MBANDAKA — Don't tell Mfutu Etawale Ratis he's a magician or a witch doctor.
The self-proclaimed traditional practitioner says he can cure mental illness. And in this northwestern region of the Democratic Republic of Congo, where modern treatments are often missing, Ratis is one of the only people trying to help patients with mental disorders.
Seated in a furnished shed in his back yard, Ratis, 50, is talking with some of his patients, while a few meters away, two sharply-dressed young people are chatting with others.
"These two are my new clients. They're already recovering," Ratis says, smiling and proud.
His technique relies on a simple approach: He tests his patients over time to see how they progress. For example, he sends them to the market to buy sugar or salt, and sees whether they can perform the task.
Ratis is currently considered one of the most respected traditional practitioners of the Congolese province of Équateur — and he proudly shows his photo album, filled with pictures of all the people he's cured.
"I have had 97 mentally ill patients so far, not to mention those who suffered from epilepsy," he says. "And most of them are now completely cured. With God's help, they can recover in about a month, provided that they haven't been ill for more than 15 years."
To make a diagnosis, Ratis interviews families and friends in order to best understand the patient's history and current condition. Their symptoms can come from excessive use of marijuana, from having suffered emotional distress, trauma or even having been involved in esotericism. Not all of the people who come to him are actually "mentally ill" in the medical sense, but rather have shown inappropriate social behavior or have, at some point, been through difficult circumstances that have left their mark.
While there are more than 700,000 inhabitants in Mbandaka, there is no facility specialized in treating mental illnesses — nor is there any structure able to take care of patients.
People are generally too poor and have no means to travel to the neuropsychiatry center of the DRC's capital Kinshasa. As a result, they turn to traditional practitioners and, based on numerous accounts, the results are noteworthy. The price is also right. "I took my brother to a health center but it didn't work. We went to see a pastor and it didn't do any good either. So we followed somebody's advice and came here to see Ratis," a local explains. "Now my brother is cured."
Official paperwork in hand, Ratis describes himself as a "traditional herbalist doctor."
He explains that he documents everything he sees and hears from his patients. "Then I prescribe the appropriate treatment," he says.
The treatments he speaks of are in fact potions prepared with plants that his patients have to drink, or to take as a collyrium. Sometimes, they are powerful sleeping concoctions made with wild roots. According to Ratis, these can make the patient sleep for up to three days, depending on the illness and reaction to the substance prescribed. "It relaxes them, calms down the nerves and freshens up their memories," he claims.
Ratis says it's a job with built-in risks. "It's a dangerous profession. You can end up treating a restless patient who can hurt you." Pointing to one of them on a picture, he goes on: "That one broke my leg. But hey, it's part of the job…"
Despite his success in curing people, Ratis deplores the fact that his activity is misjudged by the very people who he feels should be praising it. "The region's Health Ministry doesn't include us in their work. The doctors with whom we should be working hand in hand despise us," he says. "They think of us as charlatans or quacks even though we're the ones getting real results."
The confinement experience could turn brutal for those forced to live with relatives who would not tolerate a member of the family living their sexual orientation openly as a young adult. Here are stories from urban and rural India.
Abhijith had been working as a radio jockey in the southern Indian city of Thiruvananthapuram when the COVID-19 pandemic hit in March, 2020. When the government imposed a nationwide lockdown, Abhijith returned to the rural Pathanamthitta district , where his parents live with an extended family, including uncles, cousins and grandparents.
Eighteen months later, he recalled that the experience was "unbearable" because he had to live with homophobic relatives. "Apart from the frequent reference to my sexual 'abnormality', they took me to a guruji to 'cure' me," Abhijith recalled. "He gave me something to eat, which made me throw up. The guru assured me that I was throwing up whatever 'demon' was possessing me and 'making' me gay."
Early in 2021, Abhijith travelled back to Thiruvananthapuram, where he found support from the members of the queer collective.
Inspired by their work, he also decided to work towards uplifting the queer community. "I wish no one else goes through the mental trauma I have endured," said Abhijit.
Abhijith's story of mental distress arising from family abuse turns out to be all too common among members of India's LGBTQ+ community, many of whom were trapped in their homes and removed from peer support groups during the pandemic.
Oppressive home situations
As India continues to reel from a pandemic that has claimed more lives (235,524) in three months of the second wave (April-June 2021) than in the one year before that (162,960 deaths in March 2020-March 2021), the LGBTQ community has faced myriad problems. Sexual minorities have historically suffered from mainstream prejudice and the pandemic has aggravated socio-economic inequalities, instigated family and institutionalized abuse, apart from limiting access to essential care. This has resulted in acute mental distress which has overwhelmed queer support infrastructure across the country.
Speaking to queer collective representatives across India, I learned that the heightened levels of distress in the community was due to longstanding factors that were triggered under lockdown conditions. Family members who are intolerant of marginalized sexual identities, often tagging their orientation as a "disorder" or "just a phase", have always featured among the main perpetrators of subtle and overt forms of violence towards queer, trans and homosexual people.
