Recovering from psychosocial traumas: The place of dargahs in Maharashtra

Davar, Bhargavi and Lohokare, M.  (2008) ‘Recovering from psychosocial traumas: The place of Dargahs in Maharashtra’. Economic and Political Weekly, Vol. XLIV, No. 16, April 18, 2009. 60-68.

 

Recovering from psychosocial traumas: The place of dargahs in Maharashtra

 

Bhargavi V Davar and Madhura Lohokare

Center for Advocacy in Mental Health, Pune.

Dargahs have come under attack in recent times, following the tragic death of 25 mentally ill people in Tamil Nadu in August, 2001. The ‘Erwadi tragedy’ resulted in a Supreme Court suo moto intervention against local healing sites all over the country. There is witch hunting of dargahs as well as other local healing centers every year, around August by various social and statutory agencies by evoking human rights. This set of medico-legal events has not been targeted towards mental hospitals, and the mental health system, paradoxically: The primary intent of the suo moto action was reform of the mental health system. Against this context, we are presenting case studies of dargahs in Maharashtra which serve the purpose of healing from psychosocial traumas. The paper argues for a more deliberate response to the vexed question of mental healing and overall health. The paper is situated within the Indian mental health context. We do not here address the dargahs within the larger critical discourse about the place of religious institutions in re-organising political and social relationships in contemporary India.

 

1 The Supreme Court intervention into the indigenous healing sector

There is a faith healing center, Erwadi Dargah, in Ramanathapuram district, near Madurai, in Tamil Nadu. Scattered around the healing center, private parties had set up many hutments to keep persons labeled as mentally ill. According to reports of earlier investigations in this area by civil society agencies, the condition in the majority of the shelters was deplorable. On 6th August, 2001, the hutments in which 43 people were housed, chained to their beds, caught fire. 11 women and 14 men died when the fire broke out early in the morning. 3 persons died later in the hospital.

Remarkably, the local government awarded families who had dumped their mentally ill relatives in these private asylums with monetary “compensation”[1], instead of applying penalties as per Section 25 of the Mental Health Act or other criminal laws. The Government issued instructions to the District Collectors to inspect such shelters to see that no shelter functioned without a valid license. The NHRC set up its own commissions to inquire into various local healing centers[2]. After this incident, the Supreme Court initiated suo moto action against the State Government of Tamil Nadu and all other states of India [vide Writ Petition Civil No.334 of 2001].

The SC asked all the state governments to implement the Mental Health Act, 1987, and to close all shelters not covered by the Act. Importantly, it demanded to know whether mentally ill people were treated badly or kept in chains anywhere in the respective states. State governments, complying with the SC demand, found it expedient to immediately supply information on this last aspect, while remaining defensive or non-committal about other queries. Of special significance is the Saarthak petition[3],[4] Para 9, which referred to human rights violations in “certain institutions” where mentally ill are kept, expressing deep concern “about the inadequate and inhuman conditions in which mentally ill persons live in this country”. Para 9 did not define the sites, but can be read as implying all private institutions as borne out by the Annexure, which also included news about people chained in various ashrams and Dargahs[5]. The petition also prayed for “modernization” of mental health care, as per the NHRC guidelines[6]. The state responses have also reflected this inclusion of indigenous healing institutions within the ambit of the “private sector”. The State of Kerala did an extensive survey and inspection of private institutions, presented in their affidavit, including indigenous healing[7]. While largely denying other SC remarks about state apathy, the Punjab Government admitted to the “prevailing poor and inhuman conditions of mentally ill patients in certain institutions, but not in every such institution”[8]. In proposing to the Central Government a 50 bedded mental hospital, the Manipur Government said that “Due to lack of modern treatment facilities, people are following the traditional methods of treatment and families are losing confidence.[9]” The Kerala government lauded the adequate nature of the many private mental hospital facilities inspected, but interestingly, failed to make such a remark about indigenous healing centers. The AP government was highly denouncing: “In order to prevent mentally ill persons flocking to places such as Dargahs, Temples, Religious places and other unlicensed places for treatment and rehabilitation, it is necessary that the state of Andhra Pradesh has adequate rehabilitation services for the chronic mentally ill and persons with mental disability”. Further, “Provision of such services would go a long way in preventing society from utilizing services at unlicensed places such as Dargahs, temples, churches and other religious institutions which do not have proper facilities and expertise”[10].

The SC, which started judicial interventions against health governance, did not consider the conflict of interest in involving the state governments as an examiner, in fact the only examiner, of their own practices. The Erwadi related actions taken by the Supreme Court resulted in greater empowerment of mental institutions, and their authorities, as well as, a change in the relationship between the authorities and society, while not changing much within the mental health system[11]. Many states, such as TN, HP, etc. also started awareness programs to make the public aware about treatments for mental illness. Many states such as Bihar, Assam and HP have started new mental hospitals, going against global trends towards community mental health.

Vigilance over indigenous healing has increased since the SC action. The State of Haryana sent the vigilance officers under the MHA to visit local healing centers. In TN, district committees had the mandate of “making periodic inspections of places where mentally ill persons are detained and ensure the human rights of mentally ill”. District collectors also had a role to play in shutting down local institutions found violating human rights. Due to the vigilance set up locally around dargahs, 50 mentally ill people taking shelter at a famous dargah in Kolar district were chased away. The government of Andhra Pradesh took the most dogged actions to Paragraph 9, taking high level regulatory steps against the traditional healing sector. Vide DME Rc. No: 22181/MS.ZA/2001, dated 10.08.2001, issued from the Directorate of Medical Education [DME], a 5 member “expert” committee, comprising of psychiatrists visited the Syed Miran Hussaini Quadri Bagdadi Dargah, and submitted a report about conditions in the Dargah. Subsequently, the licensing authority [Director, ME] issued notice to the Dargah, asking for the hand over of mentally ill persons for medical treatment[12].

