Monday, October 19, 2015

A LOST CHILD: THAT'S ME!!

I realise that I have completed 54 years of my life. They say a cat has nine lives, but a human being has only one, unless you are a reincarnation. As I have not yet been recognized as a ‘trulku’ by anyone, I guess this is my only life. How nice! Having grown up as an orphan, living mostly in a student hostel, having embraced science to build my career to become a psychiatrist at the age of 45 years, I have not been convinced well to embrace any single religion or faith.  Wait a second; I am, but not an atheist in the real sense of the word. I was born as a Hindu; I am still among the flock of Hindus and behave like one among them. I always tick ‘Hinduism’ as my religion, whenever and wherever forms and dossiers require me to do so.  

I was fortunate to be very young, rustically na├»ve and, perhaps, ‘pure’ from an orthodox Hindu perspective to have been able to perform the final rites of my parents at the tender age of 12. As I was a long way from any exposure to modern worldly ways, I was able to meet the stringent dietary and daily protocols that would have been difficult today. If I had to do that now, perhaps my mind would question a lot of things. Is it really necessary to omit salt for 13 days? Why do I have to take only one meal? Why does wearing footwear in any way hinder? All in the name of liberating the souls of my departed parents.

I lived in student hostels most of my formative years. The same child who used to worship cows during Diwali was eating beef in the hostels of Trashigang and Kanglung schools. The child who used to fear being touched by a pig in order to avoid losing his caste started enjoying ‘phakpa sha’. The child who was ordained to believe that alcohol was the beverage of the lowest caste started liking a drink or two. If alcohol would define caste, then today I would be at the nadir of the caste system. Doesn’t matter though, as I don’t believe in it! Nothing really happened; perhaps I am lucky to have been born in Bhutan, a Buddhist country, or else I would have been ‘lynched’ by now for declaring that I have taken beef, a la Dadri.  

When I was young, in the name of religion, a he-goat used to be sacrificed during Dushera. The goat used to be identified well in advance as the one belonging to ‘devta’ and the offering was for Durga. Of course, we enjoyed the meat afterwards. Back in school, we learnt prayers written in “chokey”, which the Dzongkha teacher made us memorize and recite line by line. It still happens in our schools! When I got scared at night I used to recite ‘Om, Mani, Padme Hung’! Even today, it is the only ‘mantra’ that I know or have learnt the most. When I get shit scared, my pounding heart goes ‘Om, Mani…’

My parents were straightforward Hindus; practiced what was passed on from generations, and the rituals were also pretty straightforward. I still don’t know whether some of the rituals should be practiced! By the time I became 10 or 11 my father suddenly discovered the influence of ISKON. One day he came home with a slate carved with ‘Harey Rama, Harey Rama, Rama, Rama, Harey, Harey! Harey Krishna, Harey Krishna, Krishna, Krishna, Harey, Harey! I remember reciting that over hundred times. Nothing happened!

Around the same time, Vaishnavism came to our village from Surey, Gelephu. It required people to sort of get baptized by getting branded with ‘shankha’ and ‘chakra’ on each deltoid or thereabout. After that people were expected to live in purity – meaning becoming pure vegetarian, not mixing with people of other faith, etc. As the village headman (gup), my father refused to accept people converting to Vaishnavism.

By around 1975, Vaishnavism finally penetrated our village after the death of my parents. In fact, all my paternal as well as maternal uncles, my siblings, cousins and most of the Brahmins in my village embraced Vaishnavism. However, not everyone turned vegan.

This was the time my mind started questioning beliefs, faiths and religions. I keep hearing people say that ‘god is one’, even Facebook says so. But I also keep getting a message that ‘my god is better than your god’, or ‘my way is the best way to hit god’. At times I feel like a lost child; lost and stranded in the middle of nowhere asking for direction to reach my destination. But the directions are too many and mostly contradictory! How the hell will the lost child reach his destination?

