Sunday, October 11, 2009

PACE -- Prevention & Care for Everyone Srinagar, Kashmir, India

Creative Commons License
Ethical Democracy As Lived Practice Blog by Professor Chithra Karunakaran is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
Based on a work at
Livelihood Security, Social Medicine: A Combined Community-Based Mental Wellness Strategy

PACE is a Social Medicine, Livelihood Security Project envisioned by Dr. Arshad Arif and his colleagues. PACE operates in Srinagar and neighboring villages.

This combination of Livelihood Security and Social Medicine strategies is unique and especially urgent to secure prevention, intervention, amelioration, healing and wellness, especially for poor female producers in rural and urban armed conflict zones.

The project actively addresses the felt needs of persons living thirty-plus years in a conflict zone. An extended period of infiltrations, shootings, lootings, killings, rapes, abductions, disappearances, searches, fake trials, street violence have left tens of thousands of women, children and men suffering ongoing symptoms of depression, panic, phobias, PTSD, SAD, GAD, DID, substance-abuse related abnormal behaviors, plus other co-morbid psychopathologies.

What is striking about the PACE approach is PACE's recognition that persons with mental health afflictions
can be most effectively treated by:

1. Carefully listening to them
2. Observing their daily lives
3. Relying on their expression of their felt needs
4. Delivering on their felt needs, within an overall sustainable program
of Mental Health Recovery & Wellness Maintenance

Here's an example of the approach in practice:

Goats for Social Justice & Wellness

This past summer I volunteered in Srinagar with an innovative Social Medicine project called PACE -- Prevention & Care for Everyone. The founder-director a serene,intense,dedicated Kashmiri doctor who had quit his safe government job to directly offer care to persons suffering from symptoms related to depression, post-traumatic stress disorder (PTSD), as well as drug related problems,
told me a Goat story.

One day, Dr. Arshad Arif was treating an elderly woman patient. She suddenly asked him:


Is anyone listening to this innocent casualty of terror, violence, hunger and deprivation?

What is she telling us?

That she is fully capable of self-diagnosis. She doesn't really need a doctor to tell her what's wrong with her.

She knows what ails her. What has made her mentally ill is a cruel denial of livelihood opportunity.

If she has a goat, a goat will give her milk that she can sell to her neighbors and the money earned will give her a chance to feed herself and her family.

She will walk around while tending her goat and the very act of walking will take her outdoors with something safe and productive to do.

The very act of walking will kick in her endorphins, lessening her pain and despair, and lifting her depressive symptoms.

She wants to be an entrepreneur. She wants to be self employed and earn a living.

Who's listening?

She wants to be well and knows exactly how to get well.

She's basically saying
"Don't get my Goat. Just give me one.
Or two. Or three.
Throw in some Sheep to optimize sustainability.
I want to be self-reliant.
I want to be self-sustaining.
I am not looking for a handout.
I am looking for a leg up."
Chithra KarunaKaran

City University of New York

Ethical Democracy As Lived Practice


Anonymous said...

Drop dead leave America you will burn in Hell I pray all of you will

Chithra.KarunaKaran said...

why so much hatred and cowardice, Anonymous? Too afraid to state your name?
I wish you well. Your hate shows how much there remains to be done to accomplish ethical democracy.
Thanks for your comment to my blog which focuses on the Lived Ethical practice of democracy.