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We, members of the Mehac team, go every Friday to Wayanad.  One could call it a routine because of the regularity of the exercise. But a trip to Wayanad can never be routine. It is always fascinating. To start with you have the amazing spectacles that the exceptional nature offers you on the mountain track. At the same time, you also have the stomach – churning climb up the winding roads on the hills.   Thoughts of the very climb to Kalpetta always bring a sense of apprehension in me while zipping across the busy town of Calicut to the foothills. It is a regular phenomenon that my stomach lurches forward and I am left with a queasy feeling till afternoon. As we go through the climb few of our team members are successful in losing themselves in a deep slumber. I have never been successful at that. But then I try to drown myself in the shows offered by the bountiful nature that envelops us on this journey.

Nature is at its best. The hills with silver streaks when viewed from a distance, the lush deep valleys, the clouds billowing between the peaks, curious and brave monkeys disturbed by the human presence take away my attention. Each time we cross the coffee estates, I am reminded of the coffee blooms and their exotic fragrance. I sometimes get the thought that this is the most appropriate motif for Mehac. Mehac in Urdu has means “fragrance”. Suneesh (the good friend who drives us to various clinics) assures me that we shall experience the magic once again in March next year. I get excited like a child when I spot flowers on the creepers on the sides of the road. The blooms are of a different, of passionate and bright hues of purple, red, orange and sometimes of shades that cannot be contained under a single colour. In short, the nature encapsulates you in all its variety on every trip to Wayanad.

Of the five clinics in Wayanad, I have a soft spot for two. We get to see and interact with the tribal population in Wayanad. Vivekananda hospital in Muttil and the unit run by Amrita Hospital in Kynatti. Far away from what could be called “mainstream” Kerala society, it is like entering into a new world meeting people who are so very different. Peace descends on me with the quietness of the place. I watch committed individuals trying to help in their own different ways, and I look forward to meeting people I have met before and new ones. Large segments of the tribal community have not changed in many respects. Their attire, their way of communicating, expressing, and their cultural and social life are all new to me. I suppose there is also a sense of isolation that these groups go through lost between two worlds. Many imbibe habits and new ways of living, both healthy and the harmful ones. To me this is a learning experience. Human behaviour enmeshed in social and cultural practices and at the same time seeking to address the challenges of the new world always leaves one amazed.

A young girl experiencing anxiety, finding it difficult to cope between her newly found identity of passing the tenth standard and existing struggles in the colony life is one of the persons we helped. Guiding her gently, reassuring, and finding her an option to learn computers helped her to regain stability. She smiled gratefully when she took leave of me for her higher education, saying ‘I want to become a teacher’. A young man with recurrent stomach pain came to meet me with the hope that that the new doctors would give him some magical treatment. His investigations were normal. Such patients are quite a challenge to doctors even in the city culture we work in. I did my best explaining to him about his illness. I was not hopeful that he would turn up for the next appointment. It was a pleasant surprise to see him again and then regularly. The rapport we have established reiterates the fact that trust and confidence do half the work in providing care.

I cannot stop this account without mentioning two sisters who visit us regularly. One of them has had a chronic problem. The support given to her by her sister and her family is astounding. The patience with which they understand the changes we make in her medications, the trust they have developed in our team, the happiness they share with us when she regains stability reassures me. When the girl we treat folds her hands and says ‘potte doctore”, (good bye, doctor) the sister who takes care of her looks at me and asks almost like a demand, “you will be here next week, wont you?” I recognize and respect this question as her right and reassure her of a continuous follow up.

There are many more interesting stories in the human lives that come across us.  While we learn that optimal medications is one of the mainstays of providing psychiatric care, what strikes me most is the fact that it is the relationships one establishes with people, patients, family, volunteers , and team members that remains the backbone of a  care system. This knowledge strengthens my spirit but reminds me of the daunting task ahead of us. Total population in Wayanad is relatively lesser than other districts in the state, around 800,000. The significant point is that almost 40% of Kerala’s tribal population lives here. Evidence shows that 1% of any population has serious mental illness. To weave your way through this group of people needs special skills and sustained efforts. This is just a small beginning we have made. And, of course, we have many more Fridays to come.

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