Unsaid

2018 Ramon Magsaysay Awardee BHARAT VATWANI In a few countries, the contrast between great wealth and extreme poverty is as stark as in India. Of the latter, a popular image is its street people, dirty, dishevelled, and famished, huddled on pavements, in train stations, bus stands, and public shrines. An estimated 400,000 of them are mentally ill, victimised not so much by poverty as by a problem society has not sufficiently understood and addressed: the problem of mental health. Stigmatized and feared, the response of many to these street persons is to pretend they do not exist. One man chose not to pretend. Psychiatrist Bharat Vatwani was out dining in a restaurant with his wife Smitha, also a psychiatrist, when they were appalled at the sight of a thin, unkempt man drinking water from a street canal. Taking time to talk to the man, a mentally-afflicted college graduate, they decided to bring him to their clinic to be washed and treated. This show of empathy was not entirely surprising. Vatwani knew what poverty was like. Losing his father when he was only 12 years old forced him and his brothers to take odd jobs, like peddling books door-to-door. Struggling through school as a self-supporting student, Vatwani successfully completed his medical studies in psychiatry at Grant Medical College and at G.S. Medical College & Hospital, both in Mumbai. After their encounter with the man who drank water from a canal, Dr. Vatwani and his wife started an informal operation of bringing mentally-ill street persons to their private clinic for treatment. This eventually led to the establishment of Shraddha Rehabilitation Foundation in 1988, aimed at rescuing mentally-ill persons living on the streets; providing free shelter, food, and psychiatric treatment; and reuniting them with their families. Starting with a two-room tenement that could take only three people at a time, Shraddha drew public attention when they rescued and treated a street person who turned out to be a respected lecturer at a Mumbai art school, who had inexplicably disappeared. Learning about what the Vatwanis had done, the school’s faculty and students organized a major art exhibition that drew 141 participating artists in India and abroad, and successfully raised US＄22,357. Using this seed money, the Vatwanis bought a piece of property in Mumbai for a 20-bed facility that they opened in 1997; the unexpected donation inspired them to further expand their work with the help of private donors, volunteer professionals, and social workers. In 2006, they moved to a bigger 120-patient facility in Karjat outside Mumbai, which had five buildings on a 6.5-acre land. By then, they had strengthened their three-phase therapeutic program, consisting of the rescue and treatment of mentally-ill street persons, reuniting patients with their families, and promoting awareness of mental health in communities. Their rescue work has been aided by the police, social workers, and referrals. Shraddha’s free custodial care and treatment ranges from personal hygiene, medical check-ups, psychiatric treatment, to appropriate medication-all done in the open, healing environment of the Karjat facility where patients can engage in simple farm activities and find solace in a multi-religious meditation center. The foundation tracks patients’ families, arranges reunions, and uses such opportunities to spread a supportive and enlightened understanding of mental health among the families and their communities. In a one-of-a-kind mission that began in 1988, Vatwani and the foundation have by now rescued, treated, and reintegrated into their families and communities more than 7,000 of India’s mentally-ill roadside destitute, with a remarkable reunion rate of 95%. Vatwani’s painstaking, humane undertaking has had to contend with numerous challenges. A deeply spiritual person, the good doctor is often beset by doubts whether he has done enough, given the magnitude of the mental health problem in his coun...