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Support for the mind

Progress Report
    2007 - 2009




                    "Past the seeker as he prayed
 came the crippled and the beggar and the beaten.
                      And seeing them... he cried,
         'Great God, how is it that a loving creator
                      can see such things and yet
                      do nothing about them?'......

                     God said, 'I did do something.
                                        I made you.’

                                    -- Sufi Teaching
Who are we
                      Based in the city of Kolkata, India, Iswar Sankalpa is a non-profit
                      organization founded by professionals from the field of psychological well
                      being. We extend support, provide professional guidance and ensure
                      sensible and sensitive services for needs of the mind




                      Our vision and mission
                      The founders of Iswar Sankalpa have a vision: that of ensuring dignity and
                      holistic well being of persons with mental health problems.

                      Our mission is to two-fold:
                              -To lend a helping hand to those with mental health problems,
                              particularly to those from underprivileged sections of society, and to
                              do so in a humane manner.

                               - To empower mental health patients in attaining their rights




                      The organisation
                      Naya Daur project team                              Governing body
about us




                      Project Manager Laboni Roy                          Patron               Smt. Rotrout Roychowdhury
                      Psychiatrist    Dr. Abir Mukherjee                  President            Dr. Ranadip Ranjan Ghosh Roy
                      Social workers Amrita Roy                           Vice President       Dr. Prabir Paul
                                      Saikat Das                          Secretary            Smt. Sarbani Das Roy
                                      Banani Nath                         Asst. Secretary      Dr. Debashis Chatterjee
                                      Suprokash Chakravorty               Treasurer            Dr. Srikumar Mukherjee
                                      Chameli Saha                        Member               Sri Surajit Ray
                                      Tanmay Roy                          Member               Smt. Kalpana Basu Mazumder
                                      Tapan Prodhan
  2

             The members of Iswar Sankalpa deeply
           regret the death of Dr. K. L. Narayanan on
                                      10th April, 2008.

                    Dr. Narayanan was one of the key
               visionaries of Iswar Sankalpa, and his
              untimely demise leaves a huge gap not
            only in the organization, but in the field of
                        mental health in West Bengal.




                       File photograph of Dr. Narayanan
                    negotiating treatment options with a
                  patient at a health camp conducted by
                                         Iswar Sankalpa
Kolkata, the City of Joy, is also the ‘city of unending nights’ for a section of
its people, the homeless mentally ill. Crudely referred to as ‘pagol’ on the
street, these hapless persons wander from place to place, lost to their
families, ignored by welfare and health agencies, and pariahs to the rest of
society. No one cares to understand that these people are not ‘crazy’ - all
they have is an incommunicable mental disease, - a medical condition that
can be reversed with medication, care and a little support.




Naya                                      This report is the chronicle of the two year journey of Iswar Sankalpa’s
                                          flagship project - Naya Daur, which takes care of Kolkata’s forgotten
                                          population. It is estimated that there are over 400,000 homeless



Daur
                                          mentally ill people in India, and amongst these, over 90% have
                                          diagnosable and treatable mental disorders. Naya Daur's team of
                                          mental health professionals works within the metropolitan area of
                                          Kolkata to reach out to a segment of society that this city has forsaken
The dawn of a new era                     for far too long.



There are no easy solutions - putting mentally ill homeless persons in a shelter and administering
psychotropic medicines would be treating the
symptoms but not the disease. The disease
is not just a medical one - it is a social one       2007 - 2009 factsheet
and needs a comprehensive, inclusive and            No of patients:
holistic approach which makes society               Identified-     Over 500          Emergencies           50
responsible and accountable for restoring the       Treated         200               Referrals             37
health and dignity of a neglected people.           Under follow up 100               Repatriated           31

Naya Daur is a sustainable community-based           No of patients provided with
care and support program for the homeless            Food 700        Clothes 350       Hygiene care 204
mentally ill - a program that weaves together
state, private and community into a network          Events and groups
of resources that not only cares for the             Community Mental Health Committees               2 ( 25 people covered)
beneficiary population, but works actively           Awareness Camps conducted                      46 (752 people attended)
towards making them productive members of            Advocacy Meetings held                           5 (117 people attended)
families and community. In a resource scarce
environment, the community model has
proven to be cost-effective - by using infrastructure and services already available with the state, other
NGOs and CBOs and individual citizens, we have been able to support a larger number of beneficiaries than                       3
we would have if we had followed a conventional institution-based approach.

More heartening than just quantitative gains are the stories that are emerging - of Manasi and others whose
lives have been renewed; of Sardar, who now chooses to stay in the community that looked after him and
refuses to return to his family; of Fulwari, one of our patient’s at Sealdah who has created a little community
of her own. And the story that humbles us all - care-givers emerging in the community - some of whom are
homeless themselves.

While the successes have been many, the untimely death of Dr. K. L. Narayanan, one of the founders and
key visionaries of Iswar Sankalpa, just a year into the project has been a body blow for the team. His loss
however, has made us more determined to live up to his vision of a world where the mentally ill, whether
homeless or other wise, are treated with the respect and compassion that is their right.

This report is a tribute to his vision.

                                                                                   Sarbani Das Roy
                                                                                   Secretary, Iswar Sankalpa
Initiated in June 2007, Naya Daur is a mental health treatment project
                                                      with a difference - it provides care and treatment to a population that is
                                                      invisible to the rest of society the homeless mentally ill.




                         Identification and assessment of homeless mentally ill persons                   The metamorphosis
                         living on the streets of Kolkata                                                 Of Manasi
                         In two years, we have mapped 141 wards of Kolkata, and have
                         identified over 500 people in critical need of help. Apart from our own
                         surveillance teams, the Kolkata Police and concerned citizens help us
                         find homeless people who need psychiatric help, and have treated over
                         200 cases. While the psychiatrist assesses the clinical needs of the
                         patient, social workers assess their support needs and locate
                         community resources to take care of the patient. In cases where the
                         patient is in a critical condition, our Emergency Response Unit has a
                         specialized multi-disciplinary team to deal with the immediate crisis and
our work - 2007 - 2009




                         transfer the patient to the appropriate agency
                                                                                                          January 2008 - when we first
                                                                                                          saw Manasi, she was a
                                                                                                          deranged terrified woman, lying
                         Providing medical treatment, hospitalization and follow-up care
                                                                                                          semi-conscious near a garbage
                         The first line of treatment is treating the co-morbid physical diseases
                                                                                                          heap.
                         and injuries at general clinics / hospitals, as no psychiatric facility in the
                         city, either state or private, will treat serious physical problems. Persons
                         requiring hospitalization for serious mental diseases are transferred to
                         state hospitals. If we find that the patient needs only a daily dose of
                         medication, we ensure that the person is treated in the community
                         space which he or she is habituated to. In such cases, we provide
                         medication and advice to the care-giver, and make regular follow up
                         visits for evaluation and further treatment and support.
                         Currently, about 50 patients get food and medicines which is distributed
                                                                                                          She was brought to our camp at
                         daily by our social workers. Another 40 persons are under the care of
                                                                                                          66 Pally. She had a wound on
                         community-care givers, and are visited once a month by the social
                                                                                                          her right leg, and was
                         workers.
                                                                                                          diagnosed with schizophrenia.
                                                                                                          Taken first to Baul Mon Nursing
                                                                                                          Home, and then to Antara, she
       4                 Rehabilitation of the homeless person, either by restoring them to
                                                                                                          slowly responded to treatment,
                         their families, or by re-integrating them into the community
                                                                                                          and remembered her address.
                         Because of the debilating effect that schizophrenia and other severe
                         diseases have on the brain's cognitive faculties, many mentally ill
                                                                                                          March 2008 - Manasi returns
                         people are on the streets simply because they are lost - they've
                                                                                                          home to her husband and a
                         forgotten their own names, cannot remember their families and have
                                                                                                          fulfilling family life. Our social
                         very little idea where they've come from - symptoms that can be usually
                                                                                                          workers visit her to         top up
                         be alleviated with medication. With treatment they gradually recover
                                                                                                          her medication
                         their faculties and we make all efforts to repatriate these people to
                                                                                                          and check on
                         their homes. To date, 31 patients have been restored to their families,
                                                                                                          her
                         and another 6 have returned to work.
                                                                                                          improvement.



