The story of a 20-something man who was walled inside a room by his family that did not mean him harm
Anuradha Nagaraj Anuradha Nagaraj | 04 Nov, 2012
The story of a 20-something man who was walled inside a room by his family that did not mean him harm
BANGALORE/DAVANGERE ~ T Keshava has long, beautiful fingers that continuously draw patterns on a chequered blanket at the male psychiatry ward of the National Institute of Mental Health and Neuro Sciences (Nimhans) in Bangalore. He is 38 or maybe 39. His head is slightly tilted to the left and he does not make eye contact. But he does stop for a few seconds every once in a while, looks at all the people standing around his bed discussing his life, responds to the constant prodding by an attendant to answer questions hurled at him, and smiles.
Keshava was dramatically rescued in mid-October from a nearly 10-year-long solitary confinement in his village home in Karnataka’s Davangere district. His rescue from the darkness of a confined space to the sunlit ward of Nimhans came after Bangalore’s Regional Commi- ssioner K Shivaram read about his case in a local newspaper. It was not a very long story. It was a matter-of-fact report about a man walled into a room without doors, not a crack in the walls to let sunlight in and no access to a toilet, in Lakkimpura village, about 250 kilometres from Bangalore. The report added that he was never let out in the open, given food by his mother through a small grilled window and that he had lived this way for over 10 years.
“It sounded horrifying,” recalls Shivaram. “I called the tehsildar, confirmed the facts and drove down immediately.” What followed was a dramatic ‘rescue’. A village that had forgotten Keshava’s very existence gathered around the house to see him being released from his house prison.
Describing what he saw, Shivaram says: “It was a small space and through the window I could just about see him, huddled naked in a corner. When I asked him if he wanted to come out, he put both his hands forward as if asking me to lead him out. We broke the wall and were immediately repelled by the stench coming from that confined space. It was unbearable. And from that emerged this man with his head weighed down by at least three to four kilograms of matted hair. He looked startled but he identified his mother.”
Keshava was reportedly calm when he emerged from confinement.
He let the now eager administration organise a haircut and bath, all just outside the room he was locked up in and in full view of a village that had not acknowledged his presence all these years. Doctors from the district hospital did a preliminary health check and “everyone was amazed that his blood pressure was normal”. “He also had no skin infections, no lesions. He had a swelling on one side of his neck but that was probably because of the weight of his hair,” says Shivaram, adding that Keshava was cleaned up and taken straight to Nimhans.
Keshava has been diagnosed with schizophrenia. Actually, he was diagno- sed when he was in his early twenties, the year he stopped attending his B Com second year classes and started walking away even as people were talking to him.
Ever since, Keshava has not been the bright, “above average” and “incredibly disciplined” student he was all through his schooling years. And neither has he said much. Instead, in the past 15-odd years, he has learnt to draw patterns with his long, beautiful fingers.
And, he has lived in complete isolation. First he was handcuffed, then confined in a spacious part of the house and finally walled into an approximately 15×10 ft space. With each decision the family took, Keshava’s world shrank. The teenager who sometimes quoted Vivekanan- da to his friends grew quieter as the walls came up around him.
When Keshava first showed signs of mental illness, his brother took him to hospital. He was given shock treatment, put on medication and sent back home. The family was told to give Keshava his medicines on time. It did not work. They sold some land, got some money together and did another round of hospitals, this time even travelling to Nimhans in Bangalore. They were sent back with three months of medication. When the medicines ran out and so did the money, the family did not know what to do.
They did not know how to deal with Kesha- va’s mood swings, his violence, his sudden outbursts. They could not figure out how to ensure he had a constant supply of medicines. His brother had a farm to till, his mother was a devadasi, his sister-in-law was raising three young children. Each one did their bit to help the young Keshava but it was not enough, and one day the family decided to keep Keshava away from everyone and locked him up.
The World Health Organization says more than 50 per cent of the people who have this illness do not receive proper care and that in the developing world, 90 per cent cases go untreated.
