Dr. Lakesh Kumar Khatri
Umerkot
In Thar awareness about Psychiatric illness is very low as compared to other parts of country. Psychiatric problems are increasing in the Thar due to Poverty, low literacy rate, unemployment and drought. Due to drought pregnant mothers remain unable to take proper diet (balanced diet) and develop malnutrition. As a result of which they deliver preterm, post term babies and low birth weight babies. As Most of them are home deliveries with the help of untrained Dais, therefore the mother and the babies are at risk of developing complications like birth asphyxia, infections like meningitis, Respiratory distress etc. Most of them are unable to reach basic health units or qualified Doctors. Few of them succeed to reach district hospitals, where depending upon the condition of patient some survive and some unfortunately not. Those who survive and affected by any of these complications may develop mental retardation, and other psychiatric and organic problems. Mentally retarded children are unable to compete with normal children.
When Thari patients suffer from psychiatric illness like Depressive Disorder, Acute Psychotic disorder, conversion disorder, Obsessive Compulsive disorder, Mental Retardation, anxiety disorder or Post Partum Psychosis, majority of the psychiatric patients are moved to Bhopas or Faith healers to get rid from that problem, as they believe those diseases to be shadow of bed evil or black magic etc. BHOPAs do their un ethical routine procedure like torturing patients, they do this by beating with sticks, burning the patient with cigarettes and agarbatis and some pull their hairs and threat them to burn etc. As a reward for this whole activity they demand donation of Cow or Goat. Fake faith healers misguide the patients and satisfy them with their Taweez and dam darood etc. Some fake faith healers demand some kind of money or animals. Most of the people donate with their own will. What actually happens some of the problems are self recovered due to their short span of illness, at the time when they are being treated by BHOPAS or fake faith healers even though patient did not required that treatment and the credit of recovery goes to BHOPAS and Fake FAITH HEALERS, Patients become so falsely convinced to BHOPAs and False Faith healers. And those patients who are not self recovered because of their long span of disease, they are sent by BHOPAS and FAKE FEALTH HEALERS to qualified Doctors with an excuse that the bad evil and black magic is removed from their bodies now they require Treatment by Doctorr.
Due to lack of awareness of Psychiatric illness in community the patients usually move to local medical practionors (qualified or nonqualified), fraction of those patients also moves to Specialist (Neurophysician and Neurosurgeons). By the time they approach properly to a Psychiatrist they had already wasted their significant time and money. The disease process had also progressed by that time.
As in Government Hospitals of District Sanghar, Umerkot, Tharparkar (Mithi) there is no Psychiatrist posted. Poor Thari people face many troubles for seeking Psychiatric treatment facilities in Sir Cowsji institute of Psychiatry and behavioral sciences Hyderabad. From home in village to Hyderabad they have o hire a taxy which cost about 6-12 thousands. Regarding private clinics only single psychiatrist are offering services in Thar Districts.
Stigma also does matter in our society. Even educated people remain in denial and avoid consulting to Psychiatrist. They prefer to consult Neurophysican and Neurosurgeons. Even at some places Anxiety and somatic disorders are being treated by cardiologist and gastroenterologist. Thar needs Psychiatrist in their hospitals on Taluka Basis. As I belive if we educate the Thari People and launch awareness campaign about Psychiatric illness in Thar, we can save many lives, hudge amout of revenue, and we can improve quality of their lives.