Faith Healing : Helpful?
The community mental health project that I have chosen is the ‘Dava Dua Project’ (Dava: Medicine; Dua: Prayers) in Gujarat, India. I chose this because I feel it is creative, inventive, and thoughtful in addressing mental health needs of the community. The project is a famous and successful one.
But why an article on faith healing? This is because:
i. During a discussion on the same, I remember that we were asked some questions regarding our beliefs and opinions about faith healing. I remember that the number of hands in favor of this increased in a significant way post the discussion; however, my hand only raised against this idea; both pre and post the talk.
ii. During an informal interaction with friends, again it was clear that the class had helped them in altering their views about faith healing to a great degree and I was among the few people who were dead against the idea. I chose to call it ‘unscientific and useless’.
iii. While I was thinking about the same, I met a client who shared his experience. He told me that in his village, there was a boy who died by drowning in the well and since then his daughter has been experiencing seizures. For this, he has ‘only’ visited a Dargah/Mosque. Post this, he has seen significant improvement in his daughter. I was so tempted to share my views but realized that my understanding was lopsided and maybe biased. Also, the faith he exhibited was amazing. I do not think I would have been able to challenge him without offending him. Therefore, I decided that I would read about it.
My opinion was:
1. Even though I understand that some mental asylums treat inmates in a ruthless way, faith healing is no better as every place has its pros and cons (maybe I was looking at the cons closely, ignoring the pros)
2. I felt that the hospitals maybe seen as a place that is expensive; the faith healing places are no better. They are also money minting places.
3. For a country like India, where religion, caste, class etc. play such an essential role, such practices not only increase superstitions but also prevent modern psychiatry to build trust among people.
Therefore I chose to study & write about this as I wanted to challenge my own understanding regarding the same.
Brief description of the project:
In India, the causes of mental health concerns are often attributed to supernatural phenomena and many believe and follow magical — religious treatments (Kumar, 2013). Often criticized, these forms of treatments are not only famous and widely trusted, but also socially sanctioned. Kalathil (2010) reported that while inhuman practices like chaining are a common site even in alternate healing places, a legal action would lead to not only shutting them down but will also take away an essential community support system. In 2007, media channels reported that because of the limited numbers of mainstream institutions of mental health, people’s desperation or hope overpowers their choice of care (Kalathil, 2010).
Aims of the project:
The project aims at forming a subset within the realm of the already established traditional healing practices. It looks at complimenting the actions of the mujavars/ faith healers without challenging them. It aims at reducing the harmful methods of traditional healing e.g. chaining, creating awareness of mental illness in the community, how the caregivers can contribute and protecting the clients’ rights by providing training to the mujavars.
Strategies:
While modern psychiatry and traditional healing practices are generally considered as opposites and the positive effects are ignored by both, the Dava Dua project (by Altruist) in Gujarat aims at a fusion of two i.e. prayers and medicine. It was established to create a relationship between community mental health care professionals and the traditional healers/ mujavars at the Mira Datar Dargah, Gujarat. It realizes how the places of worship can play an essential role in the detection and treatment of mental illnesses. It has not negated the experiences of the people but has co-existed with the already established system. The project has looked at blending treatment with the flavor of religion for easier acceptability and better understanding.
Thus, the project has used the following steps/ strategies to achieve its goals:
a) Identification of a religious place where people with mental health concerns prefer to go.
b) Without discounting the importance of the priests and traditional healers, working inside the Dargah.
c) Establishing a link between the mental health professionals and traditional healers.
d) Training the mujavars with the aims being:
· Consequences of faith healing in mental illnesses.
· Role of caregivers.
· Roles and responsibilities of other members of the community.
· Legal rights of the patients.
· Safety of the people visiting the shrine.
· Sanitation and hygiene in the Dargah premises.
e) Formation of a network of government departments, local administration, priests and mental health professionals.
f) Establishment of a referral and follow up system for the clients.
Its journey…..
