In the Nepali context one of the first aspects of poverty is the lack of purchasing power. Indeed this lack of financial resources is readily expressed to us each time by our clients and their families.Almost 90% of Chhahar's clients earn on average Rs.5,500per month ($50) and most of the families own their house. Despite this, families continue to struggle every month to make means meet. In other words, ‘poverty’ for these families is closer to the idea of deprivation in the sense that they cannot make means meet, rather than absolute poverty.
Sita at the Mental Hospital Lagankhel(MHL) on the day of her discharge: Some of her family were there to pick her up. Sita’s mother had stayed with her daughter in the hospital for the whole period of her treatment, as MHL requires a carer in order to admit someone into the hospital. Sita’s sister was in charge of picking up her sister and mother from the hospital and she mentioned to us that having to take care of her sister was very expensive.
Shyam’s father, who is now too old to work, says he cannot afford his son’s medication and therefore is obliged to reduce his dosage.
These financial difficulties were also among the first factors repetately mentioned by the psychiatrist with respect to hindrances to the continuation of medication and/or formal treatment.In sum, this ‘lack of financial resources’ aspect of poverty is widely acknowledged, although in fact, there are ways around paying the full price of the prescribed medication.
At MHL, clients who cannot afford treatment can, in theory, get help from a ‘poor people fund’. In order to be eligible for this help they are required to present their citizenship, a letter from their municipality and proof of diagnosis from the doctor. In practice however, a psychiatrist revealed to us that the people assessing for the ‘poor people fund’usually ‘rely on their gut feeling and do not investigate the financial situation of the family’. These flaws in the system makes the life of those in need very difficult.