                         Thirty other persons like Manasi have been restored to their families - they
                         are homeless no more. Repatriation has been a major challenge, as many
                         of these persons homes were in other states - Assam (2 persons),
                         Karnataka (2), Maharashtra (1), Bihar (1), and Tamil Nadu (1). 8 persons
                         have been from the districts of West Bengal.
The team comprises psychiatrists, social workers, psychologists and
activists who work with the community, hospitals, homes and
shelters to bring acutely needed medical treatment those homeless
people suffering from psychological disorders.



Baseline survey and mapping
We have conducted the first baseline survey on the incidence of homeless
mentally ill persons in 141 wards of Kolkata. The baseline survey has
resulted in two significant outputs - for one, we now have an idea of the
disease profile of the primary stakeholders of our project. The second
output is a Community Resource Map Handbook, which lists agencies and
resources that are avaialble for the treatment and care of mentally ill
homeless patients in all 141 wards.

Advocacy with stakeholders
Advocacy with various institutions such as the police, the judiciary,
psychiatrists and doctors has resulted in influential stakeholders lending
their support and voice to our initiatives. More importantly, these advocacy
activites are bringing about a slow but sure change of attitude towards a
population that has been totally excluded from society so far.

Community Mental Health Committees
The stigma against the homeless mentally ill is born of ignorance -
ignorance of the disease and its debilitating effects on the sufferer. Two
mental health committees have been set up in Behala and Sealdah to
uphold the rights of the homeless mentally ill and to promote awareness
about mental health in the concerned wards. Two more such committees
                                                                               Helping
have been planned in the near future                                           society find
Community Mental Health Camps
Over 750 people have been sensitized in 46 awareness camps held
                                                                               its lost
across the city, and have been instrumental in addressing the stigma
associated with mental illness. These sessions are interactive, with
                                                                               conscience
community members sharing their previous experiences of social work.
These camps are highly effective in identifying resource persons in the                                        5
locality and for initiating action plans.

                                                                               We have busted the
                                                                               common misconception that
                                                                               the homeless mentally ill are
                                                                               aggressive and will turn
                                                                               violent if disturbed. Not one
                                                                               of the patients, although
                                                                               wary at first, have been
                                                                               hostile when approached -
                                                                               and our social workers have
                                                                               been training people in the
                                                                               community on dealing with
                                                                               them without fear.



                                                                               A community volunteer
                                                                               reassures a dazed
                                                                               patient at a health camp
Kolkata Police
                               The treatment and care delivery model                                      The Kolkata Police have been
                                                                                                          pivotal partners from the
                                                                                                          inception of the project - they
                              Naya Daur works through a unique mental health delivery model of
                                                                                                          have been instrumental in
                              public and private institutions and individual participation. We
                                                                                                          identifying street-dwellers in
                              create and work through a network of resources which includes
                                                                                                          need of care, helping us
                              state agencies, NGOs, CBOs, the media, and last and most
                                                                                                          expedite the necessary official
                              significant - the community.
                                                                                                          processes required to enable
                                                                                                          us to officially take care of our
                                                                                                          patients, and locating the
                                                                                                          families of the patients - some
                                                           Kolkata                                        of whom have been from other
                                                            Police                                        states. On a couple of
                                         Health&                                                          occasions they have provided
the concept of community




                                                                               The                        their ambulance to take
                                         Welfare                              media                       emergency cases to hospital.
                                          Depts
                                                             The
                                                                                                          Through their Para Football
                                                            patient
                                                                                                          Programmes, they have
                                            Our                              Other                        introduced us to various
                                                                           NGOs/CBOs                      community clubs who have
                                           Team
                                                                                                          subsequently been successfully
                                                            The                                           roped into our various heath
                                                         community                                        and awareness activities.

                                                                                                          The Kolkata Police have
                                                                                                          recently given us a space at
                              Sankalpa’s community care model is built on the premise that each
                                                                                                          Hastings Police Station for a
                              and every one of India’s estimated 40,000 homeless mentally ill
                                                                                                          Drop-in Centre.
                              persons has a right - a right to care, a right to dignity, and a right to
                              all the resources and services that other citizens of this country
                              enjoy.                                                                      The Railway Police Force
                                                                                                          Initially wary of our efforts, the
                              Sankalpa therefore mobilizes all sections of civil society and              RPF are our key partners at
                              government organizations to play their part in giving back this lost        Sealdah station, and have even
                              population their rightful place in society                                  sheltered 11 our patients in the
                                                                                                          station waiting room one night
                                                                                                          when a state hospital turned
       6                                                                                                  them away

                                                                                                          NGOs, CBO’s and
                           The media                                                                      local clubs
                           Apart from giving our successful efforts publicity and support, the media
                                                                                                          A number of NGOs who treat
                           has been instrumental in helping families locate their lost ones.
                                                                                                          and shelter mentally ill persons
                                                      (Left)Jhuma, whose family saw her in a              and are part of our referral
                                                      television coverage of one of our health            network - in the absence of a
                                                      camps. Jhuma had been missing for over 5            treatment centre of our own,
                                                      years.                                              they provide the necessary
                                                                                                          specialized care that our very
                                                                                                          special patients need.

                                                                                                          Holding of Mental Health
                           Babai’s photograph (right) in the
                                                                                                          Awareness and Treatment
                           Telegraph was recognized by a
                                                                                                          Camps is one of our main
                           neighbour who alerted his family.
                                                                                                          activities, and support from
                           Babai had been missing for over
                                                                                                          community and local clubs has
                           2 years
                                                                                                          been very heartening.
The Kolkata Corporation
Like the Kolkata Police, the
KMC has been involved in our
project right from the beginning   Central to the
when we conducted our
baseline survey of mentally ill
                                   delivery model
people on the streets.             is the concept
The Mayor has personally lent
                                   of care by the                          Community caregivers
his support in various ways,       community                               Firoza Begum and Sheikh
including recommending that                                                Kausar at a get-together at
our organization be donated an     In many cases, patients do not          our office
ambulance by Dr. Arjun             need hospitalization - all they
Sengupta, an MP.                   need is regular medication and
                                   some help in caring for
Our first Mental Health            themselves. Naya Daur
Committee in the East Zone to      mobilizes people from the
uphold the cause of the            community to regularly give
Homeless mentally Ill and          them their medicines, take them
spread awareness about mental      for a hair cut or a bath, and
illness is comprised of            ensure that they are protected
members and councilors from        from abuse and other crimes as
the Ward 36, 37 and 57.            far as possible.

The Borough Chairman Ms            These community caregivers are
Mousumi Ghosh is an active         ordinary people, struggling to
member of the committee and        make ends meet in their own
helps us with certificates which   lives.                                  Abdullah (on the right), one
facilitate free beds for our                                               of our homeless patients
patients in state hospitals.       Currently, Naya Daur has 40             who has recovered, takes
                                   community care givers - some of         care of Manuram, a new
                                   whom are homeless                       patient, and gives him his
                                   themselves.                             daily food and medicines




Health & Welfare
Departments
                                   Volunteers at a health camp help with   Saidul Islam, a patient who    7
State hospitals such as Bangur,    shaving a patient                       was persuaded to kick his
NRS, R.G Kar, and P.G have                                                 cannabis habit by his
admitted our patients and                                                  community caregiver
helped in their recovery,
although they lack the
necessary resources and
infrastructure to take care of
patients who may be violent.
Some of the patients have been
rehabilitated in government
homes.
However there have also been
instances when patients have
been refused treatment, and the
lack of interest and co-
ordination between state
agencies is a problem we have
yet to overcome
To hell and back
                                  In March 2008, Malleswari was found in Kalighat. She
                                   was a bizarre sight- a woman in her mid forties wearing
                                   a loincloth, her head smeared with vermilion, marigold
                                    garlands strung around her neck. She was thrashing
                                     the cars passing by with the branch of a tree. Suddenly
                                                a taxi driver stopped his vehicle and got
                                                down to beat her. Dr. Narayanan, who lived
                                                near witnessed the incident and intervened
                                                immediately. He brought the agitated
                                                Malleswari to his home and there she was
                                                given food, clothing and was cleaned up.
                                                She was very aggressive and muttered
                                                curses the whole day long. After informing
                                                the police, we took her to a nursing home,
                                                and then to Antara for treatment. Later she
                                                moved to Paripurnata- a rehabilitation
                                                centre.

