A Psychiatrist Negotiates The Prison System - Pre-Launch Stage

My second visit to this ward was less traumatic. After a 45 minute wait a larger group had collected to listen to me. This time it occurred without the use of the rod. By word of mouth, the previous group of listeners had aroused curiosity. On seeing some prisoners showing obvious signs of withdrawal, one asked if they needed medical aid. Some said yes. The majority did not. Some had already suffered for over two or three days without their drug. Some had chosen to withdraw from drugs without the aid of medication (Cold Turkey Withdrawal). Most, in any case, had gone in and out of detoxification facilities several times. Slowly it dawned on them that getting off drugs was not an issue, staying off drugs was the central problem.

A disturbing feature in the ward was the presence of heterogeneous groups in the three barracks of Ward 12. Heterogeneous groups hampered the formation of a group culture, as non-addicts did not want to belong to an addicts' group. One barrack was called B. R. Barrack wherein prisoners who were blood relatives were lodged. Most of them were not addicts. Another barrack had Tuberculosis patients and drug addicts lodged together. The danger of infection to non-tuberculosis prisoners was compounded by the risk of developing drug abuse in those not addicted. In fact, new addicts were found in this barrack after the containment exercise. Tuberculosis patients had to be shifted out. The community had to be homogenous.

One started visiting the ward twice a week. Indoor and outdoor games equipment, clothes, toothpaste, toothbrushes, soap, anti-scabies and anti-lice medication, books and magazines were brought on the following visits as more and more requests for "goodies" kept on coming. One would spend time playing cricket or volleyball with the prisoners much to the surprise of the rest of the prison. Not fulling understanding this phase of the programme, my work was initially described in a Prison Magazine as "Dr H.S.Sethi treats drug addicts with sports and games".

My visits to the ward were anxiously awaited by the prisoners after six weeks of my initial visits. Less time was necessary to gather around to hear "Doctor Sahib" as one was called. More and more prisoners would join in the gathering. Topics ranged from concepts like Responsible Concern, Sharing and Caring for self and others to Leadership, Family and Bonding. Requests for goodies continued and were met.

One day, there were objections, by a section of the group that had gathered, to some individuals fooling the "good doctor". It was not acceptable that those who were well-off were lining up for goodies. The group decided that from then onwards only those who did not get a 'mulakkat' (visit from a relative) would get their needs met by such request. This marked the formation of a rudimentary group with group norms being set by the majority. Grabbing the opportunity, my talk focused on "No free lunch". One stipulated that the goodies were not doles. A payment was expected. The price was a commitment that all would be vigilant and would not allow drugs or peddlers of drugs to enter the ward.

A culture of helping those less fortunate in the ward was slowly spreading. Serfdom, which was widespread, was slowly coming down as needs were met without menial labour. Concept Seminars continued on my visits. The topics, now, were "mutual self-help" and "I am my brother's keeper" as an extension of Responsible Concern. Money was not the only asset, education and caring were highlighted as valuable assets. The more educated would teach the less educated. Teams were formed in each barrack to give massages to those undergoing withdrawal pains. Oil was provided for this as well as incentives to the volunteers.

The new admissions and discharges into this ward was such that the culture kept on being shaken by frequent new entrants. Frequent shifting of staff members posted by the jail was a constant source of contradictory messages being given to prisoners. Finally, a permanent head warder was posted to the programme, Mr Shivanand Khemani, a rare human being who rose with the programme to later become an assistant superintendent.

Over the visits, one found that the ward consisted of several sub-groups of people, each sub-group being between two and seven people. These sub-groups always stayed, played, and worked together. If anyone was separated, requests would come that they be lodged together. The culture of these sub-groups would be either positive or negative depending upon the circumstance. An effort had to be made to change the prevalent sub-culture of these sub-groups to pro-social. One called all the prisoners and asked them to line up according to their sub- groups. On them doing so, one asked them to choose a leader for their respective sub-group.

Several meetings of "leaders" of sub-groups were held. The local name for this leader was "bhaiji" or big brother. They would disseminate the messages given to members of their sub- group. The concept of a community which looks after its own needs was mooted and how it would help recovery from drugs was discussed. The ward would now be known as a therapeutic community(TC) for recovery from drug dependence. Requests for "goodies" were now to be channelled through these chosen leaders. A rudimentary feedback system was thus started.

Some of these "leaders" were closer to other "leaders". The concept of family was now introduced to them. Four to five sub-groups would join and be identified as families with different family names. One of these leaders would be called family head and the other leaders within the family would be called Big Brothers. These designations and names for families caught on for they were developed in consultations with the leaders. Names of Mountains were chosen with the suggestion that the leaders had to inculcate pro-social values amongst their family members and to take the family to the summit of the mountain after which they were named. They named the programme AASRA Parivar, a joint system of families. Family meetings were held three times a week wherein members would share their life story, and talk of their family of origin. They would also share what happened at their court hearing and some read out letters they had received from friends and relatives.

In setting up the community, the difficulty was that all residents were at about the same level. Through trial and error and with the passage of time a rudimentary hierarchy of small brother, big brother and family head was visible. At the onset, the selection of seniors was by popularity. A major overhaul became necessary as the residents rejected popular but poor role models, those that abused drugs, and those that wielded unnecessary influence out of context with the philosophy of the TC and its value-system. Situations arose, when there were too few residents to hold family head positions. We handled such a situation by appointing jail and programme staff to head families/ be guides to assistant family heads. Deserving family heads were promoted to barrack-incharge, chief-monitor or coordinator.

