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Dawa-Dua: How medical treatment complements prayer for people with mental illness in India

Varalakshmi Vemuru's picture
Devotees at Erwadi Dargah (Photo by DMPH Erwadi)
Devotees at the Erwadi Dargah in Tamil Nadu, India. (Photo: DMPH Erwadi)
Last month I blogged about how mental illness is curable, treatable, and preventable. Today, let me take you to a town in Tamil Nadu called Erwadi, where faith and medicine now go hand in hand to address mental illness.
 
Erwadi is known for its 550-year-old Badusha Nayagam Dargah—“Erwadi Dargah,” one of the biggest shrines in India. Every day, numerous devotees of different faiths visit the shrine from surrounding villages, states, and countries. Among these visitors is a large number of people who suffer from mental illness and have come to pray for a cure. Some of them see the Dargah as their first and only hope—guided by the magico-religious belief that illness is caused by the possession of evil spirits or the performance of wicked magic—while others have turned to the shrine as a last resort after receiving ineffective treatment.
 
When I visited Erwadi Dargah in 2013 and met with a team working on a local program called District Mental Health Project (DMHP), an important partner of the World Bank-supported Tamil Nadu Mental Health Project, they expressed an urgent need to help the devotees affected by mental illness. Their subsequent discussions with representatives of the shrine revealed a lack of information on potential treatment options and strong resistance to medical interventions among the devotees. At that time, the team knew of a similar circumstance in another part of India—the state of Gujarat—so they invited the representatives of Erwadi’s religious community to learn from peers in Gujarat about complementing religious rituals with medical treatment.
 
And thus started a unique experiment called “Dawa-Dua,” or prayer-treatment.

How to use evidence to improve student learning

David Evans's picture
Access to education is improving but so must the quality of learning. (Arne Hoel/World Bank)

See if you can spot the pattern:
  • “Although the quantity of schooling has expanded rapidly, quality is often abysmal.” (Kremer et al.)
  • “Between 1999 and 2009, an extra 52 million children enrolled in primary school…Yet the quality of education in many schools is unacceptably poor.” (Krishnaratne et al.)
  • “Progress over the last decade in regards to school access and enrollment has been promising.” But “current learning levels for primary as well as secondary school students are extremely low in much of Sub-Saharan Africa” (Conn)
  •  “The most consistent focus of investment has been on increasing primary and secondary school enrollment rates… More recently, however, attention has begun to swing toward the quality of schools and the achievement of students—and here the evidence on outcomes is decidedly more mixed.” (Glewwe et al.)
  • “Over the past decade, low- and middle-income countries have made considerable progress in increasing the number of children and youth who enroll in school and stay long enough to learn basic skills… Learning in many low- and middle-income countries remains appallingly low.” (Murnane & Ganimian)

Again and again, we hear the refrain: access is improving, but learning lags. Thankfully, an increasing number of studies reveal interventions that work – and those that don’t – to improve learning around the world.

As the Paris Agreement becomes reality: How to transform economies through carbon pricing

Laura Tuck's picture


The remarkable pace at which nations of the world have ratified the Paris Agreement on climate change gives us all hope. It signals the world is ready to take the actions we need to keep global warming below 1.5 degrees Celsius. We know, however, that delivering on Paris comes with a high price tag, and that we need to help countries not just transition toward renewable energy but unlock the finance needed to get there.

Amid the enormous challenge ahead, I want to emphasize the transformative economic opportunity that putting a price on carbon pollution presents.

It’s possible to end poverty in South Asia

Annette Dixon's picture



October 17 is the international day to end poverty. There has been much progress toward this important milestone: the World Bank Group’s latest numbers show that since 1990 nearly 1.1 billion people have escaped extreme poverty. Between 2012 and 2013 alone, around 100 million people moved out of extreme poverty. That’s around a quarter of a million people every day. This is cause for optimism.
 
But extreme poverty and the wrenching circumstances that accompany it persist. Half the world's extreme poor now live in sub-Saharan Africa, and another third live in South Asia. Worldwide nearly 800 million people were still living on less than $1.90 a day in 2013, the latest year for which we have global numbers. Half of these are children. Most have nearly no education. Many of the world's poor are living in fragile and conflict afflicted countries. In a world in which so many have so much, it is unacceptable that so many have so little. 

How geospatial technology can help cities plan for a sustainable future

Xueman Wang's picture
In this video, representatives from the World Bank, GEF, and City of Johannesburg discuss the impact of geospatial tools on urban planning.

Many urban residents these days will find it hard to imagine a life without mobile apps that help us locate a restaurant, hail a cab, or find a subway station—usually in a matter of seconds. If geospatial technology and data already make our everyday lives this easier, imagine what they can do for our cities: for example, geospatial data on land-use change and built-up land expansion can provide for more responsive urban planning, while information on traffic conditions, road networks, and solid waste sites can help optimize management and enhance the quality of urban living.