   Malleswari and her son unite              After about three months she began to
        after 6 long years                   recover, and we discovered that she was
                                             from Hyderabad. Through the Kolkata Police
                      Missing Persons Squad we located her husband and young son -
- the spirit within




                      who had not seen her ever since the day she had wandered away
                      from home in a psychotic haze six years ago

                      On the 16th of January, 2009, a social worker from Iswar Sankalpa
                      escorted her home and reunited her with her family. Mother and son
                      stared at each other incessantly - it seemed for ages - until they
                      reached out and wordlessly embraced each other.


                      This is my family now
                      A resident of Bishnupur in South 24 Parganas, Prabir Kumar Sardar
                      worked as a labourer at a factory in Ballygunge. When he became
                      mentally ill, his family shunned him, and one day he left home never to
                      return. No one knew where he went, and his family made no attempt to
    8                 find him, not even to lodge a missing persons diary at the police station.

                      He used to roam naked and eat from garbage vats in the Kalighat              Tuku’s story,as reported
  Case studies




                      Rashbehari area. The people used to make fun of him. Because of his          in the Bartaman
                      flowing beard, long moustache and his habit of offering prayers, locals
                      called him Ramakrishna. A local lad, Sivaprasad Roy, developed a
                      fondness for him and brought Sardar's case to us.

                      Today, after a year of treatment, Sardar is a changed man, with little
                      resemblance to the ill-kempt 'pagol' roaming the streets. He continues
                      to live on the footpath, and takes a bath everyday at the Sulabh
                      complex. The very locals who tormented him earlier, now take care of
                      him. We contacted his family, who came to visit him and broke down on
                      seeing Sardar. They wanted to take him home, but Sardar refused to
                      leave the area. The closeness he has developed with the locals, and
                      the neglect he suffered at the hands of his family members have forced
                      him to stay back. Even the locals do not want to lose him. They are
                      planning to help him open a tea stall very soon. Sardar said: “ I have no
                      home. I want to stay here. These people are my family members”
The homeless mentally ill are often seen in
various states of mental distress and physical
abuse around railway stations, bus stands,
pilgrim centres and on street corners. They are
the 'invisible people', separated from and/or
abandoned by their families.



  The Sealdah story
Sealdah station, a major rail terminus in Kolkata,
is one such ‘home’, as it were, for West Bengal’s
migrants and displaced people. In its attempts to
enforce stricter security measures, the Railway
Protection Force (RPF) is keen to clear the
station area of vagrants, but have chalked out a
humane plan to solve the problem in partnership
with us. They have organized health camps for
those living on and around the station premises,
helped us identify those in need of medical help,
moved the courts on our behalf to allow us to
take care of these patients, and are co-operating
with our efforts in repatriating them back to their
homes.                                                     Forty two year old Lalita can barely recall when she had first
                                                           made Sealdah station her home. She has absolutely no
The RPF is planning to take similar steps with             memories of her family and native place. She only knows she
our assistance in other stations like Dum Dum              has no other place to go.
and Ballygunge.


Fulwari and friends - building community
More than other homeless people who stick together in families and communities and survive by begging or
working for minimal wages, the mentally ill are the most vulnerable because they are isolated even from the
other homeless. Many have some form of psychosis, and paranoia causes them to distrust others. They
are unable to carry out basic self care, let alone protect themselves, forage for food and look after their
meagre belongings. Many lose their memories, and wander around in a constant state of hyper vigilance.
Those who have depression and other mood disorders have no motivation to look after themselves, and do
not even have social or familial support to protect them from the pain in their minds.                                 9
Sealdah station, home to the maximum number of homeless people in the city, is where an unlikely new
community is being born. A group of our patients, all women, have come together of their own accord, and
take care of each other. They cook together, bathe together, sleep together, and watch out for each other.

One among them, Fulwari, is the leader of the team. She keeps a motherly eye over her little community,
and reports to us when someone is missing or not being cooperative. When they sit down to share their
food, one of them divides it equally and then distributes it. Even though they do not communicate well with
each other, they know that they are safe and secure - they have each other now.
Can someone tell me - where do I belong?                                      We live and learn....
                 The challenges faced have been many - some of them requiring
                                                                                               We set up a Drop-In-
                 innovative responses (see box on right). Unfortunately, enthusiasm and
                                                                                               Centre(DIC) at Sealdah where
                 creativity can only go so far, and there are many difficulties which
                                                                                               there are a large number of
                 require systemic changes in order to allow us to work effectively.
                                                                                               homeless mentally ill, intending
                                                                                               to make it a place where our
                 As mentioned elsewhere in this report, the physical condition of some of
                                                                                               patients could come and collect
                 the patients is alarming - they have open wounds, scabies, lesions and
                                                                                               their medicine, have some food
                 sores - and these have to be treated before giving them psychotropic
                                                                                               and have a bath. We however
                 medication. However, most psychiatric facilities, both private and state,
                                                                                               had to change our strategy -
                 have no facilities to treat physical problems, and institutions deal with
                                                                                               many patients were reluctant to
                 physical ailments refuse to admit mentally ill persons. A Catch-22
                                                                                               walk to the DIC, some refused
                 situation. And even when we manage to beat the system and get our
                                                                                               to let us wash their clothes
                 patients admitted - we face the wrath of our fellow citizens - one of our
                                                                                               because they would have to
                 patients with bleeding head sores was summarily thrown out of a
                                                                                               leave them behind to dry, and
                 nursing home because the other patients objected to the smell of the
                                                                                               many felt more secure in their
                 pus oozing from his wounds.
                                                                                               own surroundings even if it
                                                                                               meant foregoing a hot meal.
                 Often, emergency patients need to be kept in a sheltered place before
                 we can complete the legal formalities necessary to take them into our
                                                                                               So we now take our services to
                 care. However, no state agency seems to be willing to take the
                                                                                               the station premises, and
                 responsibility of providing a transit space - the Social Welfare
                                                                                               almost 50 people daily get their
                 Department feels that since these are mental patients - they come
the road ahead




                                                                                               food and medicines this way
                 under the Health Department - and the Health Department believes that
                 since they are homeless - they are the Social Welfare Department’s
                                                                                               Finding a suitable sheltered
                 responsibility. As of date, our patients are still in no-man’s land where
                                                                                               space for DICs has been
                 the state government is concerned. A state psychiatric facility turned
                                                                                               difficult - we plan to experiment
                 away 14 of our patients one night stating that they were ‘mentally
                                                                                               with a portable DIC in areas
                 challenged’, not mentally sick - we are grateful to the Railway Police
                                                                                               that have a high density of our
                 Force who were kind enough to house and feed them in the Sealdah
                                                                                               patients - using a folding tent
                 retirement rooms for 2 days until we found alternate homes to place
                                                                                               that can be easily set up and
                 them.
                                                                                               dismantled



                                                       There are other challenges to overcome - all of which need a huge
                                                       amount of resources that are currently beyond our means. The
                                                       absence of a transit home of our own where we can house patients
10                                                     until we transfer them to the appropriate agency continues to be an
                                                       barrier in ensuring the well-being of our patients. Vulnerability is an
                                                       issue that needs to be addressed urgently - most of the men fall prey to
                                                       addiction, while the women remain defenseless against sexual abuse.
                 Shyamoli, a young, mute girl          One of our patients, Tuku, was visibly upset when she was given a bath
                 being treated for schizophrenia       and fresh clothes - she said that her dirty body and filthy, matted hair
                 at Sealdah was victim of sexual       kept men away - and we had taken away her only protection.
                 abuse. She was looked after by
                 Iswar Sankalpa throughout her         The very nature of the illness has slowed down our efforts - because
                 pregnancy and delivered a baby        these patients tend to wander, finding them after the initial encounter
                 on 2nd of March 2009. The baby        becomes difficult. With many, rapport building takes a long time and
                 is being cared for at a home run      repeated visits are made before they begin to trust us. Some of the
                 by missionaries. Deeply               patients are from other states, and communication with them requires a
                 traumatized by having to give up      translator.
                 her baby, she regressed and had
                 to be hospitalized. She is            We also deeply regret that in spite of our best efforts - we lost four of
                 receiving both physical and           our patients - Sarada, Rajesh, Adibasi and Madhuri. We can only hope
                 mental therapy and continues to       that, before they died, they were comforted by the fact that there were
                 be under our care.                    people in this hostile world that cared about them.
BALANCE SHEET AS AT 31ST MARCH 2009 ( FC PART )

   PREVIOUS
     YEAR.                     LIABILITIES.      AMOUNT.           AMOUNT.           PREVIOUS YEAR.               ASSETS.   AMOUNT.        AMOUNT.
                                                     Rs.              Rs.                                                     Rs.            Rs.
       Nil.        GENERAL FUND.
                   Excess of Income over                                                   Nil.       CURRENT ASSETS.
                   Expenditure.                                             216.94         Nil.       Cash In Hand.                 5607
                                                                                           Nil.       Cash at Bank.             2773.94        8380.94
       Nil.        CURRENT LIABILITIES.
                   Unutilised Fund.                                          8164




                                  TOTAL.                                8380.94                                   TOTAL.                       8380.94


In terms of our report on even date.


