In rural Pakistan, among all the socioeconomic strata, the practice of Dum by religious and spiritual healers (commonly known as Peers) is quite common. Although with better outreach of health facilities it is fading away yet it maintains a stronghold among relatively less educated populace. A brief review of this practice follows. Mostly women suffering from chronic headache visit a spiritual healer for getting some kind of a relief by him. The gentleman performs various acts on the patient alongwith continuous recitation of holy verses from the Quran. This results in betterment of the symptoms of the patient. Now let’s dissect this whole cultural practice. First of all, to be precise, in most instances the patients are females of different age groups. Most of them are poor, illiterate and overburdened with domestic work load. All these circumstances make them an ideal case to be afflicted by depression and/or conversion disorder (previously known as hysteria). An interesting fact to be noted at this point is that the most common symptom of depression in our female population is of long standing mild headache. Now what happens is that due to ignorance and lack of health facilities these semi literate women end up at the door step of some spiritual healer for treatment. On the face of it the spiritual leader treats the ailment of the visiting patient by virtue of divine power embedded in the holy verses. The healer while reciting the holy Quran verses, at the same time performs certain other maneuvers on the patient like putting excessive pressure on the head of patient with his hands, placing a cake of mud on the head of the patient and later cutting it with a knife. Reportedly all this results in considerable relief for the patient as is also evident from the fact that this practice has survived for centuries in the rural hinterland.
The question to ponder is that how all this gives relief to the visiting patient. There are many factors involved in this complex scenario. First and foremost, the “attention seeking behavior” of these patients. Mostly patients of conversion disorder &/or depression show attention seeking behavior and thus taking these patients to a spiritual healer by family members in itself gives the requisite attention to the patient and has its own Second factor is the change of environment for the visiting patient. Obviously for a rural female, bound inside the four walls and dealing with endless domestic issue, it’s a welcome change to go out of her home let it be a visit to a spiritual healer.
Third factor is that of holding the patient’s head with such a force that the actual mild headache seems to have disappeared in the face of excessive pressure applied over the head by the healer. Some teen age girls often faint at the moment because of the pressure resulting from the grip of the healer. Interestingly as can be noted above that all the effects of this visit are of short duration and the symptoms are bound to return sooner or later. Thus the vicious cycle of visits to the peer sahib continues unabated until and unless the patient can consult a psychiatrist to correct her neurological chemical imbalance with the help of antidepressants.
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