At the Jinnah Hospital Lahore where people come for treatment from all over the province, consultant psychiatrist, Dr Ejaz Warraich, receives ten fresh cases of depression every day on average. That makes it 50 to 60 patients a week. People turn up for follow-ups as well and there are those who have already been diagnosed by general physicians and reach the public hospital for treatment. If that is taken into account, the doctor says, “I receive 30 patients of depression every day.”
The doctor puts the rural-urban ratio of patients at 30-70. The majority — that is 70 per cent of the depressed — come from cities. Going by the Multiple Indicator Cluster Survey (MICS) 2014, Punjab Final Report, also the latest, “66.6 per cent of the population live in rural areas while 33.4 per cent live in urban areas of the country.”
“Of these, 80 per cent are women. Whatever is being done to alleviate the status of women, is not enough. Female reproductive health is an area that demands great attention. Sexual life and its complexities affect women in large numbers. Women do not know anything about how to take care of themselves and children. Then there are marital conflicts. Women are oppressed in a male-dominated society. They really need help,” says Warraich.
“If a woman gives birth to three daughters, she is quite susceptible to depression,” says the doctor. “These are very real experiences,” says Dr Warraich who is receiving patients in the psychiatry department of the hospital for the last 21 years.
Amina (name changed) came from Hafizabad for treatment because she felt suicidal and unable to look after her children. She has a two month old daughter with her. She is talking to the doctor, “When I was 7-months pregnant I learnt it was a girl. At that moment, I had a sinking feeling in my heart and felt physically weak. This feeling persisted. I wanted a son. I already had two daughters and a son. People would say to me, ‘Allah ralaae jori’ meaning may you have a pair now. I know I should love my child but negative thoughts don’t leave me.”
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In Amina’s family, there is a pattern of one son and many daughters. “My family took me for dum to several people but to no avail. Can you help me doctor? I cannot focus on anything. I cannot listen to you for long. My thoughts drift to the one issue that I keep mulling over,” says the woman who is hardly 30 years old.
While I was at the hospital in another room where psychologists were listening intently to the patients one by one, I came across a man, a case of depression, who worked in a laboratory in Shahdara. He could not focus on conversation and had lost the zest for life. “I cannot hurt people so I do their chores as well. People around me laugh and joke while I feel altogether disinterested in their talk. I am respected at home by my parents and siblings, have a wife and three children but I don’t see a way forward from where I am. My health above all is not okay. There is loss of appetite and dizziness. I feel disinterested in life in general,” he says. The man has a pleasant disposition and looks very meek.
Unemployment, under-employment and low wages are some important factors underlying depression that need to be addressed.
“Fifty per cent patients of depression are cured while only ten are admitted in the hospital in a month,” says the doctor.
It’s time the government focused on pro-poor policies to revive economy and make it inclusive. These things are said in conferences time and again. People await a policy which will actually bring prosperity in their lives.