MITA A REAL MITA IN ASSAM

By Vinit Wahi

Dr. Sunil Kaul, a doctor in the army, was posted in Assam about decades ago. He was a public health doctor dealing with normal diseases of the people largely rural and poor. But during his tenure he observed mental health a serious problem among many persons in the region but virtually no treatment for the same. He later was joined by Jennifer aka Jenny who has been working in the region in the social sector for a long time. They started working together and got married and  are still continuing their work in Assam and other parts of the region though in a much bigger and organized scale now. Jennifer has co- authored a book “Health Inequities in Conflict- affected Areas: Armed Violence, Survival and Post-Conflict Recovery in the Indo-Bhutan Borderlands” which was published by Springer- Nature, Singapore in 2021. They are also associated with other NGOs dealing with the problem of mental health in the region.

About 16 years ago with the noble  intent of helping people come out of their mental stress or syndrome they established the Mental Illness Treatment Alliance or MITA which has come a long way since then. Since then, it has helped thousands of the people in rural North East India access affordable and timely mental healthcare. According to its film ‘MITA Cares’, which narrates the stories of patients like Geetanjali and Gobind, some 7.5 percent of Indians suffer from some form of mental illness or the other and treatment options are scarce as there are less than one (.75%) psychiatrists per one lakh population in the country, now the biggest in the world! In fact, mental illness is still a topic shrouded in fear and silence as many people don’t want to even discuss it out of some complexity. It is in this backdrop that the MITA programme’s biggest achievement has been normalizing mental illness in Assam’s rural communities. And the realization that this had to be done dawned in 2007, according to Dr Kaul, when he and his wife held a campin Rowmari.

The best  part  is that MITA provides low-cost quality treatment in areas on a regular basis to people trying to overcome mental illness at a nominal cost of Rs 300 a month for medicines, consultation and follow-ups, according to Dr Mintu Sarma who joined this project in 2013. Heading the project, Dr Sarma says some 4000 people are part of this paid programme and are required to come just once a month. However, there are still patients who can’t afford to buy more than a month’s worth of medicines. During the first three months of treatment, monthly check-up is necessary, says Dr Kaul.

During the course of this project, some of the common health issues faced by the MITA include neurological  disorders  like epilepsy. In fact, some 25 to 30 per cent of the patients who approach MITA with their problems suffer from epilepsy. Another 40 per cent have schizophrenia and psychosis. When COVID was at its peak, there were increasing cases of obsessive- compulsive disorder (OCDs)- combination of anxiety and  depression is another common ailment. Nearly half of the patients will need treatment for life. According to him, primary healthcare is provided and in 80 percent of cases, this proves successful.

Psychiatrists are also pressed into service as and when needed. Dr Kaul recalls he and his wife Jennifer were working at Majuli, world’s largest river island of the Brahmaputra River. They faced ULFA violence and were forced to leave the area. A doctor with the Army before he turned to the development sector, he recalls they had left at time but had the feeling within their hearts as to why they succumbed to the threat of violence and hence decided to return and prove themselves. The couple came back to Assam and set up a group  which  works for development of villages in North East parts of India in the education sector, child protection, women’s empowerment, peace building and mental health, operates in around 1000 hamlets in Chirang district in once disturbed Bodoland Territorial  Council areas covering about a lakh of population.

The impact of MITA has been five-fold — it has reduced fear, superstition and stigma about mental illness among the communities it serves; the humane methods of treatment have instilled hope in the minds of patients, caregivers and the communities; patients have to spend very little to procure optimal, standardized care; counseling and follow-up even by phone ensures constant support; and most patients  have   been able to get back to productive work after treatment.

Since it is a patient- funded programme, they don’t have to depend on donations. Initially, one  lakh rupees  as  investment is required in a camp. Then it becomes self- sustaining. We buy generic medicines in bulk, which makes it cheaper  for  us,”  says Dr Kaul.  The  MITA team includes clinical psychologists, trained counselors and social workers. There are 186 languages in the region and language is vital for diagnosis, treatment and counseling. At times, the MITA team takes the help of locals to communicate with patients. It has become so popular during this period that patients come from far-flung parts of Assam, Meghalaya and West Bengal. As for future plans, MITA plans to expand to other states of the North East, and it will soon have a presence in Meghalaya.