Indian asylum blaze highlights global challenge

Indian asylum blaze highlights global challenge

Pollock, Laurene

The tragic Indian asylum fire last month comes, ironically, in a year which the World Health Organization has dedicated to tackling mental illness.

Twenty seven patients, many of them seriously ill, were killed when a private asylum where they were kept chained, burned down.

The fire destroyed the home in Ervadi near Madras. Families brought their ill relatives there because of its nearness to a religious shrine thought to have healing properties. Now all private establishments in the town have been ordered to close and the 700 residents sent back to their homes. In the meantime owners have been told to remove the chains.

The country’s supreme court has asked for a report from the Tamil Nadu state government, raising issues around human rights.

There are just 500 psychiatrists in India catering for a population of one billion. While facilities have developed in the larger metropolitan areas there is still a dire shortage of help for those with mental health problems in more remote, poorer areas.

In 2001, WHO launched its ‘Stop Exclusion – Dare to Care’ year long campaign on mental health. The organisation estimates 400 million people world wide are affected by mental and neurological disorders or psychosocial problems related to drug and alcohol abuse.

But it highlights the problems in many parts of the world in overcoming the stigma and shame experienced by many families when confronted with illness.

The WHO regional office in south east Asia is developing strategies for community health programmes which focus on the availability, acceptability, accessibility of treatment, affordable medications and assessments of services.

Dr Vijay Chandra, the WHO regional adviser on health and behaviour stresses the importance of community programmes, away from hospital based psychiatry. He commented:

“Whatever services are available in the neurosciences, these only reach the metropolitan and medium sized towns. Small towns, villages and marginalised populations have no services and people sometimes do not even know they are suffering from a treatable disease.

“It is vital that we reach out to people and the basic minimum services are extended to all.”

WHO regional director Dr Uton Muchtar Rafei on World Health Day last April said it was “time to lift the veil” on mental illness.

“Five out of 10 of the most disabling disorders in the world are psychiatric, as listed in the Global Burden of Disease published by WHO.”

Medecin Sans Frontieres, the international health charity devotes part of its resources to helping those with mental health problems in crisis torn parts of the world.

See ‘A Foreign Field’, in Mental Health Nursing Vol 20 No 7 pages 20-21.

Copyright Community Psychiatric Nurses Association Sep/Oct 2001

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