,yq;ifapy; cseyk; kw;Wk; cseyj; jhjpapaYf;fhd mwpKfk;

2009 etk;ghpYk;> 2010 xf;NlhghpYk; mq;Nfhil Njrpa csey epWtdj;jpy; ,lk;ngw;w nraykHTfspy; gpd;tUNthu; nra;j gq;fspg;Gfspd; mbg;gilapyhdJ:

itj;jpa fyhepjp. Rkd; ngHdhz;Nlh (If;fpa ,uhr;rpak; kw;Wk; ,yq;if) itj;jpa fyhepjp. kNfrd; fNzrd; (,yq;if) nry;tp. ypd; ghhp (If;fpa ,uhr;rpak;) itj;jpa fyhepjp. urpj;j ngNuuh (,yq;if) fyhepjp. fkPyh rkurpq;f (,yq;if) jpU. xyptH l;hpahrp (If;fpa ,uhr;rpak;) jpU. rkpe;jpu tPuf;nfhb (,yq;if) nry;tp. Nuhgp nty;];uhd;l;-nfhpf; (If;fpa ,uhr;rpak;)

,yq;ifapy; cseyk; kw;Wk; cseyj; jhjpapaYf;fhd mwpKfk;

njhFg;G kw;Wk; gjpg;G: Rkd; ngHdhz;Nlh kw;Wk; rkpe;jpu tPuf;nfhb

ntspaPL: kf;fSf;fhd fpuhkpa mgptpUj;jpr; rq;fk; (PRDA), nfhOk;G (Peoples Rural Development Association (PRDA), Colombo) (http://www.prdasrilanka.org)

2011

iv

Kjyhk; gjpg;G - 2011 ISBN 978-955-0793-06-8 KOg;gjpg;GupikAilaJ. ,g; Gj;jfj;jpy; ve;jg; gFjpiaAk; Mrpupau;fsplk; vOj;J %yk; ngw;w mDkjp ,d;wp mr;rpLtNjh kWgpuRuk; nra;tNjh jtpu;f;fg;gl Ntz;Lk;. gjpg;Gupik Rkd; ngu;dhz;Nlh kw;Wk; rkpe;jpu tPuf;nfhb Kjy; ntspaPL: 2011 kf;fSf;fhd fpuhkpa mgptpUj;jpr; rq;fk; [Peoples Rural Development Association - (PRDA)] 64 n`hu;ud; ,lk; nfhOk;G 7 Printed by: Printed with VOC free, non toxic vegetable oil-based environmentallyfriendly ink, on FSC certified paper from well-managed forests and other controlled sources. Printed by Karunaratne & Sons (Pvt) Ltd. (info@karusons.com).

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mwpKfk; 1. cseyk; vd;why; vd;d? 2. cseyk; (Neha;) kw;Wk; guhkhpg;G Kiwikfs; ghjpf;fg;gLjy; 3. cseyj; jhjpapay; 4. td;KiwfSk;> Fog;gkhd elj;ijfSk; 5. jhjpapaypd; njhopy; uPjpahd mZFKiwfs; 6. KbTiu crhj;Jiz Ehy;fSk;> Nkyjpf thrpg;Gf;fhditAk;

vii ix xi
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vii

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,e;j Ntiyj;jpl;lkhdJ> fNdba Rfhjhu Muha;r;rpf;fhd epWtdq;fshd (Canadian Institutes of Health Research)> fNdba ru;tNjr mgptpUj;jp Kftu; (Canadian International Development Agency)> fNdba Rfhjhu mikg;G (Health Canada)> ru;tNjr mgptpUj;jp Muha;r;rp kj;jpa epiyak; (International Development Research Centre) kw;Wk; fNdba nghJr; Rfhjhu Kftu; (The Public Health Agency of Canada) Mfpa mikg;Gf;fspd; xd;wpize;j epjpAjtpAg;Dk; cyfshtpa Rfhjhu Muha;r;rp Kd;ndLg;ghsupd; [Global Health Research Initiative (GHRI)] MjuTlDk; Kd;ndLf;fg;gl;lJ. Fwpj;j ,e;jr; nrayku;thdJ kdtL kw;Wk; midj;Jyf Rfhjhu mikg;gpdhy; [Trauma and Global Health (TGH)] xOq;F nra;ag;gl;L ,yq;ifapy; kf;fSf;fhd fpuhkpa mgptpUj;jp mikg;gpdhy;; [Peoples Rural Development Association (PRDA)] eilKiwg;gLj;jg;gl;l jpl;lj;ij ,e;j Gj;jfj;jpDhlhf ntspg;gLfpd;wJ. ,e;j nrayku;tpy; gq;nfLj;j> fdlh kw;Wk; ,q;fpyhe;J ehLfspd;; fdlhtpd;> nkhd;l;upaypYs;s kf;fpy; gy;fiyf;fofj;jpd; lf;s]; kdeyg; gy;fiyf;fof epWtdj;jpdJ r%f kw;Wk; gy;fyhrhu cstpay; gphptpdJk; (Douglas Mental Health University Institute and Division of Social and Transcultural Psychiatry , McGill University Montreal, Canada)> ghHndl;> vd;gPy;l; kw;Wk; `hpq;Nf (BEH) NHS kdey ek;gpf;if epjpak; [Barnet, Enfield and Haringey (BEH) NHS Mental Health Trust] vd;gdtw;wpdJk; tsthsu;fs; gq;fspg;Gr; nra;jdu;. Njrpa kdey epWtdj;jpd; [National Institute of Mental Health (NIMH)] gzpg;ghsH> Dr.[ahd; nkd;b]; kw;Wk; NIMH cj;jpNahfj;ju;fs; Njrpa kdey epWtdj;jpy; ,lk;ngw;w nraykHTfSf;F MjuT toq;fpdH. Dr. ty;ypGuk; metujd; mtu;fspd; gq;fspg;Gld; ,e;j Ehypd; jkpo; nkhopngau;g;gpd; kPs;khw;wpaikg;Gk;> mr;Rg;gjpg;G xg;GNehf;fYk; nra;ag;gl;lJ.

ix

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mq;Nfhil itj;jparhiyahdJ Njrpa csey epWtdkhf (NIMH) khw;wkile;jjpypUe;J fle;j xd;gJ tUl fhyj;Jf;F Nkyhf mjw;Fj; jiyikj;Jtk; toq;Fk; nfsutk; vdf;Ff; fpl;baJ. Muk;g tUlq;fs; kpfTk; ,lHkpf;fitahf mike;jd. MapDk;> gpw;fhyj;jpy; rpwg;ghd NehahsH guhkhpg;ig toq;Ftjw;Fk;> ,yq;ifapy; csey Nritfis etPd cyfpd; juj;Jf;Ff; nfhz;LtUtjw;Fk; khw;wq;fisr; nra;tjw;F mHg;gzpg;GzHTnfhz;l> rfy JiwfisAk; NrHe;j jPu;f;fjuprdj;Jld; $ba tskhd rfcj;jpNahfj;ju;fs; vdf;Fg; ngUkstpy; cjtp toq;fpdH. ehk; tpUk;Gk; khw;wq;fis Vw;gLj;Jk;tifapy; ehk; cs;ehl;bYk;> ntspehLfspYk; gy;NtW KftH epiyaq;fspd; cjtpia ehbNdhk;. ,yq;ifapy; rkpe;jputPuf;nfhb jiyikapyhd kf;fSf;fhd fpuhkpa mgptpUj;jp mikg;gpid (PRDA)> jskhff; nfhz;l kdtL kw;Wk; midj;Jyf Rfhjhu (TGH) (http://www.mcgill.ca/trauma-globalhealth) epfo;r;rpj; jpl;lj;Jf;F ehk; nghpJk; ed;wp njhptpf;fpd;Nwhk;. ,tHfs; itj;jpa fyhepjp. Rkd; ngHdhz;Nlhtpd; cjtpAld; 2008,Yk;> 2010,Yk; Njrpa csey epWtdj;jpYs;s (NIMH) vkJ cj;jpNahfj;ju;fSld; ,ize;J mtu;fspd; tpUj;jpf;fhf> NIMH ,y; xU njhluhd ehd;F nraykHTfis xOq;F nra;jdH. ,r;nraykHTfSf;fhd tsthsHfs; nkhd;l;hpay; kf;fpy; gy;fiyf;fofj;jpypUe;Jk;> ghu;el;> vd;gPy;l; kw;Wk; `hpq;Nf gy;fiyf;fofq;fspypUe;Jk; (BEH)> NHS,d; csey ek;gpf;if epjpaj;jpypUe;Jk; (If;fpa uhr;rpak;), NIMH ,ypUe;Jk; ngw;Wf;nfhs;sg;gl;lNjhL> gy cs;@u; tsthsHfspd; xj;Jiog;Gk; ngwg;gl;lJ. ,e;j E}yhdJ TGH epfo;r;rpj;jpl;lj;Jf;Fk;> NIMH f;Fkpilapyhd $l;Lg; gzpapd; gy tpisTfSs; xd;whFk;. NIMH Ir; NrHe;j jhjpkhHfs;> ehk; toq;Fk; Nritfspd; xU KJnfYk;ghfTs;sdH. jhjpaH Nritapy; Mw;wy;kpf;ftHfs; rpyu; ,Ue;j NtisapYk;> mtHfs; jkJ jpwd;fisAk;> Jiwrhu;NjHr;rpiaAk; toq;Ftjw;fhd Nghjpa re;jHg;gq;fs; fpilf;ftpy;iy. jhjpkhUf;F Kiwahd gapw;rpfis toq;Ftjw;fhd ghhpa Kaw;rpfis ehk; Nkw;nfhz;Nlhk;. ,e;j Kaw;rpfspy; fle;j rpy tUl fhykhf ehk; ngw;Wf;nfhz;l cjtpfs;Fwpj;J ehk; ed;wp

ghuhl;Lfpd;Nwhk;. 2009 kw;Wk; 2010,y; TGH epfo;r;rpj;jpl;lj;JlDk;> cs;@H tsthsHfSlDk; $l;Lg;gzpahw;wpa Mr Oliver Treacy mtHfspd; jiyikapyhd BEH NHS csey ek;gpf;if epjpaj;jpypUe;J ehk; tsthsHfisg; ngw;Wf;nfhz;Nlhk;. mj;NjhL> 2010,y; jpU. Oliver Treacy apd; Vw;ghl;by; vkJ rpNu;~;l jhjp xUtH (If;fpa uhr;rpak;) vd;gPy;by; %d;W thuq;fisr; nrytpl;lNjhL> mg;gpuNjrj;jpYs;s csey Nrit mikg;GfSf;Fk; tp[ak; nra;jhH. BEH ek;gpf;if epjpaj;jpypUe;J fpl;ba ,e;j cs;sPLfs; tpiykjpf;f KbahjitahFk;. ,jd; xU Kf;fpakhd tpisT ,r;nraykHTfspy; ,lk;ngw;w rpy Kf;fpakhd gzpfspdbg;gilapy; TGH epfo;r;rpj;jpl;lk; ,e;j E}iy cUthf;fpajhFk;. ,e;j E}y; tpNrlkhfj; jhjpkhiu ,yf;fhff; nfhz;ljhFk;. MapDk;> ,ij kdeyj; Jiwapy; <Lgl;Lg; gzpahw;Wk; midtUk; thrpg;gJ Kf;fpakhdjhFk;. TGH epfo;r;rpj;jpl;lk; vjpHfhyj;jpy; NIMHcld; $l;Lg; gzpahf r%f NritahsHfisAk;> njhopy;rhH epGzu; FOf;fisAk; ,yf;Fitf;Fk; ,j;jifa E}y;fis cUthf;f vz;zpAs;sJ. ehd; ,e;j E}iy tpje;Jiug;gjpy; kfpo;r;rpAk;> ,ij cUthf;Ftjpy; gq;Nfw;wikFwpj;Jg; ngUikAk; milfpd;Nwd;.

itj;jpaf; fyhepjp. [ahd; nkd;b]; gzpg;ghsH Njrpa kdey epWtdk; mq;Nfhil ,yq;if

xi

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1.1: cyf Rfhjhu ];jhgdj;jpd; tiutpyf;fzq;fs; (WHO 2008) 1.2: csey ,yl;rpaq;fs; (ngHdhz;Nlh> 2009) 1.3: tpLjiy (Liberation) rpfpr;irKiw> fpof;Fk; Nkw;Fk; (ngHdhz;Nlh> 2009) 1.4: cseyg; gpur;rpidfSf;fhd NtWgl;l mZFKiwfs; 1.5: ,yq;ifapy; fpilf;ff;$ba Rfkspf;Fk; Kiwikfs; (Vogt, 2005) 2.1: csey Nkk;ghl;bd; Nehf;fq;fs; 2.2: jdpegUf;fhd csey jiyaPLfs; 2.3: Nritfspy; etPd mZFKiwfs; 3.1: jhjpapay; jpwd;fSk;> NriteilKiwfSk; 3.2: guhkhpg;igj; jpl;lkply; 3.3: FOthfg; gzpahw;Wjy; 3.4: gy;Jiwrhu; Nritfs; (Treacy, 2010) 3.5: cq;fs; Nehahspfis mwpe;Jnfhs;Sjy; 3.6: rpfpr;ir mZFKiw (Parry, 2010) 3.7: FLk;gj;jpd; <Lghl;il Cf;Ftpj;jy; (fNzrd;> 2010) 3.8: cseyj; jhjpnahUthpd; mbg;gilf; flikfs; 4.1: mrk;ghtpjq;fisj; jtpu;j;jy; (NICEIj; jOtpaJ> 2005) 4.2: Fog;gfukhd elj;ijfisf; ifahSjy; 4.3: mrk;ghtpjj;jpw;F gpd;duhd kPsha;T 4.4: xUtH Fog;gepiy milAk;NghJ Nfl;fg;;glNtz;ba tpdhf;fs; 5.1: cstsj;Jizj; jpwd;fs; (rkurpq;f> 2010) 5.2: cstsj;Jizahsu; xUtUf;F Njitahd jFjpfs; (rkurpq;f> 2010) 5.3: cstsj;Jizapd; ,yf;Ffs; (rkurpq;f> 2010) 5.4: cstsj;Jizapd; nraw;gbKiw (rkurpq;f> 2010) 5.5: mwpthw;wy;elj;ij rpfpr;irKiw (CBT)

xii 5.6: mwpthw;wy;elj;ij rpfpr;irapd; (CBT) ikaf; fUg;nghUl;fs; (Parry, 2010) 5.7: CBT jpwd;fspy; cs;slq;Fgit (Parry, 2010) 5.8: CBTapd; mZFKiwiag; gad;gLj;jp NehahspfSld; gzpahw;Wjy; 5.9: Fzkiljy; (Welstand-Keryk, 2010) 5.10: Fzkiljy; mZFKiw 5.11: GdHtho;Tf; Nfhl;ghLfs; 5.12: Kd;dhs; NehahsHfSldhd NeHfhzy;fs; ntspg;gLj;jpait (Perera, 2010) 5.13: guhkhpg;gpYk;> Nritiaj; jpl;lkpLtjpYk; Nritiag; ngw;Wf;nfhs;gthpd; <LghL 6.1: gadhspfSf;fhd KOikahd cseyd;