DE SUBIR KUMAR & CO.                          S.K.DE.           Membership No :- 053022.              20th September 2009
Chartered Accountants.                        Partner.                                                Kolkata .
INCOME AND EXPENDITURE ACCOUNTS FOR THE YEAR ENDED 31 ST. MARCH 2009.


       PREVIOUS                        RECEIPTS.                  AMOUNTS.             AMOUNTS.                                       PAYMENTS.    AMOUNT.   AMOUNT.
         YEAR.                                                        Rs.                  Rs.                                                       Rs.       Rs.
To          Nil.     Direct Programme Cost.                                                               By.   Grant In Aid
            Nil.     Emergency Case Management.                                                                 For, NAYADOUR.
            Nil.     In house treatment cost of 50 patients.          55,204.00                                 From Hope Foundation ( Ireland )              198,753.00
            Nil.     Dress.                                                604.00
            Nil.     Medicine.                                         2,136.00                           By.   Interest from Bank.
            Nil.                                                              -                                 From - Fc Fund.                                      216.94
            Nil.     Food ( DIC )                                      9,863.00
            Nil.     Centre Rent.                                      1,000.00
            Nil.     Awareness Meetings.                               2,000.00
            Nil.     Advocacy Meeting.                                 3,452.00
            Nil.     Community Care Givers training.                       998.00
            Nil.     Community Caregivers Kits.                        1,000.00
            Nil.     Honararium to Psychiatrists.                     28,800.00           105,057.00
To                   Programme support cost.
                     Local Conveyance ( Staff )                       10,177.00
            Nil.     Communication / Telephone/ Internet.              6,849.00
            Nil.     Documentation.                                    1,401.00
            Nil.     Printing and Stationery.                          2,739.00
            Nil.     Audit Fees.                                              -            21,166.00
To          Nil.     Programme Support Cost.
                     Project Coordinator.                             13,650.00
                     Social Worker.                                   52,800.00
            Nil.     Centre Attendant.                                 3,000.00
            Nil.     Accountant.                                       2,750.00            72,200.00
To          Nil.     Bank Charges.                                                               330.00


To          Nil.     Excess of Income over Expenditure.                                          216.94


                                         TOTAL.                                           198,969.94                                   TOTAL.                 198,969.94
In terms of our report on even date.

DE SUBIR KUMAR & CO.                                            S.K.DE.             Membership No :- 053022.    20th September 2009
Chartered Accountants.                                          Partner.                                        Kolkata .
BALANCE SHEET AS 31ST MARCH 2009.( GENERAL PART. )



PREVIOUS YEAR.                     LIABILITIES.          AMOUNT.               AMOUNT.             PREVIOUS YEAR.                           ASSETS.      AMOUNT.            AMOUNT.


        Rs.                                                Rs.                      Rs.                   Rs.                                               Rs.               Rs.
         68,592.00 GENERAL FUND.                                 68592                                                  FIXED ASSETS.
                   Excess of income over expenditure.        256974                  325,566.00                         Air conditioner.                     8,000.00
                                                                                                             19,671.00 Computer & Printer.                  11,803.00
        NIL.         CURRENT LIABILITIES.                                                                               Electric Equipment.                  2,000.00
                     Audit Fees.                                  5000                                       28,727.00 Furniture & Fixture.                 25,854.00
                     Accounting Charges.                         12000                                                  Godrej Almirah.                     10,184.00
                     United Voyage Marketing Pvt. Ltd.           15000                32,000.00                         Office Furniture.                    5,000.00           62,841.00
                                                                                                                        CURRENT ASSETS.
                                                                                                                        Loan & Advances.                    41,250.00
                                                                                                             14,827.00 Cash in Hand.                           326.00
                                                                                                             22,367.00 Cash at Bank.                       253,149.00          294,725.00




                                       TOTAL.                                        357,566.00                                             TOTAL.                             357,566.00



In terms of our report on even date.

DE SUBIR KUMAR & CO.                                                     S.K.DE.                  Membership No :- 053022.                            20th September 2009
Chartered Accountants.                                                   Partner.                                                                     Kolkata .
INCOME AND EXPENDITURE ACCOUNT FOR THE YEAR ENDED 31ST MARCH 2009.( GENERAL PART.)




            PREVIOUS                                                                                                              PREVIOUS
  TO.                                      EXPENDITURE.                 AMOUNT.                    AMOUNT.               BY.                                INCOME.         AMOUNT.   AMOUNT.
              YEAR.                                                                                                                 YEAR.

                                                                              Rs.                      Rs.                                                                    Rs.       Rs.
   "            Nil.       Direct Programme Cost.                                                                         "           Nil.     Donation.                                  622,889.00
                Nil.       Emergency case management.                                                                     "           Nil.     Interest from Bank ( SBI )                     12,602.00
                Nil.       Awareness Meetings.                                  2,925.00
                Nil.       Centre Rent.                                         1,000.00
                Nil.       Cleaning Charges.                                    5,604.00
                Nil.       Diagonist Charges.                                   1,480.00
                Nil.       Doctor Visit.                                        1,618.00
                Nil.       Dress.                                               3,040.00
                Nil.       Electric Charges.                                    4,835.00
                Nil.       Food ( Dic)                                         10,893.00
                Nil.       Honorarium to Psychiatrists.                         1,200.00
                Nil.       Hygiene.                                             1,278.00
                           In House Treatment Cost 50 Paitents.                 9,735.00
   "            Nil.       Lodging Charges.                                    46,490.00
                Nil.       Medicine.                                                448.00
                Nil.       Office Rent.                                        68,750.00
   "            Nil.        Programme Support Cost.                                                      159,296.00
                Nil.       Accountant.                                          1,000.00
                Nil.       Carrying Charges.                                        100.00
                Nil.       Consultancy Charges.                                     600.00
                Nil.       Documentation.                                            26.00
                           Maintanance Charges.                                 1,288.00
                           Printing & Stationery.                              28,320.00
                           Registration Renewal Charges.                             25.00
                           Residential Training.                               19,170.00
                           Salary.                                             95,725.00
                           Service Charges.                                         950.00
                           Staff Conveyance                                    61,176.00
                                                                                                         208,380.00
   "            Nil.       Bank Charges.                                                                       100.00
   "           16305       Depreciation.                                                                     10,741.00

                           excess of Income over Expenditure.
   "                                                                                                     256,974.00


                                               TOTAL.                                                    635,491.00                                          TOTAL.                       635,491.00


In terms of our report on even date.


