While I write this piece, my mind is numb.
It straight away takes me to the wee hours of 6th August, 2001, when the unthinkable happened at Erwadi Dargah in Ramanathapuram district of Tamilnadu.
“Erwadi Tragedy” is something which a thirty year Indian today may not even have a clue about. But when it happened it shook the nation.
So What was the Erwadi Tragedy?
It was a tragedy of humongous proportions that shook the national conscience, albeit briefly and is, best exemplified by the way the magazine Front Line depicted it –
“THE chain is blackened and the ring is horribly twisted but still fastened to the charred stump – of a leg. Mentally challenged and physically shackled he was, yet Murugaraj had desperately tried to free himself. Twenty-seven more mentally ill people died with him in the early hours of August 6 when a fire engulfed the thatched roof of the Moideen Badusha Mental Home at Erwadi, a fishing village 27 km south of Ramanathapuram town in southern Tamil Nadu. They were stripped of dignity when they lived – chained, confined and ill-treated. The manner of their death was even worse” (Front Line Magazine, August 18-31, 2001)
At Erwadi Dargah thousands mentally ill people have been coming daily for more than 200 years for a miracle cure- but their destiny is they was devoid of dignity, chained, confined and ill treated . Most never returned home.
The Erwadi tragedy sent ripples internationally.
The New York Times, wrote poignantly-
”Everyone inside was chained around their feet, and they didn’t have much chance of getting out of that shed”. It further added- “Care for the mentally ill is no source of pride in impoverished India. The fire today joins many other ghastly incidents that have been portrayed at length in newspaper accounts and lawsuits. But little is ever remedied…In both India and Pakistan, there’s this superstition that if a mental patient is kept near the grave of a saint, they will be cured by some sort of hocus-pocus”
Supreme Court of India took suo-moto cognizance of the incident based on news papers reports of the episode and it was also joined in the cause by the PIL from NGO Sarthak and activist group ACMI.
But more disturbing was the findings of the most exhaustive studies undertaken by the National Human Rights Commission, in the after math of the Erwadi tragedy, found that even in 36 mental mental health asylums of the country ( I find it difficult to accept them as hospitals) there were legion of instances of cruel treatment and people being chained, people being beaten, people being denied any kind of dignity.
The Erwadi fire tragedy also sent ripples in the Indian parliament when on 8th August, 2001 it debated the incident. An excerpt of the debate in the Lok Sabha is reproduced below-
“8th August 2001, subject- Regarding death of Inmates of a Mental Asylum in A Fire Accident at Yerawadi Town of Raamanathapuram district, Tamil Nadu
SHRI VAIKO (SIVAKASI): Mr. Speaker Sir, much again in anguish, I would like to bring to the notice of the House a terrible tragedy which took place in a Mental Asylum in a small town Yerwadi in Ramanthapuram District in the State of Tamil Nadu.
In the early morning hours on Monday, due to this fire accident, 26 inmates of that Mental Asylum were charred to death.
This is a very serious issue. The whole country was shocked. It is shudder to see the photographs in the newspapers and the scenario in the electronic media. When they were screaming and shouting because they were chained, nobody could go to their rescue and all were burnt to ashes.
12.30 hours (Mr. Deputy-Speaker in the Chair) Sir, only after this painful tragedy, things have come to light that thousands and thousands of mentally affected people are subjected to such horrible conditions in most of the mental asylums.
Today, Sir, according to a report, throughout the country 50 million people are suffering from mental problem and are in 43 hospitals with a bed strength of 23,000. Already the Mental Health Act envisages setting up of mental health authorities in every State in the year 1987 itself, but in most of the States this has not been implemented. Inhuman conditions are prevailing there. Already the life for these people was doomed. Therefore, it is high time that the Apex Court of this country took cognisance of this matter. The Central Government should take up this issue very seriously. A fact-finding team from the Ministry of Health and Family Welfare should monitor the prevailing conditions of the mental hospitals throughout the country.
Due to lack of modernisation facilities and basic amenities, they are suffering worse than cattle in those mental asylums. Sir, our hearts go to this gruesome tragedy. I express my deep anguish and condolences to the bereaved families. Most of them have been abandoned in such asylums. The most sufferers are the women inmates in most of the mental asylums.
Therefore, Sir, this is a very grave issue. The Government should take up this issue seriously and in all earnestness at least to prevent such tragedies in future.
MR. DEPUTY-SPEAKER: Now, Shri K. Malaisamy. … (Interruptions)
MR DEPUTY-SPEAKER: He has given a notice on this. That is why, I am allowing him to speak.