In India, there are an estimated four million people with schizophrenia, with ‘different degrees of impact on some 25 million family members’. Various studies indicate that the prevalence is about three per 1,000 individuals.
Keshava became a hidden statistic and in the process lost 10 years of his life. During this period, the village has been part of many state and central government surveys, health workers have worked here, teachers have run pulse polio drives, politicians seeking votes have come and gone. Successive tehsildars have known. But no one did anything.
Even the district mental health programme failed to keep track of Keshava. “It is sad,” says a candid Dr PP Patil, in-charge of the programme in Davangere district but at present battling a dengue outbreak. “This post basically exists on paper and there is absolutely no infrastructure, no additional funds to run it. There are no counsellors here because the state-run pilot project in four districts does not cover us. The only way to detect such cases would be at the clinical OPD, but even there the priorities are different. There is poor detection and follow-up across the board. We can’t justify our failure to help this man given the fact that a national programme runs to prevent exactly what happened to him.”
Oblivious to all the sudden attention, Keshava draws his patterns. “It is a case of undifferentiated schizophrenia,” says Associate Professor (Psychiatry) Shiva- rama Varambally, who is treating Kesha- va at Nimhans. “Such situations [long periods of confinement without any social interaction] can turn a normal person psychotic and for a psychotic person it is worse. His prognosis is more guarded since he has gone into a negative state, with no motivation to do anything. During these long years of isolation, he seems to have developed some sort of self-simulating behaviour that has kept him going but makes no sense to us.”
According to doctors, Keshava’s case was not an extreme one. He was not suffering from fantastic delusions nor was he completely paranoid. Most feel a couple of years of sustained medication would have kept him on track. Instead, the 10 years without medication and the seclusion has made his case worse. “It is not so much the illness as the social pressures and lack of counselling for the caretakers that has led to his condition,” says Varambally. “Even prisoners in solitary confinement are given some time in sunlight and have access to a toilet.”
According to the WHO, schizophrenia is a ‘severe form of mental illness that affects about seven per thousand of adult population, mostly in the age group 15-35 years’. Further, it states that ‘though the incidence is low, the prevalence is high due to chronicity’.
Besides being more common among them, men tend to be on average about five years younger than women when they get schizophrenia. And all schizophrenics, men and women, find it hard when they go looking for jobs, plan to get married or try and be a part of society.
These numbers and worldview mean nothing to photographer C Basavaraj. But the year 2009 does. In December 2009, he went to meet friends in Lakkimpura village. In the course of a conversation, he heard about Keshava’s confinement. Basavaraj came back to Jagalur, 20-odd kilometres from the village, but he could not get Keshava out of his mind.
“I almost instantly knew whom they were talking about,” he says. “He was in class 8 when I was in class 5 in Anabure village. My primary school and his high school were across the road. But we celebrated Independence Day together and he was the boy who gave the Independence Day speech in school in English. We were in awe of him because nobody spoke English like him. In a village, it is a big deal. And when I started researching, I realised my hunch was right—Keshava was the same boy I looked up to in school.”
So Basavaraj went back to Lakkimpura. “I went to Keshava’s house and met his mother,” he recalls. “I spent an entire day there, talking to his mother, trying to understand what had gone wrong. All she kept saying was that he was violent and locking him up was the only way of controlling him. I wanted to take a picture but she would not allow it. She said the family already had a lot of financial problems and she did not want any more trouble.”
His friends in Lakkimpura had asked if he could help Keshava and the only way Basavaraj knew was to write about it. And so he did, in the 29 December 2009 edition of Udayvani. There was no photograph but Basavaraj described Keshava’s plight in graphic detail.
“Nothing happened,” he says, the disappointment apparent in his voice. “No- body, not even the Human Rights Commission came forward to help. There was no impact and it left me feeling helpless and disillusioned.” Basavaraj gave up.