Faith and religion are as confounding as is portrayed in the Bollywood flick ‘P.K’ One set of people believes that cows will help you cross the river to heaven – a mere touch of its tail is enough – after you die. Others have no problem eating beef. Yet others believe that some ‘mantra’ or ‘knowledge’ given by a particular guru will deliver you straight upstairs. While some think that pork is dirty meat, yet many enjoy eating it. Some say ‘don’t eat meat, for it is equal to cannibalism’; others advise that meat is very nutritious and the best source of protein. Some say, ‘oh you believe in that’? Then you have not gotten the real ‘gyan’! Anyone who has not received the gyan is not going to be liberated ever. You will remain as a restless soul after you die’.

Some say, ‘my guru is god, just believe in him and you will be liberated’. Some say,  ‘just close your eyes and meditate and you will attain nirvana’ Some say, ‘look at the ash produced by my ‘Bhagwan’ out of thin air. Lick some of the ash and smear some on your forehead, you are done’. Producing things out of thin air is a roaring business and a vibrant profession in the world. Famous magicians such as David Copperfield and P.C Sorkar have produced many more things than mere ash, yet their audience does not claim that they are gods. So much claim, but the fact is I am yet to see these pretenders fly to heaven!

The primary essence I see in all of these is  - be a nice person, help other human beings, be kind, don’t cheat, be simple and be satisfied. Perhaps all these can be summarised into four virtues: no anger, no jealousy, no greed and no hatred.

If this is the real essence, I think only Gautama Buddha summarised it the best, at least for me.  I see that people cheat others and perform grand rituals to neutralize the cheating. While people try very hard to be devout and religious in the hope of liberation, rituals following the death of someone seem to be still necessary. Sometimes an ailing person may not be provided with the basic care and food while still alive, but is served the most sumptuous of meals once he is dead. Talking of dead, some say you need to burn the dead to liberate the soul, others believe that it has to be kept until the day of final judgement. Some believe that the soul is liberated in 13 days; others believe it takes 49 days.

Confusions abound! Each believer, though, claims to have a solid answer, sometime even challenging to show proof. Yet god doesn’t seem to come in one colour, race, appearance anywhere and say, ‘hey don’t get confused; here I am’. 

Thursday, October 15, 2015

PARENTS-CHILDREN CONFLICT: A REFLECTION!

In the recent years I have been witnessing a rapid rise of conflict among children and their parents. These conflicts are leading to various behavior issues in the children and young adults. Many youth are seen to be frustrated, depressed, anxious and at times outright violent against self. Frequency of attempted suicides has increased over the years and many young people have perished. Postmortem psychological assessment of those who have committed suicides most of times fails to reveal the psychological issues. There are many instances of impulsive acts of self-harm.  A minor reprimand, scolding or interception has led to the drastic consequence like suicides.

The psychological resilience of our youth seems to have reduced to a bare minimum. They don’t seem to be able to accept anything which is beyond their liking. They seem to be all the time rebellious against the parents, the teachers and the society at large.  We are facing a big challenge of frustrated and angry new generation. The religious values and protective cultural norms are no more effective. I have been having lots of questions, and most of these are unanswered. What is the root cause for all this! Where are we going wrong and who is at fault? Seriously, it is high time that we did a psychological anthropological study to find this out, but still lack the capacity.

Being a Psychiatrist working at the National Referral Hospital, I have been faced with a lot of issues related to the youth and children. On many occasions I have been put in a dilemma to strike a balance. I Just sit and reflect! Someday my reflections may generate a hypothesis for a more scientific study.

Recently I was invited to a panel discussion for celebration of the Fiftieth Anniversary of Yangchenphug Higher Secondary School and I was one of the panelists from the adult-side. The topic for the discussion was “It’s my life. Let me have it my way”.  Very bold but a nice topic; it was the voice of the youth asking for their rights. They have been educated, they know their rights, they want freedom and they want to question and resist the age-old techniques most parents resorted to in order to discipline their children. While we agreed to the children’s view, we also quizzed them if they also knew their responsibilities? Sir Michael Rutland summarized this beautifully with an analogy of the driving culture that is evident in Thimphu. He said, the topic reminded him of the motorists in Thimphu where everyone thought “It’s my life. Let me have it my way”. He said,If this was the case, there would be no traffic rules or policemen, people would be hitting each other and the result be disastrous!” He reminded the children to exercise their rights within a limit and to be cognizant of their responsibilities.

