AND ONE FLEW OVER THE CUCKOO’S NEST

Said an anonymous psychiatrist., “Madness is, contrary to the opinion of some unthinking persons, as manageable as many other distempers, which are equally dreadful and obstinate and yet are not looked upon s incurable.
Ironically, for over 200 inmates, Ranchi Mansik Arogyashala (RMA) is no better than a prison-like asylum. You can call lit a human zoo, or bedlam, or mad house, of if you are more formal and civilized, you can cal it in terms of Thomas Adam’s famous sermon: ‘Mystical Bedlam,’ or ‘The World of Mad Men’.
In a poor country like India, where mental illness is mainly confined to the dregs of society the poorest of the poor uncared and unattended lanatics are no wonder. Everyday they starve to death. Fortunately, they die, at least, a natural death.
Whereas, for the hundreds of inmates of the RMA, the life is too tortuous to live with and the home is too unresponsive to look for. These uncontrollable passions, undisciplined will and irrational minds are not only considered social rejects but also, at large, a kind of zoo whose and inmates are akin to animals.
They, the insanes, are mentally unbalanced, a forgotten breed and abandoned by their families to rot in place, like the RMA, where treatment and care often only adds to their torment.
The 67- year old Arogyshala, spread over 500 acres of land, because of its dilapidated condition of its dilapidates condition seems as if in ruins. Based in Kanke, seven kilometers from the city the very name of the asylum symbolizes crime, corruption and cruelty. Though one of the Asia’s largest mental hospitals the RMA is crawling with the sights and smells ad sounds of despair and madness.
Probably no horror movie can have as many in this asylum. Inadequate water supply, unhygienic living conditions and insufficient diet are very mild words to express approximately the inhumanity of the authority and atrocities over the patient.
The wards are equipped with choked lavatories, barren rusted costs, two or three electric bulbs here and there, and floor sand stairs filled wit human excreta. The smell of uncared for bodies living in shockingly maintained wards, the sounds of mad talk, mad-song and the primal screams of minds are all signs that the inmates have been consigned to oblivion.
Everything in the RMA assails the senses and leaves them reeling with gloom and pessimism. Especially in the female ward. Nude and semi-nude creatures, unsuccessfully trying to hide themselves either behind the bars or behind each other. A close-look is horrific. Many female inmates with long dirty nails, scratching the abscess, full of pus, developed by the over production of lice in their body.
At the same time, scores of them did not even move from their place, their shameless consistency can be taken as only the retreat of over tortuous bahaviour of the caretakers. Sexual harassment of the young female inmates in another gloomy aspect.
Meanwhile, looking into a sordid saga of the mentally ill, it has been found that nearly 400 patients shunned by their families since their admission here, have been sent back to their respective homes under police escort for forcible acceptance in their families.
A good section of this lot belong to West Bengal and were admitted, here, between 20 and 40 years age. The mortality rate of such partially cured but unclaimed patients was as high as 150 between mid-seventies and mid-eighties which has, some how, been brought down to 100 during the last five years.
However, the Supreme Court’s intervention has, to some extent, initiated a process of gradual metamorphosis of the hospitals. Therefore, the number of such shunned patients languishing in the hospital since their admission has now been brought down to about 40. To engage such patients, the hospital authorities have started an Occupational Therapy Centre.
In this workshop about 50 old patients, several of them having spent 15 years or more inside the Arogyashala, have been engaged in various occupations such as tailoring, weaving and carpentry. Besides, the institution has also started a poultry farm recently, at the cost of around Rs. 15,000 in which those languishing here for a decade, have been engaged. Nevertheless, about 40 unclaimed patients still remain confined here. They are too old to work. And their home addresses could not be traced.
Apart from all this, the most pathetic part of the situation is the doctor’s ignorant attitude towards the patients. There is no gentleness in their manners. Out of the 523 warders a few are regularly present. And the 75 nurses are more regular in the attendance register than in the wards. Though 24 doctors are hardly enough to cope with the present enough to cope with the present number of inmates, most of them are busy running their own clinics or nursing homes.
Superintending the RMA is another matter of concern. Unlike in the pre-seventies when only two superintendents – Dr. Haseeb and Dr. L.P. Verma ran the institution for 36 years, in the post-seventy era, already six superintendents have been changed, Dr. Baxi, K.R.P. Sinha, the present superintendent, too has been temporarily appointed.
However, since the Supreme Court intervened into the matter of the RMA, it has been functioning gradually well. Says Dr. Baxi, “The dark days (1972-1984) of the Arogyashala are over and I am trying my best to revive the old days”. Not denying the fact, the Bihar Governments has sanctioned rupees three crore and renovation work could well be seen inside the asylum. Recently, a lavish library for the inmates has been inaugurated. But, the union –Kanke Karamchari Sangh – is irate over the superintendent’s attitude towards fund utilization.
Says a self-styled leader that funds should primarily be utilized in manner that directly benefits the patient, in terms of healthy diet, effective medicines, hygienic convenience, comfortable sleeping arrangements, washed and untorn clothes, etc. Whereas, a large part of the funds are being utilized in building construction works.
Ranchi, probably, houses one of the largest number of sick patients in the world. Apart from the RMA, there are two other institutes – the 500-bed Central Institute of Psychiatry (CIP), run by the Union Health Ministry and the over 300-bed Davis Institute of Neuropsychiatry (DIN), a private clinic. Both these institutes, charge fees higher than the RMA.
Though CIP’s condition is equally bad its pathetic condition has always been kept hidden by is image more of an institute than an asylum. The CIP runs two diploma courses in psychiatry.
However, CIP is quite famous for a few of its prisoners of the China war.