Kotresh, another journalist from local paper Nanna Mitra, then discovered Keshava in early October. “Someone mentioned it casually and I immediately wanted to know more,” he says. “The first time I went to his house, they told me he was dead. I went again and spent some time making small talk with his mother, who had been resolutely avoiding any discussion with anyone about Keshava. In the course of the conversation, I asked about her younger son and she vaguely pointed to the room he was holed in. I said I had brought fruits I wanted to give him and she agreed to let me near the small window to hand in the fruits.”
Like Basavaraj, Kotresh was perturbed and wrote about Keshava. Unlike Basavaraj’s report, what Kotresh wrote was read by the Regional Commissioner and the ‘scandal’ was out in the open.
Devadasi Chowdamma’s house is right at the end of Lakkimpura village. The two-room stone structure has green doors decorated with torans (decorative door hangings). A dish antenna is up on the roof. The little verandah has a blue drum filled with water, a big basket of onions, a stack of firewood and a bundle of grass. A pink blouse lies on a heap of rubble right below the gaping hole in the wall through which Chowdamma’s younger son Keshava was ‘rescued’.
A lungi covers the entrance to what had been Keshava’s world. The hole leads to a narrow space. It is dark inside despite the broken wall. A few bees buzz around and a cycle has now been parked inside. There is no sunshine coming through the thatched roof. Fresh mud has been loosely spread over the floor, but the smell of urine and excreta still linger in the room. The mud walls on three sides have no signs that tell you how Keshava lived in this space. The fourth wall, made of brick, is the one that separated him from the rest of the family—his mother, brother, sister-in-law and nieces.
And there is the grilled window, through which a plate and a small pot of water was passed to Keshava three times a day. The window overlooks the mud path in front of the house. But when Keshava was holed in, his mother used palm leaves to completely cover the verandah, making sure no one could see Keshava and he could not see anyone.
“We had no idea about what was going on inside,” says Siddesh Kengerappa, who lives one house away from Chowdamma’s. “When the wall was being built, we just assumed some maintenance work was on. There were no loud noises from the house, nothing to indicate that Keshava was being locked in.”
D Kanchaobalai was around nine years old when Keshava was first locked up. “We had heard about it as young boys, and even came to see what was going on,” he says. “Some of us would take a quick peek through the window and even try to speak to him. But he never responded.” Other curious neighbours were shooed away by Chowdamma or simply told that Keshava was not at home.
Keshava’s childhood friend and college hostel roommate Basavaraj is a cotton farmer in Gowripura village, a stone’s throw from “Keshu’s” father’s village of Jyotipura. “Keshu grew up in Jyotipura and both of us did all our primary education here. His mother was a devadasi and didn’t live with the father,” Basavaraj says. “He spent his childhood with his father, but once he joined college, he started visiting his mother more often in Lakkimpura. He was a first class student and we spent our first year in college studying together, eating together and practically doing everything together. It was all very regular.”
The change happened in the second year of college. “That was when I first noticed a change,” says Basavaraj. “Keshu started staying aloof, would abruptly get up during a conversation or in the middle of his meal. And then, after our Dussehra vacations in second year, he just stopped coming to college and went and lived with his mother instead. We checked on him a couple of times, even my mother visited their house, but we were treated badly.”
Head Constable GT Venkatesh’s jurisdiction includes Lakkimpura village. Keshava’s college batchmate Venkatesh last met him in 1998-99. “He sort of didn’t recognise me,” says the in-charge of the Gadimakunte police outpost.
“And when I became a head constable and moved here, I would keep asking about him but had no idea he was being treated like this.”
There were a lot of theories doing the rounds for the “sudden mental imbalance”. Most blamed the mother, saying that he was not happy with her being a devadasi and wanted her to stop, leading to altercations. Others said he was being forced to marry against his will. A few believed he was fed something by his family that caused the “imbalance”.
The village talked, but slowly even the gossip died out. Over the years, the village boys stopped peeking through the window, friends stopped visiting to check on him, villagers stayed away and Keshava was left in solitary confinement. Slowly, Keshava simply ceased to exist.
