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Health Reports (PTG; mental health) Jharkhand, Hindustan Times, August 1, 2011

August 1, 2011



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Health camps for PTGS in state



Strap: State defines ‘hard-to-reach’ areas; long-term plans for these areas not yet made



Ushinor Majumdar



Ranchi: Along with the state government’s projects on malnutrition in the state, it has prioritised attention towards primitive tribal groups (PTGs) with the help of United Nations Children’s Fund (UNICEF) with special PTG health camps.



The health camp for PTGs starts on Monday and will last till March 2012. The focus is on general health with a particular stress on child malnutrition, since the state government is laying particular stress on malnutrition, which is responsible for the high infant mortality rate (IMR) in the state.



Dr Praveen Chandra – Director-in-Chief of Health Services, Jharkhand –  told HT, “The camps will deal with overall health of the PTG population in the state. We are also focussing upon are – immunisation and malnutrition for children, where there is a serious problem of malnutrition. Since those areas are hard to access, continued delivery of health services is difficult.”



The health services will target reaching out to these areas most which are inhabited by PTGs and Dr Praveen Chandra assures that the health department will try to address key health issues whenever they visit an area.



It is difficult to provide health services in these areas, where the PTGs live. A majority of the children belonging to PTGs suffer from malnutrition. There is a high incidence of diarrhea and malaria in these areas.



According to Job Zachariah, head of UNICEF field office in Jharkhand, 5 – 6 % of India’s child population is placed in a category of sever acute malnutrition (SAM). The estimated SAM figures for Jharkhand are roughly the same as the all-India figures. A majority of children belonging to PTGs fall in this category.



Zachariah says, “The UNICEF focus is on reaching out to people in the most deprived areas. We have identified 1,600 hard-to-reach areas, where it is necessary to deliver health services. PTGs are a part of this.”



In the camps for PTGs, UNICEF will also supply unique, ‘treated’ mosquito nets. The nets are chemically treated and can kill mosquitoes, lice and other such bugs that cause diseases.



The health camps will also supply free bed-pans to these hard-to-reach areas, which are much in demand there.



The state government has not started any long-term programme to address the needs of these ‘hard-to-reach’ areas. “We are looking into it,” says Dr Praveen Chandra.



Dr Praveen Chandra adds that “It is difficult to set up health services for these areas as there are only 20-30 households in some of these places. Of course, delivery of health services has to be universal, but we need to make optimum utilisation of resources.”



In a departmental press conference on Friday, minister of health and family welfare, Hemlal Murmu, admitted to a huge shortage of doctors. There is approximately one doctor to every 20,000 people in the state.





Govt yet to initiate, implement mental health programs in state


Ushinor Majumdar


Ranchi: In a country where ojhas (witch-doctors) still use jhar-phoonk and placebo-like herbs to treat mental disorders in villages, the state health services is still to initiate and implement programs on mental health to address what the World Health Organisation (WHO) calls the mental health gap.


Fits  and different behaviour symptomatic of mental disorders are wrongly diagnosed as caused by demonic possessions. A bulk of mental disorders such as alcoholism and schizophrenia go untreated. Schizophrenia has a worldwide incidence rate of 1% amongst the population. Awareness is the biggest hurdle the state and central government are yet to overcome.


Dr Praveen Chandra – director-in-chief of health services in Jharkhand – says, “There is low focus on provision of mental health services in the state. The centre has to mobilise programmes on mental health and then we can take it up. We are prioritising issues such as malnutrition to stop the high infant mortality and maternal morbidity rates.”


Job Zachariah – UNICEF’s chief of field office in Jharkhand – says, “We have had to prioritise direct health issues in order to prevent deaths and promote better physical health. Mental health issues are being discussed and something will be started soon.”


The WHO Mental Health Gap Action Programme (mhGAP) which addresses the gap between the incidence of mental health illnesses and services provision has recommended several measures for diminishing the gap. India is lagging in taking up these recommendations. Needless to say, Jharkhand is also facing the brunt of central government’s inaction while WHO is looking at aligning the MHGAP with the Millenium Development Goals 2015.


Dr.Thara Srinivasan – an eminent mental health specialist and director of the Schizophrenics Association of India – says, “India’s has only 4,000 mental health professionals to its estimated 1.2 billion population. Even this number does not mean automatic access to even that low number of available mental health professionals.”


As Dr. R. Thara says, “There is a huge gap in service provision – the treatment gap.” That is the lack of provision of mental healthcare by the government. The access to existing services is limited. Those in private practice charge high fees and government-run centres are few, especially so in rural areas.”


Fits or behaviours that resemble schizophrenic symptoms are often either called demonic possession caused by spells caused by witches, frequently leading to witch-burning and so on.


Gladson Dungdung – human rights activist in Jharkhand – says, “People with mental health disorders are treated poorly. There is no treatment available for them, especially in remote areas. Traditional witch-doctors are used for treating them.”


According to Dungdung, they are isolated and if such mental health patients have other physical health ailments, they cannot express their symptoms and their physical health problems go untreated. Since symptoms of a bulk of physical health problems are not externally visible, late diagnosis can result in death as well as those suffering with mental health problems cannot express their pain.


Alcoholism is also a problem in Jharkhand, as it is in the rest of the country, but no steps have been taken to set up counseling and treatment units. The present health centres are admittedly inadequate to handle alcoholism or any other mental health illnesses.


Dungdung says that alcoholism also goes untreated here. Alcohol, being a socially accepted substance, does not merit any kind of treatment, through counseling and a programme of recovery through abstinence.


The WHO MHGAP aims at scaling up services for mental, neurological and substance use disorders for countries especially with low- and middle-income. The programme asserts that with proper care, psychosocial assistance and medication, tens of millions could be treated for depression, schizophrenia, and epilepsy, prevented from suicide and begin to lead normal lives– even where resources are scarce.



MHGAP recommendations:


Provide treatment in primary care

Make psychotropic drugs available

Give care in the community

Educate the public

Involve communities, families and consumers

Establish national policies, programs and legislation

Develop human resources

Link with other sectors

Monitor community mental health

Support more research








From → Health reports

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