Diving into India's mental health landscape
A story by Emi Sasagawa
I’m woken up by a loud thump. Dinner was served an hour ago and we’re experiencing “bathroom rush hour”. The occasional collisions are the price one has to pay for choosing an aisle seat. My eyes adjust to the bright light and the noise inside the Air India Flight 112, London to Mumbai.
This is the liveliest flight I’ve been on. Two men shout at each other across the aisle in Hindi. After a brief handshake I realize they’ve just met, but it looks like they’re long lost friends. A baby cries two rows back; his mother is singing a soft lullaby to comfort him. Across the aisle a woman looks down, whispering verses from the Koran. I try to take it all in.
At 38,000 feet in the air, I’m making my way to India. For the last six months, I’ve been researching — together with a team of young reporters from the UBC School of Journalism — issues surrounding global mental health, from traditional treatments to access to care. We’ve been talking to people and organizations that are trying to make a difference, offering alternative solutions to the most vulnerable populations.
Emily, a fellow reporter traveling with me, catches my attention. She is sitting between two strangers. Arching her head backward, she smiles nervously as the man next to her asks more questions. I laugh to myself and nod. It’s hard to believe I’m on my way to my first international reporting trip. I wonder what it will be like. What will I learn? What will I see? How will I feel? I shake these thoughts off. There’s still five hours before we land. I’d better get some sleep.
From the Director
Peter Klein, Associate Professor and Director of UBC’s International Reporting Program, and Director, Graduate School of Journalism (2011–2015)
In 2009, with a generous donation from Mindset Foundation, we created the International Reporting Program to train the next generation of global journalists — allowing them the opportunity to spend time in the field, experiment with new approaches to global reporting and produce major projects from around the world.
Our media partners have included The Globe & Mail, Toronto Star, The New York Times, CBC, Global, PBS Frontline, Al Jazeera and CBS News, and past projects have won a long list of awards, including an Emmy, an Edward R. Murrow Award, a Sigma Chi Delta Award, a Webby Honor and numerous top prizes at the Canadian Online Publishing Awards.
But our bigger reward is having impact on global conversations. Our multimedia Pain Project is used by global health professionals to advocate for palliative care worldwide. Our documentary about the hazards of illegal electronic waste exports has been used by policymakers in Washington to establish strict new rules about e-waste export. And just six days after our investigation about the murder of a Brazilian Indigenous leader ran in The New York Times, more than a dozen suspects were arrested.
We are now growing the IRP into an ambitious non-profit Global Reporting Centre, the first organization in Canada dedicated to advancing global reporting and producing major projects on under-covered stories throughout the globe.”
From the Instructor
An inside look at teaching in the International Reporting Program with David Rummel, Assistant Professor, UBC Graduate School of Journalism.
Putting on the reporting cap
Rajani stares at the floor, her hands clasped together, fingers tightly intertwined. It’s hard to tell whether she is uncomfortable about the question our reporting team has just asked or the crowd of people that has formed around what was intended as a small, private conversation.
The question is about her husband. Exactly six years ago he took his own life by swallowing pesticide. Mounting debt and bad crops had pushed him to the edge. In the morning of December 6, 2008 he and Rajani argued about his alcohol drinking. Upset, he left to work, picking cotton. At noon she walked to the field, as she always did, to bring him lunch. She found him on the ground, passed out.
He was gone. There was nothing the doctors could do for him.
Rajani tells the story in Marathi but our reporting team doesn’t need to understand the language to know how hard it’s been for her. She has raised her two daughters on her own. With three jobs, she is still struggling to make ends meet. Who will pay for their dowries? What will become of them once they finish school?
After the interview I ask if I can take a photo of her. She nods yes and smiles shyly. Holding a handful of cotton she poses for the camera. Her youngest daughter stands beside her, smiling too.
Rajani’s story is all too common. Between 1995 and 2009, nearly 250,000 farmers took their lives in India. In 2009 alone every 30 minutes a farmer died by suicide across the country. The Vidarbha region in the state of Maharashtra, where Rajani lives with her teenage daughters, is considered the epicenter of this farmer suicide crisis.
“I am twenty-five years old,” Shubham says in Hindi. I try to mask my surprise, although I am certain I fail for he smiles embarrassedly. At only 25 years old, he seems to carry the weight of the world on his shoulders. The eldest son of a cotton-farming family in rural India, he has been burdened with the responsibility of caring for their livelihood.
A year ago, the pressure became too much. Unable to repay for a loan, he walked to a nearby village store and bought pesticide. On the side of a road, he drank it. “It tasted like coke with alcohol,” he recalls.
He is my age, I think in silence.
Living the story
Sometimes journalism is about split-second decisions — change the camera angle, adjust the lighting, ask a provocative follow-up question, spot an unexpected character. These last-minute, split-second choices can open up a new set of possibilities and ultimately change the course of a story.
It’s day four of the trip. Our reporting team is in Ahmednagar, a small town located three hours away by car from Pune. We are wrapping up. Peter, one of two faculty members on this trip, is filming a few final shots of the location. Videsh, a physician with global health expertise, is the other professor accompanying us. She waits outside with the rest of the team. I hold the lights to brighten the room where people wait to see the traditional healer.
