KATHMANDU, Feb 13: It´s 1.00 p.m. on February 2. Passersby at Shantinagar gate gaze at a weary woman leaning towards an electricity pole at the side of the road. [break]
She appears to be nude and covering herself is garbage that she is carrying on her back with all her effort. Dirty plastic packets hanging from her shoulder and neck give the impression that she is wearing them. In general parlance she would be a lunatic. In medical terms she is a mental patient with a probability of cure.
"A majority of deranged people seen in the streets are most likely to be suffering from chronic schizophrenia," says Dr Kapil Dev Upadhyaya, former director of the Mental Hospital Patan who is currently working as consultant psychiatrist at Model Hospital. "If treated they can return to normal life."
According to Dr Upadhyaya, a majority of cases of schizophrenia (disorders characterized by distortion of reality, disturbance of thought and language, and withdrawal from social contact) can make 90 percent progress in their condition if treatment is provided. Even the incurable ones can make about 25 percent progress.
A case in point is Kanchi (not her real name) who suffered schizophrenia in her early 20s. Some four years ago police found her in the street and took her to Bir Hospital. With injuries all over her body she was left to die near the mortuary at Bir. One day the hospital ambulance took her to the mental hospital, but left her outside the hospital gates without informing the hospital authorities.
"As she looked abandoned we thought she was HIV-infected," says Dr Upadhyaya, who treated her. "Later when we took her in we realized she was a mental patient."
Kanchi was cured in about four months. "After undergoing treatment she even started helping the sisters in the hospital give medication to the other patients," he recounts. She stayed on at the hospital helping the medical staff, for about a year, and was later sent back to her home in Jhapa.
According to records, women are much more vulnerable to mental illness. A six-month morbidity report of the Center for Mental Health and Counseling-Nepal shows that many more women compared to men suffer from mental illness.
Of the 5,669 mental patients who visited 17 mental health centers in 17 districts in the country, 2,082 were women while 1,250 were men. Of the cases dealt with between September 2008 and February 2009 there were 483 female and 213 male patients suffering from depression. Similarly, 1,133 women with anxiety came for treatment while the males with the same problem numbered 650. Those with Conversion Disorder (CD) included 124 females and 59 males, while the centers also diagnosed 90 female and 84 male cases with psychosis and 165 women and 156 men with epilepsy over the six month period.
Dr Upadhyaya says that women worldwide are much more vulnerable to certain types of mental illness such as anxiety, depression and CD, which is also known as hysteria. "This is because of hormonal and social factors," he said.
He said when a team of doctors visited Chhatre Deurali in Dhading after a reported case of mass hysteria at a local school, they found that a majority of boys in the village were enrolled in private school while girls were enrolled in government schools. "That was one of the reasons for the girls suffering hysteria," he said.
On the one hand women have a different hormonal makeup than men while socially also their situation is different. They are married off to another home where they have to adjust to other people and a different culture.
And in the rural parts of the country, women work in the fields, take responsibility for bringing up the children and also look after household chores. "The burden of work affects them psychologically," he added. "Due to hormonal factors women think from the heart, while men do so with the brain, and this makes women more vulnerable to mental stress."
sangeeta@myrepublica.com
