Priests and faith healers are the first people that Indians living with mental health challenges reach out to. Given the belief of people in traditional faith healing, the government of Gujarat conceptualized a unique intervention – the Dava-Dua program, which combines faith healing with modern psychiatric treatment. Dava-Dua translating to medicine-prayer has been shown to be more effective in improving access to care as well as treatment outcomes.
In the Mira Matar Dargah, located in the village of Unava, in the Mehsana district of Gujarat, people have been coming from around the country for centuries. They come with the hope of being healed from invisible physical and psychiatric ailments. Visitors believe that it is the Holy Saint Hazrat Saiyed Ali Mira Datar who treats them with his divine powers. The Mujavars (religious faith healers) have been relieving people of their ill health through traditional healing rituals. Leveraging on people’s beliefs, the Gujarat government saw this as a golden opportunity to roll out the Dava-Dua program.
Implemented by ‘Altruist’ – an Ahmedabad-based civil service organization working with mental health issues, the program has been running since 2008. In 2021, researchers conducted a qualitative study to understand the implementation challenges and outcomes of the program. They interviewed 6 mental health service providers involved in the implementation of the program and 26 service users across 3 categories – 9 users receiving only psychiatric treatment (Dava), 8 receiving only faith healing treatment (Dua), and 9 receiving the combination of psychiatric and faith healing treatment (Dava-Dua).
The case records of service users from July 2008 to March 2018 revealed different types of illnesses, including depression, psychosomatic illnesses, schizophrenia, anxiety, epilepsy, bipolar disorder, intellectual disability, substance use, and other disorders. The researchers also noted that most of the referrals were made by relatives and friends, followed by referrals made by faith healers from the dargah. Some referrals were also made from other sources like medical camps in the community, awareness campaigns, healthcare workers, and school-teachers. These referrals show that the program has been successful in reaching the masses. However, researchers also observed the decreasing number of referrals from faith healers over the years.
Perspectives of Dava-only users
Most of the Dava-only users mentioned that they had gone to the faith healers first. As they did not receive any relief from the faith healing, they decided to take medications. A user shared,
“I spent a lot for the dora‑dhaga [religious practice of wearing sacred thread from priests or religious healers] and bhuvagiri [Hindu traditional healers who cast off evil‑eye and remove black magic] but did not get any relief. When I came to Dava‑Dua centre, I realized that I was suffering from mental illness…[and] immediately started the treatment.”
Another user mentioned that some of her symptoms of bad dreams, sleeplessness, fear, and anger had not reduced even after visiting the dargah. They shared,
“I came to this centre because one patient from neighbouring village got treated… prior to the treatment, I had more faith in bhuvagiri, but now I realize the importance of the treatment.”
Perspectives of Dua-only users
Many users strongly believed in faith healing treatment as they did not experience any benefit from medical treatment. A user shared,
“I went to many places for treatment, changed many doctors, but all failed… [if I got relief at all] relief was temporary…after [all experiments] I came to the Dargah. I felt some superstitious power inside me, which made me ill. After my stay here, I felt good…I will improve now.”
Another user echoed,
“I am tired of taking medicines… I took many ‘desi dava’ [traditional medicine] but was not relieved from the problems. Now I believe my problems will be resolved as Mujavar is removing bad spirit from me.”
The study mentions that there have also been such users who dropped out of the psychiatric treatment and resorted fully to traditional healing only at the dargah. In addition to this, there were also users who have not benefitted majorly from either psychiatric or faith healing treatment, yet they continue to have a strong belief in traditional healing. They shared,
“I was taking medication from childhood and also have a problem with hajri [superstitious activity], and it can still appear sometimes. I came here [dargah] for the treatment…[but] not relieved from the symptoms yet… the evil within me is very strong and will leave my body one day. I must continue faith‑healing.”