Sir, this is a very gruesome tragedy. As endorsed by our colleague, we are very much sorry that this has happened. The State Government was smart and quick enough to handle the tragedy and the Chief Minister, Madam Jayalalitha was able to send the Minister concerned and all the party functionaries to this place. The entire team of the District Administration was there. They were able to take immediate measures to see how the grant can be given. They have paid Rs. 50,000/- to the heirs each of victim, Rs. 15,000/- each to those who were seriously injured, and Rs. 6,000/- each to those who have got minor injuries. A probe has been ordered into this incident. The District Administration has taken enough measures to ban this kind of asylums immediately pending a detailed contingency plan, which is under operation.
In this regard, even the Supreme Court has issued a notice and has taken cognisance of this incident. We entirely agree that though the State Government has taken all-out effort to do something concrete on this matter, it is a matter of grave concern. The State Government will work on the one side at the micro level and even at the macro level, a national plan or policy can be thought of as to how the mentally ill, mentally deranged and the mentally challenged people like them who have immense faith, belief and practice to go to such places like the ERWADI Dargha, can be handled and cured. They still believe that some cure can be possible there. But all these things should be taken into account and a comprehensive policy can be thought of at macro level.… (Interruptions)
MR. DEPUTY-SPEAKER: We have 42 Members who have given notice. I am calling one by one … (Interruptions) ” .
It is interesting to note that though 42 Members of Lok Sabha had given the notice to speak, few actually were allowed to speak, others had to get contented by simply associating with the cause and more unfortunately not much follow up action began at the macro level.
Unfortunately the Erwadi tragedy happened in a year that marked the 10th anniversary
of the rights of mentally ill for protection and care as laid by the United Nation.
Worse, Erwadi happened in a year, in the World Health Organization. had decided “Stop Exclusion-Dare to Care- as the theme of the World Health Day” with the clear message that there was no justification for excluding people with mental illness or brain disorder from our communities- there is room for every one (WHO,2001).
This happened 16 years back.
To put other way, it has been happening for centuries in India. And it continues unabated to day.
And let the truth beckon,
Erwadi was just the symptom of a much deeper malaise that afflicts the Indian nation, Erwadi came and Erwadi went, but the Mentally Ill in India remain chained-at home, in asylums, at Dargah and Temples and on street, a substantially numbers of them are chained literally and others figuratively in chains of stigma, superstition, isolation, discrimination.
They live a chained life. And die unsung. Worse, the menace of mental illness is growing and growing fast. That is why, 16 Years after Erwadi- we still need to-
“Re:Mind India, that Erwadi Matters.”
The Erwadi tragedy for me is one of existential calling for more than one reason. Firstly, I was it first hand in childhood and adolescence and has remained imprinted in the memory since then.
In my childhood I came across many chained mentally ill men and women in both my village and native town. As an adolescent bewildered and bemused I invariably used to throng at famous Pir Baba Ka Mazar at my native Arrah, to watch a special specter twice a week (Thursday and Friday)- chronically mentally ill from far off villages were brought by their family members to the Mazar in search of miracle cure. As the saying was, the saintly place would make sure the “demon and unholy spirit would leave only after physical and mental torture at the Mazar.
Between 1997-2001 when my own life was in funk due to debilitating Depression and flame-out of mania that endangered my Bipolar life in turn, I too visited Pir Baba Ka Mazar looking for miracle.
When the Erwadi tragedy happened it escaped my attention-then i was nursing the deep wound of my own chains-“the life sentence of being declared suffering from incurable bipolar disorder”. But my ignorance did not last long and in next few years the Erwadi tragedy assumed pole position in my life.
I vividly remember 1st July of 2010, barely a month or so before the day, India was to enter the tenth year of Erwadi tragedy. I was at Chennai to speak in a Mental Health Conference organized by the Banyan, where I broached the subject of observing 6th August, 2010 as India’s first National Mental Health Awareness Day. The idea was immediately co-opted by icons of mental health movement Vandana Gopikumar and Vaishnavi Jayakumar of “The Banyan” fame.
What happened next upended my mad life. A letter from me calling upon the nation to observe 6th August 2010 as National Mental Health Day” turbo-charged by feisty Vandana and Vaishnavi became viral and the day truly was observed as India’s First National Mental Health Awareness day across cities and towns.
At Delhi it was lighting the candle at “Raj Ghat” and followed next day by a National Mental Health workshop at the auditorium of All India Institute of Medical Sciences (AIIMS).