Calls from lesbians and trans men to prevent forced marriages during lockdowns.
Sappho For Equality, a Kolkata-based feminist organization that works for the rights of sexually marginalized women and trans men, recorded a similar trend. Early in the first wave, the organization realized that the existing helpline number was getting overwhelmed with distress calls. It added a second helpline number. The comparative figures indicate a 13-fold jump in numbers: from 290 calls in April 2019-March 20 to 3,940 calls in April 2020-May 2021.
"Most of the calls we have been getting from lesbians and trans men are urgent appeals to prevent forced marriages during lockdowns," said Shreosi, a Sappho member and peer support provider. "If they happen to resist, they are either evicted or forced to flee home. But where to house them? There aren't so many shelters, and ours is at full capacity."
Shreosi says that the nature of distress calls has also changed. "Earlier people would call in for long-term help, such as professional mental health support. But during the pandemic, it has changed to immediate requests to rescue from oppressive home situations. Often, they will speak in whispers so that the parents can't hear."
Lack of spaces
Like many of his fellow queer community members, life for Sumit P., a 30-year-old gay man from Mumbai, has taken a turn for the worse. The lockdown has led to the loss of safe spaces and prolonged residence at home.
"It has been a really difficult time since the beginning of the lockdown. I am suffering from a lot of mental stress since I cannot freely express myself at home. Even while making a call, I have to check my surroundings to see if anybody is there. If I try to go out, my family demands an explanation. I feel suffocated," he said.
The pandemic has forced some queer people to come out
Sumit is also dealing with a risk that has hit the community harder than others – unemployment and income shortage. He's opened a cafe with two other queer friends, which is now running into losses. For others, pandemic-induced job losses have forced queer persons from all over the country to return to their home states and move in with their families who've turned abusive during this long period of confinement.
Lockdowns force coming out
According to Kolkata-based physician, filmmaker and gay rights activist Tirthankar Guha Thakurata, the pandemic has forced some queer people to come out, succumbing to rising discomfort and pressure exerted by homophobic families.
"In most cases, family relations sour when a person reveals their identity. But many do not flee home. They find a breathing space or 'space out' in their workspaces. In the absence of these spaces, mental problems rose significantly," he said.
Not being able to express themselves freely in front of parents who are hostile, intolerant and often address transgender persons by their deadname or misgender them has created situations of severe distress, suicidal thoughts and self-harm.
Psychiatrist and queer feminist activist Ranjita Biswas (she/they) cites an incident. A gender-nonconforming person died under suspicious circumstances just days after leaving their peer group and going home to their birth parents. The final rites were performed with them dressed in bangles and a saree.
"When a member of our community asked their mother why she chose a saree for someone who had worn androgynous clothes all their life, she plainly said it was natural because after all, the deceased 'was her daughter,'" Biswas recalls.
The Indian queer mental health support infrastructure, already compromised with historical prejudice, is now struggling
In India, queer people's access to professional mental healthcare has been "very limited," according to community members such as Ankan Biswas, India's first transgender lawyer who has been working with the Human Rights Law Network in West Bengal.
"A large majority of the psychiatrists still consider homosexuality as a disorder and practice 'correctional therapy'. It's only around the big cities that some queer-friendly psychiatrists can be found," Biswas said. "The pandemic has further widened the inequalities in access to mental health support for India's LGBTQ community."
Biswas is spending anxious days fielding an overwhelming amount of calls and rescue requests from queer members trapped in their homes, undergoing mental, verbal and even physical torture. "We don't have the space, I just tell them to wait and bear it a little longer," he said.
Medical care is dismal
Anuradha Krishnan's story, though not involving birth family, outlines how the lack of physical support spaces have affected India's queer population. Abandoned by her birth family when she came out to them as a trans woman in 2017, Anuradha Krishnan (she/they), founder of Queerythm in Kerala who is studying dentistry, had to move into an accommodation with four other persons.
Isolation triggered my depression
"I am used to talking and hanging around with friends. Isolation triggered my depression and I had to seek psychiatric help." Living in cramped quarters did not help with quarantine requirements and all of them tested positive during the first wave.
What is deeply worrying is that the Indian queer mental health support infrastructure, already compromised with historical prejudice, is now struggling, placing more and more pressure on queer collectives and peer support groups whose resources are wearing thin.
During the 10 months of the first wave of the pandemic in India in 2020, Y'all, a queer collective based in Manipur, received about 1,000 distress calls on their helpline number from LGBTQ+ individuals. In May 2021 alone, they received 450 such calls (including texts and WhatsApp messages) indicating a telling escalation in the number of queer people seeking help during the second wave.
As India's queer-friendly mental health support infrastructure continues to be tested, Y'all founder, Sadam Hanjabam, a gay man, says, "Honestly, we are struggling to handle such a large number of calls, it is so overwhelming. We are also dealing with our own anxieties. We are burning out."
Sreemanti Sengupta is a freelance writer, poet, and media studies lecturer based in Kolkata.
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