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,yq;ifapy; kf;fSf;fhd fpuhkpa mgptpUj;jp mikg;G (PRDA) nkhd;l;hpay; kf;fpy; gy;fiyf;fofj;jpd; gq;FilikAld; eilKiwg;gLj;Jk; kdtL kw;Wk; midj;Jyf Rfhjhu epfo;r;rpj;jpl;lk; (TGH) kdeyj; Jiwapy; Muha;r;rp> jpwd;tpUj;jpiaf; fl;bnaOg;Gjy; kw;Wk; VidNahUf;F mwpit toq;Fjy; vd;gJ rk;ge;jkhdjhFk;. 2008 [dthpapy; ,e;j epfo;r;rpj;jpl;lk; gy;fyhrhu csNeha; rpfpr;ir> juk;rhHe;j Ma;T Kiwapay; kw;Wk; r%f csNeha; rpfpr;ir rk;ge;jkhd xU thufhyg; gapw;rpr; nraykHTfis ngUkstpy; nkhd;l;hpay; gy;fiyf;fofj;jpd; tsthsHfspd; cjtpAld; mq;Nfhil Njrpa kdey epWtdj;jpy; (NIMH) elj;jpaJ. 2009 khHr;rpy;> ngUkstpy; cs;@H tsthsHfshy; NIMH,y; Ke;jpa nrayku;TfSf;Fg; gpd;duhd gpd;njhlH nraykHTfs; elj;jg;gl;ld. 2009 etk;ghpYk;> 2010 xf;NlhghpYk; ,yq;if kdey njhopy;rhH epGzHfspd; jpwd;tpUj;jpiaf; fl;bnaOg;Gk; ,yf;Fld; TGH epfo;r;rpj; jpl;lj;Jld; gq;Filikahfg; gzpahw;wpa If;fpa ,uhr;rpaj;jpd; ghHdl;> vd;gPy;l; kw;Wk; `hpq;Nf (BEH) kdey NHS ek;gpf;if epjpaj;jpdhy; xU njhluhd nraykHTfs; kl;lf;fsg;G kw;Wk; fz;b NIMH,y; elj;jg;gl;ld. ,e;j E}iy cseyj;Jf;fhd XH mwpKfkhfTk;> cseyj; Jiwapy; gzpahw;Wk; jhjpkhUf;fhd xU ife;E}yhfTk; cUthf;Fk; Kaw;rpapy; ,jd; gjpg;ghrphpaHfs; ,r;nraykHTfspypUe;Jk; ngw;w tplaq;fisg; gad;gLj;jpAs;sdH. ,e;j E}ypd; Nehf;fk; ,yq;iff;Fg; nghUj;jkhd mbg;gil cseyf; fUg; nghUl;fis ,yq;if thrfHfSf;F mwpKfQ;nra;tNjhL> ,j;jiyg;G rk;ge;jkhf cynfq;Fk; ,lk;ngWk; nghJthd njhlH ciuahly; Fwpj;j tplaq;fisAk; cs;slf;FtjhFk;. MapDk;> mtw;iwtpl Nkyjpfkhf> ,J ,yq;ifapy; csey Nritfspy;> tpNrlkhf ,U ngUk; epWtdq;fshfpa NIMH; (Kd;dH mq;Nfhil itj;jparhiy vd;W miof;fg;gl;lJ) kw;Wk; Ky;Nyhpah itj;jparhiyfspy; gzpahw;Wk; jhjpkhH gapw;rpf;Fg; gq;fspg;Gr; nra;tjhFk;. r%f NritahsHfis kdjpw;nfhz;L ,Njtpjkhd E}nyhd;W jahupf;fg;glTs;sJ. rfy ife;E}y;fSk; Nkw;$wpa mkHTfspy; rkHg;gzq;fisr; nra;Njhhpd; ifNaLfs;>

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1. cseyk; vd;why; vd;d?

cseyk; Fwpj;J ehk; NgRk;NghJ gyH kdNeha;fisg; gw;wpNa rpe;jpf;fpd;wdH. igj;jpak; (tpru; / pissu) my;yJ kdNeha;f;F toq;fg;gLk; gy;NtW cstpay; rpfpr;irg; ngaHfs; gw;wpr; rpe;jpf;fpd;wdH. cseyk; vd;gJ> ehk; mij vt;thW tiutpyf;fzg;gLj;jpaNghjpYk;> ntWkNd kdf;Fog;g epiy> Neha; ,y;yhik vd;gjy;y. kd cseyk; Fwpj;j tiutpyf;fzk; Nehpilahd xd;wy;y. r%f> fyhr;rhur; #oiyg;nghWj;J mJ NtWghlhd topfspy; Nehf;fg;gLtNj ,jw;fhd fhuzkhFk;. kdepiyfs; my;yJ kdNeha;fs; vd;W miof;fg;gLtd rk;ge;jkhd tpsf;fk; gjpNdohk; kw;Wk; gjpndl;lhk; Ehw;whz;Lfspy; Nkw;F INuhg;gpa fyhr;rhug; ghuk;ghpaq;fspd; gFjpahf mgptpUj;jpAw;w xd;whFk;. ,J kdNeha; rpfpr;ir> csg;gpsit> kdr;NrhHT kw;Wk; igj;jpaepiy Nghd;w cstpay; rpfpr;irg; gjq;fspd; gad;ghl;Lf;F ,l;Lr;nrd;Ws;sJ. ,J rpy tpahjpfisf; Fwpj;Jiug;gJ> gy gpd;dzpfspy; ,it ,g;Nghijf;F kpfr;rpwe;j Fwpg;Gg; ngaHfshf tpsq;fpaNghjpYk;> kdpjHfisg; Ghpe;Jnfhs;Sk; tplaj;jpy;> Vida kuGfspd; fz;Nzhl;lj;jpy; mtHfspd; gpur;rpidfis Nehf;FtJ vg;nghOJNk kpfTk; gaDs;sjhf mikakhl;lhJ vd;gijf; fhl;Lfpd;wJ. gy ehLfspy;> kdeyj;jpypUe;J tpyfpr;nry;tJ> kw;Wk; igj;jpak; cs;spl;ltifapy; kdNeha;fnsd;W miof;fg;gLgtw;iw cs;slf;Fk;tifapy; cseyg; gpur;rpidfs; vd;gijg; gad;gLj;JtNj toikahfpAs;sJ. ml;ltiz 1.1: cyf Rfhjhu ];jhgdj;jpd;(WHO) tiutpyf;fzk;; (WHO 2008) MNuhf;fpak; g+uzkhd cly;> cs kw;Wk; r%f ed;dpiy cseyk; WHO tpd; Rfhjhuk; Fwpj;j tiutpyf;fzj;jpy; cs;slf;fg;gl;Ls;s csey Mf;ff;$Wld; Neubahf my;yJ kiwKfkhfj; njhlHGw;w gue;j tPr;rpyhd nraw;ghLfisf; Fwpf;fpd;wJ.

cs MNuhf;fpak; kw;Wk; kdNeha; vd;W ehk; Ghpe;Jnfhs;Sk; tplaq;fis kf;fs; ,aw;ifahd #o;epiy> my;yJ kdpjj;jd;ik kw;Wk; Rghtk; rk;ge;jkhd gue;j cyff; fz;Nzhl;lj;jpd; mbg;gilapy; jkJ mDgtq;fSf;Fk;> czHTfSf;Fk; kf;fs; toq;Fk; mHj;jq;fshNyNa nghpJk; jPHkhdpf;fg;gLfpd;wd. cs MNuhf;fpak; vd;gJ kdpjHfs; vd;wtifapy; vkJ tho;Tf;F Kf;fpakhd tplaq;fisAk;> Md;kPfk;> nrhj;Jfs;> cwTfs;> cs;sj;J kfpo;r;rp> rka ek;gpf;iffs; kw;Wk; Vidait Nghd;w tho;tpd; gy;NtW mk;rq;fSf;F ehk; toq;Fk; typAWj;jy; vd;gtw;iw cs;slf;fpajhFk;. md;whlg; gpuhHj;jidfs; XH MNuhf;fpakhd kdj;Jf;F mtrpankd;W rpyH vz;zf;$Lk;. MapDk;> NtW rpyH fz;Zf;Fg; Gyg;glhj flTSf;Fr; nra;Ak; gpuhHj;jidNa cs ];jpukpd;ikapd; milahsnkd;W vz;zf;$Lk;. rpyH ngUkstpyhd nrhj;Jfs; ,y;yhtpby; mr;r czHT nfhs;Sfpd;wdH. mNjNtisapy; VidNahH jhk; nrhj;Jfspd; ngWkjpia nghpjhf kjpf;Fk;tifapy; mjpfsT gpizf;fg;gl;ltHfshfTk;> cs MNuhf;fpakw;wtHfshfTk; ,Ug;gjhf vz;Zfpd;wdH. czHr;rprhH epiyfSk;> elj;ijfSk; me;j Neuj;jpy; tof;fpypUf;Fk; r%f> fyhr;rhug; gpd;dzpfs;> re;ju;g;gq;fs;; kw;Wk; #o;epiyapy; Nehf;fg;gLjy; Ntz;Lk;. cjhuzkhf> Mf;fpukpg;G elj;ijnad;gJ xU NghHr; #oypy;> giltPuHfs; kj;jpapy; toikahdjhf (MNuhf;fpakhdjhf) fUjg;glf; $Lk;. mNjtpjkhd elj;ij xU tpUe;J epfo;r;rpNghd;w rhjhuz r%f #o;epiyfspd;fPo; mrhjhuzkhdjhf (MNuhf;fpakw;wjhf) fUjg;glf;$Lk;. xU kuz tPl;by; mOifnad;gJ xU rhjhuz czHr;rp epiyahfyhk;. MapDk;> mJ eifr;Ritj; jpiug;glnkhd;iwg; ghHf;Fk;Ntisapy; xU rhjhuz epiyahfhJ. MfNt> cseyk; vd;gJ kdpjHfnsd;wtifapy; vkJ tho;Tf;F Kf;fpakhd tplaq;fis cs;slf;Fk; xd;whFk;. MfNt> kdpjHfs; vd;wtifapy; vkJ tho;f;iff;F Kf;fpakhd tplaq;fisNa cseyk; cs;slf;Ffpd;wJ. cseyk; kw;Wk; Neha; rk;ge;jkhd tpsf;fk; fyhr;rhug; gpd;dzpahNyNa ngUksTf;Fj; jPHkhdpf;fg;gLfpd;wJ. fPioj;Njr ghuk;gupa Kiwapy; cseyd; gw;wpr; rpe;jpf;Fk; NghJ kdjpy;> rkepiyapy; kw;Wk; xj;jpirTj; jd;ikapy; gpur;rpidfisAila kf;fspd; tho;tpay; mDgtq;fis Nehf;fpdhy; jdpegupdJk;>

FLk;gk; kw;Wk; r%fj;jpdJk; Kf;fpa gq;F gw;wp czuKbAk;. Nkw;fj;jpa topKiwapy; Ra-g+uzj;Jtk;> tpidj;jpwd; kw;Wk; jdpegH RahjPdk; vd;git kpfTk; Kf;fpakhditahf tpsq;FtNjhL> gpur;rpidfs; Fwpg;gpl;l ,lq;fspy; (clypy; my;yJ kdjpy;) ,Ug;gitahfNt Nehf;fg;gLfpd;wd. NkYk; csneUf;fPLfSf;fhd my;yJ mjpypUe;J tpLgLtjw;fhd rpfpr;irapd; mHj;jk;Fwpj;J ehk; rpe;jpf;Fk;NghJ fPioj;Nja kw;Wk; Nkiyj;Nja kuGfs; kpfTk; tpj;jpahrkhd typAWj;jy;fisNa fhz;gpj;Jepw;fpd;wd. (ml;ltiz 1 kw;Wk; 2). ml;ltiz 1.2: cseyk; Fwpj;j ,yl;rpaq;fs; (ngHdhz;Nlh> 2009)
fPioj;Nja kuG Nkiyj;Nja kuG

xd;wpize;j jd;ik kw;Wk; xj;jpirT Ra-epiwT egUf;Fk;> #oYf;Fkpilapy; FLk;gq;fSf;fpilapy; r%fq;fspw;fpilapy; jhHkPf tpOkpaq;fs; njhlHgpy; r%f xUq;fpizT rkepiyahd nraw;ghL ghJfhg;Gk;> guhkhpg;Gk; jdpg;gl;l RahjPdk; tpidj;jpwd; Ra-kjpg;G

ml;ltiz 1.3: tpLjiy (Liberation) rpfpr;ir fpof;Fk; Nkw;Fk; (ngHdhz;Nlh> 2009)

fPioj;Nja kuG Vw;Wf;nfhs;sy; cly;-kdk;-Mj;kh xd;wpizT jpahdk; xj;jpriTj;jd;ik Nkiyj;Nja kuG fl;Lg;ghL cly;-kdk; ntt;Ntwhdit gpur;rpid jPHj;jy;

jdpg;gl;l RahjPdk; gFg;gha;T%yk; tpsf;fk;

tpopg;GzHT%yk; tpsf;fk;