DE SUBIR KUMAR & CO.                                               S.K.DE.                   Membership No :- 053022.          20th September 2009
Chartered Accountants.                                             Partner.                                                    Kolkata .
Acknowledgments
We gratefully acknowledge the following persons whose patronage and
support has been instrumental in bringing us this far

His Excellency Shri Gopal Krishna Gandhi, Hon'ble Governor of West Bengal
Shri Bikash Ranjan Bhattacharya, Hon'ble Mayor of Kolkata
Dr. Arjun Sengupta, Hon'ble MP(Rajya Sabha)
Shri Goutam Mohan Chakraborty, Commissioner of Police, Kolkata Police
Shri Debashis Roy Additional Commissioner of Police Community Police Wing
Shri Rajesh Subarno, Deputy Commissioner of Police (South)
Dr.Surya Kanto Mishra, Minister of Health, Govt. of West Bengal
Moushumi Ghosh, Borough Chairperson,
Bobby Hakim, Borough Chairperson
Dr. Arunendu Biswas- Superintendant, Kolkata Pavlov Hospital
Shri Arul Jyothi, Commandant (Sealdah Division), Railway Protection Force


Our generous donors               Our funders, for their faith and backing

Alteus Biogenics Pvt Ltd          HOPE FOUNDATION Ireland
Intas                             - Ms Maureen Forrest Director; Hope Foundation
MASUMI Overseas Pvt. Ltd.         - Ms Jenny Browne- Overseas Director; Hope Foundation
Molekule
Nicholas Piramal
Patton India Ltd.
Ranbaxy Solus
S.K. Oil Terminals
Sun Pharmaceuticals

             We are only as strong as the partnerships that support us
         our gratitude to all the individuals, organizations and departments
           who have chosen to be a part of the community care network
66 Pally                          Institute of Psychiatry.                  Phulbagan Society
Alipore Judges Court              IPER                                      Pradeep Sangha,
Amra Sabai Club, Collootola       Jana Swasthya Committee                   Shyambazar
Amrapali Nursing Home             Jhamapukur Youth Sporting Club            Purbasha                     11
Antara                            Junior Boys Sporting Club, Khidderpore    Putiary Club
Antardarson                       Kabardanga Auto Union                     R.G.Kar Medical College
Antarik                           Kolkata Police                            Rajabazar Science College
ASHRAY                            Loreto Sealdah                            State Bank of India
Army Wives Welfare Association    M.R. Bangur Hospital                      Sappho for Equality
Bandhuchakra Welfare              Manas Bangla                              Sealdah Court
Association                       Ministar Club                             Shahid Smriti Sangha,
Behala Young Men's Association    Mr. D. Ashis, Medical Bank                Chetla
Bhabani Bhaban                    Mr. Shiboprosad Roy                       Shanti Youva Sangha, Akra
City Civil Court                  Ms Margaret Waterworth                    Social Welfare Department
Dr. Ranjita Biswas                Ms Vahista Dastoor                        Soujatya
Eastern Railways Womens           Ms. Deepanjana Sarkar                     Soumendra Pathak
Welfare Organisation              Ms. Samata Biswas                         Controller of Vagrancy
FORUM for Mental Health           N.R.S. Medical College                    Subhas Sangha, Kashi Mitra
Gulab Sporting Club, Cossipore    New Sporting Club, Kankurgachi            Ghat
Indian Psychiatric Society        Paripurnata                               Swasthya Bhaban
                                                                            TRACKS Home
Sankalpa - the resolution to make a difference
                                                                                Iswar Sankalpa
                                                      138, S. P. Mukherjee Road,Kolkata 700026
                                                   Phone 033 24197451 / 52 Mobile 98302 60089

                                                Email: isankalpa@gmail.com www.isankalpa.org

Registered under West Bengal Societies Registration Act 1961, Registration No. S/1L/42976 of 2006-07
                  Registered under Section 80G of the Income Tax Act, 1961, Government of India

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Sankalpa annual report-07-09-lite