Seven years have gone by from that day. And tomorrow, India enters 17th year after Erwadi Tragedy and it is time to Re:Mind India that Erwadi Matters more today.
And tomorrow is a day to take pledge and to re-remind us Indians of the following-
- Banish the Chain-take the Oath-“Change not Chain”: It is time to banish the chain fellow Indians. The practice of chaining a mentally ill or isolating and keeping him/her locked inside a room, worse throwing on the street is common. Erwadi tragedy did not eliminate the curse. It did not even reduce the incidence of such despicable practice. Take the oath- “Change not Chain“
- Jump start a Nation wide war to Stamp-Out Stigma: Time to stamp-out the age old stigma is now. Admitted the stigma that results in seclusion and discrimination is deep rooted in the very fabric of Indian society but we need a “Revolution against the stigma”. And the governmental effort will not be enough. It has to be be a nation wide war, it will need thousands of Generals and millions of soldiers. Let the war begin.
- Time to Own-up, Open-UP and Talk Mental Illness: Today it is the other person suffering from Mental Illness, tomorrow it will be you or family or friends. It is time to break the unholy silence. It is time to Own-Up, Open-Up and Talk Mental Illness. More we talk, more we create awareness and we move resolutely to banish stigma.
- Accept that Mental Illness is just a stupid illness to be fixed: Mental illness, even the most dreaded ones like recurring depression, bipolar disorders and schizophrenia can be either cured or eminently managed. All it needs is “Care and Treatment” and a disciplined life. Once we accept that it is a stupid illness to be fixed and not a flaw of the personality or curse of previous life, we have own half the war
- Care for the Care Giver: Mental illness particularly more severe one is a long haul war. Undoubtedly, it inflicts huge suffering on the sufferer, family and care givers suffer huge collateral damage too. It is also time to change the narrative, to provide the succor to care givers and also accept care giving as an economic activity. Most care-giving happens at home. The country barely has 25000 psychiatric beds in hospital. It is time to accept the economic and financial contribution of home care-givers, and to start a reasonable care-giver allowance.
- Convert Lunatic Asylums into center of Excellence: The country has 38 Lunatic asylums in the country. They are in pathetic state. Mere name change to Mental Hospital has not changed the reality. Most are in horrifying state and are designed to kill the patient and not to nurse them to health. It is time to move-up or move out. It is time to convert them into center of excellence. It will be a difficult battle but we have no option.
- Homeless, Destitute, Below Poverty Line Responsibility of State: Mental illness is an equal opportunity disease but those at the bottom of the pyramid suffer most. It is about time that the governments (central, state and local) take full responsibility of homeless, destitute and below poverty line mentally ill. Free treatment is no brainer, what is needed is composite scheme is needed-for treatment, rehabilitation and livelihood
- Create a National Coalition for Suicide Prevention: Increasing suicide in the country seldom gets the attention it deserves. we are global leaders in suicide and suicide attempts. Most suicides are attributable to extreme, distress, severe stress and depression but we donot care. Suicide cause tremendous familial, social and national loss-psychological, social and financial. It is time to turbo charge national coalition for suicide prevention.
- Time to move beyond Policy, Programme and Statute: The country has decades long dysfunctional District Mental Health Program (DMHP) and at ground performance of National Mental Health Program was as bad. We have a new National Mental Health Policy, 2014 and brand new best-practices Mental Health Care Act, 2017. But these are not even baby steps, the real thing is implementation and to look beyond. And we have no time to lose.t
- Let us Catch the beast young: Mental illness strikes early. Our schools and colleges are the places where they crop up first and they are ill equipped to handle the growing epidemic. There is case for increasing capacity building including creating a large army of counselors those who can spot the early onset. What schools and colleges need is a first-aid battalion to combat the war against mental illness.
- Time to make work place more inclusive for mentally ill -Today a mentally ill worker, employee or executive always is at the risk of losing job. Most time the person losing the job is sole bread earner of the job. The reason are plentiful- employers do not want to carry baggage, stigma and lack of awareness plays its own role and definitely a mentally ill in acute state has no or low productivity. Time has come that employers accept that that they have to give enough room to mentally ill to recuperate and recharge their battery. Employers may have to be debarred from chucking out some one from the job on the mere ground of mental illness.
These are baby steps. There is a long list of what is needed to be done. But war is long . Let us take an oath on Erwadi Day-Life of Mentally Ill in India will not be what it has been so far. That itself will be a big leap forward.
Tomorrow is also the day for Halla Bol- to declare 6th August as India’s National Mental Health Awareness Day