ed;dpiy (Wellbeing) ed;dpiy vd;gJ fle;j jrhg;jq;fspy; cseyj;ijf; Fwpg;gjw;F gad;gLj;jg;gl;Ls;sJ. ngw;Wf;nfhs;Sk; xU topahfg; gad;gLj;jg;gl;Ls;sJ. (gy Nkw;fj;ija fyhr;rhuq;fspy; cs;sJ Nghd;W) jdpg;gl;ltu; ed;dpiy [subjective wellbeing (SWB)] vd;gJ xU jdpegUila fyhr;rhur; #oYf;F Vw;g mtuJ jdpg;gl;l> cwTfs; kw;Wk; Vida Njitfspd; jpUg;jpahd epiy vd;gjhNyNa czug;gl;Lte;jJ. Vnddpy; Nkw;$wg;gl;lit jdpegupy; ghjpg;ig Vw;gLj;jf;$baitahf ,Ue;jikapdhyhFk;.) gy Mrpa fyhr;rhuq;fspy; ed;dpiy Fwpj;j r%f mwpthw;wyhdJ jdpegH mwpthw;wy;fistplf; $Ljyhd Kf;fpaj;Jtk; tha;e;jitahFk;. ed;dpiy vd;gJ ngUk;ghYk; xU r%fk;rhHe;j tplakhFk;. ,q;F jdpegH kfpo;r;rp vd;gJ gpd;js;sg;gLk; tplakhfTs;sJ. ,yq;ifapy; ed;dpiy vd;gJ FLk;g tho;tpy; jpUg;jp> gps;isfspd; fy;tpapy; jpUg;jp> ghJfhg;G czHtpy; jpUg;jp (tPuf;nfhb kw;Wk; ngHdhz;Nlh> 2009Ig; ghHf;fTk;) Nghd;w xU gue;j tPr;rpyhd #o;epiyfs; kw;Wk; czHTfisf; Fwpg;gjhFk;. ed;dpiy vd;gJ xU gue;j tplag;gug;ghf Nehf;fg;gl Ntz;Lk;. vdNtjhd; ,J r%f> fyhr;rhur; #oypy; kf;fshy; ed;dpiy vd fUjg;gLtijAk; Fwpg;gjhf mikfpwJ. ed;dpiy vd;gJ kf;fshNyNa tiutpyf;fzk; nra;ag;gLjy; Ntz;Lk;. vdNt ed;dpiy vd;gJ ve;jnthU r%fj;jpdhYk; cseyk; vdf; fUjg;gLtij Fwpg;gjhf mikAk;. ehk; cseyKk;> ed;dpiyAk; [Mental Health and Wellbeing (MHW)] vd;gjlhf midj;ijAk; nfhz;Ls;s xU tplakhf fUjKbAk;. ,jw;F ,yq;ifapy; gad;gLj;jg;gLk; %d;W nkhopfspYk; Nenuhj;j nrhw;fshd (rpq;fsj;jpy;) a` [Ptda> (jkpopy;) ed;dpiy kw;Wk; (Mq;fpyj;jpy;) Wellbeing vd;git cs;sd. rpwe;j cseyj;jpypUe;J tpyfy;fs; vkJ cseyj;jpd; epiy vk; xt;nthUtHkPJk; jhf;fk; nrYj;Jfpd;wJ. Nkw;fj;jpa fyhr;rhu kuGfspy; ngwg;gLk; csNeha; rpfpr;ir Kiwfspy; Neha;fSf;fhd Fzq;Fwpfs;> kdjpy; Nehapay; rk;ge;jkhd caphpay; khw;wq;fisg; gpujpgypg;gjhf fUjg;gLfpd;wd. ,e;j mwpFwpfs; FOf;fshf tifg;gLj;jg;gl;L Neha;fis ,dq;fhZk;tifapy; csg;gpsit (schizophrenia)>

,UJUtf; NfhshW [Bipolar Disorder (BD)]> fz;bj Neha; [Obsessive-Compulsive Disorder (OCD)], gjfspg;G (neurosis), neUf;fPl;Lf;Fg; gpw;gl;l kdtL [Post-Traumatic Stress Disorder (PTSD)] vdg; gy;NtW ngaHfs; gad;gLj;jg;gLfpd;wd. Nkw;fj;jpa kdNeha; rpfpr;irapd; Nehf;fk; Neha;f;F my;yJ Neha;fSf;F kUe;Jfs; %yk; my;yJ Nehia Fzg;gLj;Jk; Vida rpfpr;ir Kiwfs;%yk; rpfpr;ir toq;FtjhFk;. jPtpu cskhia Neha;fs; vd milahsk; fhzg;gLfpd;w gpujhdkhf csg;gpsit my;yJ ,UJUtf; NfhshWfSf;F (BD) kUe;Jfs; my;yJ NtW ngsjPfj; jiyaPLfs; {kpd;typg;Gr; rpfpr;ir [Electrical Convulsive Treatment (ECT)]} Nghd;wd mtrpakhdit. mj;Jld; ,tw;Wldpize;J cstpay; rpfpr;ir KiwfSk; [csey rpfpr;ir kw;Wk; cstsj;Jiz (psychotherapy and counselling)] Kf;fpaj;Jtk; tha;e;jitahfNt fUjg;gLfpd;wd. MAHNtj> rpj;j kw;Wk; A+dhdp (Mrpa) itj;jpa Kiwfspy; Nehnad;W ngaH Fwpg;gplg;gLk; gpur;rpidfisg; gFg;gha;T nra;tjw;F kpfTk; tpj;jpahrkhd Kiwnahd;W gad;gLj;jg;gLfpd;wJ. ,dq;fhzg;gl;L> rpfpr;iraspf;fg;gLtJ xU Fwpg;gpl;l Nehapay; my; khwhf> mJ xU eghpDs; ,lk;ngWk; rkepiyapd;ik my;yJ xj;jpirtpd;ikahFk;. nghJthf MAHNtjj;jpy; Neha;Fwpj;j mZFKiw (Nkw;fj;jpa mNyhgjp itj;jpaj;jpy; fhzg;gLtJNghd;W) ntWkNd xU FWfpa caphpay;rhH tplaky;y> mJ xU KOikahd xd;whFk;. mJ tho;f;ifKiw Fwpj;j mwpTiu> %ypif kUe;Jfs;> Mj;kPf gapw;rpfs; Nghd;wtw;wpd; xU fyitahFk;. mJ ntWkNd kUe;Jfs; kw;Wk; cly;hPjpahd jiyaPLfSf;F khj;jpuk; kl;Lg;gl;l xU tplaky;y. MAHNtjj;jpy; cd;kj;jk; (my;yJ igj;jpak;) ed;F mwpag;gl;l xU tplakhftpUe;jNghjpYk;> gy gpur;rpidfs; (cstpay; rpfpr;irapy; kdNeha; vd;W $wg;gLgit) mq;F Fwpg;gpl;l xU NehapaYf;Fl;gl;l xU Nehahf Nehf;fg;gLtjpy;iy. MfNt> mit Mj;kPf rpfpr;ir Kiwfs; vd miof;fg;gLtdtw;WlDk; (cjhuzkhf ke;jpuq;fis cr;rhpj;jy; kw;Wk; jhaj;Jfisf; fl;Ljy;)> kjf;fphpiafSlDk; (Ntj newpfis mDrhpj;jy; kw;Wk; jpUg;gjpfq;fis XJjy; Nghd;wit) ifahsg;gLfpd;wd. ,it midj;Jk; kUe;JfSlDk;> kw;Wk; Vida cliiyg; gpbj;JtpLjy; nraw;ghLfSlDk; ,ize;J ,lk;ngWfpd;wd.

ml;ltiz 1.4: mZFKiwfs;

Kiwfs; mNyhgjp kUj;Jtk; (csNeha; rpfpr;ir) MAHNtj rpj;j a+dhdp

cseyg;

gpur;rpidfSf;fhd

gy;NtW

gpujhd fhuzq;fs;

ghpfhuq;fs;

capupay; khw;wq;fshy; clypay; uPjpahd cUthFk; Neha;fs; jiyaPLfs; kdjpYk;> clypYk; rkepiyapd;ik KOikahd mZFKiw (tho;f;ifg;ghzp> kUe;Jfs;> Mj;kPf hPjpapy; Fzkhf;Fjy;)

Mj;kPf hPjpapy; Fzg;gLj;Jjy;Fzkhf;fy; rlq;Ffs; Mrpa ehLfspy; kUj;Jt ghuk;ghpaq;fisj; jtpu NtW gy Fzkhf;fy; kuGfs; toq;fptUfpd;wd. cz;ikapy;> ,yq;ifapy; cstpay; rpfpr;ir Kiwahy; tpahjpfnsd;W ngahplg;gLk; gy epiyikfSf;fhd gpujhd mZFKiw rka eilKiwfNshL ,izg;Gw;w Mj;kPf topfspD}lhf Vw;gLj;jg;gLk; Fzkhf;fNyahFk;. ml;ltiz 1.5: ,yq;ifapy;; Kiwfs; (Vogt, 2005) fpilf;ff; $ba Fzkhf;fy;

Nkw;fj;ija (mNyhgjp) kUj;Jtk; MAHNtj kUj;Jtk; Fzg;gLj;jy; rlq;Ffs;: njhtpy;> g+i[fs; Nghd;wit Nrhjpl MNyhrid jHkj;jpd; mbg;gilapyhd eilKiw mwpTiu> gphpj; rlq;Ffs;> jpahdk; FLk;g r%f MjuT ghuJ}ukhd kNdh tpahjpfnsd;W miof;fg;gLtdtw;iwf; Fzkhf;Fk; RNjr itj;jpaHfs; Nga; tpul;Ltjpy; ifNjHe;jtHfshtH mj;Juh my;yJ fl;lhbah. N`hkhfk fpuhkj;jpy; trpf;Fk; fl;lhb xUtH %d;W khj fhyg; gFjpapDs;

gy;NtW tiffspyhd njhtpy; rlq;Ffisg; gad;gLj;jp 25 gpy;yp #dpak;> 50 Nga; gpbj;jy; kw;Wk; 60 FLk;gg; gpzf;F tpla epfo;TfSf;Fj; jPHTfz;Ls;sjhfr; rkPgj;jpa mwpf;ifnahd;W njhptpf;fpd;wJ (FRkhuj;d> 2005). ,r;RNjr itj;jpaHfs; Ml;fis ve;j msTf;Ff; Fzkhf;Ftjpy; ntw;wpailfpd;whHfs; vd;W njhpatpy;iy. MapDk; kf;fs; njhptpg;gjd; gpufhuk; ntw;wp tPjk; (Nkw;fj;jpa) cstpay; rpfpr;irf;F epfuhdjhf tpUf;ff;$Lk;. jhq;Fjpwd; jdpegH jhq;Fjpwd;; vz;zf;fU ,d;dy;fis vjpHnfhs;Sk;NghJ mNdfkhd kdpjHfs; tYtile;NjhuhfTk;> NkYk; kdtsk; kpf;NfhuhfTk; Gj;jhf;fk; ngWtjhfj; njhptpf;fpd;wJ. jhq;Fjpwd; Mw;wy; jdpg;gl;l MSikg; gz;Gfs;> FLk;gq;fSk;> r%fq;fSk; ,ize;J nrayhw;Wk; tpjk;> ,irthf;fk;> njhlHghly;fs; kw;Wk; FOthfr; nraw;gLjy; vd;gtw;wpypUe;J fpl;LtjhFk;. jhq;Fjpwd; Mw;wy; rkaq;fNshL ,izg;Gw;wit vd;wtifapy; r%f eltbf;iffspD}lhf Nkk;gLj;jg;glyhk;. MfNt> xU FOtpd; ek;gpf;if Kiwikfs; kf;fs; ,d;dy;fis vjpHnfhs;Sk;NghJ vt;thW gjpy; eltbf;if Nkw;nfhs;Sfpd;wdH vd;gjpy; xU Kf;fpa ghj;jpuj;ij tfpf;fpd;wd. cjhuzkhf> kj ek;gpf;ifAs;stHfs; Nfhtpy;fs;> Njthyaq;fs; kw;Wk; gs;spthry;fspYs;s kjFUkhhplk; cjtpia ehlyhk; my;yJ kjf; fphpiafspy; <Lglyhk;. vt;thwhapDk;> ,yq;ifapy; ahj;jpiuj; jyq;fSf;Fr; nry;Nthhpd; vz;zpf;ifia Nehf;Fk;NghJ> Fwpg;ghd kj ek;gpf;ifaw;wtHfs;$l neUf;fPL my;yJ NtW ,d;dy;fis vjpHnfhs;Sk;NghJ gy;NtW kj KftH epiyaq;fis mZFfpd;wdnud;W $wyhk;. cz;ikapy;> gy ,yq;ifaHfs; mtHfs; mDgtpj;j rkPgj;jpa ,d;dy;fspypUe;J kpfTk; caHe;j kl;lj;jpyhd jhq;Fjpwd;; Mw;wiyf; fhz;gpj;Js;sdnud;W fUj;JiuahsHfs; njhptpj;Js;sdH.

10

2. cseyk; (\Neha;|) kw;Wk; guhkhpg;G Kiwfs; ghjpf;fg;gLjy;

cseyk; vd;gJ ehk; midtUk; nghpJk; tpUk;Gk; xd;whFk;. MapDk; cs MNuhf;fpa epiy vd;gJ epiyahd xU tplaky;y. ehk; midtUk; vkJ ];jpuepiyiag; ghjpf;Fk; gy;NtWtifahd kd mOj;jq;fSf;F Kfq;nfhLf;fpd;Nwhk;. kd ];jpuepiyia kPl;Lf;;nfhs;tjw;F ehk; vg;nghOJk; vkJ kPz;nlOk; Mw;wy;kPJ jq;fpepw;f KbahJ. rpwg;ghd cs MNuhf;fpaj;jpypUe;J rpW tpyfy;fisf; fhl;Lk; Mjq;fq;fSk;> kdr;NrhHTfSk;> toikf;F tpNuhjkhd elj;ijfSk; vk;kidthplj;jpYk; cz;L. ,e;j tpyfy;fis cseyg; gpur;rpidfs; vd;W miof;fyhk;. MapDk; gpur;rpidfs; tof;fkhf vk;ik kPwpr; nrd;WtpLtjpy;iy my;yJ rkar; rlq;Ffs;> ke;jpuq;fs;> jpahdq;fs;> n[gq;fs; kw;Wk; Vida tplaq;fs; Nghd;w> fyhr;rhuhPjpapy; mq;fPfhpf;fg;gl;l nraw;ghLfspd; cjtpAld; mtw;iw ntw;wp nfhs;Sfpd;Nwhk;. vt;thwhapDk;> mt;tg;NghJ cs MNuhf;fpaj;jpy; ghjpg;G Vw;gLfpd;wJ. mjd; gpd;dH VjhtJ jiyaPL my;yJ rpfpr;ir toikahfj; Njitg;gLfpd;wJ. ,J jdpegiu ,yf;Fitf;Fk; kUj;JthPjpahd jiyaPlhf> rka my;yJ Fzg;gLj;Jk; rlq;Ffshf> (jdpegHfis Kiwahff; fUkg;glr; nra;J> gpur;rpidfis ntw;wpnfhs;s cjTk;) r%f kw;Wk; FLk;g MjuT topKiwfshf ,Uf;fyhk;. cs MNuhf;fpa Kd;Ndw;wk; vd;gJ ,j;jifa ghjpg;Gfisj; jLg;gij Nehf;fkhff; nfhz;ljhFk;. ml;ltiz 2.1: cseyj;ij Kd;Ndw;Wtjd; Nehf;fq;fs; jd;dk;gpf;ifiaAk;> VidNahhpy; ek;gpf;ifiaAk; fl;bnaOg;Gjy;. tYthd mk;rq;fisf; fl;bnaOg;Gjy; - jdpg;gl;l kw;Wk; r%fuPjpahd jdpegH jhd; ngWkjpahdtu; vd;gij czuTk;> VidNahupd; ngWkjpia czuTk; cjTjy;. cly;hPjpahd kw;Wk; r%f ,lHfisf; ifahSjy;