  • 1. Support for the mind Progress Report 2007 - 2009 "Past the seeker as he prayed came the crippled and the beggar and the beaten. And seeing them... he cried, 'Great God, how is it that a loving creator can see such things and yet do nothing about them?'...... God said, 'I did do something. I made you.’ -- Sufi Teaching
  • 2. Who are we Based in the city of Kolkata, India, Iswar Sankalpa is a non-profit organization founded by professionals from the field of psychological well being. We extend support, provide professional guidance and ensure sensible and sensitive services for needs of the mind Our vision and mission The founders of Iswar Sankalpa have a vision: that of ensuring dignity and holistic well being of persons with mental health problems. Our mission is to two-fold: -To lend a helping hand to those with mental health problems, particularly to those from underprivileged sections of society, and to do so in a humane manner. - To empower mental health patients in attaining their rights The organisation Naya Daur project team Governing body about us Project Manager Laboni Roy Patron Smt. Rotrout Roychowdhury Psychiatrist Dr. Abir Mukherjee President Dr. Ranadip Ranjan Ghosh Roy Social workers Amrita Roy Vice President Dr. Prabir Paul Saikat Das Secretary Smt. Sarbani Das Roy Banani Nath Asst. Secretary Dr. Debashis Chatterjee Suprokash Chakravorty Treasurer Dr. Srikumar Mukherjee Chameli Saha Member Sri Surajit Ray Tanmay Roy Member Smt. Kalpana Basu Mazumder Tapan Prodhan 2 The members of Iswar Sankalpa deeply regret the death of Dr. K. L. Narayanan on 10th April, 2008. Dr. Narayanan was one of the key visionaries of Iswar Sankalpa, and his untimely demise leaves a huge gap not only in the organization, but in the field of mental health in West Bengal. File photograph of Dr. Narayanan negotiating treatment options with a patient at a health camp conducted by Iswar Sankalpa
  • 3. Kolkata, the City of Joy, is also the ‘city of unending nights’ for a section of its people, the homeless mentally ill. Crudely referred to as ‘pagol’ on the street, these hapless persons wander from place to place, lost to their families, ignored by welfare and health agencies, and pariahs to the rest of society. No one cares to understand that these people are not ‘crazy’ - all they have is an incommunicable mental disease, - a medical condition that can be reversed with medication, care and a little support. Naya This report is the chronicle of the two year journey of Iswar Sankalpa’s flagship project - Naya Daur, which takes care of Kolkata’s forgotten population. It is estimated that there are over 400,000 homeless Daur mentally ill people in India, and amongst these, over 90% have diagnosable and treatable mental disorders. Naya Daur's team of mental health professionals works within the metropolitan area of Kolkata to reach out to a segment of society that this city has forsaken The dawn of a new era for far too long. There are no easy solutions - putting mentally ill homeless persons in a shelter and administering psychotropic medicines would be treating the symptoms but not the disease. The disease is not just a medical one - it is a social one 2007 - 2009 factsheet and needs a comprehensive, inclusive and No of patients: holistic approach which makes society Identified- Over 500 Emergencies 50 responsible and accountable for restoring the Treated 200 Referrals 37 health and dignity of a neglected people. Under follow up 100 Repatriated 31 Naya Daur is a sustainable community-based No of patients provided with care and support program for the homeless Food 700 Clothes 350 Hygiene care 204 mentally ill - a program that weaves together state, private and community into a network Events and groups of resources that not only cares for the Community Mental Health Committees 2 ( 25 people covered) beneficiary population, but works actively Awareness Camps conducted 46 (752 people attended) towards making them productive members of Advocacy Meetings held 5 (117 people attended) families and community. In a resource scarce environment, the community model has proven to be cost-effective - by using infrastructure and services already available with the state, other NGOs and CBOs and individual citizens, we have been able to support a larger number of beneficiaries than 3 we would have if we had followed a conventional institution-based approach. More heartening than just quantitative gains are the stories that are emerging - of Manasi and others whose lives have been renewed; of Sardar, who now chooses to stay in the community that looked after him and refuses to return to his family; of Fulwari, one of our patient’s at Sealdah who has created a little community of her own. And the story that humbles us all - care-givers emerging in the community - some of whom are homeless themselves. While the successes have been many, the untimely death of Dr. K. L. Narayanan, one of the founders and key visionaries of Iswar Sankalpa, just a year into the project has been a body blow for the team. His loss however, has made us more determined to live up to his vision of a world where the mentally ill, whether homeless or other wise, are treated with the respect and compassion that is their right. This report is a tribute to his vision. Sarbani Das Roy Secretary, Iswar Sankalpa
  • 4. Initiated in June 2007, Naya Daur is a mental health treatment project with a difference - it provides care and treatment to a population that is invisible to the rest of society the homeless mentally ill. Identification and assessment of homeless mentally ill persons The metamorphosis living on the streets of Kolkata Of Manasi In two years, we have mapped 141 wards of Kolkata, and have identified over 500 people in critical need of help. Apart from our own surveillance teams, the Kolkata Police and concerned citizens help us find homeless people who need psychiatric help, and have treated over 200 cases. While the psychiatrist assesses the clinical needs of the patient, social workers assess their support needs and locate community resources to take care of the patient. In cases where the patient is in a critical condition, our Emergency Response Unit has a specialized multi-disciplinary team to deal with the immediate crisis and our work - 2007 - 2009 transfer the patient to the appropriate agency January 2008 - when we first saw Manasi, she was a deranged terrified woman, lying Providing medical treatment, hospitalization and follow-up care semi-conscious near a garbage The first line of treatment is treating the co-morbid physical diseases heap. and injuries at general clinics / hospitals, as no psychiatric facility in the city, either state or private, will treat serious physical problems. Persons requiring hospitalization for serious mental diseases are transferred to state hospitals. If we find that the patient needs only a daily dose of medication, we ensure that the person is treated in the community space which he or she is habituated to. In such cases, we provide medication and advice to the care-giver, and make regular follow up visits for evaluation and further treatment and support. Currently, about 50 patients get food and medicines which is distributed She was brought to our camp at daily by our social workers. Another 40 persons are under the care of 66 Pally. She had a wound on community-care givers, and are visited once a month by the social her right leg, and was workers. diagnosed with schizophrenia. Taken first to Baul Mon Nursing Home, and then to Antara, she 4 Rehabilitation of the homeless person, either by restoring them to slowly responded to treatment, their families, or by re-integrating them into the community and remembered her address. Because of the debilating effect that schizophrenia and other severe diseases have on the brain's cognitive faculties, many mentally ill March 2008 - Manasi returns people are on the streets simply because they are lost - they've home to her husband and a forgotten their own names, cannot remember their families and have fulfilling family life. Our social very little idea where they've come from - symptoms that can be usually workers visit her to top up be alleviated with medication. With treatment they gradually recover her medication their faculties and we make all efforts to repatriate these people to and check on their homes. To date, 31 patients have been restored to their families, her and another 6 have returned to work. improvement. Thirty other persons like Manasi have been restored to their families - they are homeless no more. Repatriation has been a major challenge, as many of these persons homes were in other states - Assam (2 persons), Karnataka (2), Maharashtra (1), Bihar (1), and Tamil Nadu (1). 8 persons have been from the districts of West Bengal.
  • 5. The team comprises psychiatrists, social workers, psychologists and activists who work with the community, hospitals, homes and shelters to bring acutely needed medical treatment those homeless people suffering from psychological disorders. Baseline survey and mapping We have conducted the first baseline survey on the incidence of homeless mentally ill persons in 141 wards of Kolkata. The baseline survey has resulted in two significant outputs - for one, we now have an idea of the disease profile of the primary stakeholders of our project. The second output is a Community Resource Map Handbook, which lists agencies and resources that are avaialble for the treatment and care of mentally ill homeless patients in all 141 wards. Advocacy with stakeholders Advocacy with various institutions such as the police, the judiciary, psychiatrists and doctors has resulted in influential stakeholders lending their support and voice to our initiatives. More importantly, these advocacy activites are bringing about a slow but sure change of attitude towards a population that has been totally excluded from society so far. Community Mental Health Committees The stigma against the homeless mentally ill is born of ignorance - ignorance of the disease and its debilitating effects on the sufferer. Two mental health committees have been set up in Behala and Sealdah to uphold the rights of the homeless mentally ill and to promote awareness about mental health in the concerned wards. Two more such committees Helping have been planned in the near future society find Community Mental Health Camps Over 750 people have been sensitized in 46 awareness camps held its lost across the city, and have been instrumental in addressing the stigma associated with mental illness. These sessions are interactive, with conscience community members sharing their previous experiences of social work. These camps are highly effective in identifying resource persons in the 5 locality and for initiating action plans. We have busted the common misconception that the homeless mentally ill are aggressive and will turn violent if disturbed. Not one of the patients, although wary at first, have been hostile when approached - and our social workers have been training people in the community on dealing with them without fear. A community volunteer reassures a dazed patient at a health camp