From this panel discussion I came to realize that while most of the children have now learnt their rights from the western perspectives, the parents have not evolved according to the needs of the time. To me, most parents lack parenting skills. We try to use the same old disciplining techniques that our parents used on us. We still believe that physical punishment is needed to correct a child; we still believe that we can impose our views onto our children and they will believe blindly. The most affected are those parents who are residing at the cities because most children back in the villages are still listening to their parents without much questioning. They still adjust to the village life and are not very alien to their parents in their views.

I can recollect those days when we were children how we were punished physically in every setting, from home to the school. We were made to “grow up” into adults much faster than the modern children. We are made responsible at a much younger age. We learnt a lot of survival skills that a farmer needed in life. Every child from the age of 8 or so had an assigned chore which was expected to be carried out without any cue or question. If we failed to perform our assignments, we would invite punishment. We grew up believing that our parents and our teachers had the right to discipline us! We believed that we deserved punishment if we deviated from our responsibilities, unlike the current generation that believes that they have the right “NOT TO BE PUNISHED”. In fact, sometimes I feel that those punishments “immunized” us to become mentally stronger and made us more resilient to stresses in life.  Of course, I don’t believe physical or corporal punishments should be used as means of “psychological immunization”.

On the other hand, we as parents do not realize that ours was a totally different life in those days. Most of us grew in the villages, for we didn’t actually have any cities until the last two decades or so. Therefore, we didn’t have the distractions that are prevalent these days, especially in the cities. We didn’t have social functions that attracted us; we didn’t have “downtowns” to hit after schools; we didn’t have internet, televisions or computer/video games to entice us; we didn’t have discotheques, restaurants or other hangouts, nor did we have the pressure of drugs.  The overall competitiveness in life was less tough, jobs were readily available and our needs were bare minimum.

Our children and youth are in a different world all together, they have all these; besides they also have the “rights” that most of us never heard of as children. Pressure to perform well in school is very high; they have to compete for limited seat available for scholarships. Many parents still are financially challenged to educate their children’s privately. They, therefore, pressurize their children further to exhaustion. Some parents still secretly wish their children to fulfill some of their unfulfilled dreams. The education system has become academic oriented and every child is expected to at least complete Middle secondary school.  We don’t acknowledge the fact that every individual is unique in his/her abilities and mental capabilities; we expect every child to be the same in intelligence and skills. We have a tendency to compare our children with the children of relatives and neighbours; we don’t mind demeaning them in front of their peers or embarrass them in the public.  We don’t realize that our children are more sensitive to these issues than we were when we were younger! We are highly judgmental and don’t communicate effectively with our children. When a child expresses that he/she is depressed, we try to ask “WHY?” rather than listening and trying to help. We sometimes even tell them to “die” if they cannot do what is expected of them. Children are not allowed to make their own decisions and parents impose their decisions onto them. We want to create the hierarchical boundaries in the family and refuse to take into confidence the opinion of our children thus alienating them further from us.  Our children have to fall back on their peers for a lot of things because we are too busy to sit with them and listen to them. Peers can be helpful but they can also be harmful, especially if they happen to be into drugs or alcohol. 

While I fully acknowledge that the children are right in saying “It’s my life. Let me have it my way”, I also want to caution that rights without responsibilities can ruin anyone. An individual is but a unit of a society at large, thus an individual cannot exist in isolation. Society runs on rules and regulations, families have their own unwritten rules that a child must respect.  An immature mind of a child may not be able to make a correct decision; therefore, guidance from elders and more experienced people in their lives is necessary. There are multiple examples to prove that immature decisions are detrimental to a child and can ruin the life. These are manifested in the form of teenage pregnancies, delinquency, criminalities, theft, murder, substance use, alcohol use, gang fights, personality problems, etc., and the list can be exhaustive!


We need to strike a balance in order avoid conflict between the parents and children. There is no other way to improve our younger generation. Blaming each other is not going to lead us anywhere. The need of the hour for all of us is to reflect on how we deal with our children. The Home environment is the most immediate environment for a child. It needs to be peaceful, safe, friendly, accommodating, loving and caring and most of all very comfortable for a child. For a child the parents should be like friends, protectors, facilitators, teachers and confidantes. Our children have become modernized; they are more aware, very sensitive and highly impulsive.  As parents, we must not expect our children to revert back to our generation but we must evolve forward and learn parenting techniques that are practical and suitable to the current generation. We are the bridge between the old and the new generation and we must teach our children to be better parents to their children. We must help them grow mentally healthy so that at no point in time should they have despair and opt to leave this beautiful world prematurely! 


