31st January 1999

This is insane

By Hiranthi Fernando

The Mulleriyawa Hospital has 24 wards of which wards 12 - 24 are in Unit 2. New patients who are brought for treatment are admitted to Unit 1. When they are ready for discharge, those patients, whose families do not take them home are sent to Unit 2. This unit is thus occupied by long term patients, some who have been there for many years. Since the unit has only 500 beds, almost half the patients have to sleep on the floor. Some of the wards are being maintained by various organizations and they have provided the patients in these wards with mats and pillows. Some patients apparently do not even have a mat or pillow to sleep on and have to make do with the bare floor for a bed.

When we last visited Unit 2, the Matron said most of the women in the unit are fit to go back to their homes. According to procedure for discharge, the patient can only be given in charge of the relative who originally admitted her to the hospital. However, these relatives appear to have discarded them and seldom even come to see them. "They need to have people to visit them and be treated as normal human beings," a volunteer worker said. The inmates who crave for company greet casual visitors and volunteer workers with eagerness. With the increasing number of patients, the hospital does not have sufficient staff to handle any rehabilitation work. Further, they are not trained in psychiatric care.

With such a glaring need for service, one cannot understand why the hospital authorities have discontinued the visits of NEST, a volunteer organization that has rendered many humanitarian services to these people in Unit 2. This organization has a lot of experience working among mentally ill patients and runs a half way home for the rehabilitation of such patients. The Director of Mulleriyawa Hospital Dr. Roy Perera informed NEST by a letter on December 12, that Ward 20 which was being looked after by them will in future be maintained by the Ports Authority and the services of NEST would no longer be required. The letter further stated, "If your organization has rendered any service to this Unit, I express my thanks."

The services rendered by NEST, so curtly dismissed by the Director of the mental hospital, goes back to 1984, when Ms. Sally Hulugalle and Ms. Kamini de Soysa, first started visiting Mulleriyawa Hospital. At that time, there were not even toilets or bathrooms. On seeing the pitiful conditions at the hospital, the two women met with the Committee members of the Seva Vanitha organization and other volunteer groups as well as some private companies and initiated the sponsorship of some wards by them. They conducted an islandwide campaign with collection points all around the country and succeeded in collecting hundreds of mattresses, over a thousand pillows and pairs of slippers.

Asia Foundation donated books. A lorry load of clothes was also taken for the inmates of the hospital.

Some of the women in the group visited the hospital every week and conducted exercise session for the inmates in the garden. A different ward was taken each week. They stopped for a break during which they had a drink, sang and related stories. These sessions which the patients seemed to enjoy, were suddenly discontinued on the basis that the women were getting too boisterous. 

"I feel that no human being should be condemned for life, as a person unable to function, on the fall of a gavel of a doctor", Sally Hulugalle said. "Sometimes families put pressure on the doctor to keep them there. I feel we can put them back into society by taking them in groups of about 20. The sheer numbers in Unit 2 cause problems for the nurses, doctors as well as the patients and their families. If they are in smaller units in special wards in the hospitals, it would be more manageable."

NEST Executive Director Harini Amarasuriya said they had started a programme where groups of 20 inmates of Unit 2, selected by the staff, were taken out on a day's outing by NEST volunteers. The women had looked forward to these outings which relieved their boredom. However, this was discontinued in 1996, for no valid reason except that the patients got over stimulated. "Most of these women have no need to be institutionalized. However, if they are ever to be able to live independently outside the institution, they must see what the world outside looks like," she stressed.

"Living under the conditions at Unit 2, for long periods would affect any patient", Harini added. "Their hair is cut in a particular way, and they are dressed in a particular way. They have not seen their face in a mirror in years. They have no privacy and nothing to call their own. Even a perfectly balanced person living under such conditions would get mentally affected." 

On our visit to Unit 2, we saw for ourselves the close cropped unattractive haircut many women had and the thick, ill fitting, shapeless garb that was issued to those who needed clothes. 

Another severe problem these women are faced with is acute boredom. They have no occupation day in and day out. "These women have been discharged as not needing hospitalization," Harini said. "Since many of them remain there for life or for long periods of time, the Unit should not be run like a hospital but more as a home. Why not at least train some of the women to do the cooking or help in the kitchen. This would be preferable to employing male kitchen staff as they now do."

Volunteers say that when male volunteer workers of NEST went to the unit the hospital authorities had objected. However, the entire kitchen staff consists of males who are bare bodied most of the day. There have apparently been instances although not very recently, where some women have got pregnant by the kitchen staff and villagers who have come in at night. 

According to Harini, NEST volunteers have not been allowed to visit the hospital since April '98. "We asked for written intimation but nothing was sent until the letter on Dec. 12. "As regards the Ports Authority taking over Ward 20, we are happy that they have volunteered to be of service. It is not just the maintenance of wards that is needed.

These women need emotional support. It is not a question of NEST being allowed to go in to the hospital or not. Something has to be done for those women, whether it be by NEST or someone else. It is a pity that we have been stopped from going in there since we have the capacity to do something."

The Sunday Times contacted the Medical Superintendent of the Mulleriyawa Mental Health Hospital Dr. Roy Perera, to find out what his reasons were for discontinuing the services of NEST. However, he refused to speak to us at all.

One can understand that with the severe overcrowding of the hospital, shortage of staff and perhaps limitations in funds an institution such as the Mulleriyawa Mental Hospital would have difficulties in providing adequate facilities for the inmates. However, one cannot understand why the institution has no place for a volunteer organization that has been of service and is willing to continue its services. 

An official of the Health Ministry whom we contacted explained that this matter would be taken up at the next meeting of the National Advisory Committee on Mental Health, to be held in the first or second week of February.

This Committee is represented by all bodies, both governmental and Non Governmental Organizations, concerned with Mental Health. He said the Committee would discuss the issue and work out a solution and a suitable plan to enable small selected groups of inmates to be taken on day outings. He acknowledged that NEST is doing positive work in the unit. 

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