Today, after Keshava has been ‘rediscovered’, he dominates all conversation in the region again. Suddenly, a lot of questions are being asked. Roommate Basavaraj constantly wonders how no one knew. “The village accountant, health worker, teachers doing surveys… someone must have known,” he says, sitting at the Gadimakunte police outpost. “Actually, I am sure everyone knew. They just left him there.”
Keshava’s elder brother Basavaraj carries a small polythene packet in his shirt pocket. The pieces of fraying paper carefully stored inside the packet tell the story of the family’s struggle to cope with Keshava’s schizophrenia.
“We tried,” he says softly. “The minute he showed symptoms, which included not sleeping at night and wandering about alone, we took him to Dharwad hospital. Besides shock treatment, they gave medication. We were also referred to Nimhans in Bangalore and got medication for three months from there. All we were told by the doctors was to take care of him and ensure he took his medicines on time.”
It apparently took three visits to the Karnataka Institute of Mental Health in Dharwad before Keshava was admitted there. In 1996, he was taken to Nimhans, records of which are available at the hospital and indicate that the financial condition of the family was not good.
Headmaster of Anabure High School, Manjunath Reddy, remembers seeing one of the most “extraordinary” students of his school many years later in shackles. “His father brought him back to school, handcuffed,” says Reddy. “He wanted some assistance to continue his treatment. I gave him the Rs 500 I had in my pocket at that moment and assumed he would be taken care of. Next I hear of his rescue. Such a shame.”
“It was not easy. He would refuse to take medicines, beat up my wife and children,” says Basavaraj. “Initially we just chained him, but later it became more difficult. We were very scared that he would hurt someone. So we secluded him in the house but he was free to roam about inside and we would take him out once in 15 days.”
According to Basavaraj, the wall came up only about 10 months ago when his daughter was to get married. “We had relatives coming from the city and didn’t want them to see Keshava,” he says. “So we built a wall thinking that once the functions were over we would put in a door. It has been nine months but we haven’t been able to do it because of our financial problems.” The wooden door still leans against the outside wall.
Keshava’s mother has not reconciled with the fact that her son was “taken away”. Last week, she went to Jagalur and bought some poison, went back home and consumed it. Now she lies on a hospital bed in Jagalur government hospital, shrivelled and incoherent.
“She doesn’t understand that this is good for Keshava,” Basavaraj says, his tone devoid of any emotion. “Once we decided what to do, we didn’t talk about it much. We made sure he ate well and cleaned him up periodically. After they took him, she feels violated. She says even if he died, he should be at home, next to her.”
The National Mental Health Programme, formulated in 1982, does not cover Davangere district. But the district mental health programme does and is based on the national policy, which highlights the need to “to shift focus from the present custodial model to a community-based approach with extension of basic mental healthcare through outreach facilities.”
“Not many, including our own doctors seem to know that detected early, mental illness is easily cured,” says Dr Karur BV, project director of the National Rural Health Mission in Karnataka and a psychiatrist himself. “Not many in our set-up would even be able to spell ‘schizophrenia’. We have drugs worth over Rs 2 crore available at periphery hospitals and they are not used.”
Incidentally, Keshava is being treated with a psychosis drug called risperidone. The drug is available free of cost at government hospitals, including the Jagalur hospital. At a chemist, one would spend less than Rs 2 on a tablet and normally three are prescribed. The government gives it at 18 paise per tablet. It is affordable and accessible, but Keshava did not know that and nor did his family.
Today, at the ward in Nimhans, Keshava’s physical condition is described by doctors as “normal”. For the lymph node swelling on the right side of his neck, he is undergoing tests at the Kidwai hospital to rule out tuberculosis. He is also scheduled to have an ultrasound. According to the senior resident treating Keshava, his oral intake is good and he has not shown any disruptive behaviour in the open ward. He is now taking his medication regularly, but doctors say it is too early to tell how soon or to what extent his mental health will improve. It takes the help of some medication, but at night, he sleeps okay.
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