After recovery: Who wants a woman like you?

Published: March 5, 2011

Patients pose for the camera. PHOTO: NOOR IFTIKHAR

This week I visited the Punjab Institute of Mental Health (PIMH) in the Shadman area of Lahore with my class. We noticed a stark difference between the men’s ward and the women’s ward.

It was a heartbreaking experience. I came to realize that the stigma of being a “mental patient” can mean loneliness and isolation for all psychiatric patients, especially women.

The men’s ward

When we entered the men’s ward we saw a group of men clad in bright blue shalwar kameez and mismatched sweaters. They were seated on rough carpets on the floor, basking in the warmth of the winter sun.

These were the stable male patients, survivors who were able to regain normal mental equilibrium with regular medication.

As they saw a flood of baajian (that was us) entering the ward, they waved to us smiling and laughing like innocent school children. It was difficult to tell that these people once suffered from socially taboo illnesses like schizophrenia.

However, the trip to the female’s ward was neither as inspiring nor as cheerful as the male ward.

The women’s ward

As we entered, a swarm of female patients ran to the open gate. The large expanse of the green lawn was full of women dressed in pink shalwar kameez. Their condition was abysmal. I was shocked.

Female patients, stable and unstable all seemed to live together.  But they did not seem happy.

While some of the ladies stood holding hands, some screamed and yelled at one another but fell silent at random intervals.

A woman who seemed to be in her 50s ran towards us and greeted us like we were long-lost relatives.  As we smiled and nodded politely, her enthusiasm mounted to a new level. She cried with delight and sang her own rendition of Noor Jahan’s Laung Gawacha, casting coy glances at us while frequently touching her nose-pin as she swayed to the tune..

Some of the older female patients had their hair cropped to manly bobs. Some walked with spastic movement and had twisted wrists and heads tilted at angles.

The director of PIMH told me that in many cases recovery was irrelevant. The institute was to be the women’s home as their families refuse to take these patients back even when their mental state has improved. He told me about a particularly tragic case of a Canadian girl, who received treatment, recovered and was duly released by the institute.

But the girl’s family refused to take her in. She was left on the streets where she was raped and tortured.

It took her months to find her way back to PIMH – where she was now diagnosed with acute schizophrenia, depression, paranoia. She has to be kept in solitary confinement. The doctor on duty told us about the girl when she explained that female patients are hardly ever accepted by their families even after complete recovery.

I felt sick, sad and hurt to know that families could behave this way.

 

Noor Fatima Iftikhar

Noor Fatima Iftikhar

An A level student at Lahore Grammar School.

The views expressed by the writer and the reader comments do not necessarily reflect the views and policies of The Express Tribune.

  • MKB

    I know of a case where a brother and sister are mentally unstable. But their condition is not very severe, so they are stable enough to appear almost normal through medication. Their elder brother who is married and has a son of his own, keeps them at home, and takes care of them. Because of this personal love and affection, their lives are much happier than they could have been in any institution. I have personally interacted with the two siblings who are taking the meds, since they both live in the house just next to mine, and yes, after a while you can tell that something is amiss, but they are able to lead fairly normal lives.
    The sad thing is, in many cases, our institutions have patients that their families could have kept at home, if they had so desired, and were willing to make the effort, like this next door neighbour of mine. Recommend

  • Tamoor Azhar

    Nice topic..Recommend

  • Syed Hussein El-Edroos

    Really sad that some families do not want them backRecommend

  • http://www.linkedin.com/pub/asim-j/30/1b3/780 Asim

    You are simply telling us something what most of us already know, it would be better if you could propose some solutions rather than simply stating what is going on. Most of the mental health patients even in western countries will have to remain in a mental institution if they are are not mentally fit to be a part of the society.And even in the western society some might not be accepted in the family home if they have made complete recovery.

    Atleast they are not being raped or left on streets. The conditions might not be good but atleast they have a roof over their head. What can be done is to give the ones who are capable of reading and writing an education and help them find real life jobs. Recommend

  • Nadir El-Edroos

    Its quite sad that while the PIMH is doing its best, it cant hope to offer a successful recovery without the support of the patients family. This is quite similar to the state of old age homes where children have literally dumped their parents, split the family inheritance and disappeared. Recommend

  • parvez

    You have chosen a different but relevant subject.
    To avoid what happened to the Canadian girl I feel a patient should be put in a half way house after release and kept under supervision. So that she/he gradually mixes with society and the world at large.Recommend

  • Feroz Ali

    I don’t understand what was so different between the men’s ward and the women’s ward. The writer kept saying that the women’s ward was in a very bad condition but she failed to offer any proof of this except that fact that the stable and unstable women were kept in the same place. Apart from this fact there is no evidence of how the women’s ward was worse than the men’s ward.