The DME inspection committee took the assistance of local police for the process. Permission from the dargah was obtained to assess the “patients” visiting the dargah. Whether this medical evaluation procedure included the consent of people is not addressed. The report constantly refers to sections of the mental health act, remarking on non-compliance and liability for legal action, but very much assuming that the dargah comes under the purview of the MHA. A sizeable population needing psychiatric treatment was identified through diagnostic procedure and referred. The Mental Health Authority was enjoined to take suitable action against the dargah. The AP affidavit suggested that such centers must be “licensed” facilities and should comply with the MHA, as if dargahs were a kind of mental institution. The question remains, why should local healing practices, which are primarily social institutions, akin to parks, restaurants, schools, offices, etc. come within a custodial mental health law? Most of these centers are registered as a Society or a Trust and are under the purview of other statutory acts regulating social institutions. If people with an affliction include an element of prayer or penance in a site of their choice as a significant contributor to their being well, should law not protect this as a health care right? On the question of voluntarism and patients’ rights, the DME report’s comments on “free movement” are remarkable:

Mentally ill persons staying in the Dargah without any relatives may be handed over by the Dargah authorities either to the relatives whose addresses they have, or to the local police station, so that appropriate reception order may be obtained for their involuntary admission into the mental hospital…”.

It is ironical that while the DME report scowls on the chaining of persons in the dargah, it notes with equanimity, arrest by the police and the use of solitary confinement in the mental hospitals for unmanageable patients and the unconditional use of forced treatment. In fact, the Tamil Nadu government, while closing down indigenous healing centers, has evolved a sophisticated procedure for the physical restraint and solitary confinement[13], both points contested by Saarthak as violative of human rights.

The said Dargah’s response is the single presenting voice in this legal discourse, as well as the single dissenting voice. The response is the beginning of a completely different world view about healing, well being and the role of such centers, from the several professional views coming from the SC action. Noting the “ancestral” nature of the Dargah, Syed Mohd. Qadiri emphasized the belief and faith that the Dargah instilled in its devotees. He noted the voluntary nature of people with problems visiting the center and that persons get “consoled with the spiritual powers of the saint”. The letter concludes by noting that as the Dargah is not a “mental hospital”, and there are no “patients”, the question of handing over patients does not arise! The SC, in an order dated 5th February 2002, among other directives, directed unambiguously and damningly, for the indigenous healing sector, as follows:

Both the Central and State Governments shall undertake a comprehensive awareness campaign with a special rural focus to educate people as to provisions of law relating to mental health, rights of mentally challenged persons, the fact that chaining of mentally challenged persons is illegal and that mental patients should be sent to doctors and not to religious places such as temples or Dargahs”. The court also ordered the construction of mental hospitals in states where none exist. The Union Ministry, while making bland responses to the continuing abysmal situation prevailing in the mental health sector, decided to map out all the faith healing centers frequented by psychiatric patients[14]. Witch hunting of such places was propagated by the newspapers[15], which talked about “most bizarre, inhuman forms of treatment” in such places, recommending that these centers must be governed by the Mental Health Act.  An editorial in the Maharashtra Herald, noted that thousands of people “obsessed by blind faith go to the village [Erwadi]”[16]. Local papers presented glowing tributes to mental hospitals: “…regional mental hospital is just like a carnival for the rural patients of Maharashtra” said one newspaper[17], totally subverting the intent of the SC suo moto action. Ironically, while the caption of the article read “No chains at Asia’s largest mental hospital”, the photograph attached showed a patient lying on the floor tightly curled up, in a small locked room with grilled iron bars, like a cage.

Paradoxically, in this instance, a legal challenge has been mounted on these institutions from a most improbable critic, the public mental health sector, itself under severe criticism from all quarters for poor services and human rights violations, a sector which is most non-compliant with the extant legal prescriptions [Goel, et. al. 2005, NHRC, 1999]. The credentials of the critic need to be first established before it can mount a reasonable challenge. A campaign, Jan Manasik Arogya Abhiyan, working in Maharashtra, has brought to light many atrocities happening in these closed institutions [www.camhindia.org/advocacy/jmaa.html], including, in the last couple of months, a case of attempted rape, a suicide and a high profile wrongful political commitment. At present, a PIL is also pending before the Mumbai High Court, adding to the long list of PILs against the mental hospitals in the state. This is not a peculiarity of the state but is descriptive of the situation in the country as a whole.

Our paper derives from a 3 year field project [18] undertaken in 9 districts of Maharashtra with an objective to explore subjective meanings attached to people’s personal distress and healing, with special reference to emotional health, as they are mediated by indigenous healing. Indigenous mental healing included several traits: having a local origin, being vernacular / oral, being unorganized, and having the function of healing people through shamanic or faith healing methods. Sites included mandirs, dargahs, churches, shrines and cults. The Dargahs visited during the study period were the Hazrat Shahadval BabaRahmatullah Aliha Dargah Sharif [Sadal Baba, Pune]; Mirawali Dargah [Ahmednagar],  Mira Saheb Dargah [Miraj]; Mira Rehan Mira Saheb Dargah [Vishalgad]; Khwaja Kabir Dargah, [Nandre]; Sailani Baba Dargah [Sailani]; Babu Jamaal Dargah, [NesKumbhoj and Kolhapur].We also collected secondary or promotional textual and audio visual materials about the centers. Approximately 25 hours of visual data was recorded and photographs taken at various sites. We interviewed four types of respondents, viz. sufferers, care givers, healers, and medical service providers. We interviewed healers who healed at an individual level [n=11], catering to a small, localised community of sufferers, as well as large healing cults based upon the worship of a deity, pir or a sant who is attributed healing powers [n=32]. Multiple data sets were compiled, including in depth interviewing, case studies, field observations and focus group discussions. 283 in-depth interviews were conducted [43 healers, 57 service providers, 108 users, 75 carers]. The sample was selective, including those who volunteered for the study. After initial screening, we included users who came to a local shrine for a ‘problem’. Data was coded and recursively recoded before and after fieldwork. Some qualitative data was quantified through SPSS. The rest was developed as content analysis spreadsheets using Excel. Case studies were developed from in-depth interviews.