11

csg;ghjpg;gpd; jhf;fk; ghpfhukspf;Fk; jiyaPLfs; xU eghpd; cseyk; rhpahf ,y;yhtpby;> tpNrlkhf mtH xU NfhshW my;yJ tpahjpahy; ghjpg;Gw;wpUe;jhy;> egH jdf;Fj;jhNd ghjfkhd ghjpg;Gf;F MshtNjhL> me;j egNuhL njhlHGw;w xt;nthUtUk; ghjpg;Gf;F cs;shfpd;wdH. kw;wtu;fSldhd cwTfs;> FLk;g tho;T kw;Wk; r%f,izg;G vd;gd ghjpg;Gf;Fs;shfpd;wd. MfNt> ,ad;wsT tpiutpy; mtH rpwe;j cs MNuhf;fpa epiyf;F kPl;nlLf;fg;gLtJ xt;nthUtUf;Fk;> KO r%fj;Jf;Fk; Kf;fpakhdjhFk;. ,J me;j eghpd; nfsutj;ijg; Ngzp> mtuJ (mthpd; FLk;gj;jpdJk;) kdpj chpikfisf; nfsutpj;J> FLk;gj;jpYk;> r%fj;jpYk; mjpFiwthd Fog;g epiyAld; nra;ag;gLjy; Ntz;Lk;. jiyaPLfs; r%fj;jpy; my;yJ xU epWtdj;jpy; Kd;ndLf;fg;glyhk;. mJ (Nehahsp vd;W ,dq;fhzg;gLk;) xU jdpegiu my;yJ mtH NrHe;jpUf;Fk; FLk;gk; my;yJ r%fk; Nghd;w FOit ,yf;Fitf;fyhk;. Fzkhf;fy; r%fk; vd;gJ xU epWtdj;jpDs; eilKiwg;gLj;Jk;tifapy; tFj;jikf;fg;gl;l XH jiyaPlhFk;. ,q;F (,q;fpUf;Fk; kf;fisf;nfhz;l) xU nraw;ifahd r%fk; cUthf;fg;gl;L> mDruizaspf;fg;gLk;. FO mkHTfs; elhj;jg;gl;L> ,q;Fs;stHfs; Nkhjy; Kuz;ghLfspd;wp xd;WNrHe;J thOk; toptiffis mgptpUj;jpnra;tjw;F cjtp toq;fg;gLfpd;wJ. ,e;j mZFKiw cz;ikapy; jdpegHfspilNa cwTg; gpur;rpidfisf; nfhz;ltHfs; tplaj;jpNyNa gaDWjpkpf;fjhf tpsq;fpaJ. ml;ltiz 2.2: jdpegH cseyj; jiyaPLfs; jdpegH rpfpr;irKiwfs; rpfpr;ir Nghd;wit) FOr; rpfpr;irKiw FLk;g rpfpr;irKiw r%f MjuT (kUe;J rpfpr;irKiw> cstpay;

12

csey guhkhpg;G Kiwfs; kw;Wk; jiyaPLfs;rpfpr;ir ,t;tplj;jpy; ,uz;L epfo;Tz;ikfisf; ftdpj;jy; Ntz;Lk;. (m) ,yq;if kf;fs; vg;nghOJk; cs MNuhf;fpag; gpur;rpidfisf; nfhz;ltHfSf;F cjtpiaAk;> rpfpr;iriaAk; ngw;Wf;nfhs;tjw;Fg; gy;NtW topKiwfisg; gad;gLj;jpte;Js;sdH> kw;Wk; (M) mJ mNyhgjp (Nkw;fj;ija) cstpay; rpfpr;irahf ,Ue;jhYk; rhp> kjhPjpahd jiyaPLfshftpUe;jhYk; rhp> rlq;Ffs;%ykhd Fzkhf;fyhftpUe;jhYk; rhp> my;yJ RNjr itj;jpa rpfpr;irKiwfshftpUe;jhYk; rhp. ve;j xU tifahd mZFKiwapdJk; xg;gPl;LhPjpahd gaDWjpFwpj;j njspthd rhd;W vJTkpy;iy. rfy tifahd rpfpr;irKiwfSk;> jdpegH mbg;gilahdjhftpUe;jhYk; rhp> r%f mbg;gilahdjhftpUe;jhYk; rhp> kUj;JthPjpahdjhftpUe;jhYk;> rhp> kj hPjpahdjhftpUe;jhYk; rhp> gadw;witahftpUf;fyhk; Njitaw;w tpisTfisf; nfhz;bUf;fyhk; (,it Ml;fSf;Fr; Nrjk; tpistpf;Fk; tpisTfshfTkpUf;fyhk;). kw;Wk; my;yJ itj;jpaHfs; Nghd;W Nt~k;NghLk; Vkhw;Wf;fhuHfshy; J~;gpuNahfKk; ,lk;ngwyhk; vd;gijAk; ftdpj;jy; Ntz;Lk;. mNyhgjp (Nkw;fj;ija) cstpay; rpfpr;ir (cjhuzkhf> kUe;Jfis $ba msTfspy; nfhLg;gjhy;> my;yJ kpd;rhu typg;G rpfpr;iria mbf;fb toq;Ftjhy; Ml;fSf;Fr; Nrjk; tpisaf;$Lk;). ,t;thNw> kj KftH epiyaq;fspd; Mj;kPfr; rpfpr;irKiwfSk; jkJ nrhe;j cjtp toq;f ,ayhikia Nehf;fhJ> njhlHe;Jk; ek;gpf;iffis Kd;ndLg;gjd;%yk; (cjhuzkhf n[gpj;jy;) cz;ikapy; jPq;ifNa Vw;gLj;jyhk;. ,ayhikahy; f~;lKWk; kf;fspd; Njitfis cjhrPdk; nra;Ak; mNjNtisapy;> kuGrhH itj;jpa Kiwfs;%yk; ,tw;Wf;F NkYk; rpwg;ghd cjtpia toq;fyhk; vd;gijg; ghHf;fj; jtWfpd;wdH. rpyH jPa rf;jpfis my;yJ Nga;fis Xl;Lk; Nehf;fpy; fl;bitj;J> mbf;Fk;; kdpjhgpkhdkw;w nfh^ur; nray;fSf;Fk; cs;shf Nehplyhk;. rkPgj;jpy;> tpNrlkhf Nkw;F my;yhj fyhrhug; gpd;dzpfisr; NrHe;jtHfs; tplaj;jpy; Nkw;F ehLfspd; (c-k;: UK) kuGrhH Nkw;fj;jpa (mNyhgjp) cstpay; rpfpr;irapd;

13

gaDWjpFwpj;Jg; ngUkstpyhd re;Njfq;fs; vOg;gg;gl;Ls;sd. Nfushtpy; ,lk;ngw;w rkPgj;jpa Ma;nthd;W (Haliburton, 2004) %d;W tpjkhd rpfpr;ir tbtq;fisg; ngw;Wf;nfhz;l ghuJ}ukhd cseyg; gpur;rpidfisf;nfhz;l egHfspd; mDgtq;fis Nehf;fpaJ. ,it MAHNtjk;> (Nkw;fj;jpa) mNyhgjp kdNeha;; rpfpr;ir kw;Wk; kj hPjpahd Fzg;gLj;jy; vd;gitahFk;. midj;Jklq;Fk;tifapy; ghHf;Fk;NghJ> %d;W mZFKiwfSNk rkkhd mstpy; gaDWjptha;e;jitahfj; Njhw;wkspj;jd. xU KiwapypUe;J gad;ngw;Wf;nfhz;ltHfs; NtnwhU KiwapypUe;J gad;ngwtpy;iy. rpfpr;irf;fhd gy;NtW mZFKiwfs; ,Uj;jy; kw;Wk; NehahspfSk;> cwtpdHfSk; njhpTnra;af;$bajhftpUj;jy; midtUf;Fk; mjp$Ljyhd ngWNgWfis cWjpnra;fpd;wJ vd;gijj; Njly; Kiwfs; vLj;Jiuf;fpd;wd. njd;dpe;jpahtpy; ,lk;ngw;w NtNwhH Ma;T (Raguram et al. 2002) csg;;gpsit kw;Wk; ,UJUtf; NfhshW Nghd;w cstpay; rpfpr;ir tFg;gpdg;gLj;jiyr; NrHe;j Neha;fshy; ghjpg;Gw;NwhH tplaj;jpy; Nfhtpy; Rfg;gLj;jy; Kiwfs; kuGrhH cstpay; rpfpr;irKiwfisg; Nghd;W gaDWjpAs;sit vd;gijf; fhl;bAs;sd. jw;Nghija rpfpr;ir Kiwfspd; gaDWjpFwpj;j mwpT kl;lj;jpypUe;J ghHf;Fk;NghJ> my;yJ mwptpd;ik kl;lj;jpypUe;J ghHf;Fk;NghJ mZF Kiw jpwe;j kdg;ghd;ik kw;Wk; eilKiwg; gad;rhHe;j xd;whftpUj;jy; Ntz;Lk;. rpfpr;ir rk;ge;jKw;w egUf;F mD$ykhdjhf my;yJ mthpd; FLk;gj;jpdhpd; tpUg;Gf;Fhpajhf ,Uf;Fk;tiuapy;> mj;NjhL rpfpr;ir kdpjhgpkhdk; cs;sjhfTk;> jPq;fw;wjhfTk; ,Uf;Fk;tiuapy; kUj;JthPjpahd my;yJ Mj;kPfhPjpahd ve;j tbtj;jpYkhd rpfpr;iriag; Gwe;js;sp tplhjpUg;gJ Kf;fpakhdjhFk;. kdpjHfspd; kdpj chpikfs; vg;nghOJk; kjpf;fg;glNtz;Lnkd;gNjhL> kNdhtpahjpahy; ghjpg;Gw;NwhH my;yJ jPa Mtpahy; gPbf;fg;gl;NlhH fl;bitf;fg;gLjy; my;yJ mbf;fg;gLjy; Nghd;w kdpjhgpkhdkw;w nraw;ghLfSf;F cs;shf;fg;gLjyhfhJ. KOf;f KOf;f ,d;wpaikahjjhf ,y;yhtpby;> mtHfspd; Rje;jpuk; gwpf;fg;gLjyhfhJ. (td;nray; kw;Wk; Fok;gpa elj;ijFwpj;j 4Mk; mj;jpahaj;ijg; ghHf;fTk;.)

14

,yq;ifapy; kf;fs; cseyk; rk;ge;jkhd gpur;rpidfis vjpHnfhs;Sk;NghJ mtHfs; gy;NtW tiffspyhd cjtp%yq;fis ehLk; #o;epiyNa fhzg;gLfpd;wJ. gpujhdkhf Ml;fs; FLk;gj;jpdJk;> ez;gHfspdJk;> kw;Wk; r%fj;jpdJk; Mjuit ehLfpd;wdH. ,jw;F ntspapy; mtHfs; Nkw;fj;jpa (mNyhgjp) itj;jpaKiwapy; gapw;rpngw;w (Nkw;fj;jpa) kdNeha; rpfpr;ir Kiwapy; gapw;wg;gl;ltu;fisAk;> MAHNtj> rpj;j kw;Wk; A+dhdp RNjr itj;jpaHfisAk; (IMP)> gy;NtW rlq;Ffs;%yk; Fzg;gLj;JNthiuAk;> kj epWtdq;fisAk;> kjFUkhiuAk;> gy;NtW tifahd cstsj;Jizahsu;fisAk;> r%f NritahsHfisAk; ehLfpd;wdH. gyUf;Fr; rpy rpfpr;ir Kiwfisg; ngw;Wf;nfhs;tJ kpfTk; nryT epiwe;jjhftpUf;fyhk;. mj;NjhLmy;yJ mit Vkhw;Wf;fhuHfshy; kf;fisr; Ruz;Ltjw;Fg; gad;gLj;jg;glyhk;. NkYk;> cseyg; gpur;rpidAs;stHfs; fl;bitj;J> mbf;fg;gLtjd; %yk; NkhrkhfTk; elj;jg;glyhk;. ,J vg;nghOJNk ,uf;fkw;w xU eilKiwahff; fz;bf;fg;gLjy; Ntz;Lk;. cseyg; guhkhpg;Gj; Jiwapd; etPd mZFKiw xU rkepiyahd guhkhpg;G Fwpj;Jg; NgRk; xd;whftpUj;jy; Ntz;Lk;. ,J epWtd mbg;gilapyhdJk;> r%f mbg;gilapyhdJkhd xU fyitahftpUj;jy; Ntz;Lk;. gaDWjpAs;s r%fg; guhkhpg;G vd;gjd; fUj;J> egUf;F mtrpakhd MjuitAk;> rpfpr;iriaAk; toq;ff; $ba Ml;fisAk;> KftH epiyaq;fisAk; ,dq;fz;L> mZfp> FLk;gk;> ez;gHfs;> maytHfs; kw;Wk; r%fk; Nghd;w ,aw;ifahd MjuT Kiwikfis mzpjpul;br; nraw;gLj;JtjhFk;. mj;NjhL Fwpg;gpl;l egH r%fr; nraw;ghLfspy; <LgLtjw;Fk;> VidNahUld; gpur;rpidfisj; jPHj;Jf;nfhs;tjw;Fk;> fyhr;rhuk; kw;Wk; gpd;dzpAld; ,zf;fkhdnjd;W mtH vz;Zk; cjtp topKiwfisg; ngw;Wf;nfhs;tjw;Fk; MjuT mtrpag;gLk;. MfNt> guhkhpg;ig vtH toq;fpaNghjpYk;> fyhr;rhuhPjpapy; nghUj;jkhd jhfTk;> mg;gpuNjrj;jpd; r%f kw;Wk; murpay; ajhHj;jq;fisf; ftdj;jpw; nfhs;tjhfTk; ,Uj;jy; Ntz;Lk;.

