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Cast off by outer and inner worlds

A nation is truly inclusive, rights and capabilities promotive, and embed- ded in a culture that values justice and equity when it respects and

cares for its most vulnerable. Despite progress in science and technology, and strong nudges in the direction of devel- opment and growth, the lives of one seg- ment of society — homeless persons with mental illness — remain un- changed. This group lives on the fringes, invisible and forgotten. “I was so unwell that I offered to sell my child for a bowl of curd rice. If I hadn’t been rescued by the police and introduced into a treatment system, I would have lost my child forever.” “The maggots jumping out of my un- healed wounds… they didn’t grab any- one’s attention. And I was too ill to feel them myself. My matted hair, soiled clothes, stench and unsavoury demea- nour, however, did. I was swept away from the centre of the city where the rich lived to a slum-like area that would tol- erate people like me.” “The voices — they drove me mad. They were angry, judging and unkind. In hindsight, quite like the world we live in.” These are voices of homeless persons with mental illness; individuals who continue to struggle in a world that prides itself on advancements in rights and morality. The state, science and so- ciety have failed this group on many counts. In this fast-paced world, the ca- pacity to engage and to remain engaged with persistent problems is limited, es- pecially with those problems that open up ambiguities and pose everyday challenges. Despite progressive human rights leg-

islation meant to preserve individuality, the rights of this group remain largely violated. Freedom is an essential attri- bute of what these rights constitutes. I would, however, argue that freedom, when placed in the capabilities frame- work, thrives much more. Thus, merely addressing the right to live freely on the streets is disregarding the more valuable right to a full life. It is no coincidence that both World Mental Health Day and World Homeless Day occur on the same date. The rela- tionship between mental illness and homelessness is bi-directional and trag- ically symbiotic, each bolstering the oth- er. Abject poverty and social disadvantage, untreated mental or phys- ical illness, migration, and poor access to healthcare are some of the causal path- ways that render a person homeless. Particularly vulnerable are persons with mental illness who either lose their pri- mary caregiver, or experience multi-di- mensional distress on account of glaring inequities and social deficits such as poor nutrition, unemployment and in- appropriate housing. Limited mechanisms are available to respond to this crisis today. While the Supreme Court directive that mandated the presence of a shelter for every one lakh population has been gradually gath- ering momentum, its implementation remains somewhat uncertain and am- bivalent in the case of this constituency that presents a complex set of problems. Existing care pathways — apart from these shelters — include mental hospi- tals, civil society organisations, beggars’ homes and, sometimes, prisons. Mental hospitals often hesitate to admit such persons owing to cumbersome judicial

October 10 was World Mental Health Day and World Homeless Day. It’s no coincidence, says
October 10 was World Mental
Health Day and World Homeless
Day. It’s no coincidence, says
the problems faced by homeless
people with mental illness.

procedures, persistent and chronic men- tal illness that often doesn’t remit easily, absence of a caregiver, and human rights related challenges. Even when they do admit the patient, the state of mental hospitals in our country leaves a lot to be desired. The lacunae are not just in their poor management. Running a large facil- ity that caters at any point to around 500 to 1,000 individuals, all afflicted with a range of mental disorders, in an envi- ronment ridden with limitations and scarcity, particularly inadequate human resources, would be an impossible task even for a high quality management team. Further, mental hospitals carry the legacy of their rather unpalatable history of power play and social exclusion. For many homeless persons who have no family or home to return to, long- term institutional care remains the only option. This results in people languish- ing in mental hospitals for extraordina- rily long periods of time. A spectrum of services for homeless persons with men- tal disorders needs to be developed, in- cluding care on the streets, inclusive living options in the community, coun- selling kiosks, social entitlements, skills development and livelihoods facilita- tion. The first Indian Mental Health Pol- icy and the proposed Mental Health Care Bill refer to the unique needs of this vulnerable group. While this signifies positive intent and affirmative action, its translation into meaningful response on the ground calls for a more concrete, tangible and strategic action plan. In this context, state, science and so- ciety have key roles to play: the state because it will have to liaise effectively with many stakeholders and use con-

