ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Health : Distorted Development

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The World Bank contends that by 2005 schizophrenics will be fourth or fifth ranked contributors to the global burden of disease, becoming more important than even cardiovascular diseases. And the Bank is worried about it because the social cost of the care of schizophrenics is stupendously more than for the others. Prompted by this scenario of a horrific future, the Bank has been releasing extensive funding for research into the cause of the problem. One such project is a huge multi-institute study headed by the National Institute of Mental Health and Neuro Sciences, one of the pioneering institutes in the care of the mentally ill. The project apparently is meant to establish a uniquely Indian base to understand the gene-environmental interactions that cause the disease. According to some estimates, some two crore people in India suffer from this illness which makes the project not only prestigious but also extremely relevant. The question that arises however is this: if schizophrenia is so widespread a problem, then why have our health programmes ever addressed it. In fact, why is it that our health programmes have almost uniformly maintained a studious silence over what is known as mental health?

Health by a broad definition should mean physical health and emotional and psychological well-being. Curiously, the country’s health planners seem to have decided that physical health or at least the lack of illness subsumes emotional and psychological well-being. In consequence, at no level of the health care infrastructure – the grass roots and sub-centre level, at the PHC or the tertiary level – has adequate attention been given to what is called mental health. Most health policy documents have been content to at best include a paragraph or two to the need to ensure care for psychologically ill patients. This perception, however, remains at the level of lip-service. Neither PHCs nor even the district level hospitals are equipped to handle these problems. In consequence, traditional practices continue to be sought, which are often so closely linked to social and cultural perceptions of the illness that the ‘cure’ often results in ostracism of one sort or other. Even more serious are other manifestations of psychological problems and mental illness. With little help from fragmented traditional healing traditions or from the modern medical system, there are any number who are abandoned by their families, so that even if cure is possible, rehabilitation becomes impossible. Given a social fabric which is undergoing severe stresses and strains, such as in India, it is hardly surprising that a range of illness syndromes from maladjustment and depression to more severe problems are increasingly becoming manifest.

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