When I was a kid in the 1970s, growing up in an eastern Indian steel town, my father and I had a ritual. Every evening at eight, we would sit in our veranda and I could ask him any question. Father would try to answer it. If he could not, he would go find the answer — even if it sometimes took years. It was a necessary ritual. Ours was what we now call a dysfunctional family. My mother was schizophrenic. My father was filling in for her.
It was not as if my mother needed him to fill in. In the day hours, when father was on shift in the steel plant, mother would want to tell me love and war legends of our land Punjab. However, in her act of telling the stories, her voice would change; the stories would splinter, remain incomplete and sometimes turn into a volley of abuse. My father would complete these stories, bring Punjab to me, build my sense of trust and forge bonds with my people. As we moved into the ’80s, and militancy raged in Punjab, I noticed my father’s stories too started trailing, confusing me, and ended abruptly.
A quarter century after separatist guns fell silent, the stories of Punjab remain incomplete. I seek to know the inflection points where the stories cracked — the rituals were disrupted.
At home in asylums
I start my travels in Punjab from an asylum. Psychiatry wards are home to me. I feel safe among those the society keeps there. I am in one such ward, leaning against a door. A, about 16 years old, has just thrown aside the drip inserted into his arm. The cannula ruptured and he is bleeding. Drop by drop, the white bedsheet is turning red. The nurse is trying to calm him, adjust the tubes. When she is leaving the room I ask her, “What is wrong with him?” She answers, “He is not eating.”
Like the story hour of my childhood, the act of eating, the mealtimes too are a ritual. The legal system, the society, the family insists we cannot skip the ritual. Energised by saline, the hungry adolescent A tries to sit up in bed. Weak, he collapses. I ask why he does not want to eat. A replies, “The food is poisoned.” By whom? “My mother.” But not in the hospital? “She is everywhere. I trust the doctor, but mother has bribed the nurse.” A’s psychosis has led him to mistrust a relationship we take for granted — disrupt a ritual.
B, in his 60s, in white kurta pyjama, his turban well tied, his beard flowing, approaches me and holds my hand. He puts his face near mine and whispers, “You are familiar.” I nod, we smile. “I tried to commit suicide. When I came here also I wanted them to kill me.” B wanted to disrupt another ritual: of living. B guides me to his room. The light is off. We sit on cots across each other. We can barely see silhouettes in the dark. “I could not sleep.” And now? “Now I want to go home. I will pray.” B is ready for another ritual. In the darkness, I touch his feet. He pats my head. “Oh! I forgot to put on the light.” B presses the switch. I am amused. I had assumed B had a thing for darkness. “Tell me to sleep.” I ask B to sleep. B puts out the light.
I remain grateful to psychiatrists who allow me to visit wards or sit in their meetings with patients. But nothing had prepared me for the déjà vu I had in the consultation room. A pretty, young girl walks in with her mother. They are smiling. The psychiatrist is confused. He asks if all is well. The mother replies, “Yes, daktar sa’ab , we have brought sweets.” She passes a box of mithai. “What is this for?” asks the doctor. “C’s marriage is fixed.” The doctor is taken aback. “But she has to finish school.” “We will allow until matric. After that her husband and in-laws can decide.” C is beaming away, her eyes cloudy, her mind elsewhere, her shoulders and body rigid. “Is the boy known to C?” The mother answers, “No. But they will know each other after marriage.” The doctor asks C how she is doing. C’s answers are monosyllables. The doctor prescribes the dosage and tells them to come back a month later for follow-up. “Bless her, daktar sa’ab .”
The doctor asks if the in-laws know about C’s condition. The mother answers, “Are we fools? Why would we tell? She will be fine after marriage. I guarantee.”
After they leave, the doctor tells me, “C had her first catatonic schizophrenia episode more than a month ago. This is their third visit. She seems to be doing okay.” The question of why my mother was married when she was unwell and my father’s family was not told about her condition, has haunted me all my life. A half-century after my parents’ marriage I had just witnessed my history repeated. “But marriage? Where did that come from? C has to finish treatment, studies!”