vergence as a strategy to respond to the layered needs of this group; science be- cause it will have to find an evidence base — from practice, existing models of care, and grassroots level social innova- tions — to build strong and varied exper- iments in different settings that are contextually relevant and culturally nu- anced. Society, because we have thrust upon these persons the unitary identity of a homeless or mentally-ill person and used it as a central feature of oppression, disregarding the transience and multi- dimensionality in one’s identity con- struction. These men and women were born in homes like you and me. They aspired for a bright life like you and me. Somewhere down the line, their lives changed, as they were deprived of what you and I continue to enjoy — life, health and personhood. And then their narra- tive changed. At the turn of the century, Martha Nussbaum listed 10 central capabilities that she thought were integral to every individual. Homeless persons with men- tal illness are deprived of almost every capability on this list, be it bodily integ- rity or bodily health, the ability to affil- iate, play, exercise political will, own individual space or exercise control over one’s environment. Despite the explicit emphasis in our Constitution, to protect all its citizens, especially those who are fragile, both the State and us — its people — have failed to uphold this value and vision in action and spirit. It’s now time to reverse this trend.

The writer is co-founder of The Banyan and the Banyan Academy of Leadership in Mental Health (BALM).

the Banyan Academy of Leadership in Mental Health (BALM). THE OTHER HALF By Kalpana Sharma Out


By Kalpana Sharma

Out in the open

The absence of sanitation facilities for women during disasters enhances their vulnerability.

L ast month, while our attention was

diverted by what our politicians

were doing on foreign shores and at

home, tragedies on a massive scale

were being played out in many parts of the country. Besides the devastating floods in Kashmir last month, vast swathes of the rest of India have also been inundated by floodwaters. Odisha, Bihar, Assam and Meghalaya have seen some of the worst flooding in years. For these states, floods are an annual phenomenon. But this year they have been worse and in places where the waters never advanced with such force in earlier years. So even as the usual tamashas and tirades occupy our news space, spare a thought for the women, men and chil- dren in these states who are still strug- gling. Even as I write this column, an estimated four lakh people in Assam and Meghalaya, spread over 4,446 villages in 23 districts are homeless or badly affect- ed by the floods. Thousands of people remain in relief camps because they can- not go back to their villages. In Odisha last month, rising river wa- ters submerged thousands of villages in 23 of the 30 districts in the state. In Bihar, too, the flooding has been relent- less, spreading destruction, destitution and disease. While the reports in the media on these states are few and far in-between — you have to make a determined effort to mine out the news from mainstream In- dian media — the few reports that have appeared make heart-rending reading. One report that I found particularly touching appeared in The Hindu on Au-

gust 27, 2014, under the headline, ‘Wom- en fight shame in flood hit Bihar’




cle6356043.ece?homepage=true). It quoted women in Bihar’s Supaul district talking about the particular challenge that they face as women in the wake of floods.

A woman in her thirties was quoted

saying, “Poor women like us face more problems to relieve ourselves when floods force us to flee our villages. It is our fate. No one can imagine this except those like us.” Another older woman said, “We have no option but to relieve ourselves in the open by closing our eyes and minds to the hell-like situation.” What they are talking about is the pa- thetic absence of any sanitation arrange- ment for women during such disasters. You might argue that in any case many of these women would not have toilets and are therefore used to open defecation. But can anyone imagine what this wom- an means when she says they close their “eyes and minds” when they go out to relieve themselves in a flooded landscape? Why, people would legitimately ask, should we make such a fuss about wom-

legitimately ask, should we make such a fuss about wom- PHOTO: AP en’s problems at such


en’s problems at such times when every- one — men, women and children, as well as the elderly — are affected? I do so because in many ways women’s vulner- abilities are enhanced at such times. If they confront a daily challenge of san- itation, this is compounded during floods and other disasters. Yet, when relief measures are put in place, the particular needs of women are often overlooked. In a powerful article that Assam-based journalist Teresa Rehman wrote after the 2010 floods in her state (infochangein-


she quotes a

woman called Salma Begum from Sonit- pur district: “Sometimes we have to seek permission from the owners of a dry patch in order to defecate. Most often we have to do it discreetly, on other people’s land, as it becomes difficult to control oneself. Sometimes, during the floods, we starve ourselves so that we do not need to defecate.”