Story of origin and the role of pirs as healers

Dargahs retain a distant relationship with formal Islam and a close relationship with the function of healing. When we refer to Dargahs, therefore, we do not contextualize it within the discourse on religion, but rather that on healing traditions. They do retain their connection with sufism in all its diversity, colour, ritual practice, shamanism, music and expression. However, here too, it is difficult to see any purified form of religion. Formal Islam frowns upon what it sees as expressions of abandonment, such as ecstatic trancing, drumming, music, possession, etc. found in abundance in these places as a ritualistic part of healing. Ozturk and Goskel [1964] in the context of Turkey, writes that the government outlawed magical religion in 1925. The writers observed a discrepancy in what the Koran actually says and how it is practiced in folk practice. The “Koran does not approve it either, and does not attribute supernatural powers to mankind” [p. 350]. Further, “[m]iracle cures by men are not accepted” [p. 350]. Attacks [even life threatening] by the religious purists on sufi prophets and poets is not unknown in the history of sufism and of Islam. All dargahs are syncretist and local, and cater to a wide diversity of people from different caste and religious backgrounds in the locality. There are also a variety of healing churches, mainly Pentecostal, which are based on the faith that Jesus Christ was a wandering minstrel / healer. We have found a wide variety in the religious denominations of healing centers, defying any attempt at harmonizing with formal religion.

Dargahs are local healing sites with ritual healing practices dating back to five or more centuries [Bihari, 1962]. Every dargah has a healing myth or a story of origin, linked to the spread of sufism in the subcontinent and the associated sanctifying processes. This story is often depicted in the context of healing. A pirs arduous journey from the Middle East seeking the subcontinent, carrying on the teachings of Prophet Mohammed or his descendants, are a part of the myth. Some pirs in the dargahs of Maharashtra are associated with the world famous patron saint of Ajmer, Khwaja Garib Nawaaz Moinuddin Chisthi. Mirawali Dargah is dedicated to a pir, Mirawali Baba, who is said to have come to India at the time of the Mughal invasion. The name of Sadalbaba dargah in Pune reads as Hazrat Shahadaval Baba Rahmatullah Aliha Dargah Sharif, the history of which goes back to almost 800 years to medieval India. Shahdaval Baba was said to have belonged to Medina, the Holy City. His spiritual leader [Rasool] instructed him to go towards India to spread the word of God. Shahdaval Baba travelled through Afghanistan and entered the subcontinent with Mohammad Ghori’s army, when the latter attacked India in the year 1192. After reaching India, Baba went to Ajmer and became Moinuddin Chisti’s disciple and on his instructions came to this area. Healers of the Shamna Mira Dargah consider themselves as descendants of the pir.  The Khwaja Kabir Dargah, dedicated to two pir brothers, Khwaja and Kabir are depicted as coming to India with the specific mandate of ridding and protecting people from all the matters relating to evil spirits and black magic. Legend has it that Malik Rahen, the sufi pir of Vishalgad, near Kohlapur, came to India from Iran.

The magical healing powers acquired through a lengthy and relentless process of travel, ordeal and purification, can easily be assimilated within a therapeutic framework of achieving personal stamina and mental well being. The ‘sacred’ plays a crucial role in the healing process [Kakar, 1983]. Healing is a central theme of sufi life. Pirs were serendipitously graced with healing powers, inscribed in cultural memory and oral history. Mirawali Baba settled down in Ahmednagar and soon his healing powers started attracting scores of sufferers to this area. Sadal Baba received his healing powers in Ajmer and several mythical stories abound about these powers. At Mirawali, people come to be healed of problems, which no doctor can diagnose or where the doctors have given up all hope. Large numbers of people come here to get cured of mental illness. Some pirs also inherited their healing powers. Kabir Baba at Khwaja Kabir was said to have performed healing miracles. Shamna Mira of Miraj grew up aspiring to serve people just like his parents did.

The role of the pir as one who not only heals, but as omnipotent and all-powerful, is reflected in the stories of origin. The pirs took sides with the underprivileged and stood for justice. Legend has it that pir Shamna Mira martyred his life to protect the interests of the poor farmers against feudal atrocities, being inclined towards social service, humanism and religious reform. Sailani Baba is believed to have come into this world with a mission to heal and protect devotees from evil influences and injustice, and blessing them with happiness. For this he is graced with divine power and spiritual knowledge viz. Riddhi-Siddhi Vidya.

Many a dargah served as shelter and haven for wandering, homeless, destitute and poor people. Unlike psychiatry, where wandering is considered a psychotic symptom, wandering sufferers and healers are well accepted in the local healing centers. Saadal Baba, under Moinuddin’s Chisthi’s tutelage, served the poor. At Mirawali Dargah, A’Nagar, there is a sizable population of homeless persons, absorbed within the shrine economy, fed by the mujawar and the temple management. The living conditions in the Sailani Dargah were unacceptably squalid, with a population of about 5000 sufferers staying in a slum, in the forest land surrounding the dargah. People from neighboring regions, totally bereft of any development initiative, eventually seek shelter in the dargah. Such places, where inequity is very visible, are a human rights disaster and swift and sensitive interventions are required. The dargahs are not provided any kind of infrastructure, civic services or other supports by the government.