In a seminar by Balm (2009), Milesh Hamlai from the Altruist reported that when this project was initiated, the mujavars felt that their way of functioning would be questioned and challenged. They saw the mental health professionals as a threat to their stable source of income. The project members therefore faced a lot of opposition at the beginning. But, slowly they were able to win the confidence of the mujavars who now see the mental health professionals as a part of their team.
The project members always keep mujavars in a loop. The clients come to the psychiatrists after being referred by the mujavars. In this way, the priests have started believing that the team is not there to negate what they do but there to compliment them in the process.
The importance of the mujavars in motivating others to see the psychiatrists and psychologists has been a major breakthrough of the project. It was realized that people trusted the mujavars to a great degree and would also adhere to them more than anyone else, the professionals helped mujavars in understanding other ways of identification and treatment of mental illness. They in turn helped the caregivers in identification of signs and symptoms, how to take care of the client, and most importantly, the adherence to medicines. Once the clients leave the premises, the mujavars stay in touch with them and continue to advise them. The project members ensure that medicines reach the patients on time.
Outcomes:
In a seminar hosted by BALM (2009), Manish Hamlai from Altruist pointed out towards the success stories of the project:
a) The mujavars who saw improvement in the clients and liked the training module have started taking sessions for other mujavars. This shows the faith that they have in the team.
b) A survey was conducted by the organization. Mujavars were asked about the efficacy of three ways of healing: faith healing only, medicines only and both. They reported that successful recovery by faith healing only is 40%, by medicines alone is 20% and by both faith healing and medicines is 40%. This indicates an increasing acceptance of the rituals and medicines together.
c) A survey conducted with 200 patients revealed that in their opinion, recovery only by faith healing was 25%, medicines — 18%, medicines and rituals both — 40%. This indicated that apart from the rituals, the medicines given at the Dargah; free of cost were effective.
d) The mujavars not only help in awareness creation but also refer the clients to the psychiatrists. They also take charge of the clients post their meeting. This includes ensuring drug adherence, counseling, and how the caretaker needs to behave with the client.
Principles of Community Mental Health:
The principles of community mental health include: prevention, change, indigenous resources, citizen participation, sharing power, social justice, sense of community, level of analysis, radiating effects and empirical grounding.
Prevention: rather than reacting to a problem, an ideal way could be to identify ways to minimize or prevent the issue. This would also mean lessening the demand for treatment. This project fulfills this principle of prevention. This is because it looks at awareness programs and training the mujavars that leads to prevention of a number of concerns.
Change: rather than being an outsider who provides his/ her expertise, the need is to be in the community to see what are the requirements and aiming at change with collaboration with the members. This project involves members to be in the Dargah, day after day to understand the context and the frame of mind and beliefs held by the people visiting the shrine and thereby bringing about change collaboratively.
Indigenous Resources: this principle looks at understanding what exists in the community and why has it been working. The indigenous resources in this context are the environment that the Dargah offers and the mujavars. What is the beauty of this project is the importance given to these two. The project members have very smartly utilized these indigenous resources well. However, my reservations remain with the over dependency on the mujavars.
Citizen Participation: community members are experts of their own situation. Therefore, it is important to consider their participation while designing, implementing and evaluation of the intervention. The project fulfills this principle as it aims at looking at the situation and intervening according to the needs of the members, taking into consideration their belief systems.
Sharing Power: a successful community project requires removal of us versus them mentality and sharing power. What is essential is the involvement of all the members of the community. Not sharing power would lead to misguided interventions. This project does not warrant an ‘us versus them’ attitude. In fact, it respects the community’s faith and works around it. It has also not involved itself in any sort of power struggle. It has allowed the already established channels to prosper and therefore has not disturbed the belief system of the people.
Social Justice: the project fulfills the principle as it involves equitable allocation of resources without any discrimination.
Sense of Community: this project realizes the importance of the sense of community and therefore works with the community within the community. It does not look at the client as away from the community and therefore does not aim at sending the clients to the hospitals but works with them while they choose their place of stay which is generally the shrine itself.