Wednesday, July 20, 2011

CHASING HAPPINESS


Long ago when I was in the village, I was a contended young boy.  Happiness was easy to find. We did not require wealth to buy happiness! Small things in life use to give us enough happiness, and our parents didn't have to struggle to make any one of us happy.
Rice with some vegetable curry would be the most delicious food. We would look forward to special occasions such as Diwali and Dashera to have a meal with meat. Having had the opportunity to have such specials food during those occasions would make us really euphoric! Three good meals that kept our stomachs full were enough to make us satisfied. We didn't even know that the foods that our children eat today ever existed! We simply knew that foods were grown in the fields and needed a lot of hard work to produce. We didn't have any clue about foods being sold in restaurants until much later.  On the way to Tashigang, where I went to study after graduating from my village school, we saw people eating in hotels and restaurants but we didn’t have much privilege to dine in those.  We generally carried rice with us to be cooked where ever we put up overnight. 
We were made to believe that wearing clothes was primarily to protect us from weather and to protect our modesty! We didn't have the slightest knowledge about any fad or fashion, nor did we have the choice for any colour or design. We would get a new pair of clothes during the festive season and that too came after a long wait of one year. A new pair of clothes used to bring lots of joy for us.  We would go visiting relatives during those days showing off our new dresses.
Everyone walked bare feet, including the domestic animals, so question didn't arise of not wearing any foot wears. Walking barefoot was, therefore the norm of the society. I learnt to wear flip-flops only after I joined the school at Tashigang. I bought my first pair of block-heeled shoes sometime in 1977 after I earned enough money for it working as a labourer during school winter break. I felt myself at the top of the world at the feeling of walking about 3 inches above ground!
Entertainments that amused us and gave us extra dose of happiness were simple things, such as school concert, rice paddy harvesting season, going around playing "Dewshi" during Diwali nights, watching a pair of rooster or bull fighting, watching football matches in the rain etc. We were fortunate to have a small Sony radio which used to sing a variety of Nepali songs for us every day and that was one thing that really amused my. For elders, happiness perhaps was more evident when they grew more crops, when the cattle population grew or when there was birth of new family member! Religious congregations during weekends, where people chanted of religious songs, seemed to make them elated for long.
Things have become different now and I have to be constantly chasing HAPPINESS in this modern era of materialism! I do not seem to be able to catch it though. The salary I earn has to be shared among many of us in the family, not only my own but also my relatives' because I am the first generation of salary earner. I have many more new things to acquire but I always run short of budget. There are number of desires which are unfulfilled and make me NOT HAPPY! For example, I don't have a house to call it mine, keep aside having a building in Thimphu; I simply have a tiny little Alto car when my friends move around in SUVs like Tucson and Prado; I wear mostly Bangladesh made garments and have not been able to afford designer dresses; my meals are as simple as they used to be when I was a village boy except that I may be taking more meat items now; I cannot afford the balanced diet of enough protein, minerals and vitamins, consisting of plenty of vegetables, meat, eggs and fruits, as learnt in Medical school. 

There are many reasons for me NOT to be HAPPY! My children are not securing first position in their classes and that makes me unhappy. My neighbour has a better sofa sets, bigger and latest television set, iPad, iPhone and whatnots which I have not been able to buy and that makes me unhappy.  The desires are limitless; list of things I want is unlimited.
I am not the only lone citizen of the GNH (Gross National Happiness) country who aspires to be happy.  There are many, may be the entire population, who would try to be happy with the DESIRE for innumerable things that have become part of our lives particularly in an urban setting. We have a large number of so called educated youth who are roaming the streets of Thimphu and Phuentsholing after graduating from Middle secondary schools, thanks to the free basic education in our country! Having got the taste of urban life no one likes to go back to the villages where life is tough.  The job market is highly competitive and almost saturated. These tenth grade drop-outs have  desires like anyone else.  But how would they then fulfil those desires without resorting to theft, burglary, mugging, and fraudulence? 