The doctor clears his throat. “Well ... it is really a private decision. I tried to probe if C’s family prevented her from loving someone, whether that triggered her illness... but that is not the case. The groom seems to be a stranger. I can’t interfere.”
In C’s story, at stake were competitive rituals: C’s medication was treatment but its intake was a ritual to prevent episodes of mania. Being a woman, in feudal, patriarchal Punjab, C was studying because we assume we have a system where educated folks advance. However, in lived reality her destiny was the ritual of marriage. The illness was set to disrupt this destiny. With her marriage fixed, her family was relieved. It was prepared to hide her illness in the belief that marriage fixes people. This was exactly my mother’s family’s stance when my parents married. My mother never became fine, her condition worsened. I am stunned. I want to scream.
Mental health statistics
Exactly a year ago on World Health Day, the department of psychiatry, Government Medical College and Hospital, Sector 32, Chandigarh, released the report ‘National Mental Health Survey: Punjab’. It showed that one in eight Punjabis, or 21.9 lakh people in the State suffer mental illness. Only 20 per cent of them (4.38 lakh) have access to treatment. The survey found that in Punjab the total lifetime prevalence of mental illnesses was 18 per cent (national level: 13.7 per cent) and the current prevalence was 13 per cent (national level: 10.5 per cent). The survey mentions that treatment gap was 57 per cent for severe mental disorders, 81 per cent for alcohol use disorders and 82 per cent for depressive disorders.
Punjab has fewer than 60 psychiatrists in the government hospitals and medical colleges. There are another 67 private practitioners. “The ratio of doctor to people is 0.46 per lakh. Punjab needs at least 270 psychiatrists,” says Dr BS Chavan, current director-principal, GMCH-32. Since there are only 13 MD psychiatry seats in four medical colleges, it will take at least 11.5 years for Punjab to meet the deficiency. There is an acute shortage of mental health professionals: 12 clinical psychologists, where the requirement is at least 226; 32 psychiatry social workers and four nurses. Nineteen out of 22 districts of Punjab are not running the district mental health programme.
The ritual of protest
Looking out of the hospital, at the society, at the politics, I wonder about the conditions in which Punjab’s people live. Do Punjab’s systems inspire trust in people? Do they help people feel they belong? When I entered the State in the fall of 2015, the White-Fly epidemic had devastated the cotton crop in south Punjab’s Malwa region. For over two decades, Punjab — once called the bread basket of India — has been dealing with the after-effect of the Green Revolution. All components of the agrarian ecosystem have betrayed the hardy farmer: waters for the land, fertility of the land, quality and production of seeds, market and sale of produce, prices and monies that the farmer can earn. Every small and marginal farmer, every farm labour I meet says, “Agriculture is no longer profitable. We are stuck. We have no options.”
I wonder how different it is from A’s paranoia, where he claimed his mother has poisoned the food. The poisoned food of Punjab shows in the Cancer Train thrice a week to Bikaner. It shows in the health indices of the State, the fall in the sperm count of the famously masculine Punjabi. Basmati growers from north Punjab’s Majha and sugar cane growers from central Punjab’s Doaba joined the cotton growers from Malwa for a rail-roko protest. Eleven farmer and farm labour organisations called for compensation from the State for not regulating the process of agriculture — fake pesticides and news of bribes. The government never heard the cries. It abandoned the farmers and labour, ruptured the very basis of democracy — accountability.
A night before the leaders called off the strike, pages from the holy book of the Sikhs were found on the streets of village Bargadi. In the ensuing days, weeks, months, the incident repeated over 200 times all over the State. Old fears were stoked — the Sikh religion is under threat. Yet, amidst the storm, Punjab held its rage for over two weeks. Its Sikh, Hindu, and Muslim came out on the streets in protest. The administration went missing, the leaders hid in their homes. The anger against the Shiromani Gurdwara Prabandhak Committee’s (SGPC) decision to pardon Gurmeet Ram Rahim over a decade-ago incident where he had imitated Guru Gobind led to the call for a pre-democratic, pre-modern nation state, community ritual of the Sikhs — Sarbat Khalsa.