The “urban geo-data gap”
 
However, information and data that provide the latest big picture on urban land and services often fail to keep up with rapid population growth and land expansion. This is especially the case for cities in developing countries—home to the fastest growing urban and vulnerable populations.

When does pollution policy work? The water quality and infant mortality impacts of Mehta vs. Union of India

Quy-Toan Do's picture
India’s rivers are heavily polluted. According to official estimates, 302 of 445 river stretches fail to meet even bathing criteria (Central Pollution Control Board [CPCB], 2014). This is known to have a heavy disease burden: each year, 37.7 million Indians are affected by waterborne diseases, 73 million working days are lost, and 1.5 million children are estimated to die of diarrhea alone (Water Aid, 2008). 
Yavuz SariyildizShutterstock.com

Mental illness is curable, treatable, and preventable: a story of hope from India

Varalakshmi Vemuru's picture
On World Mental Health Day, here’s a fact to reflect on: people with mental illness are among the socially excluded and marginalized groups in society. They are often misunderstood, ignored, or simply invisible.
 
In India alone, an estimated 70 million people—or 5% of the population—suffer from mental illness. The southern state of Tamil Nadu, for instance, has one million people living mental disorders—about 3-5 cases per village. Meanwhile, the country faces a severe shortage of psychiatrists and psychiatrist nurses, and clinical care is scarce in rural India. Due to deep social stigma related to mental illness, such serious issues are largely invisible at the community level.

That’s why, in 2012, we launched a comprehensive social and clinical care program with the government of Tamil Nadu to inform and educate local communities on mental health issues, as well as to encourage families and people affected by mental illness to seek treatment. Working with leading local health practitioners, we based the campaign on a core message that was simple, powerful, and resonated with the community:
   
Through a poster on do’s and don’ts of addressing mental illness, the campaign advised the community to
1) seek help from a psychiatrist, 2) start medication, 3) attend counseling sessions, and 4) join self-help groups. (Image: TNEPRP / World Bank)

Making South Asian Apparel Exports More Competitive

Ritika D’Souza's picture

Apparel workers in Bangladesh

There is now a huge window of opportunity for South Asia to create more apparel jobs, as rising wages in China compel buyers to look to other sourcing destinations.  Our new report – Stitches to Riches?: Apparel Employment, Trade, and Economic Development in South Asia  –  estimates that the region could create 1.5 million new apparel jobs, of which half a million would be for women. And these jobs would be good for development, because they employ low-skilled workers in large numbers, bring women into the workforce (which benefits their families and society), and facilitate knowledge spillovers that benefit the economy as a whole.

But for these jobs to be created, our report finds that apparel producers will need to become more competitive – chiefly by (i) strengthening links between the apparel and textile sectors; (ii) moving into design, marketing, and branding; and (iii) shifting from a concentration on cotton products to including those made from man-made fibers (MMFs) – now discouraged by high tariffs and import barriers. These suggestions recently drew strong support from panels of academics and representatives from the private sector and government when the report was launched mid-year in Colombo, Delhi, Dhaka, and Islamabad. South Asia is now moving on some of these fronts but a lot more could be done.

Moving up the apparel value chain
Stitches to Riches? finds that South Asia’s abundant low-cost labor supply makes it extremely cost competitive (except for possibly Sri Lanka). But rapidly rising living costs in apparel manufacturing hubs, coupled with international scrutiny, are increasing pressure on producers to raise wages. Plus, countries like Ethiopia and Kenya, who enjoy a similar cost advantage, are entering the fray, and some East Asian countries already pose a big challenge. The good news is that the policy reforms needed to keep the apparel sector competitive would likely benefit other export industries and transform economies (view end of the blog).

What if…we could help cities more effectively plan a lower-carbon future?

Stephen Hammer's picture
Visit worldbank.org/curb

If climate change were a jigsaw puzzle, cities would be a key piece right at the center of it. This was reinforced by more than 100 countries worldwide, which highlighted cities as a critical element of their greenhouse gas (GHG) emission reduction strategies in their national climate plans (aka INDCs) submitted to the UNFCCC in 2015.

Since the ensuing signing of the Paris Agreement, these countries have shifted gear to focus on turning their climate plans into actions. What if, as many of us may wonder, we could find a cost-effective and efficient way to help put cities—in developing and developed countries alike—onto a low-carbon path of growth?

CURB: Climate Action for Urban Sustainability, launched this Climate Week, is an attempt to do just that. A free, data-driven scenario planning tool, CURB can readily help cities identify and prioritize climate actions to reduce carbon emissions, improve overall efficiency, and boost jobs and livelihoods.

A joint vision for effective city planning

What CURB can do for cities owes very much to the inspiration and stories we have taken from them in developing the tool. It was a fortuitous few hours in early 2014 at the C40 Cities Climate Leadership Summit in Johannesburg, South Africa that really got the ball rolling on the development of CURB.

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