Continued receiving of goodies was now contingent on pro-social behaviour as well as genuine need. The new goodies now being asked for were three televisions, one for each barrack. Each family head had a notebook to write down the names of prisoners entering and exiting each family, requests for goodies, and positive or negative behaviour of any prisoner in the family. Duty shifts were set up wherein family heads and big brothers would monitor behaviour round the clock. The best barrack would get a television set.

In mid-november, 1993, on the occasion of presenting the first television set, we were pleasantly surprised to have a visit from Dr Kiran Bedi. On being requested to address the ward, she thanked me for coming to help her. My reply was that I was grateful that she had come to visit our community and invited her to join our community. The eight family heads then spoke one by one. Each presented different aspects of the programme. The education programme, the monitoring system, the peer support along with massages (modified cold turkey withdrawal), family meetings and need-fulfilment were highlighted. The community was proud that they took care of the needy. They explained how they identified with their family, how the big brother or elder looked after the new entrants, and how the culture was undisturbed by distributing new entrants between families. With time, the new entrants were being lodged with big brothers selected by demonstrated pro-social behaviour. With proximity, these prisoners grew attached to each other. The controlled bonding experiment had worked.

Within the Therapeutic Community, the style of living, and living with demonstrable values was stressed upon. The family groups presented the setting for "repair work". Conflicts arose when a member wanted the fulfilment of his desire to the detriment of another family member. Strong emotions, generated amongst family members whenever such an event happened, were dealt with in the stages of confrontation, conversation, commitment, and fellowship in Encounter Groups. These involve airing of defects in attitudes of the erring member, sharing of similar defects and how they were overcome by group members, followed by acceptance on the part of the erring member who is forced to adopt a more conforming attitude. External pressure from family members would force a new way of behaving for the erring member to feel comfortable again in his family.

The second television set was presented in December, 1993 by an AASRA volunteer, Ms Shumita Didi, who started working in November, 1993. Her involvement brought about a needed feminine touch to the programme. Shumita had a knack to get each family to take up assignments. Families now chose a day in the week when they would be responsible for cleaning up the ward and the bathrooms. Some pet pigeons were left behind by a convict who had been released. Shumita helped motivate prisoners to take care of the birds. She built the first aviary of this prison. Her green fingers also started the first garden of AASRA ward. A plot of land in front of the ward which was used as a dumping ground was slowly developed as a landscaped garden project.

By December, 1993 one was getting a big hole in one's pocket as one's work was self-funded. By now replacements of sports goods was necessary. One shared this with the prisoners. They volunteered to contribute to a fund from where further goodies could be bought. Prisoners who got a "mulakkat" (visit from a relative) would contribute five to ten rupees. One promised to match their contributions rupee for rupee each month. All in the community would have access to things purchased by this fund. These things included toiletry goods, footwear and sports-goods. The fund, after several fits and starts, finally took off after several months.

In December, 1993, an AASRA volunteer, Mr Pradeep Goyal, off heroin for four years, joined me on my visits to the prison. While I held meetings with family heads, he would hold meetings with the rest of the community and share his story of recovery from drugs. He motivated others to share their experience with drugs, their gradual downfall, and their recovery after joining AASRA Parivar. He joined the project as its first staff member after AASRA got a modest grant from I.C.Trust. His coming full-time was a boon to the project. A roster of activities was now implementable and one-to-one sharing started.

Dr Kiran Bedi was positively encouraging by her visits to this programme while on her rounds to Jail 4. Her numerous suggestions were readily incorporated into the programme. This helped get respectability for the residents of this community from other prisoners. For suddenly, they were no more untouchables. The prisoner-teachers started coming in once again and holding classes. The local music group was encouraged to come regularly each morning for a Mood-Making Session. The Superintendent, Mr P.R.Meena and the Deputy Superintendent, Mr Sunil Gupta, took active interest in our community. Mr Meena's passion for helping the needy was amply fulfilled by this community. Mr Sunil Gupta's leaning towards spiritual upliftment met expression in this programme. Each contributed immensely to the blossoming of AASRA Parivar.

January 1994 saw the recognition of this programme by Delhi Police Foundation for Correction and Rehabilitation. The Navjyoti Award was presented to AASRA for this new contribution for Rehabilitation of Drug Addicts. One received the prize on behalf of residents of the Programme. Later, at a small ceremony, inside the ward, one presented the shawl from Navjyoti to the man who really deserved it, Mr Shivanand Khemani. Cash coupon awards were also presented to the convict officer of the ward and other family heads. To everyone's surprise, the cash was deposited by them in the ward's welfare fund.

The Tailoring Workshop was launched with the donation of two sewing machines and cloth by well-wishers. These souls still contribute hundreds of metres of cloth each year from which new clothes are stitched for the have-naughts. Other workshops which were flourishing by now were the Ironing Workshop and the Barber's shop.

Two prisoner-teachers, Mr Pramod Mishra and Mr Naresh Kakkar, attended some of my concept seminars in AASRA Ward. Their interest grew and they requested to join in as volunteers. They got themselves assigned to the community as teachers. Mr Pramod Mishra had a deep sense of concern for his fellow mankind. He converted concept seminars into stories with examples from Hindu Mythology and would speak of these in other wards where he would be posted. His work in the adolescent ward of Jail 4 was a seed for AASRA's future work with adolescents. Both these persons worked hard and translated concept seminars delivered by me into hindi, an effort which multiplied delivery of such lectures by prisoners themselves. By March '94, one could give token stipends/honoraria to several prisoners for their work in the community. Our staff members had increased to three with the joining of Mr Devinder Kohli and Mr Amit - both recovering addicts and trainee counsellors. Mr Kohli was instrumental in the proper functioning of the Welfare Fund. Mr Amit was known for the quality of his sharing recovery.