Perspectives of Dava-Dua users
Users who received the combined psychiatric and faith-healing treatment expressed a strong belief in both. They believed both to be an essential part of the same treatment. A user mentioned,
“I came here [dargah] to get rid of evil spirit within me…I started medication at the same time, healing for removing black‑magic effects from my body. I got relief from pain as well as attacking evil spirit in the body…medicine alone cannot help… the evil spirit is so powerful…”
As people receive relief from pain and other ailments from the medication, their belief in the system gets reaffirmed. This leads to an increase in referrals through family, relatives, and friends. Interestingly, one user also attributed their access to the Dava-Dua centre to Allah’s wishes. They mentioned,
“I came to dargah for dua since a long time in‑between I got ill, and I believe that my illness was a Upar Ni Asar [superstitious event]. I was aware of the Dava Dua Centre, so I started medication from there. I feel that Allah showed me the path for the treatment.”
Perspectives of Service Providers
The service providers have a variety of responsibilities, from counseling users and their caregivers to educating the faith healers and building a community network with them. In their work of running the Dava-Dua program efficiently, they face many challenges.
Treatment adherence
Users from across the country come to the dargah in the hopes of healing themselves. Hence, in cases of users belonging to outstation areas, follow-up for treatment can become a challenge when they leave the dargah. Medications have been made available free of cost by the government and are also couriered to the users. However, it can become difficult to provide this facility if the user stops communicating with the Dava-Dua centre. Similarly, another challenge is users stopping treatment after receiving some relief from the treatment. They come back to the centre after their illness manifests again. Such a gap in treatment delays recovery.
Communication challenges
Service users shared that as users come from different parts of the country, communicating with them can become a challenge due to language barriers. Additionally, communicating and convincing the faith healers at the dargah can also be difficult at times. This is because different healers vary in their willingness to collaborate with psychiatric treatment. A psychiatric social worker shared,
“…convincing the Dua patient for the Dava (medicine) is hard work…hence we first convince the Mujavar [priest] that his client [the patient] needs treatment with the Dua…if Mujavar to agree than only he sent the patient for medication at the centre.”
Human resources and financial constraints
At the program, high employee turnover has been a concern. In addition to this, interrupted flow in funding, unavailability of medications, and lack of adequate space to run the program have been major challenges. The lack of adequate space does not allow service providers to exercise privacy and maintain confidentiality during sessions.
Program Acceptance and Effectiveness
Despite the challenges, the program has been accepted adequately by the community members. Moreover, increased awareness, as well as other community mental health programs, have also brought more visibility to the program. The program has also been successful in “appreciating patient reality and negotiating a shared plan of treatment,” as it allows users to choose treatment as per their beliefs and hopes.
However, for the program to run sustainably, there needs to be long-term trust-building and collaboration between faith healers and medical practitioners. Such a long-term relationship can only be built through open dialogue and willingness of both parties.
The researchers also highlighted the potential of scaling-up of this program. It can be replicated and reproduced in similar faith-healing settings across India and other countries. The study also urges future researchers to look into potential ethical issues like dual roles and boundaries that may arise while implementing such a program.
Conclusion
To conclude, it is important to note Gujarat’s state government initiative on combining faith healing with psychiatric treatment. As opposed to removing faith-healing completely by labeling it unscientific, letting people make their own treatment decisions also shows the state’s view of upholding the legal capacity of people. It promotes the agency of people living with mental health issues. Moreover, the provision of psychiatric treatment at faith healing sites also decreases the stigma of mental illness.
Mad in South Asia’s four-part special report on faith healing sites across India shows people’s continued beliefs in faith healing. And, how it is their own meaning-making that aids healing.
Neha Jain
Neha Jain is a doctoral scholar at the Department of Humanities and Social Sciences, IIT Kanpur. In her doctoral work, she is exploring institutionalized and de-institutionalized mental healthcare settings in India to understand the nature of care and recovery in mental health through the experiences of various stakeholders. She is also a counseling psychologist trained in trauma-informed therapy and works through an attachment lens with people in their early adulthood years. Apart from therapy and research, she loves reading personal newsletters and listening to Desi rap music.