We have yet another category of youth that has become difficult now. They are the ones who are onto alcohol and drug abuse. They probably are the ones who come from broken families, or families which are busy trying to earn a living and do not have much time to monitor their children.  There are others who are so affluent that they simply keep their children pleased with money but have no TIME for them.  These are the ones who frequent the bars and discotheques, creating nuisance at times.  In spite of such obvious privileges they enjoy, they seem to be always ANGRY and far from HAPPY!

Buddhism teaches us that "desire is the main cause of suffering" and not desiring will make us HAPPY but who listens to this and who practises it? When everyone else is competing in the rat-race, nobody would sit back and watch others gathering wealth?  Given the opportunity everyone would like to be the wealthiest person in the world! But will that wealth bring HAPPINESS to these people, or is HAPPINESS still out of reach even to them? May be, I guess their desires would still be unmet and they may continue to be UNHAPPY!

On retrospect, I would rather prefer to go back in time when I was a village boy contented with the small things that came my way bringing little packages of HAPPINESS now and then!

Thursday, August 5, 2010

Happiness in depression

Bhutan, the land of Gross National Happiness, has been seeing an increasing number of patients with depression, especially from the rural areas. Mental illness, particularly depression, is viewed as a paradoxical mental status for a country which is trying very hard to make the concept of GNH a reality. Being one of the two psychiatrists in Bhutan, I find it really hard to answer questions many visitors ask me about the reason behind increasing number of people suffering from depression. I really do not have any evidence to give an answer right away, however, when I reflect, I cannot help but highlight some factors which might have significant effects on the psyche of our older generation making them stressed and depressed.

We have seen rapid modernization and development over the last four decades. People got exposed to modern ideas, lots of information on health and education was given to them, and many other modern concepts became evident which were unknown until then. Schools were built everywhere. Children of school going ages were encouraged to get enrolled in schools with promise for better future for them. People learnt to take advantage of the family planning services that were extended to every household to cut the family size to a manageable level. “Small family, happy family” was a dream everyone aspired to have! Young parents in the eighties and nineties wanted all their children to go to school. They wanted them to study hard and get government jobs. For those who went to school, there was smooth sailing all the way. While few managed to do graduation, most got educated up to high school level and got into smaller jobs. The more brilliant ones pursued higher education to become professionals, and yet others achieved bigger positions in the civil service. All in all, none of them returned to the villages to live with their parents.

The young parents of those days have become aged now and they are staying back at the villages. Having educated all their children, there is now no one to help the parents in the farming work. The government encourages the villagers to cultivate their land and the “Gup” (village headman) makes sure it is done, at times forcefully. There is no excuse for keeping the land fallow, not even the frail health of the owner. In absence of ready labour force in the form of children and relatives, there is no option for the parents but to toil and toil until they get fully exhausted. To be a farmer in Bhutan, especially where mechanization is unknown, is perhaps the most difficult job than anything else. The day to day work in the field is manual and tiresome.

The global warning is a reality and the impact is obvious. This year alone there were several flash floods and landslides damaging substantial amount of arable lands and crops. Unpredictable weather conditions such as untimely rainfalls, storms, hail storms and drought are other factors that keep a famer always worried. The food grains, product of their hard toil, are never safe until harvested!

To make the matter worse, we have been seeing a number of wild animals increasing over the last few decades; we may call this the adverse affect of conservation of forest and preservation of the environment! People not only have to work hard to grow the crops but have to stay awake in the nights to protect them from wild animals, at times paying with their own lives!

In such a scenario, there is definitely a constant flow of stress hormones, and it is but understandable for a farmer to feel severely stressed. This stress causes a lot of harm to the mind and the physique of a villager. No wonder then, are we, getting more and more depressed people now, even though we would like them to be happy.

