Death in darkness

THE government is all set to execute a mentally ill prisoner on Tuesday. Ghulam Abbas, a 36-year-old resident of Rawalpindi, has spent over 13 years on death row. Medical records from the last six months indicate that he has been frequently visited by psychiatrists — around five times in the month of April alone. This suggests that Abbas’ mental health has deteriorated drastically. And yet, he has not been provided adequate healthcare at a proper facility.

According to close relatives, Abbas exhibited learning disabilities as a child because of which he was deprived of even the most basic primary education. They add that he would regularly suffer from seizures, indicating the possibility of epilepsy.

Abbas also has a family history of mental illness. His father, who was imprisoned for more than 10 years before being released, showed signs of mental illness and even attempted suicide by slitting his throat. Fortunately, he was saved by jail authorities but never recovered from his condition and died soon after being released. Abbas was only a young boy at the time. One of Abbas’ paternal aunts also suffers from a mental illness while another aunt has a neurological disorder necessitating regular drainage of excess fluid from her brain.

In a preliminary examination of Abbas’ health records, Dr Malik Hussain Mubbashar, a veteran psychiatrist with over 50 years of experience and the recipient of Sitara-i-Imtiaz and Hilal-i-Imtiaz, maintained that this strong positive history of mental illness in the family suggests that he was genetically disposed to suffer from the same.

The gallows are ready, this time for a mentally ill prisoner.

He also notes that the psychiatrist visiting Abbas at the jail recently prescribed him Risperidone, a strong antipsychotic drug, while before he was being treated for depression and anxiety. This indicates that Abbas is suffering from severe psychosis and is hence not fit to be hanged. In fact, his execution would not only be a violation of his right to dignity and amount to cruel and inhumane punishment, it would also be an egregious violation of Islamic law.

We must not forget that Khizar Hayat, another mentally ill prisoner, passed away in March this year after spending 16 years on death row. He was not hanged, but his last breath on a hospital bed — anaemic and hypotensive — was just as much a result of indifference and negligence of the state.

And then there are others. Prisoners like Kanizan Bibi, a paranoid schizophrenic, who has spent more years in prison on death row than outside and hasn’t spoken a word in eight years. Prisoners like Imdad Ali, another schizophrenic who has been repeatedly assaulted by fellow inmates. Will we fail all of them — all those who are imprisoned by their minds and shackled by the state, shunned by stigma and scorned by shame?

In two days, Ghulam Abbas will be no more — executed by the state in the face of overwhelming evidence of his unstable mental condition. In two days, we will rue another death to apathy. In two days, we will wax lyrical about our ignorance of mental diseases. We might even vow to never let it happen again.

But eventually, we will forget. We will forget just like we have forgotten about Khizar. We will return to our darkness and pretend to not see. We will grope, trying to hang on to our justifications for being blinded by apathy. But we mustn’t. We must lift this veil of darkness to be able to see how mental illnesses, said to afflict 20 per cent of Pakistan’s population, are eating away the minds of already emaciated prisoners.

Our legal system is still in its infancy when it comes to understanding mental illnesses. There was a time when the supreme judiciary declared that schizophrenia was a recoverable illness. The Punjab government consequently challenged the court’s verdict, making it reconsider the interpretation of the Punjab Mental Health Ordinance, 2001. Since then, there have been some small victories. The Punjab and federal mental health authorities have been established and members have also been announced.

Countries all over the world have developed systems to evaluate the mental health of prisoners. There is no reason Pakistan cannot do the same. But it cannot be done without will and resources. As a priority, we need an adequate screening mechanism to evaluate suspects’ mental health at the time of detention with consequent follow-ups. This cannot be done through cursory questions about which government is in power and what month of the year it is.

People, and prisoners in particular, with mental illnesses can be shrouded in a darkness that engulfs their minds. Sometimes, a little ray of light can allow them to have moments of clarity. This is not an indication of their culpability. But to put them in prisons and to execute them is an indication of our lack of vision.

The writer is an assistant professor of psychiatry at King Edward Medical University.

Twitter: @drhotiana

Published in Dawn, June 16th, 2019