15

ml;ltiz 2.3: Nritfspy; etPd mZFKiwfs; epWtd guhkhpg;Gf;Fg; gjpyhf rpW myFfs; kw;Wk; r%fj;jpd; fyitahd guhkhpg;G fyhr;rhu kw;Wk; r%fg; gpd;dzpfSf;F ,irthf;fk; nra;ag;gl;lJ. c-k;: ,yq;ifapy; FLk;gk; rk;ge;jKWtJ Kf;fpakhdjhFk;. rka kw;Wk; Mj;kPf uPjpahd tplaq;fs; ftdj;jpy; nfhz;L ntspg;gLj;Jjy; mtrpak; RNjr itj;jpa KiwfSf;F gq;fspg;gjw;F tha;g;G toq;fNtz;Lk;;. Mj;kPfhPjpapy; Fzg;gLj;jy; mDkjpf;fg;gLjy; Ntz;Lk;. cseyk; rk;ge;jkhd RNjrpaf; fUg;nghUl;fSf;F kjpg;gspj;jy; Ntz;Lk;. Nrit toq;fYf;fhd mZFKiwfs; caphpay; kUj;Jt kw;Wk; r%f

(Nkw;fpy; cUthf;fg;gl;l) csNeha;; rpfpr;ir Kiwapy; tpahjpfSf;fhd fhuzq;fs; caphpay;-guk;giuapay; vd mDkhdpf;fg;gLtjhy; mJ caphpay;- kUj;Jtkhfpd;wJ. ,J caphpay;-kUj;Jt Neha; khjphpnad;W miof;fg;gLfpd;wJ. ,q;Fs;s gpujhd mZFKiw eghpd; caphpay; nraw;ghl;ilg; ghjpf;Fk; kUe;Jfis my;yJ Vida cly;hPjpahd rpfpr;irfis toq;FtjhFk;. ,q;F r%f kw;Wk; cstpay; jiyaPLfSk; rpfpr;irf;fhd Nkyjpf tplaq;fshfg; gad;gLj;jg;glyhk; (1Mk; mj;jpahaj;ijg; ghHf;fTk;). Vida fyhr;rhuq;fspy; (Nkw;fj;ija) csey rpfpr;iriag; gpuNahfpg;gJ Fwpj;j nrhw;gjk; fyhr;rhuq;fSf;fpilapyhd cstpay; rpfpr;ir vd;W miof;fg;gLfpd;wJ. ,q;F Nehapd; mwpFwpfs; gpur;rpidfshy; mtjpAWk; Ml;fspd; fyhr;rhug; gpd;dzpapy; jq;fpAs;s khwpfshf Nehf;fg;gLfpd;wd. tpahjpfs; ntWkNd r%ff; fhuzq;fSf;fhf epHkhzpf;fg;gl;l fUj;jpay; tplaq;fshf Nehf;fg;gLfpd;wd. ,J rpwpJ khw;wk;nra;ag;gl;l XH caphpay; - kUj;Jt cstpay; rpfpr;irahFk;. Nrit toq;fy; vg;nghOJk; Nritiag;

16

ngw;Wf;nfhs;Nthhpd; r%f kw;Wk; fyhr;rhur; #oy;fisf; ftdj;jpw; nfhs;Sjy; Ntz;Lk;. Mrpaf; fyhr;rhuq;fspYk;> tpNrlkhf ,yq;if kf;fspd; fyhr;rhuq;fspy; kf;fspd; Mj;kPf mk;rq;fs;> kjk;> FLk;g cwTfs; kw;Wk; xUtNuhnlhUtH nfhz;Ls;s cwTfs; rk;ge;jkhd czHTfs; vd;git jdpeghpd; caphpay; mk;rq;fisg;NghyNt Kf;fpak; tha;e;jitahFk;. MfNt (Nkw;fj;jpa fyhr;rhuj;jpy; cUthFk;) caphpay;-kUj;Jt Neha; khjphpapd; ngWkjp jd;dstpy; kpfTk; kl;Lg;gLj;jg;gl;l xd;whFk;. ,yq;ifapd; fyhr;rhug; gpd;dzpfSf;F (Nkw;fj;jpa) cstpay; rpfpr;irapy; fhzg;gLk; mwpitg; gad;gLj;Jk; kpfr;rpwe;j top fyhr;rhuq;fSf;fpilapyhd cstpay; rpfpr;irAld; ,ize;j xU r%f mZFKiwiag; gad;gLj;JtjhFk;. Neha;Fwpj;j r%f mZFKiwapy; Ml;fisg; ghjpf;Fk; gpur;rpidfs; mtw;wpd; r%fj; jhf;fj;jpd; gpufhuk; gFg;gha;T nra;ag;gl;L> ghprPyid nra;ag;gLfpd;wd. caphpay; - kUj;Jt mZFKiwapy; ,lk;ngWtJNghyNt Neha;fs; fz;lwpag;gl;L> ngaHfSk; toq;fg;gLfpd;wd. MapDk; mtw;wpd; gpwg;gpay; kw;Wk; fhuzk; vd;git gpujhdkhf xU jdpeghpd; caphpay; njhopw;ghl;by; khw;wq;fshf Nehf;fg;gLtjpy;iy. mit gpur;rpidfSf;F mtHfspd; nrhe;jg; gjpy; nraw;ghLfs; kw;Wk; kd ,lH ntspg;ghLfspd; xU fyitahfNt Nehf;fg;gLfpd;wd. ,e;j ntspg;ghLfs; mtHfs; jk;ik xU egnud;wtifapy; vt;thW Nehf;Ffpd;wdH kw;Wk; kdpjr; #o;epiyFwpj;j mtHfspd; mbg;gilahd ek;gpf;iffs; - tho;tpd; mHj;jk; kw;Wk; tho;tpd; Nehf;fk; vd;gtw;iwg; nghWj;Jg; ngUkstpy; NtWglf;$baitahFk;. tpahjpFwpj;j xU r%ff; fz;Nzhl;lj;jpy; Kf;fpakhd tplak; me;j egUld; gzpahw;WtJk;> mtUld; neUf;fkhfj; njhlHGw;wtHfSld; gzpahw;WtJk;> ,lHfspypUe;J ntspNaWk; topiaf; fhz;gpg;gjw;F cjTtJkhFk;. mtrpakhdtplq;fspy; kUe;Jfs;; xU ghj;jpuj;ij tfpf;ff;$Lk;. MapDk;> ,it vg;nghOJk; cstpay; rpfpr;ir (Ngr;R rpfpr;irfs;)> cjtpiag; ngw;Wf;nfhs;Sk; RNjr topKiwfs; (Mj;kPfhPjpapy; Fzg;gLj;jy; Nghd;wit) kw;Wk; mtHfs; thOk; r%fg; gpd;dzpfspy; khw;wq;fs; Nghd;w jiyaPLfSld; ,izf;fg;gLjy; Ntz;Lk;.

17

,yq;ifapy; (Nkw;fj;jpa) kd Nehapy; cseyg; guhkhpg;G Mrpahtpy; gy Njrq;fspy; ,lk;ngw;wJNghyNt> epWtdq;fs; mbg;gilapyhd XH csey Kiw Kd;dH Gfyplq;fs; vd;W miof;fg;gl;l kdNeha; itj;jparhiyfs; ,yq;ifapy; gphpj;jhdpa FbNaw;wthj murhq;fj;jpdhy; Vw;gLj;jg;gl;litahFk;. ,g;nghOJ fhk;ngy; ghHf; vd miof;fg;gLtjw;F ntF mz;ikapy;> nfhOk;G khtl;lj;jpy; mike;Js;s nghuisapy; xU rpwpa itj;jparhiy ,yq;ifapd; KjyhtJ kdNehahsH Gfyplkhf khw;wpaikf;fg;gl;L> 1847,y; jpwe;Jitf;fg;gl;lJ. 20k; E}w;whz;bd; Muk;gg;gFjpapy; gpujhd gl;bdq;fspy; mtjhdpg;G myFfs; epWtg;gl;ld. ,Wjpapy; 1926,y; 1830 NehahsHfisj; jq;fitf;Fk;tifapy; mq;Nfhil kdNehahsH Gfyplk; jpwe;Jitf;fg;gl;lJ. FbNaw;wthj murhq;fj;jpdhy; epHkhzpf;fg;gl;l ,g;Gfyplk;> rfy Kaw;rpfisAk; Nkw;nfhz;l gpd;dH filrp Kaw;rpahf cwtpdHfs; xUtiuf; nfhz;Lte;J NrHf;Fk; Xhplkhf my;yJ igj;jpak; vd;W nghyPrhuhy; ,dq;fhzg;gLk; xUtiu XH cwtpdH my;yJ ez;gH te;J tPl;Lf;F mioj;Jr;nry;Yk; tiuapy; milj;Jitf;Fk; Xhplkhf tpsq;fpaJ. mj;NjhL> mJ VNjhnthU fhuzj;jpd; epkpj;jk; mtHfsplkpUe;J tpLgl tpUk;Gk; cwtpdHfs; my;yJ VidNahH mtHfisf; fhtypy; itf;Fk; XhplkhfTk; tpsq;fpaJ. vdNt> mDkjpf;fg;gl;lJk; mtHfs; cwtpdHfshy; iftplg;gl;ldH. xU Nehahsp FzkilAk;NghJ mtH tPL nry;yNtz;Lnkd;gij cwtpdHfSf;F tpsq;fg;gLj;Jk; Kaw;rpfs; ntF rkPgj;jpNyNa Nkw;nfhs;sg;gl;ld. ntsp NehahsH rprpf;ir epiyaq;fspy; mNyhgjp (Nkw;fj;jpa) cstpay; rpfpr;irfs; fpl;LtJk; xg;gPl;LhPjpapy; rkPgj;jpy; ,lk;ngw;w xd;whFk;. kf;fs; cseyg; gpur;rpidfSf;fhd cjtpfisg; ngw;Wf;nfhs;Sk;tifapy; gy;NtW %yq;fis ehLfpd;wdH vd;gJk; mq;fPfhpf;fg;gl;Ls;sJ. 1980fspd; gpw;gFjpapypUe;J murrhu;gw;w epWtdq;fs; r%f mbg;gilapyhd csey guhkhpg;ig toq;FtjpYk; epajpr;rl;lj; JiwapDs; tpNrl Nritfis toq;FtjpYk; XusT ghj;jpuj;ij tfpj;Jte;Js;sd. ,it Nest (http://www.nestlanka.com) kw;Wk; BasicNeeds (http://basicneeds.org) Nghd;w mikg;Gfshy; toq;fg;gLk; Nritfis cs;slf;Ffpd;wd. 2005 Mk; Mz;L

18

cseyj; jpl;lnkhd;W ntspaplg;gl;L> epajpr;rl;lj;JiwapDs; r%fj;Jf;fhd rpy Nritfs; mwpKfg;gLj;jg;gl;ld. ,g;nghOJ ehl;bd; gy gFjpfspy; gy ntspNehahsH rpfpr;ir epiyaq;fSk;> xUrpy GdHtho;T myFfSk; cs;sd. mj;NjhL> Rw;way; $W itj;jparhiyfspy; rpwpa myFfs; ];jhgpf;fg;gl;Ls;sd. fy;Kidapy; fhzg;gLtJNghd;w (http://www.kamha.org) ,tw;Ws; rpy ,lj;Jf;Fk;> mtw;wpd; Nritfisg; ngw;Wf;nfhs;Sk; kf;fSf;Fk; nghUj;jkhd r%f khjphpfshf elj;jg;gLfpd;wd. mg;gpuNjrq;fspd; kf;fSf;Ff; fpilf;ff;$ba cjtp kw;Wk; guhkhpg;G rk;ge;jkhf ve;j msTf;Fr; RNjrpa topKiwfs; xd;wpizf;fg;gLfpd;wd vd;gJ Fwpj;J vJTk; njspthftpy;iy.

19

3. cseyj; jhjpapay;
jhjpaH jpwd;fSk;> eilKiwfSk;
ml;ltiz 3.1: jhjpaH jpwd;fSk;> eilKiwfSk; Fzkhf;Fk; #onyhd;iw cUthf;Fjy; mtjhdpg;G> tpahf;fpahdk; kw;Wk; mtjhdpg;Gfis mwpf;ifapLjy; guhkhpg;igj; jpl;lkpLjYk;> Kd;Ndw;wj;ijf; fz;fhzpj;jYk; Vida cj;jpNahfj;ju;fSld; FOthfg; gzpahw;Wjy; NehahspfSld; rpfpr;ir cwnthd;iw cUthf;Fjy; vspikahd rpfpr;irj; jiyaPLfs; FLk;gq;fSld; gzpahw;Wjy; 1. Fzkhf;ff; $ba #onyhd;iw cUthf;Fjy; Nehahsu; tpLjp xd;iw my;yJ itj;jparhiy xd;iw rpfpr;irr; #oy; nfhz;l xd;whf khw;Wk; rpe;jidfs; kdNeha; itj;jparhiyfspy; Fzkhf;ff; $ba r%f top Kiwfs;Fwpj;j jj;Jtk; kw;Wk; eilKiwapypUe;J gpwe;jitahFk;. ,jd; fUj;J KO itj;jparhiyAk; kw;Wk;my;yJ xt;nthU jdpg;gl;l tpLjpAk; Fzkhf;ff; $ba xU tifahd rpW r%ff;FOthf my;yJ r%fkhf khw;wg;gl;lJ vd;gjhFk;. xU Fzkhf;ff; $ba r%fj;jpy; (m) mjd; mq;fj;jtHfs; mjd; md;whl eltbf;iffspy; xU FLk;gkhf my;yJ r%fkhfg; gq;Nfw;W> ahH vijr; nra;tJ vd;gJ rk;ge;jkhfj; jk;kpilNa jPHkhdnkLj;Jr; nraw;gLtjhFk;. (M) rpwpa FOf;fspYk;> nghpa FOf;fspYk; gq;Nfw;Nghhpd; fpukkhd $l;lq;fs; ,lk;ngWtNjhL> jdpegHfspilapyhd fye;Jiuahly;fSk; ,lk;ngWfpd;wd. ,q;F ,e;j r%fj;jpy; epfo;gtw;iwf; fye;Jiuahb> gpur;rpidfisg; gFg;gha;T nra;tjd; %yk; gy;NtW mq;fj;jpdHfspilNa epyTk; gjw;wepiyfs; Fiwf;fg;gLfpd;wd. mjhtJ xU r%f czHit mgptpUj;jp nra;a Kaw;rpnaLf;fg;gLfpd;wJ. midj;Jklq;Fk; Nehf;fk; Nritiag; ngw;Wf;nfhs;NthH jk;ikg; nghWg;Ngw;Wf;nfhs;s cjTtJk;> Ra-epiwTf;Fj; jilahfTs;s tplaq;fis tpsq;fpf;;nfhs;Sk;tifapy; VidNahUld; ,ize;J

