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May 21, 2001

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The Rediff Special/ Shobha Warrier

A Centre of Hope

At the age of 15, Mohanraj first tasted alcohol when he had a glass of beer. "My father was an alcoholic. He spent all his money on alcohol. My dream was to study and become a big man, but I had no money to pay the fees. In frustration, I started drinking. Just like my father. During those days, my only clothing was a torn lungi and a shirt. On most days, I had no food to eat. Remember, I was only a teenager then. Everybody knows how humiliating it is for a teenager to roam around the city in a torn lungi."

Mohanraj got a job as a tea-boy in a textile unit and worked hard. During his free time, he learnt how to cut material and tailor it. Soon, he became an expert tailor and started his own unit, which earned him over Rs 2,000 a day. He was very happy; now, he could drink as much as he wanted. On holidays, he would start drinking in the morning itself; on weekdays, it was limited to the evenings. He also smoked at least 40 cigarettes a day.

"When I consumed alcohol, I was transported to a world that was very different from the one I saw around me; it was very beautiful, happy and joyful."

By the time he turned 18, his vices had consumed his factory and all his money. He returned to being a pauper.

Life looked up when he got married. He started a tailoring unit once again, rented a decent house and bought a vehicle. But he was also drinking heavily. By the time he was 24, his wife was gone, as was the house, the vehicle and the business. A defeated man, he now drank because he wanted to die.

It was then that he heard an organisation called the TTK Hospital offered free treatment to alcoholics who could not afford one. Six months after being detoxified, he had a relapse. Back at the hospital, he decided there was no looking back. This time round, he had to succeed.

"I was offered a job as a master in the tailoring unit at the hospital. Today, I can proudly say I haven't touched a drop of alcohol for the last one-and-a-half years. This, despite the fact that I live with my father and brother who are both alcoholics. I have stopped smoking too. I know I have wasted 16 years of my life but, thanks to this hospital, I am finally happy."

Many such Mohanrajs have benefited from the TTK Hospital.

The seed for the hospital was sown 22 years ago on soil drenched with the tears of a young widow.

In 1979, T T Ranganathan, the 33-year-old grandson of industrialist and former Union finance minister T T Krishnamachari, died in the USA where his family had taken him to treat him for alcoholism. Nobody, neither his parents -- Padma and T T Narasimhan of the TTK Group -- nor his young wife, Shanthi, were able to help him defeat the disease.

"At that time, we were not able to get any help for him because there were no centres in India for treating alcoholics. Besides, people did not know how to deal with alcoholism. Doctors would advise you to cut down on drinking. They never understood it was a disease. Medical professionals, too, were not aware of what exactly alcoholism was at that point in time. And, after my husband's death, there was a burning desire in me to do something to help other patients and their families," says Shanthi.

She was barely 30 when her husband passed away. Her in-laws did not want to brood over what had happened; they encouraged her to bury the past and pursue her dreams. There was only one thing that Shanthi, a post-graduate in social service administration, wanted to do. As the first step in this direction, she went to the US and trained at the Hazeldon Institute in Minneapolis.

A year later, she was back in Madras, ready to start a de-addiction centre. The only problem was a place. The Narasimhans immediately turned over their seashore residence to their daughter-in-law, so that she could start a daycare centre for treating alcoholic patients.

A small beginning was made with a dedicated group of five, six people. They would visit industries and educate them about the menace of alcoholism. As industries keep referring patients to them, word spread about the centre. "Alcoholism," says Shanthi, "is a group activity. It was mainly through our patients' recommendations that more and more alcoholics started coming to us for treatment. A patient who had benefited from our treatment would motivate others and later bring them over to us."

The fact that she was the daughter-in-law of the famed TTK family helped; there was no dearth of financial help. The TTK group contributed Rs 11 million and, in 1987, a 60 bed hospital was built. This was the first hospital in India that devoted its resources to treating alcoholics and drug addicts.

Initially, though, everyone around her -- including the professionals -- were sceptical. "Poor girl!" they thought. "She wants to do something to forget her sorrow. She could have done something for orphans or widows. Why does she want to work with alcoholics?"

Dr R R Cherian, a clinical psychologist who was one of the first people to join the TTK Hospital, says, "At TTK, we developed the skill to treat alcoholics for the first time in India. The Minnesota model that we follow here is a borrowed idea. It is a residential programme, so the patient has to be admitted to the hospital."

The treatment aims to:

Enhance motivation: The treatment process begins with an initial assessment of the patient by an intake counselor. After the addiction is confirmed, the patient's level of motivation and the support available to him is gauged.

Patients usually deny their problem when they go for treatment. So, as the first step, it is necessary to create an awareness about the problem. The patient is then admitted into the primary residential treatment programme, which lasts for a month.

Detoxification: Medical management or detoxification is necessary to make the withdrawal process from alcohol or drugs safe and comfortable. It is carried out under the supervision of the director, medical services. Patients are then treated for their physical problems as most of them suffer from gastritis, acidity, insomnia, etc.

Psychological support: Once the patient stabilises physically -- this normally takes three to four days of medication -- he is moved to the psychological therapy wing of the hospital, where he participates in yet a highly structured programme. This includes community meetings, individual counselling, re-educative lectures, group therapy and exposure to self-help programmes. The family members also have to follow separate programmes throughout the day.

Psychological therapy also is very important. It is necessary to make alcoholics understand that, once they become de-addicted, they cannot go back to social drinking. It is absolutely essential that they stop taking alcohol completely.

The day begins: A typical day in the hospital begins with a community meeting in which the counselor narrates a value-based story to the patients. Patients relate this story to their personal experiences, which in turn helps them assess themselves. Each patient and family member who accompanies him is assigned a counselor.

The TTK Hospital prefers group therapy to the traditional, isolated psychiatric approach. Patients are encouraged to talk about themselves and their painful past. Frank and constructive feedback from other group members breaks down denial and helps patients recognise and acknowledge their problems.

The day ends with a meeting of the Alcoholics Anonymous or the Narcotics Anonymous. Here too, patients share their experiences with other members.

All patients are treated as in-patients for a month. Once released, they are required to report back to the hospital every month for a period of five years. Even if the patient refuses to come back, the hospital tries to contact him and bring her/him back. The centre also has a community support programme that involves a third party, other than the patient's immediate family, who alert the centre in the event of a patient's relapse.

When a patient completes one year without touching alcohol or drugs, they celebrate the day as her/his birthday at the hospital, where they are asked to share their experiences with other patients. The patient is also given a medallion on the occasion.

Of the 15,000-odd people treated at the hospital in the last 14 years, 55 per cent have been able to lead normal, sober lives. "Forty-five per cent of our patients do face problems in recovery. A good number stay on the borderline, alternating between relapse and recovery. We do not wish to claim a patient has recovered unless he is able to maintain a certain quality of life, apart from maintaining a drug-free existence."

Patients come to the TTK Hospital from as far as Sri Lanka, the Maldives, Bangladesh, Nepal, Myanmar, etc, where there are no such treatment facilities available. It also trains professionals from within and without the country to deal with this problem.

Shanthi Ranganathan says the average age of alcoholics is around 35 years, and that of drug addicts, between 25 and 35. In the year 1999, she was honoured with the first United Nations Vienna Civil Society award for her 'Outstanding Contributions in the Fight Against Drug Abuse and Crime.'

Also see the following interviews...
Shanthi Ranganathan: 'When recovering addicts come and share their happiness, one feels satisfied'
Sivasankari: 'Unfortunately, we tend to condemn alcoholics'

You might also like to read...
Confessions of an alcoholic

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