Why people approach the local healing centers

It has been established beyond doubt that a significant proportion of population accesses local healing systems, spiritual or secular, in the context of mental health problems, across varied cultural settings [Amarsingham, 1980; Harding, 1975; Kapferer, 1991; Ngoma, 2003; Nichter, 1981; Ruiz and Langrod, 1973; Somasundaram, 1973; Skultans, 1987, 1991; Satija et.al, 1982]. More often that not, health service seekers traverse between these diverse and seemingly contradictory systems in their search for healing [Asuni, 1979; Kapur, 1979]. In the Indian context, 74.7% of psychiatric patients had consulted a traditional healer before coming to the hospital. Out of these, 33.3% had consulted one place only, while 17.3% had gone to more than 10 such places. 30% of the patients in the above study expressed satisfaction and noted improvements in their condition. 45% of the patients have not found satisfaction and expressed disappointment. 25% suggest that they will advise others to go to traditional healers [Gujarat Mental Health Mission, 2003]. Goldberg and Huxley [1992] cited data from a famous WHO eleven centric study in the year 1991, including European, American and South East Asian countries. The writers noted, “Pathways in countries well provided with mental health staff but dominated by general practitioners and to a lesser extent by hospital doctors, while less well resourced centers like those in Pakistan, India and Indonesia, showed a wide variety of pathways with native or religious healers often playing an important part” [p.30]. A study [Kapur, 1979] carried out in a town of western India showed that a majority of respondents do not wish for help for “possession” but among those who do, a mantarvadi is the healer of choice. 48% of men and women had consulted both doctor and indigenous healer, while 18% and 19% of men and women respectively had consulted only an indigenous healer. In the African context, Friedson [2000] has noted that both the western and the local healing systems are flourishing and that the “availability of western medicine has not replaced traditional medicine- communities decide where they want to go [emphasis added] depending upon symptoms …” [p.45].

We have described in another paper [Lohokare and Davar, 2008], providing 2 case studies of local healers, that people approach the local healing sites with an explicit expectation of being healed from their problems. The relationship is perceived as successful because of the shared cosmology of health and well being. Jain [2006] observed that while the health care system was at the periphery of a notion of “community” among villagers, the local healer [bhagat], and objects of local healing [bhut, chaitan, devi, devta] were central. The literature and our study also suggest that people choose to go to local healing centers for expressly psychosocial problems. Users are inclined to access places where they can express their problem as they experience it, where they sense a match between their causal models of illness and the models prevalent in the healing space; places which will address cosmological and personal, existential issues; where they will not be forced to directly confront their problems at the individualistic level, as a “disorder”, but can depend on divine [serendipitous] or collective mediation.

Approximately one fourth of the people living with afflictions, who we interviewed were from dargahs. Poverty was commonly observed. More than half the users interviewed by us were extremely poor, being on BPL card, earning in kind, earning less than Rs. 3000/= or having no earnings whatsoever. But nearly one fourth had earnings of more than Rs. 5000/= per month and many had a personal vehicle. Most users reported having a “roof above their heads”, using LPG and had access to a municipal tap in their homes. One third of the users interviewed however were in insecure housing. Homelessness was evident in a small sub group of people attending the THCs. Nearly one fourth of the users interviewed were unemployed. Women, when asked about their occupation, routinely reported family occupation or husband’s occupation. Many users, male and female, were involved in small trade or occupation, in the unorganized sector. Half the users [50.48%] interviewed by us were educated till their schooling. A small percentage was professionals. 1 person we interviewed was a doctor. The data also suggests that indigenous healing centers are popularly frequented by the deprived caste groups The socio economic situation of the afflicted depended upon the kind of place they visited. The dargahs attracted the more poor and the marginalized sections of society, even though here too, we interviewed people who came from the more privileged classes and castes.

We explored in depth with the afflicted persons about the reasons for visiting dargahs. We are here presenting a content analysis [Table 1]. The data was developed by content analyzing narratives collected from the users of the centers. Since we were interested in knowing if words and concepts describing psychological well being were used by people, we developed several codes around this for our analysis. The narratives are therefore presented to suit our research intent and our methodology.

Table 1- Reasons for visiting the center

User code   Physical Mental Socio-economic Cultural
 Sangli_01 [M] Khwaja Kabir, Nandre body swelling and pain Childlessness Karni done on wife
 Sangli_02 [M] dizzy, couldn’t sleep, couldn’t eat because of stomach ache felt scared Evil influence Karnidone by relatives
 Sangli_03 [F] Used to feel giddy very ofteneyes used to pain, body ache

 