There is another factor now in the recent days and that is the rural urban migration, and the educated generation sticking to the urban centres. Life becoming difficult at the villages with all those odds most prefer to earn a living in the cities, even if it is just hand to mouth. They stick to the urban centres, establish a family and then get entangled in the webs of modernization. The salary they earn is limited, and the so called necessities in the towns and cities are many. Every day there is a new thing to be acquired, and the desire for materialist achievements is a never ending! Even if somebody wants to help their parents they become helpless. Few afford to send money to their parents, and most cannot afford to do that too. The attachment with the parents slowly gets distant and the dreams of the parents of a ‘small and happy family” becomes a remote and fading illusion.

Some children who are really concerned about their parents would like them to stay with them in the cities. But for the parents who have always lived in the village, it becomes a great plight to stay in apartments inside big buildings where 12 to 15 families live but never interact! The children seem always busy either trying to make a living, or glued to the television! No one seems to interact much with each other, and the conversations are always brief and precise. The way of life they find in the urban areas is beyond the imagination of a person who has always lived in the village minding his agricultural land and farm. Back home they are used to interact with their neighbours freely, share the common interests among them and help each other in almost every occasion. The building, even though, has as many households and people as in a small village, there is no sense of belongingness. They soon start feeling homesick and prefer to go back to their “home” and live with their dear neighbours where they find more warmth emotionally and feel closer to them than their offspring!

It is, therefore, too much of an expectation for these physically and emotionally fatigued lots to be happy. Philosophy alone will not bring about happiness, and to expect happiness in depression is ridiculous! We need to find out the multiple factors associated with depression and address them effectively if we want to take these rural folks out of the blues!

Friday, November 27, 2009

Women and depression:

Over the recent times a lot has been happening to boost the status of women in the society. Women now shoulder greater responsibilities and are capable of doing almost anything that men can do. In spite of these social advancements women still remain vulnerable to number of mental illnesses and depression is the most common one. Women mostly present with unexplained physical symptoms, such as tiredness, aches and pains, dizziness, palpitations and sleep problems.

The common symptoms of depression are Persistent sad or low mood, Loss of interest or pleasure in usual activities, including sex, Restlessness, irritability, or excessive crying, Feelings of guilt, worthlessness, helplessness, hopelessness, pessimism, Sleeping too much or too little, early morning awakening, Appetite and/or weight loss or overeating and weight gain, Decreased energy, fatigue, feeling "slowed down", Thoughts of death or suicide, or suicide attempts, Difficulty concentrating, remembering, or making decisions, However, not everyone with depression experiences all of these symptoms, and the severity of the symptoms may vary from person to person. In order to consider depression as a disorder, the symptoms must persist for more than two weeks and should interfere with one’s work or family life.


Major depression and dysthymia (chronic depressed mood) affect twice as many women as men. This two-to-one ratio exists regardless of racial and ethnic background or economic status. Many factors unique to women are suspected to play a role in developing depression. These can be reproductive, hormonal, genetic or other biological factors. Abuse and oppression due to gender biases and certain psychological and personality characteristics are also some other factors. However, it has not been possible to pinpoint any the specific cause for depression as many women exposed to these stress factors do not develop depression.

Scientific studies done in many other countries show that higher incidence of depression in females begins in adolescence. This is due to the fact that roles and expectations change dramatically during adolescence. Other stresses of adolescence include forming an identity, confronting sexuality, separating from parents, and making decisions for the first time, along with other physical, intellectual, and hormonal changes. These stresses are generally different for boys and girls, and may be associated more often with depression in females. It is also suggested that men and women differ in their expression of emotional problems. While men choose to self medicate by taking alcohol or drugs, women tend to express these through emotion, thus becoming depressed.

Adulthood has its own share of stresses for women. These are major responsibilities at home and work, single parenthood, and caring for children and aging parents. Even in a married relationship women carry a greater share of child care and household responsibilities. Role conflict sometimes becomes an issue too. Women at times need to choose between family and work responsibilities, often having difficulty in deciding about which choice is the "proper" one!

Unlike men, women go through many reproductive events. Menstrual cycle, pregnancy, the post pregnancy period, infertility, menopause, and sometimes, the decision not to have children are various reproductive events they go through. All of these events can bring fluctuations in mood which can include depression in some women. Although the specific biological mechanism explaining hormonal involvement in depression is not known many researchers have confirmed that hormones have as effect on the brain chemistry leading to changes in emotions and mood. Because of this many women experience certain behavioral and physical changes associated with phases of their menstrual cycles. In some women, these changes are severe, occur regularly, and include depressed feelings, irritability, and other emotional and physical changes called premenstrual syndrome. During the post delivery period women are more likely to suffer from depression. Postpartum depressions can range from transient "blues" following childbirth to severe, incapacitating, psychotic depressions.