  • 6. Kolkata Police The treatment and care delivery model The Kolkata Police have been pivotal partners from the inception of the project - they Naya Daur works through a unique mental health delivery model of have been instrumental in public and private institutions and individual participation. We identifying street-dwellers in create and work through a network of resources which includes need of care, helping us state agencies, NGOs, CBOs, the media, and last and most expedite the necessary official significant - the community. processes required to enable us to officially take care of our patients, and locating the families of the patients - some Kolkata of whom have been from other Police states. On a couple of Health& occasions they have provided the concept of community The their ambulance to take Welfare media emergency cases to hospital. Depts The Through their Para Football patient Programmes, they have Our Other introduced us to various NGOs/CBOs community clubs who have Team subsequently been successfully The roped into our various heath community and awareness activities. The Kolkata Police have recently given us a space at Sankalpa’s community care model is built on the premise that each Hastings Police Station for a and every one of India’s estimated 40,000 homeless mentally ill Drop-in Centre. persons has a right - a right to care, a right to dignity, and a right to all the resources and services that other citizens of this country enjoy. The Railway Police Force Initially wary of our efforts, the Sankalpa therefore mobilizes all sections of civil society and RPF are our key partners at government organizations to play their part in giving back this lost Sealdah station, and have even population their rightful place in society sheltered 11 our patients in the station waiting room one night when a state hospital turned 6 them away NGOs, CBO’s and The media local clubs Apart from giving our successful efforts publicity and support, the media A number of NGOs who treat has been instrumental in helping families locate their lost ones. and shelter mentally ill persons (Left)Jhuma, whose family saw her in a and are part of our referral television coverage of one of our health network - in the absence of a camps. Jhuma had been missing for over 5 treatment centre of our own, years. they provide the necessary specialized care that our very special patients need. Holding of Mental Health Babai’s photograph (right) in the Awareness and Treatment Telegraph was recognized by a Camps is one of our main neighbour who alerted his family. activities, and support from Babai had been missing for over community and local clubs has 2 years been very heartening.
  • 7. The Kolkata Corporation Like the Kolkata Police, the KMC has been involved in our project right from the beginning Central to the when we conducted our baseline survey of mentally ill delivery model people on the streets. is the concept The Mayor has personally lent of care by the Community caregivers his support in various ways, community Firoza Begum and Sheikh including recommending that Kausar at a get-together at our organization be donated an In many cases, patients do not our office ambulance by Dr. Arjun need hospitalization - all they Sengupta, an MP. need is regular medication and some help in caring for Our first Mental Health themselves. Naya Daur Committee in the East Zone to mobilizes people from the uphold the cause of the community to regularly give Homeless mentally Ill and them their medicines, take them spread awareness about mental for a hair cut or a bath, and illness is comprised of ensure that they are protected members and councilors from from abuse and other crimes as the Ward 36, 37 and 57. far as possible. The Borough Chairman Ms These community caregivers are Mousumi Ghosh is an active ordinary people, struggling to member of the committee and make ends meet in their own helps us with certificates which lives. Abdullah (on the right), one facilitate free beds for our of our homeless patients patients in state hospitals. Currently, Naya Daur has 40 who has recovered, takes community care givers - some of care of Manuram, a new whom are homeless patient, and gives him his themselves. daily food and medicines Health & Welfare Departments Volunteers at a health camp help with Saidul Islam, a patient who 7 State hospitals such as Bangur, shaving a patient was persuaded to kick his NRS, R.G Kar, and P.G have cannabis habit by his admitted our patients and community caregiver helped in their recovery, although they lack the necessary resources and infrastructure to take care of patients who may be violent. Some of the patients have been rehabilitated in government homes. However there have also been instances when patients have been refused treatment, and the lack of interest and co- ordination between state agencies is a problem we have yet to overcome
  • 8. To hell and back In March 2008, Malleswari was found in Kalighat. She was a bizarre sight- a woman in her mid forties wearing a loincloth, her head smeared with vermilion, marigold garlands strung around her neck. She was thrashing the cars passing by with the branch of a tree. Suddenly a taxi driver stopped his vehicle and got down to beat her. Dr. Narayanan, who lived near witnessed the incident and intervened immediately. He brought the agitated Malleswari to his home and there she was given food, clothing and was cleaned up. She was very aggressive and muttered curses the whole day long. After informing the police, we took her to a nursing home, and then to Antara for treatment. Later she moved to Paripurnata- a rehabilitation centre. Malleswari and her son unite After about three months she began to after 6 long years recover, and we discovered that she was from Hyderabad. Through the Kolkata Police Missing Persons Squad we located her husband and young son - - the spirit within who had not seen her ever since the day she had wandered away from home in a psychotic haze six years ago On the 16th of January, 2009, a social worker from Iswar Sankalpa escorted her home and reunited her with her family. Mother and son stared at each other incessantly - it seemed for ages - until they reached out and wordlessly embraced each other. This is my family now A resident of Bishnupur in South 24 Parganas, Prabir Kumar Sardar worked as a labourer at a factory in Ballygunge. When he became mentally ill, his family shunned him, and one day he left home never to return. No one knew where he went, and his family made no attempt to 8 find him, not even to lodge a missing persons diary at the police station. He used to roam naked and eat from garbage vats in the Kalighat Tuku’s story,as reported Case studies Rashbehari area. The people used to make fun of him. Because of his in the Bartaman flowing beard, long moustache and his habit of offering prayers, locals called him Ramakrishna. A local lad, Sivaprasad Roy, developed a fondness for him and brought Sardar's case to us. Today, after a year of treatment, Sardar is a changed man, with little resemblance to the ill-kempt 'pagol' roaming the streets. He continues to live on the footpath, and takes a bath everyday at the Sulabh complex. The very locals who tormented him earlier, now take care of him. We contacted his family, who came to visit him and broke down on seeing Sardar. They wanted to take him home, but Sardar refused to leave the area. The closeness he has developed with the locals, and the neglect he suffered at the hands of his family members have forced him to stay back. Even the locals do not want to lose him. They are planning to help him open a tea stall very soon. Sardar said: “ I have no home. I want to stay here. These people are my family members”
  • 9. The homeless mentally ill are often seen in various states of mental distress and physical abuse around railway stations, bus stands, pilgrim centres and on street corners. They are the 'invisible people', separated from and/or abandoned by their families. The Sealdah story Sealdah station, a major rail terminus in Kolkata, is one such ‘home’, as it were, for West Bengal’s migrants and displaced people. In its attempts to enforce stricter security measures, the Railway Protection Force (RPF) is keen to clear the station area of vagrants, but have chalked out a humane plan to solve the problem in partnership with us. They have organized health camps for those living on and around the station premises, helped us identify those in need of medical help, moved the courts on our behalf to allow us to take care of these patients, and are co-operating with our efforts in repatriating them back to their homes. Forty two year old Lalita can barely recall when she had first made Sealdah station her home. She has absolutely no The RPF is planning to take similar steps with memories of her family and native place. She only knows she our assistance in other stations like Dum Dum has no other place to go. and Ballygunge. Fulwari and friends - building community More than other homeless people who stick together in families and communities and survive by begging or working for minimal wages, the mentally ill are the most vulnerable because they are isolated even from the other homeless. Many have some form of psychosis, and paranoia causes them to distrust others. They are unable to carry out basic self care, let alone protect themselves, forage for food and look after their meagre belongings. Many lose their memories, and wander around in a constant state of hyper vigilance. Those who have depression and other mood disorders have no motivation to look after themselves, and do not even have social or familial support to protect them from the pain in their minds. 9 Sealdah station, home to the maximum number of homeless people in the city, is where an unlikely new community is being born. A group of our patients, all women, have come together of their own accord, and take care of each other. They cook together, bathe together, sleep together, and watch out for each other. One among them, Fulwari, is the leader of the team. She keeps a motherly eye over her little community, and reports to us when someone is missing or not being cooperative. When they sit down to share their food, one of them divides it equally and then distributes it. Even though they do not communicate well with each other, they know that they are safe and secure - they have each other now.
