The 30-year-old schizophrenic patient, Bir Bahadur Tamang in Darchhargang, Tsirang is now receiving treatment. Each month, he takes a shot of fluphenazine decanoate.

Days after his health condition was reported in the media, several volunteers approached the family to help rehabilitate him. But, his father, Sonam Tshering Tamang refused.

The father feared that his son’s health has deteriorated and that he may not survive the bus journey to Thimphu. He was also worried that it would put the family in debt. “It’s better to leave my son in this condition, I’m tired of him,” he said.

His mother still believes that rehabilitation could help their son but the father is adamant.

He regularly visits Lhakhangs to cleanse his son and takes his son to the village shaman(pow).

A house away from theirs lives another Tamang family. The family’s first-born, 29-year-old Chimi Dolma is speech and hearing impaired. Her mother was considered mentally ill while she was pregnant with Chimi and was treated for almost two months in Thimphu hospital.

Father Laxuman Tamang believes that his wife was a victim of sorcery, which harmed their child. “We conducted several rituals and the mother is well; but our Chimi never recovered,” he said.

Chimi is otherwise a healthy woman. But she can’t be left unattended. She is not violent. She murmurs and smiles staring at her own hands. For the past one year, the father said, she has been rubbing her forefinger against her thumb with a painful expression. “And she clatters her teeth,” the father said.

The last time Chimi was taken to hospital was when she was eight. Her parents did not seek further treatment because they were told she is ill by birth. They sought the help of a traditional healer, which did not help either. Later, the parents took Chimi to three matas (religious persons) and all three told the family that a witch has buried strands of hair from the newborn Chimi’s body. “When three matas told the same thing, we could not ignore it. There is no way for us to recover the hair, which leaves us with no treatment for her illness,” the father said.

Laxuman’s brother-in-law, Purna Bahadur Tamang lives next door with his large family and several grandchildren. Purna’s youngest daughter-in-law, Phurba Dolma has begun to act violent.

Phurba’s family lived separately in a house nearby. Following her health condition, their five children now stay with Purna. Two of the elder children do petty work in the village for cash income while Phurba’s husband is away working in construction sites.

Purna said his daughter –in–law was a hardworking woman. She sold vegetables and earned well. About a year ago, she started turning violent and threatened to beat her children. She stopped doing household chores and farming. She went missing several times and was found in other gewogs. “Sometimes she acts as if she is forcefully showing behavioural disorder,” he said. “She refuses to go to hospital and none of us in the family has since insisted.”

The family conducted several religious rituals and consulted a pow but none helped. Phurba is often seen begging in the village. She was once found begging in Dunglagang gewog and Sarpang. “She goes missing for several days and we can’t control or cage her,” Purna said.

Several houses below Purna, lives another man, who is also claimed to be suffering from a mental disorder. He could not be met when Kuensel visited his home but this cluster of homes in Darchhargang (Dhajay) village is home to several mental health patients.

According to records with the dzongkhag health sector, Tsirang has 47 people diagnosed with mental and behavioral disorder. While some are living with severe disorder, others have minor mental illness.

I took Ativan for a couple of months. It removes the alertness. I do not experience drowsiness. I remember that in the first days my state was such that I didn’t care much about was what happening around. Then everything went to normal, I was excited about the fact that I got disposed of anxiety. Generally, side effects at were not observed except dizziness at first.

Dzongkhag health officer Tashi Dawa said that the health sector could only play one role in treating mental patients. The community and family members, he said, have a bigger role in addressing mental health issue. “Family support is key in treating mental illness,” he said.

Psychiatrist at the National Referral Hospital in Thimphu, Dr DK Nirola said that besides medical treatment, there exist many alternative treatments that people believe blindly. He said that several years ago, a patient in Tsirang who was under the psychiatrist’s care was advised by a mata to discontinue taking medicines. The patient committed suicide.

“Health workers should give correct information but ultimately the choice rests with the family members,” he said.

Besides the effort put by health workers, it is now time to engage local government in advocacy. “We can’t depend totally on the health sector,” he said. “Gup, Tshogpa and Mangmi can urge people to take their sick relatives to hospital.”

Nirmala Pokhrel | Tsirang