feeling tired, used to babble strangely, thought of committing suicide many times husband died of alcoholism, dowry harassment, driven out of the home, children dying[Repetitive theme] driven mad through witchcraft
 Sangli_04 [M] continuous nausea, breathlessness,could not eat or drink anything, would feel ill instantly Karani
 Sangli_05 [M] neck hurts, limbs feel weak, wobbly, fever, bladder and stomach is not clean, inspite of cleaning  can’t sleep at night,  the effect of pills wears off, Baba wakes her up Dreams of Baba, pradakshina helped 
 Sangli_06 [F] Shamna Mira dargah Miraj body ache, pricking sensation, swelling in legs and face, limbs were joined together, couldn’t see at all couldn’t do anything
 Sangli_07 [M] fever, cough, cold all the time, body pain, couldn’t eat or digest food No medicine helped. Only ash and water from here helped.
 Sangli_08 [M] since 14, stomach ache, head ache, couldn’t digest food, swelling of body ‘lahari’, tension, the head was light to get released from witchcraft
Kolhapur_11 [M] Babu Jamaal Dargah Had an accident, head received a crack, became unconscious, after 5 months, when on duty in the factory,  became blind and started feeling giddy, was in coma, there was a blood clot and operation was done Daughter [MA, B Ed] was fixed to be married, some people broke it up Baba’s miracle. Mujawars prayed and did pradikshina. After 13 days, the problem was resolved. Ate angara and felt better, could come back home, did a check up and was declared ‘clear’ after that.
 Kolhapur_12 [M] Angry, unhappy, grew sad since whole life seemed ruined. Economic problems, failures in life, family conflict, wife left him left home and stayed here for many years. Dreamed of Baba. Stayed at the Dargah in Kumbhoj as well. Lived like a beggar, praying to God, two visions of Baba, went to Kumbhoj to live for 2 days, someone came at 2:00 am in the night and offered water. These are Baba’s miracles, wife returned.
 Kolhapur_13 [M] Felt like two needles were being pierced in forehead felt scared if I looked at anybody Had strayed
 Kolhapur_14 [M] 3rd, 4th and 5th discs of spinal cord had slipped, admitted in hospital  daughter got divorced immediately after marriage, dragged on in court for many days, she could not have remarried till the divorce was finalised The operation was necessary but Baba’s vision one night made everything alright.Due to Baba’s blessings, the case results were favourable and daughter remarried.
 Kolhapur_15 [M] developed backache and after some time couldn’t get up or sit, loss of semen through urine working in a pin factory for about 12-13 hours a day
 Pune_01 [F] Feeling fatigue Feels worried all the time sisters not getting married, brother’s wife had 2 abortions,spent 1 1/2 lakhs on marriage: violence and dowry harassment. Desertion. Husband remarried. Remarriage. Similar problems including desertion.
 Pune_02 [F] Weakness
 Pune_03 [F] feel worried and fearful about family Problems and tensions in the house. [repetitive theme] No work. Living on daughter’s support. Many mouths to feed in the house. Witchcraft by relatives.
 Pune_04 [M] Feel ill, limbs fall loose, giddy, feel or sometimes a snake has wrapped him in his coils, weak limbs, no appetite hence weakness feel extremely claustrophobic, like someone is strangulating him, can’t sleep the whole night
 Buldhana_01 [M] stomach bloated up, body was burning, suffering from cancer of the throat very scared
 Buldhana_02 [F] scratching in left foot, breathlessness, full left side in pain, fever, clicking in neck Losses in business witchcraft
 Buldana_03 [F] spasms and pain in back  Brain had become dysfunctional, could not concentrate on job and work Witchcraft through food
 Buldhana_04 [F] Dysmenhorrea, bleeding would not stop for 20 days during menstruation.couldn’t digest anything.

Suddenly felt a jolt and vomited horribly. It was nearly fatal.

 ‘Mooth mari’ [a type of working witchcraft] Karni and bleeding, started together.
 Buldhana_05 [F] Bloody vomits, giddiness Strange behaviour: couldn’t keep clothes on, would eat faeces, was wandering here and there.  Would not feed child. ‘Mooth marli’. I am suffering from Karni from 36 years.

People access local healers for curing what is primarily experienced as a ‘problem’. The definition of a ‘problem’ may be specific, having the quality of an important life event or process which suddenly disrupted mundane life and caused trauma. But it is not presented as a “symptom” located at a specific locality of the body. The manifestation is more robust, which can be called psycho-social-spiritual. In these experiences, there are physical, psycho-physical, psychological, psycho-social as well as spiritual dimensions, which are individualized and diverse. This is a crucial pointer towards how communities frame their well being and health: there is no artificial division between ‘health problem’ and one’s emotions, relationships, socio-economic context, and life experiences surrounding it. Aches and pains in different parts of the body, particularly head and joints, spasms, clicking, fatigue, fits, immobility, weakness, and head burning were very commonly reported. Giddiness, lightness in the head, stomach problems, fevers were also reported. Some people had medical problems of a severe nature, or who were critically ill, such as cancer, coma and spinal fracture. Individualised expressions of the ‘problem’ was the rule, rather than the exception [scratching in left foot, feel like someone is strangulating him, sometimes a snake has wrapped him in his coils, something wriggling in his stomach, the limbs were joined together]. In other sites, we also interviewed people who had a specific disability [e.g. alcoholism, childlessness or disability caused by polio]. Women did talk about various reproductive health problems. Contrary to common professional beliefs, that people are not aware of their own mental health, users had a wide ranging vocabulary about their mental states. In fact, in our larger study, mental health and psychosomatic experiences figured very high among the list of problems reported. Problems ranged from what would in modern terms be called psychotic [seeing visions, strange behaviour, someone whispering in the ears, couldn’t keep clothes on, wandering, suicidal] to a more diverse range of emotional states [sadness, worry, fears, lack of concentration, sleeplessness, anger and tension].

Many people came to the dargahs to be “cured” of karni or witchcraft problems. Experienced existential, psychological or spiritual questions manifest as mental disturbance. We came to know through our study that, not only is witchcraft / evil spirit possession not mental illness, but mental illness, physical health problems, and a hosht of other thraas are the consequence of witchcraft and spirit possession. Of the 95 responses received from all users [n=103], 85% said that all mental illness happens due to witchcraft or black magic. Severe symptoms [for example, behaving strangely] are usually diagnosed as witchcraft. Jealousy or suspicion [which psychiatry may characterize as ‘paranoia’] is a major interpersonal theme of witchcraft afflictions. Witchcraft experiences are relational, and refer to conflicts in relationships, usually identified specifically and in causal terms, by the indigenous framework. Caste, religious differences, gender differences, and sexual taboos [for example homosexuality or prostitution] find linguistic expression in witchcraft expression, diagnosis and treatment, and are manifested as psycho-social, spiritual or moral suffering. Our study clearly showed a pattern that for medical problems, health care was sought; and for psycho-social-spiritual problems, including witchcraft and evil spirit possession, local healers were sought [also confirmed for example by Ozturk & Goskel, 1964]. It was difficult to differentiate the purely psychological, physical, or the spiritual in the manifestations of the suffering.