  • 10. Can someone tell me - where do I belong? We live and learn.... The challenges faced have been many - some of them requiring We set up a Drop-In- innovative responses (see box on right). Unfortunately, enthusiasm and Centre(DIC) at Sealdah where creativity can only go so far, and there are many difficulties which there are a large number of require systemic changes in order to allow us to work effectively. homeless mentally ill, intending to make it a place where our As mentioned elsewhere in this report, the physical condition of some of patients could come and collect the patients is alarming - they have open wounds, scabies, lesions and their medicine, have some food sores - and these have to be treated before giving them psychotropic and have a bath. We however medication. However, most psychiatric facilities, both private and state, had to change our strategy - have no facilities to treat physical problems, and institutions deal with many patients were reluctant to physical ailments refuse to admit mentally ill persons. A Catch-22 walk to the DIC, some refused situation. And even when we manage to beat the system and get our to let us wash their clothes patients admitted - we face the wrath of our fellow citizens - one of our because they would have to patients with bleeding head sores was summarily thrown out of a leave them behind to dry, and nursing home because the other patients objected to the smell of the many felt more secure in their pus oozing from his wounds. own surroundings even if it meant foregoing a hot meal. Often, emergency patients need to be kept in a sheltered place before we can complete the legal formalities necessary to take them into our So we now take our services to care. However, no state agency seems to be willing to take the the station premises, and responsibility of providing a transit space - the Social Welfare almost 50 people daily get their Department feels that since these are mental patients - they come the road ahead food and medicines this way under the Health Department - and the Health Department believes that since they are homeless - they are the Social Welfare Department’s Finding a suitable sheltered responsibility. As of date, our patients are still in no-man’s land where space for DICs has been the state government is concerned. A state psychiatric facility turned difficult - we plan to experiment away 14 of our patients one night stating that they were ‘mentally with a portable DIC in areas challenged’, not mentally sick - we are grateful to the Railway Police that have a high density of our Force who were kind enough to house and feed them in the Sealdah patients - using a folding tent retirement rooms for 2 days until we found alternate homes to place that can be easily set up and them. dismantled There are other challenges to overcome - all of which need a huge amount of resources that are currently beyond our means. The absence of a transit home of our own where we can house patients 10 until we transfer them to the appropriate agency continues to be an barrier in ensuring the well-being of our patients. Vulnerability is an issue that needs to be addressed urgently - most of the men fall prey to addiction, while the women remain defenseless against sexual abuse. Shyamoli, a young, mute girl One of our patients, Tuku, was visibly upset when she was given a bath being treated for schizophrenia and fresh clothes - she said that her dirty body and filthy, matted hair at Sealdah was victim of sexual kept men away - and we had taken away her only protection. abuse. She was looked after by Iswar Sankalpa throughout her The very nature of the illness has slowed down our efforts - because pregnancy and delivered a baby these patients tend to wander, finding them after the initial encounter on 2nd of March 2009. The baby becomes difficult. With many, rapport building takes a long time and is being cared for at a home run repeated visits are made before they begin to trust us. Some of the by missionaries. Deeply patients are from other states, and communication with them requires a traumatized by having to give up translator. her baby, she regressed and had to be hospitalized. She is We also deeply regret that in spite of our best efforts - we lost four of receiving both physical and our patients - Sarada, Rajesh, Adibasi and Madhuri. We can only hope mental therapy and continues to that, before they died, they were comforted by the fact that there were be under our care. people in this hostile world that cared about them.
  • 11. BALANCE SHEET AS AT 31ST MARCH 2009 ( FC PART ) PREVIOUS YEAR. LIABILITIES. AMOUNT. AMOUNT. PREVIOUS YEAR. ASSETS. AMOUNT. AMOUNT. Rs. Rs. Rs. Rs. Nil. GENERAL FUND. Excess of Income over Nil. CURRENT ASSETS. Expenditure. 216.94 Nil. Cash In Hand. 5607 Nil. Cash at Bank. 2773.94 8380.94 Nil. CURRENT LIABILITIES. Unutilised Fund. 8164 TOTAL. 8380.94 TOTAL. 8380.94 In terms of our report on even date. DE SUBIR KUMAR & CO. S.K.DE. Membership No :- 053022. 20th September 2009 Chartered Accountants. Partner. Kolkata .
  • 12. INCOME AND EXPENDITURE ACCOUNTS FOR THE YEAR ENDED 31 ST. MARCH 2009. PREVIOUS RECEIPTS. AMOUNTS. AMOUNTS. PAYMENTS. AMOUNT. AMOUNT. YEAR. Rs. Rs. Rs. Rs. To Nil. Direct Programme Cost. By. Grant In Aid Nil. Emergency Case Management. For, NAYADOUR. Nil. In house treatment cost of 50 patients. 55,204.00 From Hope Foundation ( Ireland ) 198,753.00 Nil. Dress. 604.00 Nil. Medicine. 2,136.00 By. Interest from Bank. Nil. - From - Fc Fund. 216.94 Nil. Food ( DIC ) 9,863.00 Nil. Centre Rent. 1,000.00 Nil. Awareness Meetings. 2,000.00 Nil. Advocacy Meeting. 3,452.00 Nil. Community Care Givers training. 998.00 Nil. Community Caregivers Kits. 1,000.00 Nil. Honararium to Psychiatrists. 28,800.00 105,057.00 To Programme support cost. Local Conveyance ( Staff ) 10,177.00 Nil. Communication / Telephone/ Internet. 6,849.00 Nil. Documentation. 1,401.00 Nil. Printing and Stationery. 2,739.00 Nil. Audit Fees. - 21,166.00 To Nil. Programme Support Cost. Project Coordinator. 13,650.00 Social Worker. 52,800.00 Nil. Centre Attendant. 3,000.00 Nil. Accountant. 2,750.00 72,200.00 To Nil. Bank Charges. 330.00 To Nil. Excess of Income over Expenditure. 216.94 TOTAL. 198,969.94 TOTAL. 198,969.94 In terms of our report on even date. DE SUBIR KUMAR & CO. S.K.DE. Membership No :- 053022. 20th September 2009 Chartered Accountants. Partner. Kolkata .
  • 13. BALANCE SHEET AS 31ST MARCH 2009.( GENERAL PART. ) PREVIOUS YEAR. LIABILITIES. AMOUNT. AMOUNT. PREVIOUS YEAR. ASSETS. AMOUNT. AMOUNT. Rs. Rs. Rs. Rs. Rs. Rs. 68,592.00 GENERAL FUND. 68592 FIXED ASSETS. Excess of income over expenditure. 256974 325,566.00 Air conditioner. 8,000.00 19,671.00 Computer & Printer. 11,803.00 NIL. CURRENT LIABILITIES. Electric Equipment. 2,000.00 Audit Fees. 5000 28,727.00 Furniture & Fixture. 25,854.00 Accounting Charges. 12000 Godrej Almirah. 10,184.00 United Voyage Marketing Pvt. Ltd. 15000 32,000.00 Office Furniture. 5,000.00 62,841.00 CURRENT ASSETS. Loan & Advances. 41,250.00 14,827.00 Cash in Hand. 326.00 22,367.00 Cash at Bank. 253,149.00 294,725.00 TOTAL. 357,566.00 TOTAL. 357,566.00 In terms of our report on even date. DE SUBIR KUMAR & CO. S.K.DE. Membership No :- 053022. 20th September 2009 Chartered Accountants. Partner. Kolkata .
  • 14. INCOME AND EXPENDITURE ACCOUNT FOR THE YEAR ENDED 31ST MARCH 2009.( GENERAL PART.) PREVIOUS PREVIOUS TO. EXPENDITURE. AMOUNT. AMOUNT. BY. INCOME. AMOUNT. AMOUNT. YEAR. YEAR. Rs. Rs. Rs. Rs. " Nil. Direct Programme Cost. " Nil. Donation. 622,889.00 Nil. Emergency case management. " Nil. Interest from Bank ( SBI ) 12,602.00 Nil. Awareness Meetings. 2,925.00 Nil. Centre Rent. 1,000.00 Nil. Cleaning Charges. 5,604.00 Nil. Diagonist Charges. 1,480.00 Nil. Doctor Visit. 1,618.00 Nil. Dress. 3,040.00 Nil. Electric Charges. 4,835.00 Nil. Food ( Dic) 10,893.00 Nil. Honorarium to Psychiatrists. 1,200.00 Nil. Hygiene. 1,278.00 In House Treatment Cost 50 Paitents. 9,735.00 " Nil. Lodging Charges. 46,490.00 Nil. Medicine. 448.00 Nil. Office Rent. 68,750.00 " Nil. Programme Support Cost. 159,296.00 Nil. Accountant. 1,000.00 Nil. Carrying Charges. 100.00 Nil. Consultancy Charges. 600.00 Nil. Documentation. 26.00 Maintanance Charges. 1,288.00 Printing & Stationery. 28,320.00 Registration Renewal Charges. 25.00 Residential Training. 19,170.00 Salary. 95,725.00 Service Charges. 950.00 Staff Conveyance 61,176.00 208,380.00 " Nil. Bank Charges. 100.00 " 16305 Depreciation. 10,741.00 excess of Income over Expenditure. " 256,974.00 TOTAL. 635,491.00 TOTAL. 635,491.00 In terms of our report on even date. DE SUBIR KUMAR & CO. S.K.DE. Membership No :- 053022. 20th September 2009 Chartered Accountants. Partner. Kolkata .
  • 15. Acknowledgments We gratefully acknowledge the following persons whose patronage and support has been instrumental in bringing us this far His Excellency Shri Gopal Krishna Gandhi, Hon'ble Governor of West Bengal Shri Bikash Ranjan Bhattacharya, Hon'ble Mayor of Kolkata Dr. Arjun Sengupta, Hon'ble MP(Rajya Sabha) Shri Goutam Mohan Chakraborty, Commissioner of Police, Kolkata Police Shri Debashis Roy Additional Commissioner of Police Community Police Wing Shri Rajesh Subarno, Deputy Commissioner of Police (South) Dr.Surya Kanto Mishra, Minister of Health, Govt. of West Bengal Moushumi Ghosh, Borough Chairperson, Bobby Hakim, Borough Chairperson Dr. Arunendu Biswas- Superintendant, Kolkata Pavlov Hospital Shri Arul Jyothi, Commandant (Sealdah Division), Railway Protection Force Our generous donors Our funders, for their faith and backing Alteus Biogenics Pvt Ltd HOPE FOUNDATION Ireland Intas - Ms Maureen Forrest Director; Hope Foundation MASUMI Overseas Pvt. Ltd. - Ms Jenny Browne- Overseas Director; Hope Foundation Molekule Nicholas Piramal Patton India Ltd. Ranbaxy Solus S.K. Oil Terminals Sun Pharmaceuticals We are only as strong as the partnerships that support us our gratitude to all the individuals, organizations and departments who have chosen to be a part of the community care network 66 Pally Institute of Psychiatry. Phulbagan Society Alipore Judges Court IPER Pradeep Sangha, Amra Sabai Club, Collootola Jana Swasthya Committee Shyambazar Amrapali Nursing Home Jhamapukur Youth Sporting Club Purbasha 11 Antara Junior Boys Sporting Club, Khidderpore Putiary Club Antardarson Kabardanga Auto Union R.G.Kar Medical College Antarik Kolkata Police Rajabazar Science College ASHRAY Loreto Sealdah State Bank of India Army Wives Welfare Association M.R. Bangur Hospital Sappho for Equality Bandhuchakra Welfare Manas Bangla Sealdah Court Association Ministar Club Shahid Smriti Sangha, Behala Young Men's Association Mr. D. Ashis, Medical Bank Chetla Bhabani Bhaban Mr. Shiboprosad Roy Shanti Youva Sangha, Akra City Civil Court Ms Margaret Waterworth Social Welfare Department Dr. Ranjita Biswas Ms Vahista Dastoor Soujatya Eastern Railways Womens Ms. Deepanjana Sarkar Soumendra Pathak Welfare Organisation Ms. Samata Biswas Controller of Vagrancy FORUM for Mental Health N.R.S. Medical College Subhas Sangha, Kashi Mitra Gulab Sporting Club, Cossipore New Sporting Club, Kankurgachi Ghat Indian Psychiatric Society Paripurnata Swasthya Bhaban TRACKS Home
  • 16. Sankalpa - the resolution to make a difference Iswar Sankalpa 138, S. P. Mukherjee Road,Kolkata 700026 Phone 033 24197451 / 52 Mobile 98302 60089 Email: isankalpa@gmail.com www.isankalpa.org Registered under West Bengal Societies Registration Act 1961, Registration No. S/1L/42976 of 2006-07 Registered under Section 80G of the Income Tax Act, 1961, Government of India