2: Then, now
Nothing much has changed in this grim world in Mulleriyawa
after seven years,discovers Kumudini Hettiarachchi
2 revisited. The first visit was seven years ago in May 1998. The
second was last Thursday and tragically for all those within, nothing
seems to have changed. What has changed is that some have passed
on, not to the world outside, but to the grave and the world beyond
if there is one. New faces have taken their place.
women and more women. Young, middle-aged and old. A majority in
clean clothes and some even giving off a whiff of scented powder.
Some looking more ill than others. But some even looking saner than
you and I.
world, nay Sri Lanka, has passed these women by. They have fallen
through the system and remain condemned to a life sentence at Unit
2 – of the Mulleriyawa Teaching Hospital housing mentally
ill patients – until death releases them.
environs just beyond the gate of Unit 2 are straight out of a picture
postcard. Trees, fields and greenery everywhere, no houses or buildings
in sight -- leaving one with a sense of peace and tranquillity.
through Unit 2's unmanned, broken gate, the image is shattered.
One, lonely lost-looking soul, with unkempt hair is standing in
the rain a few yards from the gate. The whole place is teeming with
women, while hospital staff who seem terribly outnumbered to do
the work, are briskly moving around.
and despair weigh you down as hordes of women surround the vehicle
and beg for a few rupees. "I want a toffee," says one,
while another begs for a cake of soap. A third would like a chew
wards though clean, are overcrowded. There are flies everywhere.
There are women on beds, many on the floor and some seated along
the corridors. The Sunday Times learns that this mental institution
which has the capacity to house only 400 patients has more than
you come to take me home? I have been waiting for you so long,"
pleads patient M. who is seated on the floor near a bed. Look closely
and you see that she is tied with a twirled cloth to the leg of
the bed. Why? Eka paattama kalanthe dala vetenawa, volunteers an
elderly patient explaining that M. faints without warning. M. has
been here for about eight years, she claims. The silver-haired elderly
patient is a veteran of Unit 2, with about 20 years inside its walls,
though there are others who have broken even this record with about
more patients are tied to the legs of beds like M.
It is mid-morning but in a corner bed of another ward, sleeps a
young woman. Stop by her bed and soon a curious woman comes by and
gives her a firm whack on her leg to wake her up.
am here for depression. It was my brother who admitted me to the
hospital, from the suburbs of Colombo where I used to live. I am
married but have no children. My husband is at home," says
pretty 35-year-old patient X, her large eyes filling with tears.
With no hope and no visitors, she is gradually coming to terms with
her karme, destiny or whatever that she will spend the rest of her
days sleeping, eating and idling at Unit 2.
we walk into another ward, all the patients start waving. "Kavada
balanna awe?" one asks while the others gather round us and
clamour, "Maava, maava."
one pays these hapless, helpless women a visit. They have been dumped
at Unit 2, to waste away their lives and die as society's outcasts.
crucial questions that arise are: What are the authorities doing
about it? Is it the trend worldwide to tie up mentally-ill patients
and treat them like sub-humans? How often is the condition of patients
at Unit 2 re-evaluated? What kind of treatment should we provide
to violent mentally-ill patients?
the authorities wake up from their slumber and take bold action
to bring in a more humane system of treatment, with dignity, for
these women or will they be Sri Lanka's dirty little secret, to
be hidden away at Unit 2?
Unfortunately, the Director of the Mulleriyawa Teaching
Hospital under which comes Unit 2, was unable to meet us at the
time of going to press. Therefore, an interview with him regarding
the conditions at Unit 2 will appear next Sunday.
draft Mental Health Strategy for Sri Lanka 2005 states:
illness is extremely common. It has been estimated that some 376,000
Sri Lankans suffer from serious debilitating mental illnesses
including bipolar illness, major depression and schizophrenia
at any given time. Serious mental illness primarily affects people
when they are young.
10% of the population is thought to suffer from other forms of
mental illness. More women than men suffer from depression.
Lanka has one of the highest suicide rates in the world.
key issues which will affect the mental health of the population
include the last 20 years of civil conflict and the recent tsunami.
Between 20,000 to 40,000 people affected by the tsunami are expected
to go on to develop mental illness, most notably depression and
medically unexplained symptoms
vision contained in this draft strategy is to develop a planned,
comprehensive and community based mental health service organized
and implemented by good co-ordination at national, province and
district and community level and integrated with general health
services at every level of care.
The draft strategy while acknowledging that modern mental health
care services all over the world have now moved away from the
use of centralized custodial asylums to less restricted community
based care systems, however, states that "although Sri Lanka
began to decentralize its mental health services long ago, this
process has been unduly slow”.
Specifically, with regard to the three psychiatric hospitals in
the Colombo area, Angoda, Mulleriyawa and Hendala, the draft strategy
states that a review is being undertaken of all patients.
The draft Mental Health Strategy seems good on paper. Hopefully,
the authorities will ensure that systems are in place to provide
care with dignity.