In this instance, women like Salma were beneficiaries of the government’s Total Sanitation Programme, in partic- ular low-cost toilets. Yet, one flood, and everything including these toilets are washed away. Women like her are then left with no alternative but to revert to the age-old practice of open defecation, with the added complication of not find- ing a dry spot. Floodwaters are indiscriminating. They sweep away everything and every- one that comes in their way. But for the survivors, the story varies greatly de- pending on class, caste and gender. And this is where the voices of women like

Salma from Assam or the women from Bihar must be heeded. The process of relief and rehabilitation must necessar- ily be ‘gendered. The absence of toilets is

a woman’s problem in a very specific

way. Sweeping our streets clean is all very

well but surely cleanliness must mean that women do not need to live through

‘a hell-like situation’ on a daily basis.






By T.M. Krishna

Addicts to sensation

For consumers like us, news becomes entertainment beyond a point.

I t was like any other day. I sat with my eyes moving from my gmail inbox to an English news channel, which drew me, need I clarify, towards the

United Nations, with our Prime Minis- ter emphatically making his presence felt on the minds of everyone inside and outside that iconic space. Will he ad- dress the ‘K’ issue? What will be his form of rebuttal? But suddenly the scene shifted. It was a pavement in Chennai. Women and men were bawling, screaming and cursing the judge who had the gall to send their beloved Amma to jail. An- chors and on-site reporters from Chen- nai and Bangalore gave us a running commentary on every car, cycle, auto and van that entered or left the court house or Chief Minister Jayalalithaa’s residence. Cut the scene here… Within minutes, we were transport- ed back into the United Nations and its vicinity to feel the Modi wave. Support- ers had arrived in and around his hotel and the excitement was palpable. In between all this there was the small matter of the floods in Assam and Meghalaya. As I write, I understand that over four lakh people have been affected and 85 people are dead. But this ‘minor’ story was like a 30-second ad film placed between two mega-seri- als. This sequence repeated itself through the day with the occasional Asian Games news sandwiched in-be- tween. All in all, that day, Jayalalithaa was the star. The reporter around the Modi fan- fare was as charged as every one of the fans in New York. The anchor in the studio was pumped up and Modi’s every word was heard and noted. But when it came to Jayalalithaa, the reporting on this channel became somewhat, shall I say, detached, impersonal. But when the telecast turned to the

detached, impersonal. But when the telecast turned to the floods, the anchor could be seen at-

floods, the anchor could be seen at- tempting an empathetic tone. Is it humanly possible for a person who jumps from story one to three within 10 minutes only to swipe back to story two to actually feel? The truth is

that, after a point of time, the anchor is an actor who knows how he needs to sound and look depending on the story being told. He is the package, curated to perfection giving us ‘content’ that after

a point is immaterial. Why do I say

immaterial? Because, on that day, peo- ple losing their homes and lives in As- sam were not as important as Modi or Jayalalithaa. They could wait for anoth- er 24 hours to receive their television

time-share. One may say that news is like life where death and birth, joy and suffering come together, one after another. In a way, may be news channels are philo- sophical levellers. A fascinating thought indeed! But the issue here is not about the varied news reports being targeted at us. It is about a conscious plan to sell news, where the channel clearly places market value on the kind

of news that needs to reach us.

Even in tragedy there is saleability. The floods in Kashmir have greater vis- ibility than those in Assam. But this is not just about the televi- sion channels; it is as much about us sitting on our couches demanding from every thing excitement, instant grat- ification and titillation. We are inter-


ested in the news not for what it conveys but for how it does so — the more exciting, the more shocking, the

better. We will complain that an anchor is noisy, jingoistic and violent; yet night after night at 10.00 p.m. we will watch ‘him’ hyper-ventilate from his vantage position. Every TV station knows this and plays to this reality; it is only in degrees that they differ. Are television channels responding