Pregnancy, if desired, does not lead to depression and having an abortion does not appear to lead to a higher incidence of depression either. However, women with infertility problems may be subject to extreme anxiety or sadness, most of the time aggravated by cultural beliefs where infertility is considered ominous. Teenage pregnancy or young motherhood is also a risk for depression due to the increased stress. Housewives who depend on their husbands for financial needs can become uncertain especially when they have abusive husbands. Frequent domestic violence and apathetic attitude of parents and siblings towards married daughters or siblings can lead to helplessness and hopelessness.

Untreated depression can lead to suicide but even severe depression can be highly responsive to treatment. Of course, believing one's condition as "incurable" is often part of the hopelessness that accompanies serious depression. Indeed, treatment is not to eliminate life’s inevitable stresses and ups and downs but to enhance the ability to manage such challenges and lead to greater enjoyment in life.

Silence behind domestic violence

Domestic violence is also known as domestic abuse, spousal abuse, child abuse or intimate partner violence. It can be broadly defined as a pattern of abusive behaviours by one or both partners in an intimate relationship such as marriage, dating, family, friends or cohabitation.

The commonest form of domestic violence seen in Bhutan is spousal abuse, particularly, violence against the wife by her husband. In the recent times we have been seeing an increasing number of such cases. Many women visit the forensic unit and the psychiatric OPD of JDW NR Hospital for various problems which include physical injuries and mental trauma.

The Royal Government of Bhutan has been doing a lot lately to elevate the status of women in the society and alleviate their sufferings. There are now a number of agencies taking care of the needs of the women. The National Commission for Women and Children, RENEW (Respect, Educate, Nurture and Empower Women), and the Child and Women protection unit of the Royal Bhutan Police are such organizations.

In absence of a scientific study, it becomes difficult to pinpoint one single cause for spousal abuse in Bhutan; however, it is not so difficult to guess some of the possible causes. Alcohol seems to be the most important cause followed closely by gambling. The other causes would be personality mismatch, jealousy, financial dependence of a woman on her husband, emotional factors, helpless situation etc.

Alcohol is not only the main culprit by itself, it is also an indirect cause for other mental illnesses leading to more abuse and violence. Most common form of mental disorder in alcoholics is morbid jealousy, also known as pathological jealousy or “Othello syndrome”. Persons suffering from this condition can have unshakable belief that their partners are unfaithful; it can be so severe that the sufferer may even kill the spouse for this.

Even though we have so many organizations to protect these victims of abuse and violence, why are not all coming out to seek help? Although it is appropriate to find the cause for domestic violence, it is also equally important to find out the reasons for their helplessness. What could be the reasons for them to be so secretive? Why do they prefer to hide and weep behind closed doors?

While I may be wrong, I feel these are some of the reasons for the silence behind the domestic violence:

1. Financial dependence:
Due to disparity in education in the past more males are employed in Bhutan than women, thus women are more dependent financially on their husbands. Financial dependency makes women vulnerable to feel obliged to their husbands. Men take advantage of this situation and victimize their wives to comply with their wishes, be it unreasonable and unjustified.

2. Social customs:
In some ethnicity, especially in a patriarchal society, the girls once married belong to the in-laws. They will have nothing to do with their own parents and siblings except for some emotional attachment. In Hindu society, for example, the daughter becomes the “property” of the in-laws. The girl will relinquish her “clan name” to adopt the one from her husband. Such customs can make the women highly susceptible for abuse and violence. Even when the relatives know that their daughter or sister is abused they hardly offer help to mitigate the problem. She is not even welcomed to her parental home when she is thrown out by her husband thus making her helpless and hopeless.

3. Emotional factors:
Women tend to be more emotionally attached to their children because of which they would not mind to continue the relationship for the sake of their children even though there is constant oppression from the husbands. Many women take the role of protector for their children from the abusive husbands, in the process suffering more and more.