Level of Analysis: the way a person behaves depends upon a number of reasons. This project does not look at one level of analysis but considers various reasons for the same. It looks beyond the ‘obvious medical reasons’ for the way one behaves and also considers the environment one comes from and the beliefs one holds. The project members do not judge anyone for holding such views, just compliments them beautifully.
Radiating Effects: when an intervention is planned, it is important to take into consideration the radiating effects/ ripple effects of the same. While planning this project, the effect of each action on the community and the project itself have been taken into consideration. Because of such an understanding, the mental health professionals have been able to form a base for themselves and have been able to instill confidence in the community.
Empirical Grounding: there is a need to define, understand and address the community issues in such a way that it can be researched. In my opinion, the project has looked at an in depth understanding of how the project works. However, it has not researched the reasons behind the faith shown towards the mujavars. I feel that an understanding of the same would be useful in forming a better base and increasing confidence among the community members.
Recommendations:
Naraindas et el., 2014 in their book, ‘Asymmetrical Conversations’ suggested that although the project attempted to negotiate the practices of ritual healing, it can be seen that the belief still exists. Even though the pilgrims have shown an increase in drug adherence, a major contribution still remains with the mujavars. Therefore, the dominant culture remains. I understand that the project’s aim was complimenting and not a substitution. I also understand that the patients come there in a different frame of mind and therefore a direct interaction with the doctors may not be fruitful. However, I am concerned about the dependence on the mujavars. The project members’ focus has been on not challenging the mujavars, however, in order to understand the faith exhibited in them, the project members could look at the reasons for the same. An in depth understanding of this ‘faith’ and the reasons behind them can help better understand the immense confidence and bent towards this over medicines.
Kalathil (2010) suggested that the reasons behind people choosing faith healing over hospitals are: belief in the healing power, presence of a community based care, large and boundary less premises, bad experiences at the hospital, stigmatization and the process being expensive and ineffective. In my opinion, the project could look at slowly creating a model for the pilgrims that challenges the stereotypical image of a hospital. This would not be a challenge to the dargah but only a complimentary setting where people with severe mental illness can stay and their positive experiences can alter the already held negative beliefs about hospitals.
Key Learning and Reflection:
As I mentioned before, the rationale behind choosing this topic was my lack of understanding for the same. I was not only against the idea of faith healing but also felt that it was useless superstition with no returns. However, my opinion has changed to some degree. This is because at work I met a parent who told me how he trusts the dargah more than anyone. This made me think about my own beliefs. I realized that before every exam I also read the Hanuman Chalisa. When I am upset or feel stressed, I like to visit the Gurudwara or a Mandir. Do the idols bring about some magic or drastically change my situation for the better all of a sudden? No. It is the faith that I have towards God and that is what draws my attention towards them in times of happiness and stress. What if this problem was a psychological one? Related to some disorder? Since I am from this field, I would choose a doctor for the same, however, at some point because of the lack of options, I may choose to go to a faith healer! This change in my thinking is a drastic one and came about after seeing a video that talks about how one wants to do everything in order to see improvement in their loved ones.
I liked how this project respected the beliefs of people, understood the opinion of the community members and worked around it. It did not lose its aims in the power struggle but worked at what was required.
When I visited Satara, Maharashtra, Dr. Dabolkar said that it may not be wise to challenge the system always, working with it, staying within it works very well. This project does exactly that!
However, I see this as a ‘jugaad’/a way out, a way to not question what is going on but utilizing the resources of the people who are considered most important by the members of the community. My problem is over dependence on the mujavars which I believe has stemmed from the lack of understanding of their ways of functioning and whether there is some logic behind the faith healers’ actions.
Does not focusing on understanding the logic behind their actions means not challenging them or points towards an indirect negation of the same? I believe that an in depth research in the same help them to better understand the belief systems and why the faith healers continue to dominate the setting.
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