to our shallowness or is it the other way around? Does that really matter; we are all the same, aren’t we? We are all consumers; news con- sumption is not any different from buy- ing a Coke to satisfy our craving for sugar and caffeine. Just like the anchor, we too shift gears for every story, not knowing what we felt for the story that just passed. But unlike make-believe entertain- ment, here the news channel has only so much control over what is fed to us. Depending on what or who would catch our eyeballs for the longest, the time allocation is varied, but in essence keeping to a show of variety. We ‘news

junkies’ are exactly that — junkies. We don’t know why we watch news, but delude ourselves that we are more in touch with the world and that we do care. We are addicts to sensation. That is what we are, addicts, hooked to our daily joint — news.


The chair persons

Continued from page 1

niors in contention for the post, Vilasrao Deshmukh and Sushilkumar Shinde, had peripheral links with Adarsh. But Prith- viraj Chavan’s ‘political lightweight’ rep- utation has meant that his efforts to cleanse Maharashtra has seen him bat- tling both his own party men and Con- gress ally, the Nationalist Congress Party, with the latter breaking a 15-year- old alliance on the issue of seat sharing for the upcoming Maharashtra assembly polls. Ironically, in the recent Lok Sabha polls, when the Congress was reduced to

just two seats in Maharashtra, it was Ashok Chavan who not only won Nanded, but also helped party col- league, Rajiv Satav, secure the neigh- bouring seat of Hingoli. If Ashok Chavan proved his popularity — even after being sidelined — so did BJP’s B.S. Yeddyurappa. In July 2011, his party forced him to step down as Chief Minister of Karnataka, after the Lo- kayukta investigating cases of illegal mining indicted him. In November 2012, he quit the BJP to formally launch the Karnataka Janata Paksha. But after the BJP lost power in the State in the Assembly polls of 2013,

the party started making overtures to Yeddyurappa. In January 2014, he announced the merger of his party with the BJP, ahead of the Lok Sabha elections. But, unlike in the case of the Congress and the BJP, when the leader of the party is him/herself forced to step down, control over the proxy chief minister takes on another dimension. In July 1997, Lalu Prasad Yadav was forced to step down on charges relating to the fodder scam after seven years as Chief Minister of Bihar. Filling the gap was his wife Rabri Devi, who was sworn in on July

25, 1997. Not only did she rule for the rest of the term till February 11, 1999, but the Rashtriya Janata Dal — as it was called by then — won a third term and she was sworn in as chief minister for a second time, finally demitting office on March 6, 2005. Interestingly, while Yadav’s own political career saw more downs — last year, he was forced to resign his membership of the Lok Sabha after he was formally convicted — Rabri Devi flowered as a politician. When she became CM in 1997, she had never made a political speech. On assuming office, she took her job seriously,

attending office with more diligence than her husband, following up on issues, learning on the job, even asking her husband to conduct his politics outside the family quarters. She also soon became a pro at making political speeches, even as she continued to maintain — Bharatiya Nari style — that she had done it all for her husband. The case of AIADMK supremo J. Jayalalithaa, who recently became the first chief minister to be convicted while in office, is closer to that of Yadav than the other examples cited above. For one, the choice of her successor was entirely hers as it was with Yadav in 1997. She had to step down at the height of her popularity, months after her party won 37 of the 39 Lok Sabha seats in Tamil Nadu,

just as the Janata Dal/RJD stayed on in power in Bihar for eight years after Yadav quit as CM. In Jayalalithaa’s case, this is the second time she has had to step down on corruption charges. The first time was in 2001 but, on both occasions, she chose loyalist and former minister O. Panneerselvam. Indeed, after her recent imprisonment, not only did her grief-stricken supporters hold protests, Panneerselvam also wept during his inauguration. In 2001, when he be- came chief minister for the first time, he proved his credentials as a reliable stand-in by stepping down to make room for her after she was acquitted six months later. In his brief innings as CM, he even refused to use the chair she had occupied. Indira Gandhi would have approved.

brief innings as CM, he even refused to use the chair she had occupied. Indira Gandhi



brief innings as CM, he even refused to use the chair she had occupied. Indira Gandhi