20

gzpahw;WtJk;> VidNahUld; xj;jpirthf thOtJkhFk;. ,itaidj;Jk; kUe;Jfs; kw;Wk; jdpg;gl;l cstsj;Jizia ngw;Wf;nfhs;tjw;F Nkyjpfkhf ,lk;ngWgitahFk;. ,d;W gy mgptpUj;jpAw;w ehLfspy; kdNeha;fSf;F gpujhdkhf r%fj;jpNyNa rpfpr;iraspf;fg;gLfpd;wJ. MfNt> NehahsHfs; itj;jparhiy r%fq;fis Mf;FksTf;F ePz;lfhyk; itj;jparhiyapy; jq;Ftjpy;iy. xUrpy njhpTnra;ag;gl;l ,lq;fspNyNa Fzkhf;ff; $ba r%fq;fs; elj;jg;gLfpd;wd. ,it MSikf; NfhshWfs; cs;stHfs; kw;Wk; Vida ePz;lfhyg; gpur;rpidfs; cs;stHfs; tplaj;jpNyNa elj;jg;gLfpd;wd. MapDk;> ,d;dKk; gy gpd;dzpfspy; Fzkhf;ff; $ba r%fr; rpe;jidfs; gad;gLj;jg;gLfpd;wd. ,it gpd;tUtdtw;iw cs;slf;FtjhFk;: (m) md;whlg; gpur;rpidfisf; fye;JiuahLtjw;Fk;> mwptpg;Gfisr; nra;tjw;Fk;> jdpegHfspilNa epyTk; gpur;rpidfisj; jPHg;gjw;F Kaw;rpnra;tjw;Fk; r%ff; $l;lq;fisAk;> NehahsHfSf;Fk;> cj;jpNahfj;ju;fSf;Fk;; ,ilapyhd $l;lq;fisAk; elj;Jjy;. (M) cj;jpNahfj;ju;fSf;Fk; NehahsHfSf;Fkpilapy; njhlHghly; jilfis kpfTk;Fiwthf;Fjy; (cjhuzkhf) rPUilfis mzpahky;tpLjy;> jdpg;gl;l ngaHfisg; gad;gLj;Jjy;> kw;Wk; nghJthd #oiy ,ad;w msTf;F tpjpKiwaw;wjhf;Fjy;%yk; ,ijr; nra;ayhk;. (,) tpLjp Kfhikj;Jtk; rk;ge;jkhf ,ad;w msTf;Fj; jPHkhdq;fspy; NehahsHfis <LgLj;Jjy;. 2. mtjhdpj;jy;> tpahf;fpahdk;nra;jy; kw;Wk; mwpf;ifapLjy; tpahjpapd; milahsq;fs; epyTtJ Fwpj;Jk;> ve;j msTf;F mit rPuilfpd;wd my;yJ rPuilatpy;iy vd;gJ Fwpj;Jk; mtjhdpg;Gfis itj;jpaHfSf;F mwpf;ifapLtJ jhjpkhhpd; kuGhPjpahd flikahFk;. ,f;fhyj;jpy; jhjpj;njhopy; mtjhdpg;Gfs; mwpFwpfs; Fwpj;J Kf;fpakhdtw;iw kl;Lky;yhJ> eilKiwf;F> Kf;fpakhd tplaq;fisAk; cs;slf;Ffpd;wd. MfNt> jhjpacj;jpNahfj;ju;fs; kw;Wk; Vida NehahsHfs; Fwpj;j Nehahshpd; gpujpgypg;Gfs;> mthpd; nghJthd elj;ijfs;> Njitfs; (Nehahshpd; fz;Nzhl;lj;jpy;)> tpUg;gq;fs;> vj;jifa jhjpapay; eilKiwfs; NehahsHfSf;F cjTfpd;wd> vit

21

mtHfSf;Ff; Fog;g epiyiaAk;> gaj;ijAk; Vw;gLj;Jfpd;wd Nghd;w mtjhdpg;Gfisr; nra;;jy; Ntz;Lk;. vtuhtJ Mgj;jhdtH my;yJ Fog;gepiyf;F ,yFtpy; cl;glf; $batH vdf; fUjg;gl;lhy;> ,lHKfhikj;Jtf; fzpg;gPnlhd;W elj;jg;gl;L> tplaq;fs; Fwpf;fg;gLjy; Ntz;Lk; (gpd;dH ghHf;fTk;). mtjhdpg;Gfs; tpahf;fpahdk; nra;ag;gLjy; Ntz;Lk;: cjhuzkhf> xU NehahsH Vd; ,d;DnkhU Nehahsiug; ghHf;Fk;NghJ gjw;wkilaNtz;Lk;> my;yJ kdr;NrhHtila Ntz;Lk; ,J tof;fkhf ,aYkhapd; NehahspAld; fye;Jiuahly;fs;%yk;> mj;NjhL jhjpaH jhk; mtjhdpj;j tplaq;fs; Fwpj;Jj; jk;kpilNa fye;Jiuahly;fs;%yk; nra;ag;glyhk;. ,j;jifa fye;Jiuahly;fs; KiwkhWk;NghJ kw;wthplk; gzpia xg;gilf;Fk;Ntisapy; ,lk;ngwyhk;. vJ Kf;fpakhdnjd;W fUjg;gLfpd;wJ vd;gijg;;nghWj;J mtjhdpg;Gfis mwpf;ifapLtJk;> mtw;iw vt;thW tpahf;fpahdk;nra;tJ vd;gJk; mNdfkhd itj;jparhiyfspy; epWtpj; jhgpf;fg;gl;Ls;sd. 3. guhkhpg;G> jpl;lkply; kw;Wk; fz;fhzpg;G guhkhpg;Gj; jpl;lkply; mZFKiw (CPA) xt;nthU NehahsUf;Fk; Fwpg;gpl;l jhjpnahUtH ,Uf;Fk; #oypNyNa kpfr;rpwg;ghdKiwapy; ,lk;ngWfpd;wJ. kpfr;rpwg;ghf> xU guhkhpg;Gj; jpl;lk; rk;ge;jKw;w Nehahspf;Fk;> jhjpkhUf;Fkpilapyhd Ghpe;JzHitg; gpujpgypf;fNtz;Lk;. mJ rpyNtisfspy; Kf;fpakhd cwtpdHfSld; (guhkhpg;G toq;FNthH) $l;LKaw;rpahf cUthf;fg;gLfpd;wJ. vt;thwhapDk;> jhjpkhUf;Fk;> NehahsHfSf;Fkpilapyhd ,e;j xj;Jiog;G kl;lj;ij Vw;gLj;j ePz;lfhyk; vLf;fyhk;. xU guhkhpg;Gj; jpl;lk; Kjypy; jhjpkhHfshy; tiuag;gl Ntz;bapUf;fyhk;.

22

ml;ltiz 3.2: guhkhpg;Gj; jpl;lkply; vg;nghOJk; NehahspAlDk;> (,ad;why;) cwtpdHfSlDk; xj;Jiog;Gld; gpur;rpid tplag;gug;Gfis ,dq;fz;L> cld;ghl;Lf;F tUjy; ftdk; mtrpag;gLk; Fwpj;j gpujhd tplag;gug;Gfis ,yf;Fitj;jy; ,ize;jKiwapy; Fwpapyf;Ffis Vw;gLj;Jjy; nghUj;jkhd jiyaPLfis;cjtpiaj; njhpTnra;jy; gpur;rpid tplag;gug;Gfis kPs;-fzpg;gPL nra;jy; guhkhpg;Gj; jpl;lnkhd;W gpujhd gpur;rpidfis tiutpyf;fzg;gLj;jp> Fwpapyf;FfisAk;> Fwpf;N;fhs;fisAk; Vw;gLj;jp> xU nray;jpl;lj;ij vLj;Jiuj;jy; Ntz;Lk;. jpl;l Kd;Ndw;wk; Fwpj;Jk;> Gjpa mtjhdpg;Gfs; kw;Wk; fye;Jiuahly;fisg;nghWj;J ,lk;ngWk; khw;wq;fs;Fwpj;Jk; fhyj;Jf;Ff;fhyk; kPsha;Tnra;ag;gLjy; Ntz;Lk;. 4. FOthfg; gzpahw;Wjy; njhopy;rhH epGzHfspd; mzpfs; itj;jparhiyapypUe;J ntspf;fsg; (outreach) gzpfspy; (neUf;fPl;Lj; jiyaPl;Lf; FOf;fs;) KOf;f KOf;f r%fj;jpy; (r%f csr; Rfhjhu mzpfs;) my;yJ gpujhdkhf xU itj;jparhiyapy; (tpLjp mzp) gzpahw;wyhk;. xd;whfg; gzpahw;Wk; xU FOthd Ml;fs; jhkhfNt xU gaDWjpkpf;f mzpahtjpy;iy. mtHfs; xU nghJthd Nehf;fj;ij <l;bf;nfhs;tjw;Fk;> xU rpwe;j njhlHghly; mbg;gilapyhd Ghpe;JzHit mq;fj;jtHfspilNa Vw;gLj;jpf;nfhs;tjw;Fk; gzpahw;Wjy; Ntz;Lk;. mzpapd; rfy mq;fj;jpdHfspdJk; g+uz rhj;jpa tsj;ij ntspf;nfhzHtjw;Fr; rpwe;j jiyikj;Jtk; Kf;fpakhdjhFk;.

23

ml;ltiz 3.3: FOthfg; gzpahw;Wjy; nghJthd Nehf;fk; rpwe;j njhlHghly; jiyikj;Jtk; fpukkhd $l;lq;fs; mq;fj;jtHfspilNa ek;gpf;if xU tpLjpapy; my;yJ gfy;Neu itj;jparhiyapy; xU Fzkhf;ff; $ba #oiy Vw;gLj;Jtjw;Fk;> gjtp mq;fj;jpdH xt;nthUtUk; NehahspfSld; xU Fzkhf;ff; $ba cwitj; ];jhgpg;gjw;Fk; gaDWjpAs;s FOg; gzp mtrpakhFk;. xd;whfg; gzpahw;Wk; FO vt;thW njhlHe;J xU gaDWjpAs;s mzpia Mf;FtJ vd;gijf; fhyj;Jf;Ff; fhyk; fye;JiuahLtJ mtrpakhFk;. ,jw;Ff; fpukkhd $l;lq;fs; mtrpakhFk;. xt;nthU mq;fj;jtUk; jdJ nghWg;gpd; kl;lk; Fwpj;Jk;> nghWg;ig vg;nghOJ NtnwhUthplk; xg;gilg;gJ vd;gJ Fwpj;Jk; njspthftpUg;gJ mNdfkhd re;jHg;gq;fspy; gaDs;sjhFk;. mzp mq;fj;jtHfspilapyhd ek;gpf;if jPHkhdfukhdjhFk;. MfNt> egHfSf;fpilapyhd gpur;rpidfisf;; fye;JiuahLtjw;Fk;> jPHj;Jf;nfhs;tjw;Fkhd xU Kiwik ,Ug;gJ mtrpakhFk;. ml;ltiz 3.4: gy;Jiwrhu; Nrit (Treacy, 2010) gfpug;gLk; ,yl;rpak; ,ize;j jd;ik jiyikj;Jtk; mZFKiw kw;Wk; csg;ghq;Ffspy; NtWghLfis mq;fPfhpj;jy; fUj;njhUkpg;gpD}lhd jPHkhdq;fs; mq;fj;jpdHfspilNa rpwe;j njhlHghly; tYthd mk;rq;fspy; khWghLfis Vw;Wf;nfhs;Sjy; jPHkhdq;fisf; $l;bizf;Fk;tifapy; Kf;fpakhdtHfis epakpj;jy; jfty;fs; fpilg;gij cWjpnra;jy;

24

gy #o;epiyfspy; gy tpj;jpahrkhd Jiwfisr; NrHe;j njhopy;rhH epGzHfs; Nehahspfisf; ifahStjpy; VNjhnthU topapy; rk;ge;jKWfpd;wdH. mt;thwhapd;> Nehahspfs; gy;NtW Ml;fsplkpUe;J cs;sPLfisg; ngw;Wf;nfhz;L mjp$Ljyhd mD$yq;fisg; ngw;Wf;nfhs;Sk;tifapy; gy;JiwrhH gzpfs; ,d;wpaikahjitahfpd;wd. mj;NjhL> gy;NtW njhopy;rhH epGzHfs; (mzpapy;) xd;WNrHe;J gzpahw;whtpby; Nehahspfs; Kuz;gLk; mwpTiufshy; Fog;gkilaf;$Lk;. njhopy;rhH epGzHfs; VidNahH Vw;fdNt nra;j tplaq;fisj; jhk; kPz;Lk; nra;tjpy; ngUksT Neuj;ij tPzhf;ff;$Lk;. mtHfs; jk;kpilNa Kuz;ghLfis Vw;gLj;jpf;nfhs;sTk; $Lk;. xU gy;Jiwrhu; mzp xU gfpug;gLk; ,yl;rpaj;ij mgptpUj;jp nra;Jnfhs;sTk;> fye;Jiuahly; kw;Wk; rpwe;j jiyikj;Jtj;jpD}lhff; fUj;njhUkpg;ig <l;bf;nfhs;sTk; KaYjy; Ntz;Lk;. nghUj;jkhd> gaDWjpAs;s gy;Jiwrhu; mzp Ntiyia eilKiwg;gLj;JtJ mt;tsT ,yFthf ,y;yhjpUf;ff;$Lk;. xU Fwpg;gpl;l Jiwrhu; my;yJ egH jPHkhdk; Nkw;nfhs;tjpy; Mjpf;fk;nrYj;Jk; Nghf;F fhzg;glf;$Lk;. Nehahspfs; xUtiutpl NtnwhUtiu tpUk;Gtjhy; gpsTfs; Vw;glf;$Lk;. rpy mq;fj;jpdHfs; tplaj;jpy; xU nghJthd mZFKiwia xl;bepw;gJ fbdkhftpUf;fyhk;. vdNt> ,lHfis mjpFiwthf;Fk; xU fl;likg;G ,Ug;gJ mtrpakhFk;. 5. xU Fzkhf;ff; $ba cwit Vw;gLj;jpf;nfhs;Sjy; ml;ltiz 3.5: cq;fsJ NehahsHfis mwpe;Jnfhs;sy; (Parry, 2010) mtHfs; fPo;tUk; tplaq;fis vt;thW Nehf;Ffpd;wdu; vd;gij xt;nthU NehahspaplkpUe;Jk; mwpe;Jnfhs;sTk;: mwpFwpfs; cl;gl jPHTfhz;gjw;F mtrpakhd mtHfspd; tho;f;ifg; gpur;rpidfs;Fwpj;J mwpe;Jnfhs;sTk; itj;jparhiyapy; guhkhpg;gpd;fPo; ,Ug;gjw;fhd fhuzq;fs;> rpfpr;irapd; Nehf;fq;fs; mtHfspd; tYthd mk;rq;fs;> Mw;wy;fs; kw;Wk; gytPdq;fs; mtHfspd; gpd;dzpfs;