The government tried to prevent the plenary. It called out the irregularities of its conduct, lack of SGPC support, and prohibited the community from gathering at the Akal Takht at Darbar Sahib. Yet, the plenary was held. Many lakhs attended. However, a few leaders hijacked the agenda. The Sikh community now has two sets of religious leaders — one appointed by SGPC and another by Sarbat Khalsa. All the other proposals — a Sikh parliament, apology from leaders, freeing political prisoners, restoring the decorum of SGPC — remain deferred. The Akali Dal stays in control of the representative body of the Sikhs. This eroded the ritual of the hallowed Sarbat Khalsa.
Democracy - missing in action
Soon after, in central Punjab, notice boards emerged in villages saying no leader of Akali Dal, Congress, Aam Aadmi Party was allowed in that village. Yet, the nation state and Punjab needed to get through with elections, form a government, like they needed to feed A, save B. The pretence of democracy hides its autocratic and apathetic nature. This has been on since 1992, when turnout in elections was 23 per cent and Akalis had boycotted it.
This showed up starkly in the election year 2016. AAP played the rituals of the leader in a turban, flashing of swords, the jaikara of the Sikhs — Jo Bole So Nihal, Sat Sri Akal , appropriated Bhagat Singh and his slogan Inquilab Zindabad. AAP leader Arvind Kejriwal called Bikram Singh Majithia, then minister, the biggest drug smuggler and threatened to arrest him. AAP promised the moon: it created a craze for tickets, brought in external observers, ushering in a quasi surveillance state among its cadre — an atmosphere of doubt and secrecy, sting operations and snitching, creating a snake pit out of the very people who had welcomed them with open arms just two years earlier. This was not the Punjab I knew even from the broken stories of my childhood. Recently, Kejriwal apologised to Majithia, thus proving how much of AAP’s attempt at “saving” Punjab was mere bluster.
Congress leader Amarinder Singh swore on the Granth Sahib. He promised to wipe out drugs, corruption, end police high-handedness, create jobs for youth, and provide loan waiver to debt-ridden farmers and labour. The Congress manifesto’s key point was to regain Punjab’s honour. The Congress won the elections. As soon as it came to power in March 2017, it started crying: coffers are empty. It is a bit rich that they were unaware of the fiscal and real situation of Punjab.
The Congress has just completed one year in office. It has no money, it now delays salaries of government employees, has turned the farm debt waiver from ₹72,770 crore to ₹1,500 crore, faces corruption charges in its mining policy, delays in transport policy, has not taken on the sand or media mafia, still no jobs for youth... the list is long. It can be seen in the memorandums in the hands of agitating farmers, labour, teachers, thermal power plant employees, anganwadi workers, and so on. It can be seen in the way there is no let-up in the rates of suicide in the agrarian sector. The government fails every promise it made and has turned them into empty rituals.
The greatest gap, both during the Akali and Congress reigns, is the lack of data: what is the number of farmers, marginal farmers, farm labour, industries, industrial workers, migrant labour, drug addicts, cancer patients?
Where are the education, health, tolls and taxes reports? The multiple sets of figures — government, universities, people’s organisations — contradict each other and can confuse anyone trying to understand the gaps in Punjab’s stories.
Conclusion
I can now understand the inflection points of the ruptures in the stories my father told me in my childhood. They are pending resolution over the last half-century: Centre-State relations, Anandpur Sahib resolution, river waters, lack of transparency over Operation Blue Star, justice towards a community after the 1984 carnage. No one has addressed them. Punjab’s high mental illness incidence is an indication of the erosion of democracy in the State. Who can its people trust?
Punjab screams, but neither the Centre nor its own government listens. That is why Punjab goes silent either through farmer and worker suicides, or in a stupor of drugs, or awaiting the elusive visa to escape its claustrophobia. Through lack of accountability and apathy, democracy has become an empty ritual, vacated of the trust between the individual and the State. I remain bewildered.
Amandeep Sandhu is the author of ‘Sepia Leaves’ — a novel about living under the shadow of schizophrenia