Ritual as healing

Healing is a process that takes place via an individual’s world of experience and the meaning that they attach to it. Glik [1988] in a comparative study, demonstrates how locally contextual symbols pervade all facets of healing – in the mythologies of the healing ideologies, the persona of the healer, family-like nature of the group of sufferers and the rituals themselves. Since in any healing context, empowerment of the sufferer constitutes a crucial milestone in the healing process, language assumes unprecedented importance. McGuire contends, ‘The very act of reinterpreting the sources of disorder in terms of the group’s beliefs is part of “healing”’ [McGuire, 1983; pp. 234]. Dyadic categories, light and darkness, higher and lower worlds, purity and impurity, wellness and illness, good / evil, death / rebirth, devi / pischach are integral to the language, providing people with surrogates to express their emotions and feelings [McGuire, 1983]. Csordas’ [1983] elaboration of the ritual of uttering prophecies also illustrates this point well. The rhetoric used in the sessions creates a predisposition in the person to be healed, akin to placebo, a process central to mental healing. In this way, the ritual language not only creates in the person an awareness of a ‘larger’ purpose for her healing, but also assures her of the help given by transcendental as well social factors. Concentration on positive symbols is suggested to the afflicted, while simultaneously pushing her away from the negative ones. Csordas’ [1983] account of a healing ritual within the Pentecostal church describes the healer as directing the person in prayer to positive aspects of every stage in the afflicted persons’ life, while distracting the person’s attention from traumatic events through visualization of Jesus Christ. It gives the power back to the person and her milieu to do something about it.

Unlike other local healing traditions of health, psychosocially relevant practices in the dargahs play upon various ritual dimensions of the embodied and psychological, both at the individual level and at the level of social groups. The sufi form of spiritual practice involves intense personal and group expression of bhakti and union with god through song, drumming, music and verse [Bihari, 1962]. Expression of intense emotion, crying, ecstasy, altered states of perceptions, etc. which in normal life may be seen as violent mood swings, or mania, or other symptoms of mental illness, has a very high value. Union [with god or spirit] bringing about ecstasy, or separation causing agony, is freely expressed: A person may cry for hours or maintain a blissful emotional state for hours, preoccupied with his or her own emotions. Sufi poetry describing this process is vivid: “every pore of the body… a tongue [Bihari, 1962:p.66]; “feel His fragrance coming and invigorating me” [p.66]; not eating and “being reduced to bones by austerities” [p.68]; unseen voices reprimanding [p.68]; being inhabited by beings other than self; divine visions [p.75]; etc. Deprivation of food and sleep is common, and accepted as evidence of surrender, and does not elicit censure. Abuse of god for abandoning a devotee may come across as great anger or great grief or even as madness.

The conferment of a vision by the pir is a valued state in sufism, and a person so graced is validated. The devotees cry for that first vision and react to it with a great sense of being touched by grace. In narrations of this experience, it may be characterized as a ‘bliss’ experience, involving higher skin sensitivity and conductance, an emotional state of euphoria, lightness, forgetfulness of self, feeling disembodied and expansive, etc. While the initial vision may result in seriously altered states of perception, it is not pathologized as a hallucination and individual interpretation of the vision is accepted. Semantics of the vision [what it means to the sufferer] is talked about, and the relationship established between the person and the vision. This is usually an embodied, a tactile or a multi-sensory phenomenon, where the pir touches or embraces the devotee. It is believed that “the pursuers of the path should laugh less and weep more” [p.79], and sufis like to live close to death – they are enjoined never to forget death [p.79].

All the healers that we interviewed in the dargahs mentioned that they were only a “servant” of the pir, refusing to “take credit” for the healing. Several of the healers we interviewed had gone through a “purification” process themselves, particularly the individual female mediums of the Khwaja Kabir Dargah in Nandre: They had initially approached the dargahs for their own healing, and after becoming healed, became healers themselves. They are often visited by the baba, and are possessed by him. They described these experiences as making them feel “happy” and “content”, and achieving “mental satisfaction”. Chanting or vocalization of some kind is associated with the experience. The possession experience made some of them pleasantly tired, as there was some physical pain due to the frantic body movements. Another healer felt energized after the sanchar, and it took away all the tiredness. One healer mentioned that “If I don’t get hajeri, I feel dull”. Another compared the experience to a deep sleep state, and coming out feeling refreshed. Some healers in the dargahs had a vision or a dream from the pir, and consider it their personal calling to serve the ailing. None of the healers whom we interviewed, believed that they were a kind of a doctor, but some said that they were “doctors of the soul”. Some male healers even talked about offering “maternal love” to the devotees, and most claimed to use their intuitive faculties, more than linguistic or logical faculties. Some healers were trained in Koranic methods, such as aayats. For most, their work [no one saw it as a ‘profession’] was a customary practice, and included ancestral worship.

What we witness in dargah healing is the mundane, of life mixing with a quest for the psycho-spiritual in everyday terms. Thursday is an important day at most of the dargahs, when the pir’s powers are said to be especially prominent. However, people tend to stay at the dargah, or in nearby areas during the ritual time period. 40 days is the magic number. Having a specified ritual time builds faith, and heightens efforts on as well as faith in one’s own recovery.