25

ml;ltiz 3.6: Fzkhf;fy; mZFKiw (Parry, 2010) Nehahspfspd; gyq;fisf; Ftpag;gLj;Jjy; jkJ gpur;rpidfisg; ghprPyid nra;tjw;F NehahspfSf;F cjTjy; ajhHj;jg+Htkhd ,yf;Ffis Vw;gLj;jpf;nfhs;tjw;F NehahsHfSf;F cjTjy; gpur;rpidfisj; jPHg;gjpy; Jbg;ghd ghj;jpuj;ij tfpg;gjw;F NehahsHfis Cf;Ftpj;jy; Fwpg;gpl;l rpfpr;irj; jiyaPLfisg; gad;gLj;Jjy; jhjpkhH gpujhdkhfj; jk;ikr; rpfpr;irapd; iff;fUtpfshfNt gad;gLj;jpf; nfhs;fpd;wdH. MfNt> Fzkhf;fy; cwT vd;gJ kpfTk; Kf;fpaj;Jtk; tha;e;jjhFk;. rpfpr;irrhH epiyia Vw;gLj;jpf;nfhs;tjw;Fj; jhjpkhH jkJ NehahsHfis ed;F mwpe;jpUg;gJ Kf;fpakhdjhFk;. NehahspfSld; gzpahw;Wtjpy; jhjpkhH cstsj;Jiz kw;Wk; mwpthw;wy;> elj;ijr; rpfpr;ir (CBT) cs;spl;ltifapyhd gy;NtW mZFKiwfisf; iff;nfhs;syhk;. ,it Ie;jhk; mj;jpahaj;jpy; RUf;fkhf tpghpf;fg;gl;Ls;sd. vt;thwhapDk; jhjpkhH jkJ nghJthd gapw;rpapd;NghJ xU nghJthd Fzkhf;fy; mZFKiwia Vw;gLj;jpf;nfhs;tjw;F mwpe;Jnfhs;fpd;wdH. 6. vspikahd Fzkhf;fy; jiyaPLfs; NehahsHfSf;F xU jdpegH mbg;gilapyhd vspikahd Fzkhf;fy; jiyaPLfs; %yk; cjtp toq;Ftjw;F kpfTk; fLikahd gapw;rpia Nkw;nfhs;tJ mtrpakpy;iy. rfy jhjpkhUk; jhk; gzpahw;Wk; mzpapd; xj;Jiog;Gld; jkJ ftdg;guhkhpg;gpypUf;Fk; NehahspfSld; vspikahd jdpegH gzpfspy; <LglKbAk;. jhjpkhH eilKiw mZFKiwfs; rk;ge;jkhd mj;jpahak; 5 NehahsHfSldhd jdpg;gl;l gzpapy; cstsj;Jiz kw;Wk; elj;ij mZFKiwfis tpghpf;fpd;wJ. 7. FLk;gq;fSld; gzpahw;Wjy; ,yq;ifapy; FLk;gq;fs; gy topfspy; xU kpfKf;fpa ghj;jpuj;ij tfpf;fpd;wd. mNdfkhd kf;fisg; nghWj;jtiuapy; kdj;JaH

26

kw;Wk; Neha;fspypUe;J kPl;rpngWtjpy; FLk;g myF kpfTk; jPHkhdfukhd xd;whfyhk;. MfNt> csey Nrit r%fj;jpy; ,lk;ngw;whYk; rhp> my;yJ kdNeha; itj;jparhiy Nghd;w xU epWtdj;jpy; ,lk;ngw;whYk; rhp> FLk;gq;fis csey Nritapd; xU tp];jhpg;ghfNt Nehf;Fjy; Ntz;Lk;. rkPgj;jpy; kdNeha; itj;jparhiyapy; mDkjpf;fg;gl;l mNdfkhd cs;NehahsHfisg; ghHg;gjw;Fg; gyH tUifjUfpd;wdH. ,tHfs; tof;fkhf mtHfspd; FLk;g mq;fj;jpdHfshtH. FLk;g <LghL vd;gJ gy;NtW topfspy; Cf;Ftpf;fg;glyhk;. ml;ltiz 3.7: FLk;g <Lghl;il Nkk;gLj;jy; (fNzrd;> 2010) (mDkjpf;F Kd;duhf) fzpg;gPl;bd;Nghjhd FLk;gj;Jldhd re;jpg;G itj;jparhiy tpLjpfSf;F ,yFtpy; nry;yf;$bajhftpUj;jy; cj;jpNahfj;ju;fSld; mbf;fb ,lk;ngWk; re;jpg;Gf;fs;> kw;Wk; FLk;gq;fSldhd $l;lq;fs; tUifjUtjw;F FLk;gq;fSf;F MjuT toq;Fjy; (c-k;: gpuahzr; nryTfs;) rhj;jpakhdtplj;J NehahspAld; jq;fp trpj;jy; (c-k;: kl;lf;fsg;gpy; mUfpypUg;gtH Kiw) tpLtpg;gjw;F Kd;dH FLk;gj;jpdUld; re;jpg;G Nehahsp xUtH itj;jparhiyapy; mDkjpf;fg;gLk;NghJ> mNdfkhd re;jHg;gq;fspy;> mq;F vd;d elf;fpwJ vd;gJ rk;ge;jkhff; FLk;gq;fspy; ngUk; Mjq;fq;fSk;> Fog;gepiyAk; epyTfpd;wJ. MfNt> mtHfspd; md;Gf;FhpatHfSf;Fg; nghUj;jkhd> mDjhgj;Jld;$ba guhkhpg;G toq;fg;gLtJFwpj;J cWjp toq;Fjy; mtrpakhFk;. FLk;gj;jpdH rpfpr;irfs; gw;wpAk;> Nehawpjy; gw;wpAk; tpdhf;fis vOg;g tpUk;gf;$Lk;. jhjpkhH ,tw;Wf;Fg; gjpyspf;f Ntz;Lk;> my;yJ FLk;gq;fis mt;thW nra;af; $bathplk; mDg;Gjy; Ntz;Lk;. Nehahspfspd; gy gpur;rpidfs; FLk;g tho;f;if kw;Wk; cwTfs; Fwpj;jitahFk;. MfNt> xU Nehahsp rk;ge;jkhd FLk;g mq;fj;jpdHfspd; fUj;Jf;fisg; ngw;Wf;nfhs;tJ mtrpakhFk;. mj;NjhL NehahsHfSf;fhd rpfpr;ir> Neha; kw;Wk; Nehahspfspd; Njitfs; Fwpj;j FLk;gq;fspd; mwpT+l;LjYld; ,ize;J nry;Yjy;

27

Ntz;Lk;. rpy re;;jHg;gq;fspy; jdpahf my;yJ VidNahUld; NrHe;J NehahspfSf;F cstsj;Jiz toq;Ftjpy; FLk;gj;jpdUk; rk;ge;jKWjy; Ntz;Lk;. r%fj;jpy; gzpahw;Wk; my;yJ gfy; itj;jparhiyfspy; NehahsHfSf;Ff; guhkhpg;G toq;Fk; jhjpkhH cstpay; fy;tp vd;W miof;fg;gLtij toq;Ftjpy; rk;ge;jKwyhk;. ,jd; fUj;J> gpur;rpidfspd; jd;ik kw;Wk; Rfkiltjw;F mtHfs; vt;thW cjtyhk; kw;Wk;my;yJ rk;ge;jKwyhk; vd;gJFwpj;J tpsf;fkspg;gJ vd;gjhFk;. cstpay; fy;tp mzpapd; Vida mq;fj;jpdUld; NrHe;J itj;jpaHfspd; MjuTld; my;yJ <Lghl;Lld; toq;fg;gLjy; Ntz;Lk;. ,j;jifa gzpia cs;NehahsHfs; tplaj;jpy; Mw;wyhk;. MapDk;> ,J cwtpdHfs; itj;jparhiyf;F tUk; Neuq;fistpl jhjpkhH tPLfSf;F tp[ak;nra;Ak;NghJ kpfr; rpwg;ghf ,lk;ngwyhk;. jhjpkhH r%fg; gzpapy; my;yJ gfy; itj;jparhiyfspy; gzpahw;Wk;NghJ jdpg;gl;l NehahspAld; gzpahw;WtJNghd;Nw FLk;gj;;jpy; gzpahw;WtJk; Kf;fpakhFk;. guhkhpg;Gj; jpl;lk; FLk;gj;Jld; my;yJ guhkhpg;G toq;Fk; FLk;g mq;fj;jpdHfSld; fye;Jiuahlg;gLjy; Ntz;Lk;. rpfpr;ir my;yJ guhkhpg;Gg; gpd;dzp rk;ge;jkhd VjhtJ khw;wq;fs; ,lk;ngWKd;dH mtHfisf; fye;jhNyhrpg;gJ Kf;fpakhdjhFk;. FLk;gj;jpy; egHfspilNa gpur;rpidfs; ,Ug;gpd;> jhjp ,itFwpj;J mwpe;Jnfhs;tjw;F Kaw;rp Nkw;nfhs;sNtz;Lk;> my;yJ FLk;gj;ij ,g;gzpia Mw;wf;$ba NtnwhU njhopy;rhH epGzhplk; rpghupr nra;jy; Ntz;Lk;.

28

jhjpapaypd; mbg;gilf; flikfs; ml;ltiz 3.8: csey jhjpj; xUthpd; mbg;gilf; flikfs; rpwe;j njhlHghliyAk;> ek;gpf;ifiaAk; Vw;gLj;Jjy; NehahsHfspd; r%fg; gpd;dzp kw;Wk; fyhr;rhuk;Fwpj;j mwpT mjpfhuf; Nfhl;ghLfs; (NehahspfSf;Fk;> cj;jpNahfj;ju;fSf;Fkpilapy;) ,Ue;j NghjpYk;> NehahsHfisj; jkf;Fr; rkhdtHfshf kjpj;jy; NehahsHfSf;fhd cq;fs; nrhe;jg; gpujpgypg;Gfisg; Ghpe;Jnfhs;Sjy; (Nehahsp tpj;jpahrkhd XH ,dj;Jtf; FOit> [hjpia my;yJ r%f tHf;fj;ijr; NrHe;jtuhf ,Uf;fyhk;) NehahsHfSld; Fzkhf;fy; cwTfis Vw;gLj;jpf;nfhs;Sjy; jdpg;gl;l cwT me;juq;fk; Ngzy; kdNehahspfSf;Fk;> mtHfspd; FLk;gq;fSf;Fk; tYt+l;Ljy; Nehahspfs; rhHgpy; gug;Giunra;jy; (Advocacy) Vida gjtp mq;fj;jpdHfSf;F Nehahspapd; fUj;ij tpsf;Fjy; Nehahspapd; fUj;JfSf;F kjpg;gspj;jy; Nehahspapd; ghJfhg;ig cWjpnra;jy; ,J jdpegH kw;Wk; kdpj chpikfSf;fhd kjpg;gpdhy; rkepiyg;gLj;jg;gl Ntz;Lk; jdpj;Jtj;ijAk;> kdpj chpikfisAk; kjpj;jy; Vd; rpy chpikfs; kWf;fg;gLfpd;wd vd;gJFwpj;Jj; njspthf vLj;Jiuj;jy; (c-k;: Nehahsp kUe;J Fbf;f kWf;Fk;NghJ> itj;jparhiyiatpl;Lg; Nghf tpUk;Gk;NghJ my;yJ jdpikg;gLj;jNtz;ba Njit ,Uf;Fk;NghJ) rl;lhPjpahd flg;ghLfis kjpj;jy; NehahspfSf;Ff; guhkhpg;G toq;Fjy; (guhkupg;G rk;ge;jkhd flik) tpsq;fpf;nfhs;Sjy; kUe;Jfis my;yJ Vida rpfpr;irfis toq;Fjy; td;Kiw my;yJ Fok;gpa elj;ijiaf; ifahSjy;

29

itj;jparhiyfspy; gzpahw;Wk; jhjpkhH md;whlk; NehahsHfSld; njhlHGw;wpUg;gjhYk;> mtHfisg;gw;wp mwpe;Jnfhs;Sk; re;jHg;gj;ijg; ngw;wpUg;gjhYk; rpfpr;irapd; Kd;dzp epiyapy; cs;sdH. mNdfkhd re;jHg;gq;fspy; VjhtJ xU tplaj;ijr; NrHe;J nra;Ak;NghJ> xd;whf ele;Jnry;Yk;NghJ> my;yJ xU tpisahl;by; <LgLk;NghJ Nehahspfs; Kf;fpakhd tplaq;fs;Fwpj;Jk; jkJ nrhe;j Neha;fs;Fwpj;Jk; jhjpkhHfSld; ,yFthff; fijf;fpd;wdH. MfNt> jhjpkhH mtHfNshL NrHe;J tplaq;fisr; nra;tjpy;> tpisahLtjpy;> njhiyf;;fhl;rp ghHg;gjpy;> rhg;gpLtjpy;> NrHe;J goFtjpy; jkJ NehahsHfisg; gw;wp mwpe;J nfhs;Sfpd;wdH. NehahsHfSld; NgRtJ tpjpKiwahd cstsj;Jiz mkHTfspy; my;yJ $Ljyhd re;;jHg;gq;fspy; tpjpKiwaw;w topfspYk; ,lk;ngwyhk;. MapDk;> gy Fwpg;ghd flikfs; mtHfSf;F cz;L. 8. njhlHghly; kw;Wk; ek;gpf;ifia Vw;gLj;jy; ,J vg;nghOJNk ,yFthd xU tplaky;y. njhopy;rhH epGzHfs; NehahsHfs; kPjhd XH mjpfhu epiyiaf; nfhz;bUg;gjhy; Vw;wj;jho;T epiy xd;W cs;sJ. ,J NehahsHfspy; gPjp kw;Wk; mq;fyha;g;G epiyfSf;F ,l;Lr;nry;tjhy;> rpyH jhjpfs;kPJ gifikahd czHTfis ntspg;gLj;jyhk;. MfNt> jhjpkhH jkJ nrhe;j czHTfisg; Ghpe;Jnfhz;L> ,e;j tplaq;fs; njhlHghliy Vw;gLj;Jtjpy; FWf;fplhjtifapy; ele;J nfhs;s Ntz;Lk;. cz;ikapy; xU kdNeha; rpfpr;irg; gpd;dzpapy; jhjp Nehahsp cwT mt;tsT ,yFthdjy;y. jhjpkhH ,JFwpj;Jr; rpe;jpg;gjw;Fk;> rfghbfSlDk; Kfhikj;Jtj;JlDk; fye;JiuahLtjw;Fk; re;;jHg;gk; fpl;Ljy; Ntz;Lk;. mDruiz toq;fg;gLk; MjuTf; FOf;fs; my;yJ jhjpkhH ,t;tplaq;fisg;gw;wpg; Ngrf;$ba> xUtUf;nfhUtH Nkw;ghHit vd;git rpy rkaq;fspy; gaDs;sitahFk;. 9. xU Fzkhf;fy; cwit Vw;gLj;Jjy; xU jhjpapd; ,uz;lhtJ flik xt;;nthU NehahspAlDk; xU Fzkhf;fy; cwit Vw;gLj;JtjhFk;. xU Kf;fpa jhjpj; jpl;lk; ,Uf;Fkhapd;> jhjp Kf;fpa jhjpahf tpsq;Fk;

