‘I do not feel well here as such. But it has become my home’: abandonment and care in healing shrines

Abstract

In thinking about care, much research has focused on kin relations, family-related care, and formal (medical) or informal care providers. Yet, how do we understand care responsibilities in contexts where kin care is absent despite being a desired social norm, and people turn to other community sources or practices? This paper draws on ethnographic research in a Sufi religious shrine in western India well-known for providing succor to those in distress, including those with mental illness. Interviews were conducted with pilgrims who had left homes due to strained relationships with kin members. For many of them, the shrine emerged as a sanctuary, even while not entirely a safe one, allowing women to live alone. While both academic research on mental health institutions and state responses have delved into the abandoned or ‘dumped woman’ in long-stay institutions or care homes, this paper argues that ‘abandonment’ is not a straightforward condition, but rather a dynamic discourse that works in different ways. For women bereft of kinship ties, narratives of being abandoned by kin became ways of justifying long (and sometimes permanent) residence in religious shrines, which were able to absorb such ‘abandoned’ pilgrims who had nowhere else to go, even if half-heartedly so. Importantly, these alternative forms of living made possible by shrines reflect women’s agency, enabling women to live alone even while belonging to a community. In a context with limited social security options for women in precarious family situations, these care arrangements become significant, even if they are informal and ambivalent forms of care. Keywords: kinship; abandonment; agency; care; religious healing

Keywords:

• Kinship
• abandonment
• agency
• care
• religious healing

Acknowledgements

The author would like to thank the special issue editors for their careful reading of the manuscript and helpful comments which have strengthened the paper. All errors and omissions that remain are mine. This work was supported by the Wellcome trust [Grant number 096420/A/11/Z]. The author declares no conflict of interest. Ethical approval for the research was obtained from the Institutional Ethics Committee of IIT Hyderabad.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 For more on debates about the place of local healing shrines in mental health care, see Davar and Lohokare (2009). Much discussion has focused on the need for mental health reform and adoption of a rights-based approach to mental health care (e.g. Patel 2013, Gopikumar and Parasuraman 2013), even as critics have raised questions about the excessively medicalized approach such ‘reform’ has entailed (e.g. Davar 2012; Clark 2014; Mills 2014; Sax and Lang 2021). For instance, national mental health policies and programmes have largely defined ‘mental health care’ in terms of ensuring the availability of essential psychotropic medicines in health care institutions and the community (Jain and Jadhav 2009).

2 While I am aware of the controversy surrounding this ethnography, issues about the ethics and authenticity of the work lie beyond the scope of this paper, which restricts to consideration of the key arguments and findings.

3 One example is the state’s attempt to handle the migrant crisis in India which occurred during the pandemic in 2020 by providing counseling to migrant workers living in unbelievably precarious conditions (Kottai 2020).

4 In a different context, Jadhav and Barua (2012) analysis of mental health in the context of human-animal conflicts that implicate the role of humans, non-humans, materials, and institutions is an interesting departure from medicalized approaches to mental health.

5 In addition to the establishment of the clinic, other ‘reforms’ included shutting down the asylums attached to the dargah and banning practices such as the use of chains to prevent pilgrims from running away.

6 Although delving into this issue is beyond the scope of this paper, it is important to note that the very name Dava aur Dua, which has an appealing rhythm and ring to it in Hindi, was a significant factor in the attractiveness of the clinic (and the project).

7 For a nuanced discussion of the significance of the lobaan in dargahs see (Bellamy 2006).

8 An elaborate discussion of the centrality of place in ritual healing is beyond the scope of this paper. Suffice it to say that the very word for trance, hajeri, refers to ‘presence’ and trance is a central aspect of healing in the shrine.

9 While the clinic was initially opened within the premises of the shrine, following considerable opposition from the shrine attendants, who felt that their space was being appropriated by doctors, it was later moved to a nearby building outside the shrine.

10 This rapid consultation approach is fairly typical of psychiatric practice in public health contexts in India, as many scholars such as Nunley (1996) and Halliburton (2009) have noted, partly stemming from an attempt to legitimize what is perceived as a low-status specialization in medicine.

11 ‘Counselling’, here, essentially entailed the clinical psychologist’s efforts to convince pilgrims to seek psychiatric treatment at the clinic for their ‘illness’.

12 In the context of the dargah, the word taqleef, best translated as ‘suffering’, ‘difficulty’, ‘pain’ or ‘distress’, was typically used by pilgrims to refer to the pain and suffering that they experienced, often from the result of spirit-related afflictions.

13 Sana here referred to the ritual practice of bathing or immersing one’s body in the muddy water, in an attempt to dispel the possessing ghost. Post-Ervadi, some of these practices were banned by the state, while some continued.

14 This paper does not make judgements about whether Sana was indeed suffering from a psychiatric disorder or not as that is beyond the scope of this paper. It is for this reason that I speak of Sana as a ‘pilgrim’ and not a ‘patient’. While there is no doubt that Sana was in distress, it is less clear how that translates into psychiatric diagnostic categories. Here, Luhrmann’s (2000) elaboration of the cognitive leap that is involved in the task of making a diagnosis is pertinent, for the very process of diagnosis entails fitting the patient’s amorphous and vague complaints into relevant categories that would permit a diagnostic judgement.

15 It is clear that for Sana the world of biomedicine was a composite, undifferentiated whole, all of which had failed her – whether it was treatment for tuberculosis, or psychiatric treatment, or the numerous times she had approached hospitals for ‘glucose drips’ when feeling weak.

16 Along similar lines, Halliburton (2003) has drawn attention to the important role played by the pleasantness of the healing process, arguing that patients prefer not just treatments which are effective, but also treatments which are experienced as soothing and pleasant.

Additional information

Funding

This work was supported by the Wellcome trust under Grant [number 096420/A/11/Z].