she understood what her son was going through, but she felt incapacitated to do anything for him. I do not know if my listening helped but her face would haunt me for the rest of my life, and it is in such moments that we realize our limitations as humans, many things in life are inexplicable and beyond our comprehension and even if we wanted to do something about itï¿½ nothing can be done. God does works in mysterious waysï¿½ I guess we all have to go through our ordeals and tribulations in life and the only way we can help each other sometimes is by sharing. We cannot change anything but perhaps we can bring a cheer in someoneï¿½s gloom and some relief to the suffering of the less fortunate.
Then I met this man with honey colored eyes and a humble smile. He knew his way around and was very acquainted with things around him. However, before I could mistake him for one of the assistants I found out that he was actually one of the ex-inmates who comes back here everyday to give back his little bit to the place where he found his life and realized what it was to live again. He had in fact returned from the nadir of alcoholism and addiction. He started at the age of twelve just exploring, and before he could realize he was heavily into it. With more then 20 years of addiction behind him, it was his 285th day out of addiction that day, after his relapse earlier. Love, care, understanding and acceptance that he received here in San Ker along with the treatment, has turned him into a person with a sense of responsibility for himself and the society. He comes to San Ker daily for counseling other addicts and helping them in their recovery. When I asked him what plans he has for the future, he promptly said ï¿½to give back to this place what he got back from here ï¿½his lifeï¿½ ï¿½. When I met him, I realized this world is not so hopeless after all, there is still hope and it is people like him who bring optimism to this world, restoring our faith in goodness, giving us reason to be happy and hopeful about. Many of the recovered patients with earlier history of either addiction or mental illness and perhaps those who have nowhere or no one, to go back to, have been employed here by the center itself. While for some, it is a second home wherein they find their equilibrium, in the quiet and tranquil atmosphere, where above all, love and dedication of the doctors and the helpers is the treatment, more then the medications itself. Indeed, this band of dedicated workers, are bound together by a deep sense of dedication and commitment they share for their common cause.
The inmates who are on the road to recovery, are given vocational training and encouraged taking up any hobby or activity, for which they have a natural flair for like painting, knitting, woodcraft, bamboo craft etc. Their artistic competence, can be matched with the best in the field, with lovely oil paintings, candle stands etc. on display, being ample proof for that. There are no isolated wards or separate rooms. The inmates are kept together in a dormitory kind of set up with separate sections for men and women. They are encouraged to participate in collective activities and exist in a group, where they can communicate and relate to each other as a responsible member of a society.
With no help or facilitation from the government, just a repayable loan from MIDC that has been multiplying because of the interest, and an occasional donation from a touched soul, Dr Syiem seem to be fighting against all odds to keep the rehabilitation center running with a meager charge of rupees 60 per day, with many poor patients just let off without even that sometimes. Initially starting with just 10 patients, kept in a Cowshed sparkled clean and turned into wards, partitioned into two for male and female, Dr. Syiem got a room to himself for OPD, after 10 years of opening of the centre. He gave up a paying lucrative government job, a future abroad, came to this remote isolated corner of his hometown and state, to open the rehabilitation centre for the poor and the needy. ï¿½For the richï¿½ he says ï¿½could go anywhere, it is the poor, who need helpï¿½. No wonder Dr. Syiem calls himself a hopeless optimist.
Struggling with cancer himself, a large part of his neck has been removed. Cancer being abated for the time being, though he did have a relapse a few months back, he says, his dream is to open a small unit for Cancer treatment, in the North East ï¿½ a treatment providing unit ï¿½ helping people to reach the right diagnosis and working in co-ordination with other larger institutes and hospitals of the country. His target is the poor segment of people who cannot afford to go out for treatment periodically, as is required in the case of Cancer. The amount of money spent on traveling, lodging and boarding, could be, in fact spent in the treatment of the disease itself, if such a facility was available here in the North East. Having first hand experience, he realizes what an uphill task it is for poor with less resources to get the best course of treatment and advice in the case of Cancer. Well Dr. Syiem has many dreams, shared by all his teammates, another one being a ï¿½hospiceï¿½ for the terminally ill patients, a place where they can die in peace, comfort and solaceï¿½ in acceptance of their impending destiny.
Agile and on his toes most of the time Dr Syiem hardly looks like a person who has had a tryst with Cancer and for the time being it seems he has beaten it with his optimism resilience and buoyancy. While the work of other psychiatrists in the same field like Dr C. Ramasubramaniam of Tamil Nadu , recipient of the `Best Doctor' award from the Tamil Nadu government in 1999 and whose M.S. Chellamuthu trust and research foundation for the mentally challenged has received equal recognition, Dr Syiemï¿½s contribution in the same field has gone unrecognized by the State government here. San Ker is only one of its kinds in the Northeast. However, who cares for the efforts and the endeavors of these dedicated people trying to make a difference in our so-called sane world. Are the people in position and power listening or even touched by the personal endeavors of these committed people, perhaps noï¿½ they are more busy with land deals and scandals, securing their position and chairs and trying to get a larger slice from the cakes of corruptions.
Although 30 percent of the cases are curable if detected on time, it is the social stigma attached to the illness that poses more threat to the recovery of the patients. Society insults and injures these patients causing relapses after treatment and cure. ``The problem is not with the patients but with society, which does not provide a congenial atmosphere for them', says Dr J S Bapna, director of the Institute for Human Behaviour and Allied Sciences, Delhi (IHBAS). Doctor Syiem also holds the same opinion, he feels that society discards and considers them as outcasts totally giving up hope on their recovery. Families discard them even if totally cured. Moreover, most of them languish in mental asylums and hospitals without being visited or taken care by their relatives. No wonder there are many cases where in the patients after cure still pretend to be insane, not wanting release from the hospital. Relapses are so common, abetted by the social conditions, that sometimes it all seems so hopeless, no wonder Dr Syiem says that the suicide ratio among all the professions is the highest in psychiatrists.
In a population of I billion we have 3500 registered psychiatrist, 37 government owned hospitals (most of them jails turned into one), Mental disorders affect almost 5 percent of the population. Only 16 lakhs patients have access to treatment. And according to NHRC report, 14 hospitals still have jail like structures, 20 have high walls, lighting is inadequate in 14 and 33 still have closed walls. This does not give a very good picture of the state of mentally challenged in our country. It is only when tragedy like the Erwadi case occur where 27 inmates were charred to death chained to their beds, that we wake up to realities. Although in papers, The Mental Health Act of 1987 ensures protection of the mentally ill. There are specific procedures laid down for treatment and care of the mentally ill, and the WHO Declaration of Rights of Mentally Ill, 1991, clearly declares their rights specifying, chaining and restraining a violation. However, it is still a long way to go before they get their due, as even the government has shown little interest in the matter.
The Central Coordination Committee that was set up to review and coordinate the activities of all governmental and non-governmental agencies dealing with the matter has met only twice in the last six years. While the Union Ministry of social justices says, it is a concern of Union ministry of health and they in turn are considering it as a state subject. Actually all government be it State or Central work in the same way, they will not deal with the problem and shift the responsibility on each other, till a case like Ervadi occurs. Which then makes the government go hyper with the issue, with ministers and officials vociferously shouting, showing statistics and data trying to catch the maximum slice of limelight, from the agony of the unfortunate. Ironically, in the pandemoniumï¿½ quiet dedicated and sustained workers like Dr Syiem are all forgotten.