    Anyway a very important topic. Recommend

  • Kaisar A

    You have only seen the tip of the iceberg…. But it is good as majority has just closed their eyes and ears and live in their own world without realizing the pathos of the mental patients who are very much part of us. We, as a society, are so self righteous and even kill others in the name of religion but would never follow religion in its true sense. These members (mental patients) have every religious and moral right to be treated with love and respect but what happens to them in general by the society and by the (majority of) the staff in particular cannot be described in words… A society so indifferent deserves what it’s going thru… Keep trying to lessen the agony of some… even one…. because we can.Recommend

  • NFI

    @Feroz Ali: The fact that the stable and unstable patienst co-existed was the biggest flaw there was. It could hinder the stable patient’s progress, and in itself if was very detrimental. When in psychosis, you obviously do not keep track of what you’re saying. Fights erupted, then quieted down by themselves. Things like that could pinch someone’s nerves. It was not a healthy environment to be in. Keep the stable and unstable apart – like they did in the men’s department. It did both of them a world of good.
    You have to consider that somehow, “bad conditions” just do not pertain to living conditions. Especially for mental patients, you have to look beyond that and give the healthiest environment possible – no one would care if the facilities are high-tech and upto date but such blunders are being made.Recommend

  • Hala

    This was really sad.Recommend

  • Khalid Rahim

    @ Noor Fatima you showed moral courage along with your school mates to visit an institution
    where most would shun or prevent others from visiting. Then bringing up the plight of those who
    seek rehabilitation within the society and their once dear ones? Does not need a powerful or rich minister or an academic genius to bring solace to such victims, but a society with infallible
    character?Recommend

  • S Hayat

    It’s amazing how the writer of this article has shared this touching first hand experience with us because nowadays even if people have an idea about certain things prevalent in our society, nobody really stops to think about it – let alone do something about it. If the writer has not given a solution, at least she took out some time to share her experience in such a heart felt manner. Because she, being a seventeen year old, cannot do more than this at this stage; but I’m sure we can always hope someone who has the means and capability might feel compelled to do something about these forlorn and rejected but completely healed people – educating them being one of the options, as Mr. Asim said. And you never know, it could actually be through an ardent account of a teenager’s visit to PIMH. So let’s not point out faults in this article and appreciate the writer’s effort to make people aware, since awareness is the first step to finding a solution. Recommend

  • NFI

    @S Hayat:
    Thank you S! Took the words right out from my mouth! :)Recommend

  • http://www.linkedin.com/pub/asim-j/30/1b3/780 Asim

    @Author “Keep the stable and unstable apart – like they did in the men’s department. It did both of them a world of good”

    So how much of it did you discuss with the director of PIMH and what was his/her reply ? Just curious to know. Recommend

  • NFI

    @Asim:
    We asked the director in charge about that. She said that “it was recreational hour for the inmates.” The fact that the inmates were enjoying the winter sun was part of recreation.
    When we further asked why stable and unstable were kept together – she muttered something along the lines of “renovations being carried out” (although nothing of the sort was visible to us) – and took us to another area. Recommend

  • Amna I.

    A nice read. Sheds a lot of light onto the probably most ignored area by the govt and the society at large. Kudos to the young author for bringing this issue to the forefront. Recommend

  • NFI

    @MKB:
    You are absolutely correct! However, the patients that we met with in the male wards, cited problems in being accepted back. Even if the family IS able to provide the love and affection these patients so desperately need and is able to shield them from the society’s crude remarks at large, they still face economical issues. The medicines are provided to the patients without charge when treated at PIMH, but outside, some families cannot afford to buy medicines. All in all, it still paints a pretty bleak picture for mental patients.Recommend

  • NFI

    @Nadir El-Edroos:
    Spot on. But the residents of old homes can at least lend each other moral support. That kind of bond is difficult to find amongst mental patients, where each patient seems to be fighting an internal battle they have little control of.Recommend

  • NFI

    @Kaisar A: I fully reciprocate your words and sentiments. Its time we rise up to the occasion and own these people – they are as much Pakistanis as you and I. What we’ve been doing to them is abominable and damnable – but all is not lost. Sparing a thought for the plight of such patients is just the beginning – helping and supporting these people can change their lives.Recommend

  • P.K.

    Wow!
    Amazing how you’ve written it! very moving!Recommend

  • Nwaq

    Mental poblems are on rise in Pakistan and the sad thing is this we are not acknowledging it.When the problem starts we just ignore it till it gets really serious.Secondly it is stigmatic,patient is simply termed as PAAGAL.We should have more articles written like this so as to create awareness about this serious issue of society.Recommend

  • NFI

    @Nwaq:
    Very true and spot on. Even patients who recover fully and are stablisied via proper medicine intake, they can never shed the stigma of being a “paagal”, which severely affects their life chances and esteem.Recommend

  • Ammar hasan

    I like your topic.. Keep up the good work. Recommend

  • http://innerreflectionstranscribed.wordpress.com/ Sumera

    Mental illness has social stigma and taboo’s attached to it pretty much in every country. But there are far reaching consequences in cultures such as Pakistans where having one “mad person” in the family means being treated like everyone’s “mad” in that family by larger society. Its not uncommon to find cases where family members have dropped their mentally ill relative at an asylum and never looked back – they are too much of a burden and much is at stake, such as their reputation in their community and social status for the family to acknowledge this mentally ill relative, nevermind actually having this person live with them in their home. Even if this person recovers or begins to stabilise, the tag of mad/pagal retains – society does not let these people progress.

    What these people need is rehabiliation, with appropriate aftercare that involves not only medication but also therapy where appropriate.Recommend

  • NFI

    @Ammar hasan:
    Thank you sirRecommend

  • mehak rafique

    i truely agree with whta you have said.
    i have visited PIMH a couple of times…at first i felt devastated at the fact the way they have kept the patients to move about and roam around sp freely, considering male patients. where as female patients are kept in their rehabs and wards. the living conditions are so poor..
    any how i wanted some more information from you, as in your observations, your interactions with the patients , the doctors etc…i need it for my research article
    ill be thankful to you :)Recommend

  • NFI

    @Sumera:
    Exactly! In our society, there is no provision for the mentally ill to shed the stigma and the entire family comes under fire for something that is actually no one’s fault.Recommend

  • NFI

    @mehak rafique:
    Sure you can email me your queries, I can try and answer them.Recommend