“My depression went, self confidence grew. I regained faith in my own recovery. I had left all hope of getting well. Here, hopes grew. I believed I would get well”.

“I was brought in an auto, but went back on my own two legs. Hence I felt good about it”. [Male user, Ahmednagar]

People who do not recover in the ritual time intensify their efforts at recovery. Others, with a complex set of problems, particularly incurable medical conditions such as cancer, use as many resources as they can find to seek solace and cure. Typically, the rituals are simple, and may include making ritual offerings to the pir; making wishes [mannat mangna]; tying sacred threads, lemons, bangles or other artifacts for wish fulfilment; drinking holy water; eating holy ash; bathing and personal cleansing; lighting incense; circumambulation [pradakshina]; seva at the dargah; wearing locked chains around one’s ankles or hands in the pir’s name [baba ki bedi]; making an application to the pir [arzi]; trancing seances; mediumship; undertaking physical ordeals; and exorcism from spirit possession and witchcraft.

Personal calling by the pirs [through visions, voices, ‘signs’ or dreams] was fairly widespread. Dargahs allow for the acting out of emotions, which is seen in psychotherapy as ‘cathartic’. The healing propensity of the local healing traditions is attributed to several factors like arousal of faith, complete emotional commitment of the sufferer, affirmation of shared beliefs, the symbolism entailed in healing rituals and their dramatic quality having effects akin to therapeutic techniques like placebo, catharsis, suggestion, etc. [Kleinman and Sung, 1979, Kleinman, 1980, Jadhav, 1995, Helman, 2001]. The healing process has also been seen as symbolically representing certain values, emotions, social relationships and normative codes, which are a part of the participants’ phenomenological world as well as their external social environment [Brown, 2001, Glik, 1988, Csordas, 1983, McGuire, 1983, McCreery, 1979]. The value of shamanic practices of possession and trancing are seen as a form of psychodrama, another post-modern therapeutic technique, by some writers [Casson, 2004].

Healing in these centers is achieved by involving the sufferer’s body in the healing process, since for a sufferer, a physical experience is the most immediate and concrete means of experiencing the divine power [Csordas, 1988, Seligman, 2005]. Various other physiological responses of the participants like possession, trancing, fainting, tingling sensation, buzzing in the ears, burning, etc. denote the affirmation that the divine power is indeed being manifested, convincing them of their healing experience. An extraordinary variety of repetitive, swift, jerky involuntary body movement is seen in possession and trance, for e.g., twitching, twisting, trembling, shaking, head banging, slow body rotation, crouching, running, somersaulting, swaying, heaving, turning from side to side, body thrashing, jumping, fast movements of hands and legs, etc. Such bodily sensations may be seen as trauma or stress discharge responses according to some neuroscientists [Levine, 1997]. Facial muscles move and distort into various involuntary movements, such as eye ball rolling, grimacing, etc. The use of the vocal chords and the abdomen to exhale forcefully or to make repetitive, mumbling, moaning, groaning, screaming, guttural sounds which may or not be words is very common. Possession and trance states that we have studied and filmed in the many dargahs we visited, are indicative of the emotional absorption of users and their altered states of embodiment, perception and experience. Most women we interviewed, who were possessed reported feeling warm, light, fresh, peaceful and relaxed after the experience. While evil spirit possession is shamed by the community, deity possession is revered. Women journey from evil spirit possession to deity possession, becoming healers themselves, as oracular or mediumistic.

In our interview of users of indigenous healing, people reported benefits. Various dimensions of well being were [feeling peaceful, contented, gaining in confidence, hope returning, getting more will power, wanting to get on in life, body healed, reduction of conflict, improvement in domestic and financial situations, social status] reported herein. The afflicted, who visited the centers have been doing so for long periods of time, sometimes even after the problem is resolved. Many visited for 5 years and more, long enough to warrant the label of “chronic” patients within the modern medical system. However, such sufferers are not so labeled in the centers, and often become local anchors for the centers, taking responsibilities in the upkeep of the centers. We interpret this as a different experience of well being with respect to time and self history: the “early intervention” and treatment schedule of modern medicine, makes health and sickness a determinate temporal event. What we see rather is an engagement with sickness and well being, through seamless time in personal and social life. There is also acceptance, and surrender, that not everything needs to be intervened with. People also reported visiting to “stay well”.

Researches in different religious contexts have suggested mental health benefits from spiritual / religious practices. Lee and Newberg [2005], exploring the link between religion and health, conclude that being religious offers positive health and mental health benefits in the areas of disease incidence and prevalence, disease and surgical outcomes, promoting general well-being, in the specific area of depression. Clinical researches report religious interventions resulting in faster improvement in religious patients, in depression, bereavement and anxiety disorders [Azhar et.al., 1994; Valla and Prince, 1989, Raghuram, et. al. 2002; Razali et.al., 2002]. Recent advances in psycho-biology and in cultural healing practices [Jilek, 1989; Winkelman, 2000; Csordas, 1983; West, 2000; Krippner, 1989; Koenig and Cohen, 2002; Seligman, 2005] describe the positive, recovery oriented, neuro-endocrine changes effected by certain ritual, embodied practices routinely found in the dargahs, including possession, trancing, alternative states of consciousness and meditative [non-cognitive psycho-physical] states. Some people with psychosocial disabilities have found that a connection with the sacred within oneself, leading up to and sustaining their recovery, other than giving the necessary strengths and capacities required to lead others into recovery [Statsny and Lehmann, 2007; Minkowitz and Dhanda, 2006].

