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Tamil Nadu

The unheard voices of women caregivers for people with mental illness

Varalakshmi Vemuru's picture
SHG meeting of people with mental illness and caregivers. (Photo: TNMHP)

Thirty-year old Vijaya (name changed) spent 10 years of her life not talking to anybody. Her parents were daily wage laborers, scraping together a sparse living in India’s southern state of Tamil Nadu. Unaware of any treatment, and afraid of being stigmatized or shunned by their community, they did not disclose their daughter’s illness to anyone. Instead, Vijaya suffered in silence, confined to the house, and hidden from public view.
 
It was only when the Tamil Nadu government’s Mental Health Program (TNMHP) reached out to their community that Vijaya’s life underwent a dramatic change. After six months of working with the program’s community facilitators, Vijaya’s parents took her for treatment, and within a year, the young woman began interacting with others more frequently.
 
Poor mental health places a huge burden on individuals, families, and society. From developed countries to emerging market economies, mental disability – ranging from common mental disorders such as depression to severe mental illnesses and retardation – has profound impacts on people’s economic and social well-being.
 
As cited in “Out of the Shadows: Making mental health a global development priority” in 2010 alone, depression cost an estimated US$800 billion in lost economic output. What’s worse, these costs are expected to double by 2030.
 

For the differently abled by a differently abled – an inspiration from Tamil Nadu, India

Varalakshmi Vemuru's picture
Mr. Kannan, a differently abled social entrepreneur
Mr. Kannan, a differently abled social
entrepreneur. (Photo: Varalakshmi Vemuru)
During my recent mission visit to Sivagangai District in Tamil Nadu, India, I met with Mr. Kannan, a social entrepreneur. I was visiting communities to understand the latest efforts under the Tamil Nadu Empowerment and Poverty Reduction Project (TNEPRP) to support the differently abled with economic activities following their identification and mobilization. For six months now, Mr. Kannan is running a Community Skills School (CSS), an innovative approach to skills enhancement, in the Kalaikulam Village. At the school, which provides self-identified and motivated trainees with skills to repair home appliances, Mr. Kannan has already trained 70 differently abled men and three women. Among the trainees is his wife, who is differently abled herself, but is of huge support to Mr. Kannan in running the CSS and in working with women. He has an agreement with TNEPRP to train a total of 180 differently abled, including a planned group of 30 women.


He has an agreement with TNEPRP to train a total of 180 differently abled, including a planned group of 30 women. Run on a guild program model, the CSS ensures that upon completion of a one-month program on skills enhancement, the trainees can become self-employed or work in small enterprises repairing home appliances in their own and neighboring villages. The rapid urbanization of rural Tamil Nadu offers plenty of such opportunities.

Mr. Kannan designed the key aspect of the curriculum—which goes beyond technical training—based on his own life experiences. During our conversation, I found out that Mr. Kannan is differently abled himself—he was afflicted with polio at the age of three and has lost the use of both his lower limbs. As a result, Mr. Kannan needed a wheelchair to get around. Nevertheless, he was not deterred and continued his education to receive a diploma in mechanical engineering from a local Polytechnic. He ended up at Samsung’s service center in Chennai, the state capital, where he spent four years acquiring skills in home appliance repair. 
 

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.

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)

5 questions about road safety in India

Arnab Bandyopadhyay's picture
 
Panoramic view of car jam in India


In the run up to the first hackathon on road safety in India, we caught up with Arnab Bandopadhyay, Senior Transport Engineer at the World Bank and asked him a few questions: 
  • Why is the World Bank focusing on road safety in India?
India’s roads are among the most dangerous in the world. The number of deaths from road accidents has risen sharply over the past decade. More than one million people have lost their lives in the past 10 years alone and another 5.3 million have been disabled or disfigured for life.

While India has less than 3% of the world’s vehicles, it accounts for some 11% of the world’s road deaths. That too, when many such incidents are not documented at all.

Road accidents are not only traumatic for victims and their families but also take a huge economic toll on the country.    They cost an estimated 3% of GDP each year. The large majority of road accident victims are pedestrians, cyclists and motorcyclists - mostly from the economically weaker sections of the society – making road safety a matter of social equity. Promoting road safety is therefore an important national priority.

On a Recent Trip to Tamil Nadu…

Charukesi Ramadurai's picture

Five years ago, M. Revathy was a single mother abandoned by her husband, living in the small town of Tirunellikaval in Tamil Nadu. She is high school educated but was unable to find any employment except in a loom in her town. She was paid a pittance there and had the status of a bonded laborer. Today, she has her own loom at home and sells her saris at a good price to the wholesale market. She has a smile on her face as she says proudly that she sends her three sons to school and supports them and her father on her income.

Revathy was one of the women identified under the Tamil Nadu Empowerment and Poverty Reduction Project, 75% funded ($274 million) by the World Bank a few years ago. This project called Pudhu Vaazhvu (meaning New Life) has given a livelihood, and hope for thousands of women, unemployed youth and the differently abled in the state and has also been recognized by the World Bank as one of the best such projects in the world.