It’s nearly 5:00 p.m and the sun is already setting. My arms are beginning to ache. I’m about to tap Peter on the shoulder — when I notice something happening at my feet.
A woman, kneeling down, is mumbling to herself, rocking her body back and forth to the rhythm of her words. Her name is Rahmunisa. Something tells me this is the moment we’ve been waiting for all day.
Something tells me this is the moment we’ve been waiting for all day.
I nudge Peter, pointing to where Rahmunisa is kneeling. I whisper: “I think there is something happening.”
Peter knows exactly what I’m talking about. From across the room, the Koranic healer notices the mumbling woman too.
The session is about to begin. Another woman, sitting beside Rahmunisa, is passed a small metal bowl filled with half-used incense sticks. She lights the sticks, raising them to Rahmunisa’s eyes. A conversation begins between the Koranic healer and what is believed to be a spirit that has possessed the kneeling woman. They speak in broken Marathi, shouting across the room.
Another bowl is passed to the helpful woman sitting beside Rahmunisa. It contains a cotton ball dampened with a strong-smelling solution. The cotton ball is raised to Rahmunisa’s eyes. She begins to cry instantly. The process of healing has begun.
Our stay in Pune, India’s growing tech hub, introduced us to those most in need. Nearly half of the city’s population of around five million lives in the slums. Without access to care, the most vulnerable look for help wherever they can find it. Many resort to traditional healing to treat physical and mental ailments, such as leg pain and spiritual possession. For them, healers offer treatment that is trusted and cheap. The healers explain illnesses in a language that can be understood — without big words and long-winded explanations.
As outsiders, it’s easy to dismiss what we don’t know. As Rahmunisa clapped her hand in prayer, shouting across the room to the traditional healer, it was hard not to be enthralled by the moment. I didn’t have a frame of reference. How did it work? What was happening? At that very second, I became more aware of my ignorance and having no previous experience forced me to just live in the moment, to live the story as it happened.
The impact of what we do
Inside the semi-open ward of the Institute of Human Behaviour and Allied Sciences, New Delhi’s largest mental health institution, a patient suffering from a severe mental disorder approaches me. His name is Jaafar. As he comes up, he pulls a small paper bag from his pocket. He stops three feet away, searching in the bag for something.
After a few seconds, he pulls out a blue poker chip. Holding it on the palm of his right hand, he offers the chip to me. I take it and hold it tightly. I am not sure whether this is a gift. Waving his hand in the air, he shows me what he wants me to do: Toss the chip in the air. I do as I am ‘told’, throwing and catching it with my left hand. Jaafar giggles and picks up the chip from my hand. Still smiling, he walks away.
Jaafar is one of 20 male patients living in this ward. Locked gates and standing guards separate these men from the outside world. They all have severe mental disorders such as schizophrenia. Inside a large room, two rows of beds face each other. Here is where they sleep, eat and pass their time.
The hospital has come a long way. Patients are no longer chained to their beds. There’s a courtyard where Jaafar and his friends can sit in the sun, a room with some chairs where they can play games and long corridors where they can walk, back and forth — but not past the iron gates.
In the last leg of our reporting trip, we were able to look into the lives of the most severely ill and their reality in a mental institution. We visited the children’s ward, where a wall covered in drawings offered a gateway into the minds of young patients. We filmed an electroconvulsive therapy session and watched a young woman cry in desperation as she waited to hear if her sister’s treatment had been successful. We walked around a psychiatric emergency room where another woman broke down crying because her husband had left her in the hospital, without any hope he would come back for her.
When that final day began, I was still just trying to do my job. But as it progressed, my objective became less about getting the shots we needed and more about truly understanding the story. Being able to view the world through a camera lens was all I wanted to do at that moment — to maintain the distance, to remain strictly an observer.
When that final day began, I was still just trying to do my job. But as it progressed, my objective became less about getting the shots we needed and more about truly understanding the story.
Unfortunately, the truth is we are never just observers. As reporters we are, at the least, observing participants. What we do and don’t do, it matters. Unasked questions, un-photographed stills and unrecorded shots — these are choices we make in every moment that determine the final story.
I am no longer in India but my role as an observing participant is unchanged. Back in Canada, as we spend days and nights at the School of Journalism crafting the perfect video, new questions arise: What characters will we keep? What story will we tell? What effect will this all have in the end?
For now, all we can hope is that our efforts will start a conversation, a conversation about what mental health means, who it affects and how we, as a society, can provide love, assistance and care to those most in need — whether it’s in the slums of Pune or Vancouver’s Downtown Eastside.
About the Author
Emi Sasagawa is a graduate student at the UBC School of Journalism specializing in global politics reporting. She holds a Bachelor of Science in International Relations from the London School of Economics and Political Science. She is a 2015 International Reporting Program Fellow, working on a project on global mental health and a 2015 News21 Fellow, reporting on marijuana legalization in the United States. Her work has been published by The Tyee, Megaphone, The Huffington Post Canada and AlterNet. She is also a recipient of the 2014 Silver Canadian Online Publishing Award for Best Interactive Story in the Blue Category.