The research indicates that psychosocial realities for many individuals do include a person centric relationship with some notion of the transcendental. The transcendental concept with which a person relates psychosocially and spiritually may be god, a guru, sant, pir, or infact, a revolutionary notion of utopia. The healing at the dargahs suggests that rather than any structured system of religion, theology or the primacy of [any kind of] Word or Scripture, a chaotic and spontaneous approach to an intensely personal embodied and multi-sensory experience of transcendence, including shamanic and primal practices and experiences, may bring psycho-spiritual relief in everyday life to a vast number of people.

Conclusion

Several concerns are raised by the legal interventions into the local healing sector. Of primary concern is the fact that, these institutions are facing an immediate threat and closure by the so called “modern” mental health institutions. Secondly, the mental health authorities at various departmental levels have absolutely no knowledge cover or evidence base for their witch hunt. Third, given their poor track record in establishing a human rights compliant health service, they do not possess the necessary credentials in mounting a challenge to the local healing sector. Finally, in this process, the local healing community, comprising of the institutional authorities, healers, users and communities, has not ever been a part of or even a passive listener to these normative processes. Our workshops with the local healers showed that there is little awareness among them about the recent legal frameworks coming into their work with so much force.

Whether the healing centers actually provide psychosocial healing or not is a question thriving with multiple answers and interpretations, as shown in the anthropological literature. Absent, comprehensive data sets in local contexts, there is no reason to abandon the value of such centers in psychosocial recovery and empowerment. Available evidence seems to suggest the positive aspects of healing and recovery using holistic methods, other than offering various social and safe spaces for experiencing life through vulnerability. While not suggesting at all that people suffering from mental health problems should henceforth be referred to a local healing center, or that a traditional healer should be a part of any ‘multi-disciplinary’ mental health team, we definitely argue for the important spaces offered by such centers for psychological healing and recovery. Such local healing centers can offer important lessons in creating the necessary architecture and ambiance of community healing, other than useful non-medical techniques of self recovery. Our study has shown that, having more or better mental health services may not necessarily change that, unless such services provide access to these personal healing aspects found in the dargahs and other such mental healing centers.

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[1] Erwadi Case Study Files, Library and Documentation center, Center for Advocacy in Mental Health, Pune

[2] 12-02-2002, “NHRC directive on mentally ill patients”, The Hindu

[3] Writ 562 of 2001, Saarthak and Achal Bhagat versus Union of India, Ministry of Social Justice and Empowerment, Ministry of Health, Disabilities Commissioner and other State Governments

[4] This intervention was filed by Saarthak and Achal Bhagat as one among several filed by various state and other parties to the SC action. Carers’ groups, user groups as well as professional bodies, have filed independent interventions before the court.

[5] Times Of India, 8-7-2001, “Story of the shackled in Hyderabad”, featuring Syed Meeran Hussaini Quadri Bogdad in Hyderabad”; ibid. “Nine chained in Patiala too”; Hindustan Times, 19-08-2001, “Erwadi waiting to happen near Delhi” featuring the Shastriji Dharamshala at Faridabad near Delhi, run by a vaidya]

[6] “Quality Assurance in Mental Health”, NHRC, New Delhi.

[7] 15.3.2001, Affidavit filed by Health Secretary, Government of Kerala.

[8] 28.2.2002, Affidavit filed by the Principal Secretary, Health and Family Welfare Department of Punjab, Chandigarh

[9] 26.2.2002, Affidavit filed Chief Secretary, Government of Manipur

[10] 18.3.2002, Affidavit filed by Jt Commissioner and Incharge Special Officer, Legal Cell, Government of AP.

[11] In March, 2008, the Pavlov mental hospital in Kolkatta, was in the news for keeping women patients completely naked. The explanation given by the authorities was that the clothes had been sent for laundry. On March 8th, a woman was raped in the Yerawada mental hospital, causing outrage in civil society.

[12] 18.3.2002, Affidavit filed by Jt Commissioner and Incharge Special Officer, Legal Cell, Government of

[13] “Solitary confinement” or the “cage beds” are small 6×6 cage like rooms, walled on 3 sides and grilled on the fourth. They are bare cells with no bedding, fans, toilets, or anything. Persons restrained here often are reduced to living there naked for days or even months. Food is passed through a small hole in the grill. The persons entombed here are forced to urinate and defecate in the open and await staff mercy to reach a state of better hygiene. All private and public institutions have cage beds. The existence of such “facilities” has been challenged before the supreme court.

[14] 11-8-2001, Saturday, “Faith healing centers for mentally ill to be monitored”, The Hindu.

[15] 10-8-2001, “Another Yerwadi is right next door: Temple town in Rajasthan offers kill-or-cure treatment for mentally disabled”, The Indian Express, New Delhi.

[16] 9-8-2001, Thursday, Maharashtra Herald, “Ban misuse of faith healing: Those shielding asylum owners should be charged.”

[17] 8-8-2001, “No chains at Asia’s largest mental hospital”, Wednesday, Pune Times.  At the point of writing this article, a public interest litigation is pending before the Bombay High court against the said hospital.

[18] Financial support for this study [2003-2006] was provided by the IDPAD / ICSSR. The Bapu Trust, Pune, housed the program and provided appreciable administrative and library support. Deepra Dandekar, the project co-ordinator and Deepak Salunke were other team members of the project, whose contributions are deeply appreciated. Mira Oke, P Joglekar and Sadhana Natu provided ethical and technical advisory inputs into the project, for which we are very grateful.

7 thoughts on “Recovering from psychosocial traumas: The place of dargahs in Maharashtra

  1. When I initially commented I clicked the “Notify me when new comments are added” checkbox and now each time a comment is added I get four e-mails with the
    same comment. Is there any way you can remove me from that service?
    Thanks a lot!

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