IOn Saturday morning, about 40 people on foot, bicycles and rickshaws began to infiltrate Koklong village. They sit outside a bungalow and wait to see a psychiatrist at a monthly treatment camp for people with mental health conditions.
The camp provides a lifeline to this remote, impoverished community in the state of Assam, in the north-east of the country India.
Among those seated is Aisha Ali*, 32, who was diagnosed with schizophrenia as a teenager. She struggled to receive ongoing treatment because her family wasn’t always able to pay for medication or psychiatrist appointments. In the past, she would sometimes have to travel 200 kilometers from her home in Koklong, near the Bhutan border, to the state capital, Guwahati, for treatment.
That changed two years ago when ant Action Northeast Trust, a rural development organisation, started the camp in her village. Now, every third Saturday of the month, Ali can meet with a psychiatrist and pick up medication for 300 rupees (about £3) at a time. This is a day’s wages for many people in the village, laborers or farmers, but ten times less than the cost of a private consultation. The camp is the only way to get consistent, low-cost treatment in the area.
NCDs are simply that; unlike, say, a virus, you can’t catch them. Instead, they are caused by a combination of genetic, physiological, environmental and behavioural factors. The main types are cancers, chronic respiratory illnesses, diabetes and cardiovascular disease – heart attacks and stroke. Approximately 80% are preventable, and all are on the rise, spreading inexorably around the world as ageing populations and lifestyles pushed by economic growth and urbanisation make being unhealthy a global phenomenon.
NCDs, once seen as illnesses of the wealthy, now have a grip on the poor. Disease, disability and death are perfectly designed to create and widen inequality – and being poor makes it less likely you will be diagnosed accurately or treated.
Investment in tackling these common and chronic conditions that kill 71% of us is incredibly low, while the cost to families, economies and communities is staggeringly high.
In low-income countries NCDs – typically slow and debilitating illnesses – are seeing a fraction of the money needed being invested or donated. Attention remains focused on the threats from communicable diseases, yet cancer death rates have long sped past the death toll from malaria, TB and HIV/Aids combined.
‘A common condition’ is a Guardian series reporting on NCDs in the developing world: their prevalence, the solutions, the causes and consequences, telling the stories of people living with these illnesses.
Tracy McVeigh, editor
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Quick guide
common condition
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The human toll from non-communicable diseases is huge and rising. These diseases end the lives of nearly 41 million of the 56 million people who die each year – three-quarters of them in the developing world.
Non-communicable diseases are simply; Unlike, say, a virus, you can’t catch them. Instead, they are caused by a combination of genetic, physiological, environmental, and behavioral factors. The main types are cancers, chronic respiratory diseases, diabetes and cardiovascular diseases – heart attacks and strokes. Nearly 80% are preventable, and all are on the rise, spreading relentlessly around the world as population aging and lifestyles driven by economic growth and urbanization make being unhealthy a global phenomenon.
Non-communicable diseases, which were once seen as diseases of the rich, now predominate in the poor. Illness, disability and death are perfectly designed to create and extend inequality – and being poor makes it less likely that you will be accurately diagnosed or treated.
The investment in treating these common and chronic conditions that kill 71% of us is incredibly low, while the cost to families, economies and societies is staggeringly high.
In low-income countries, non-communicable diseases—usually slow and debilitating diseases—see a fraction of the money needed to invest or donate. Attention remains focused on threats from infectious diseases, yet cancer death rates have long outpaced malaria, tuberculosis, and HIV/AIDS combined.
Common Case is a Guardian series on non-communicable diseases in the developing world: their prevalence, solutions, causes and consequences, and tells the stories of people living with these diseases.
Tracy McPhee, editor
“She is much better now and no longer suffers from psychotic episodes,” says her brother, Ahmed Ali. She is able to work independently.
Sonali Sarkar*, 40, was diagnosed with severe depression and anxiety by a camp psychiatrist last year. She had been attending sessions because she had become frustrated and had begun to neglect her children. She is now feeling better. “I am so happy that I can now take care of my husband and children,” she says with a smile.
Last India’s National Mental Health Survey, from 2015 to 2016, it was found that 15% of Indian adults required treatment for one or more mental health conditions. But there is a severe shortage of trained professionals across the country, and a lack of funding to improve the situation. less than 1% Of the national health budget for 2022-2023 is directly allocated to mental health.
in Assam, India Sixth poorest state and the poorer In the northeast, authorities run a mental health program in the district but it does not reach all 31 counties. Where it does run, it has problems, including shortages of staff, medication and funding.
The Ant started monthly treatment camps at his base in Rowmari village, 25 kilometers from Kuklung, in 2007. Hundreds of patients came from all over the state, queuing from early morning to see the paramedics. The overwhelming response spurred the organization to expand the program in 2014. The non-profit now runs monthly camps at 25 locations across Assam with the help of local partners.
The camps are held on a specific day every month and at the same place, so that “even if a patient stops coming for a while, they know exactly when and where to find us,” says Dr. Sunil Kaul, co-founder of The Ant.
“Nearly 50% of our patients need to continue taking medication for life,” he adds. This makes access to regular, consistent treatment crucial. Camps have continued throughout the covid pandemic, in a time of mental illness more Significantly.
The Ant hires experienced psychiatrists who give up their weekends to work at deeply discounted rates. They are also sources of high-quality generic medicines from A non-profit organization that manufactures essential medicines for charities.
Cowell estimates that the ant has treated more than 8,000 patients since 2007. “80% of our patients who complete at least the first three months of treatment return to what they were doing before the disease,” he says. “When the patient comes back to us on his own and is able to engage in preservation, we feel very happy.”
Ant treatment camps, says Dr. Bharat Vatwani, one of India’s most respected psychiatrists, “are a lifeline for the mentally ill in these remote rural parts of India, where the mental health infrastructure is often poor.” He adds that the organization’s work “also creates that much-needed thrust into the cultural myths and stigma that circulate around mental illness.”
Kaul says Ant is planning to expand the program in Assam and other states. “Our goal is to establish mental health camps in all eight northeastern states within the next three years.”
*Names have been changed to protect identities