In contrary to the general notion that Bhutanese women have equal status and rights as their male counterparts, they are more dependent on their husbands for almost everything. That is why most women suffer silently without even mentioning about the abuse and violence to anyone, not even to their treating doctor. Some women even go to the extent of concealing the real cause of their physical injuries with which they come for treatment. Even though they may be going through severe mental depression, they will rather complain about physical symptoms, such as aches and pains, chronic headaches and insomnia.

Unless we take care of the factors leading to the “silence” women will continue to suffer quietly within the four walls of their houses. They will continue to be the victims of violence and abuse. If we don’t protect our daughters, sisters and our women relatives from their abusive partners, we will never be able to empower them!

Monday, August 17, 2009

Experiment with tobacco

Experiment with tobacco

It was in 1970, I was 9 years old and was studying in class II, my father wanted me to attend a private school some 2 hours’ walk from our village at Diklai. We usually got about two months summer holidays and my father wanted me to take extra lessons to be able to top the class. To reach Diklai we had to cross a river which had a huge log of timber laid across it for a bridge. The children from this village had difficulty in attending the only village school which was situated at Dalim, about 3 hours walk. Probably that was the reason for setting up of that private school. The school was a mere shabby shed of thatch roof with bamboo mats as walls, large enough to accommodate around 30 children. There were no rooms for different classes so everyone attended the same class, a multi-grade style. There was just one teacher who may not have had any qualification beyond the sixth standard. Whatever it was, I had to attend that school along with a cousin brother Chakra Bahadur Thapa.

During one of the classes at Diklai, I saw a student of my age taking khaini (chewing tobacco). I knew for sure it was tobacco but I could not imagine a boy of nine taking it regularly. I had seen my father taking khaini but he was an adult and probably it was right for him to indulge in that habit; but a boy doing that was unimaginable!

I had seen how my father used to procure his quota of khaini. He used to buy long leaves of dry tobacco from Assam and it was processed manually into palatable ‘khaini’. I had almost mastered the art of processing it, for I had assisted my father on many occasions. The leaves were chopped finely, some lime (calcium carbonate) was added and it was rubbed vigorously between the palms, occasionally sprinkling water onto it. When done, it used to be packed in an air tight long cylindrical container with a sallower compartment on the other end for some extra lime. On numerous occasions I had helped him process the ‘khaini’ but it never occurred to me that I should try. To me, tobacco chewing was the privilege only the adults were entitled to.

However, when this classmate of mine took it so casually I got interested too. I asked him why he was taking it and he said that it gave him some sort of pleasurable sensation. He also asked me if I wanted to try. At first I hesitated but later I thought, why not? We were sitting right at the back of the class and the teacher was quite unaware of what was going at the back. That boy took out a small polythene pouch from his shorts’ pocket gave me a pinch of tobacco from it on my palm. I had seen my father holding the tobacco between the forefinger and the thumb, and almost imitating him in my imagination, I did the same thing. I took the entire amount between my forefinger and thumb of the right hand, with the left hand I parted my lower lip from the gums and made a receptacle to hold the tobacco and carefully placed it there. As directed, I was to keep the tobacco there until all the ‘juices’ got extracted. Slowly I could feel the bitter and strong taste of tobacco flooding the floor of my mouth. I had the urge to spit but I had to experience the pleasure and I was not supposed to spit out. I swallowed about ten millilitre of oral secretion dressed with tobacco juice with utmost difficulty. The next swig was not so bad but within no time I started experiencing some strange feelings. My head started reeling, I was feeling tremulous and my limbs became listless. I was nauseated and would vomit any moment. I wanted to get up but my feet were too weak by then. I took the help of my hands and with great effort stood up, swaying back and forth. I gathered courage to request the teacher to go out. I said I was feeling unwell. I barely managed to reach a spot just out of earshot for other to hear me retching, and brought out everything! The khaini came first followed by the rice and buttermilk I had for breakfast and then the gastric juices; when nothing was left inside, the bitter bile came out! I was totally exhausted but slowly I started feeling better in the sense that my head was stable, the tremulousness had gone by then and I regained the strength in my limbs. That was almost near death experience to me!