{"id":580487,"date":"2025-11-19T13:41:28","date_gmt":"2025-11-19T13:41:28","guid":{"rendered":"https:\/\/www.europesays.com\/uk\/580487\/"},"modified":"2025-11-19T13:41:28","modified_gmt":"2025-11-19T13:41:28","slug":"we-have-seen-families-take-individuals-with-psychosis-to-a-witch-doctor-the-irish-times","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/uk\/580487\/","title":{"rendered":"\u2018We have seen families take individuals with psychosis to a witch doctor\u2019 \u2013 The Irish Times"},"content":{"rendered":"

While the metaphorical question, \u201chow do you eat an elephant?\u201d is often linked to the late Archbishop Desmond Tutu <\/a>and his approach to tackling the issue of apartheid in South Africa<\/a>, it could just as easily apply to the challenge India <\/a>is facing when it comes to one of the world\u2019s most pressing health issues \u2013 dementia<\/a>.<\/p>\n

\u201cOne bite at a time\u201d, was Tutu\u2019s answer to the pachyderm question. But when you consider data from 2017-2020 highlighting India has approximately 8.8 million individuals over the age of 60 living with dementia, that\u2019s some chewing.<\/p>\n

Future projections don\u2019t make things any more palatable.<\/p>\n

Out of an overall population of 1.4 billion, there are 119 million people aged 60 and above, and that population, like much of the rest of the world, is ageing rapidly. India\u2019s elderly population is projected to reach over 347 million, or nearly 20 per cent of the total, by 2050. (Ireland, by turn, is projected to have more than 1.6 million people over the age of 65 by 2051, a doubling of the current number.)<\/p>\n

Enter the elephant eaters: Dr Sridhar Vaitheswaran, Dr Rohith Khanna Deivasigamani, and their DEMCARES team. Their project, \u201cReaching the Unreached\u201d targets the rural regions of the Chengalpet district Tamil Nadu, a state that boasts the most southern point of this vast country as well as 14.8 per cent (10 million) of its older population, nearly 4 per cent (400,000) of whom are believed to live with dementia. Their vision is to develop a community-based model for geriatric mental health and dementia care that could be easily adapted for use in other rural communities across India and other low- and middle-income countries. <\/p>\n

\u201cThe challenge can feel overwhelming when you look at the numbers,\u201d explains Dr Deivasigamani, when we sit down for a chat in Trinity College\u2019s Global Brain Health Institute (GBHI). \u201cWhen you spend time working in those villages and communities, you become a part of their lives. They are no longer just numbers. Many of them spoke to us about feeling lonely in their later years, and how our team\u2019s visits and conversations brought them comfort and happiness.\u201d<\/p>\n

DEMCARES <\/a>was launched in 2015 by the Schizophrenia Research Foundation India<\/a>, a WHO-recognised entity founded in 1984 by Dr M. Sarada Menon, the first woman psychiatrist in India. Its rural project, Reaching the Unreached, benefits from funding from the Azim Premji Foundation.<\/p>\n

Dr Deivasigamani grew up in modest circumstances in Chennai, a city of 6.8 million, going on to become the first doctor in his family. For the next 12 months, however, Dublin is home, as his work in the field of dementia care saw him selected as one of the 2025-26 cohort of Atlantic Fellows hosted by the GBHI in Trinity College. Both GBHI and the fellowships are funded by Atlantic Philanthropies, the \u201cgiving while living\u201d foundation established by the late Irish American entrepreneur Chuck Feeney, which, over 37 years, invested more than $8 billion worldwide, with significant contributions to the education sector in Ireland as well as the Northern Irish peace process.<\/p>\n

\"\"<\/p>\n

Dr Deivasigamani is quick to praise his chief and mentor, Dr Sridhar Vaitheswaran, for facilitating the Fellowship opportunity and for his vision in establishing the \u201cReaching the Unreached\u201d programme. Its model is based on recruiting and training a network of community health workers \u2013 19 in total, all women, as they are more likely to be given access to strangers\u2019 homes while providing care. These frontline workers travel enormous distances, often in extreme weather conditions on unpredictable public transport, to deliver the vital intervention. A wider network of 79 volunteers, many of whom are local men keen to play their part, support them in the local villages.<\/p>\n

The team initially deploy well-known travelling storytellers and performers to deliver \u201cVillu Paattu\u201d, an art form of musical storytelling popular in Tamil Nadu and other parts of southern India. Such performances help raise interest and awareness while tackling myths and misconceptions.<\/p>\n

\u201cThe people of Tamil Nadu are used to these storytellers coming through their villages. We recruited one of the most well-known from the area to work with us. It took some work to get the content right, to make sure their story was getting across the right messages about dementia, but it works well. After performances, we have people coming to our team saying \u2018my family member has these symptoms\u2019!\u201d<\/p>\n

\"\"<\/p>\n

Following the performances, the community health nurses host screening programmes, while mobile clinics and home visits are used to confirm diagnosis. Since 2023, 45,000 rural community members have been engaged through 1,549 awareness programs, some 10,000 of whom received screening.<\/p>\n

Referrals were made for 2,630 individuals to one of the three psychiatrists (including Dr Deivasigamani) or three psychologists involved in the program, who confirm any diagnosis. More than 2,000 people have been diagnosed with a formal mental health condition (twice the number of women than men), with 270 diagnosed with a form of dementia. The cost per person screened translates to a remarkably cost-effective 2,755 Indian Rupees (\u20ac27). <\/p>\n

Beyond the scale, challenges abound. <\/p>\n

There is no definitive term for dementia in the local language of the region, Tamil, so the team use the common term Maradhi Noi or \u201cdisease of the memory\u201d to get their meaning across. <\/p>\n

\u201cMost people believe the symptoms are just something that happens when people get older and there\u2019s nothing that can be done about it. That is a big obstacle to overcome,\u201d explains Dr Deivasigamani. \u201cThere is also a fear of receiving a diagnosis \u2013 that their family member will be shunned or discriminated against if they get one.\u201d<\/p>\n

One symptom, psychosis, brings with it a challenge that the HSE didn\u2019t have to consider when it launched Ireland\u2019s first national dementia strategy in 2014: the belief that evil spirits may be at play. <\/p>\n

\u201cWe have seen family members take individuals with psychosis to a local faith healer or witch doctor first, as they believed an evil spirit or black magic had fallen upon them.<\/p>\n

\"TheThe DEMCARES team. <\/p>\n

\u201cThis is ingrained in the local culture. Families seek a Sammiyar, or divine intervention, as faith healers are seen as an intermediary between them and their gods. But you are more likely to see families bring young people suffering from psychosis or mental health disorders for this type of treatment.\u201d <\/p>\n

To acknowledge the continued prominence and importance of faith healers in rural life, they are depicted in the theatre performances and storytelling; this also aims to inform faith healers about the signs and symptoms of dementia. Such embedded cultural practices can have ramifications when a pharmaceutical intervention is prescribed to help delay or manage some of the more serious symptoms of dementia or other mental health conditions. <\/p>\n

\u201cThere is still a significant anti-medicine sentiment in rural communities \u2013 they will ask if there is any other option, despite reassurance that medication can help with some of the more challenging behavioural symptoms,\u201d Dr Deivasigamani notes.<\/p>\n

Having a family member available to administer medication correctly can be a challenge, too. Such rural parts of India are empty of their young on both a daily and permanent basis so they can seek employment in urban centres. For a son or daughter left to care for the last surviving elderly parent, journeys are long and public transport dependent. This leaves many older family members, mostly women, living alone while suffering from advanced dementia and dangerous symptoms, including a tendency to wander and get lost in what can be treacherous landscapes. <\/p>\n

In desperate last-ditch measures to keep them safe while their carer is away at work, some have been found chained to a tree or in their house all day. <\/p>\n

\"\"<\/p>\n

\u201cIt looks like they are doing so much harm, but they are doing the only thing they can do to try and keep their mother or father safe,\u201d explains Rohith, painfully aware of how the images provided look to the public. \u201cThey are helpless \u2013 surviving from one day to the next on the money they earn. We had one such case where a son was left caring for his mother who had severe, advanced dementia. He left each day at 4.30am, returning at 8pm. He was in tears \u2013 \u201cwhy would I do this to my mother if I had another option?\u201d he cried to us. <\/p>\n

\u201cThis is where our local volunteers are invaluable \u2013 they help administer the medication. But it remains a big challenge. Early intervention could do so much to help these people.\u201d <\/p>\n

Remember that the next time someone asks you how to eat an elephant. <\/p>\n","protected":false},"excerpt":{"rendered":"While the metaphorical question, \u201chow do you eat an elephant?\u201d is often linked to the late Archbishop Desmond…\n","protected":false},"author":2,"featured_media":580488,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4317],"tags":[183608,425,105,730,218,2196,16,15],"class_list":{"0":"post-580487","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-mental-health","8":"tag-alzheimer-s-disease","9":"tag-dementia","10":"tag-health","11":"tag-india","12":"tag-mental-health","13":"tag-south-africa","14":"tag-uk","15":"tag-united-kingdom"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@uk\/115576654457173734","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/580487","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/comments?post=580487"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/580487\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media\/580488"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media?parent=580487"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/categories?post=580487"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/tags?post=580487"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}