30

NehahspfSldhd ,e;j cwit Vw;gLj;jpf; nfhs;tjw;Ff; Fwpg;ghd ftdk;nrYj;jg;gLjy; Ntz;Lk;. Fzkhf;fy; nraw;ghl;Lf;;Fj; jhjp xUtH gu];gu ek;gpf;ifNahL$ba jdpg;gl;l cwTfis fl;bnaOg;gNtz;bAs;sJ. ,J xt;nthU Nehahsp rk;ge;jkhfTk; xU jdpegH vd;wtifapy; xU jhjp cz;ikapy; ftdk; vLf;fpd;whH vd;Dk; XH czHit Nehahspapy; fl;bnaOg;GtjhFk;. jhjpkhH NtW Ml;fsplk; Ngha; mtw;iwf; $WthHfs; vd;W NehahsHfs; vz;zpdhy; mtHfs; jkJ gpur;rpidfs;Fwpj;Jj; jhjpkhhplk; vJTk; $wkhl;lhHfs;. MapDk;> xU jhjpf;Fk;> Nehahspf;Fkpilapyhd me;juq;fk;NgZk; epiy KOikahd xd;whf ,y;yhjpUf;fyhk;. NehahsHfs; me;juq;f epiyFwpj;Jf; Nfl;lhy; #o;epiyia tpsq;fg;gLj;Jjy; Ntz;Lk;. ,J Nehahspapd; kpfr;rpwe;j eyd;fSf;fhfg; gzpahw;Wk; XH mzpapy; jhjp xU gFjpahfTk; mzpapd; Vida mq;fj;jtHfSld; jfty;fisg; gfpHe;Jnfhs;tJ Nehahspapd; kPjhd mf;fiwahf ,Uf;Fk;;. Kf;fpakhd tplak; vd;dntdpy;> NehahsHfs; jkJ kpfr;rpwe;j eyd;fSf;fhfNt jfty; gfpHe;Jnfhs;sg;gLfpd;wJ vd;gijAk;> ntWk; mul;il my;yJ nghOJNghf;F Nghd;W NtW VjhtJ fhuzj;jpd; epkpj;jk; my;y vd;gijAk; epr;rakhf mwpe;Jnfhs;tjhFk;. jhjpkhHkPJ NehahsHfs; ek;gpf;if itg;gnjd;gJ ,aw;ifapy; ,yFthf ,lk;ngWk; xd;wy;y. jhjpkhH Ghpe;JzHT> mtHfspd; eyd;Fwpj;j mf;fiw kw;Wk; midj;ijAk;tpl Kf;fpakhf khpahij vd;gtw;wpd;%yk; ,ijg; gbg;gbahff; fl;bnaOg;Gjy; Ntz;Lk;. Nehahsp jhjpkPJ ek;gpf;if itj;jhy;> jhjp mtH Fzkilaf;$ba tifapy; mtUf;F mtrpakhd Mjuit toq;FtJ rhj;jpakhFk;. 10. gug;Giu

xU jhjpapd; %d;whtJ flik Nehahspapd; rhHgpy; gug;Giu Nkw;nfhs;tjhFk;. jhjp xUtH Nehahsp xUtiu mzpapd; NtW ve;j mq;fj;jtiuAk;tpl NkYk; neUf;fkhf mwpe;Jnfhs;sf;$Lk; vd;gjhy; jhjp itj;jpaHfs; cs;spl;ltifapy; mzpapd; Vida mq;fj;jtHfSf;F tplaq;fis tpsq;fg;gLj;jf;$ba kpfr;rpwe;j epiyapy; cs;shH. ,it tpLjpapy; epyTk; epiyikfs;> cj;jpNahfj;ju;fs; mtHfSld; NgRk;Kiw> toq;fg;gLk; rpfpr;ir kw;Wk; NtW tplaq;fs; rk;ge;jkhf NehahsHfspd;

31

czHT vj;jifaJ vd;gitFwpj;jjhFk;. ,f;flikia xOq;fhf epiwNtw;Wtjw;Fj; jhjp rpfpr;ir kw;Wk; Nehawpjy; Nghd;w NehahsH Nfl;ff;$ba Nfs;tpfSf;Fg; gjpyspg;gjw;Fj; jahuhftpUj;jy; Ntz;Lk;. mj;NjhL> ,ij cjtpfukhd xU topapy;> MapDk; cz;ik kw;Wk; NeHik epiwe;j topapy; nra;jy; Ntz;Lk;. 11. ghJfhg;ig cWjpg;gLj;Jjy;

jhjpnahUthpd; ehd;fhtJ flik Nehahspapd; jdpj;Jtk; kw;Wk; kdpj chpikfis kjpf;Fk; mNjNtisapy; mtHfs; midthpdJk; ghJfhg;ig cWjpnra;tjhFk;. MapDk;> ,jw;F Nkyjpfkhf Nehahspfs; jhk; nrhy;git nrtpkLf;fg;gLfpd;wdntd;Wk;> jkJ tpUg;gq;fSf;F kjpg;gspf;fg;gl;Ls;sJ vd;Wk; czHtJ Kf;fpakhdjhFk;. NtW thHj;ijfspy; $Wtjhapd;> mjpfhug; gjtpapy; ,Uf;Fk; xt;nthUtUk; NehahsHfis ehl;bd; rl;lq;fspd; fPo; chpikfisf;nfhz;l Fbkf;fshf elj;Jk; flg;ghl;bidf; nfhz;Ls;sdH. 12. jdpegH chpikfis kjpj;jy;

jhjpnahUthpd; Ie;jhtJ flik ,yq;ifapy; Fbkf;fs; my;yJ tjpthsHfs; vd;wtifapy; xt;nthU NehahspapdJk; jdpj;Jtj;ijAk;> kdpj chpikfisAk; kjpg;gjhFk;. ePq;fs; ,e;j chpikfis mtHfSf;F kWf;fj; jPHkhdpj;jhy; - cjhuzkhf kUe;J Fbf;f kWg;gjw;fhd xU Nehahspapd; chpik> mtHfs; epidj;jJNghd;W te;JNghFk; chpik. chpikfs; rk;ge;jkhd rl;lq;fs; cs;spl;ltifapy; ePq;fs; Vd; mt;thW nra;fpd;wPHfs; vd;gJFwpj;J cq;fs; kdjpy; njspthd epiyg;ghL ,Uj;jy; Ntz;Lk;. ,e;j tplaq;fs; fbdkhd gpur;rpidfisAk;> eyd; Kuz;ghLfisAk; Njhw;Wtpf;ff;$Lk;. MfNt> ,ijr; rfghbfSf;fpilapYk;> chpa Kfhikj;Jtj;JlDk; fye;JiuahLjy; Ntz;Lk;. 13. guhkhpg;G toq;Fjy;

jhjp xUthpd; MwhtJ flik jkJ NehahsHfSf;Fg; guhkhpg;G toq;FtjhFk;. jhjpj; njhopypd; guhkhpg;G toq;Fk; ghuk;ghpak;

32

ePz;l fhykhf epytptUtjhFk;. csNeha; Vw;gl;l Ml;fs; VidNahUld; Ngrhky; xJq;fpapUg;gJ %ykhfTk;> Fok;gpa elj;ij my;yJ Nfhgj;ij ntspg;gLj;jy; %ykhfTk; jkJ mr;rj;ijAk;> Fog;gj;ijAk; ntspaplf;$Lk;. jhjp ,tw;iw tpsq;fpf;nfhs;sNtz;Lnkd;Wk;> NehahsHfis ,uf;fj;Jld; elj;jNtz;Lnkd;Wk;> NehahspapdJk; kw;Wk; Vida NehahsHfspdJk; eyd; kw;Wk; ey;tho;T Fwpj;j csg;ghq;Fld; vg;nghOJk; xU guhkhpg;G elj;ijia ntspf;fhl;lNtz;Lk; vd;Wk; vjpHghHf;fg;gLfpd;wJ. itj;jpaHfshy; Fwpj;Jiuf;fg;gLk; kUe;Jfisf; nfhLj;jy; kw;Wk;my;yJ xU gy;Jiwrhu; Nritapdhy; jPHkhdpf;fg;gLk; Vida rpfpr;irfis toq;Fjy; vd;gd NehahspfSf;Fg; guhkhpg;G toq;Ftjpy; xU gFjpahFk;. rpfpr;ir rk;ge;jkhfj; jhjpnahUtUf;F VjhtJ re;Njfq;fs; Vw;gl;lhy;> mtH mtw;iw NkyjpfhhpfSlDk;> rk;ge;jKw;w itj;jpaHfSlDk; fye;Jiuahb VjhtJ tpsf;fj;ijg; ngw;Wf;;nfhs;s Ntz;Lk;.

33

4. td;KiwAk;> Fog;gkhd elj;ijfSk;

,e;jg; gFjpapYs;s MNyhridfs;> Nkk;gl;l rpfpr;irKiwf;fhd If;fpa uhr;rpaj;jpd; (UK) Njrpa epWtdj;jpdhy; ntspaplg;gl;l XH mwpf;ifapy; (http://www.nice.org.uk) ,Ue;J ngwg;gl;litahFk;. ,aYnkd;why;> mrk;ghtpjq;fs; epfohky; jLg;gJ vg;nghOJk; rpwg;ghdjhFk;. xt;nthU rk;gtj;ijAk; kdpjhgpkhdj;Jld; ifahStNjhL> ,aYkhapd; mrk;ghtpjj;jpw;F gpd;duhd kPsha;nthd;W Nehahspapd; gq;Fgw;wNyhL ,lk;ngWjy; Ntz;Lk;. ml;ltiz 4.1: mrk;ghtpjq;fisj; jtpHj;Jf;nfhs;Sjy; (NICE, 2005,Ue;J ngwg;gl;lJ) Nehahspia mtjhdpj;jYk;> VidNahUld; fye;JiuahLtJk; xt;nthU NehahspapdJk; gpur;rpid> gpd;dzpfs; kw;Wk; mtHfisf; Fog;g epiyf;F ,l;Lr;nry;Yk; fhuzpfs; vd;gitFwpj;J mwpe;Jnfhs;Sjy; vj;jifa #o;epiyfs; xt;nthU NehahspiaAk; Fwpj;J mwpe;Jnfhs;Sjy; Fog;gepiyf;F ,l;Lr;nry;fpd;wd> Mj;jpukilar; nra;fpd;wd vd;gJ

(c-k;: xU rk;gtj;Jf;Fg; gpd;duhd kPsha;tpd;NghJ) vt;tsT rpwg;ghd Kiwapy; rk;gtq;fisj; jtpHj;Jf;nfhs;syhk; vd;gJFwpj;J Nehahsp mikjpahf ,Uf;Fk; Neuj;jpy; mtUld; fye;JiuahLjy; VjhtJ Ntiy toq;Fjy; gjw;wepiy mjpfhpj;Jr;nry;Yjy; kw;Wk; tplaq;fs; jPtpukilahJ Fiwjy; vd;git Fwpj;J Neufhyj;NjhL fz;lwpjy; NtnwhU jhjpf;Fg; nghWg;ig xg;gilf;Fk;NghJ $wNtz;ba mtjhdpg;Giufisf; Fwpj;Jitj;jy; nghJthf kdpjHfisf; Fog;GtJ vJ vd;gijAk;> mtHfis mikjpg;gLj;JtJ vJ vd;gijAk; mwpe;Jnfhs;tjw;F cj;jpNahfj;ju;fs; fw;Wf;; nfhs;tNjhL> mtHfs; jkJ mtjhdpg;Gfisf; Fwpj;Jf;nfhs;sTk; Ntz;Lk;. cjhuzkhf>

34

rpy NehahsHfisg; nghWj;jtiuapy; mtHfspd; fz;fis Nehf;fpathW rpy Fwpg;gpl;l topfspy; mtHfSld; NgRtJ mtHfisf; Fog;gf;$Lk;. gyH jkJ czHTfisr; Rje;jpukhf ntspapLtjw;Fr; re;jHg;gk; fpilf;Fk;NghJ mikjpailfpd;wdH. mtHfis XH mikjpahd gpuNjrj;jpy; (jdpikg;gLj;jy; miw my;y) ,Uf;ftpLk;NghJ my;yJ mtHfis VjhtJ nraw;ghl;by; (glk; tiujy; my;yJ cly; mg;gpahrk; Nghd;wit) <Lglitf;Fk;NghJ mtHfspy; rpyH mikjpailaf;$Lk;. xUtiu kpfTk; neUf;fkhf mtjhdpg;gJ xU Nehahspiaf; Nfhgkilar; nra;af;$Lk; my;yJ td;Kiwf;Fj; J}z;lf;$Lk; vd;gijf; ftdpf;f Ntz;Lk;. MfNt> xUtiu mtjhdpf;Fk; kl;lk; kpfTk; Fiwe;j epiyapy; xUthpd; nfsutk;> me;juq;fk;> mthpdJ ghJfhg;G kw;Wk; mtiur; Rw;wpAs;s VidNahhpd; ghJfhg;G vd;gtw;Wld; ,zf;fkhdKiwapy; ,Uj;jy; Ntz;Lk;. cj;jpNahfj;ju;fs; Nehahsp Fog;gkilAk; ,lHfisf; Fiwf;f Kaw;rpnra;J mtHfSld; Ngrp> mikjpg;gLj;jpa gpd;dNu XH caH kl;lj;jpyhd mtjhdpg;G ,lk;ngWjy; Ntz;Lk;. td;Kiwr; nraw;ghLfis mtjhdpj;J Fwpg;ngLj;J mLj;JtUk; jhjpkhu;fSf;F njupag;gLj;JtJ Kf;fpahdJ. Vd; Nehahspia mtjhdpg;G nra;fpwhu; vd;gijAk; Nehahspf;F tpsf;Fjy; Ntz;Lk;. mj;Jld; ,ayYkhapd; ifaspg;G nra;Ak;NghJ NehahspAk; cldpUj;jy; cfe;jjhf ,Uf;Fk;. ml;ltiz 4.2: Fog;gkhd elj;ijiaf; ifahSjy; jPtpuj;ijf; Fiwj;jy; (Ngrp mikjpg;gLj;Jjy;) fijg;gJ%yk; tpuf;jp kw;Wk; Nfhg czHTfs; ntspNaw ,lkspj;jy; mikjpahd ,lj;jpy; jdpNa tpLjy; ftdj;ijj; jpirjpUg;Gjy; (VjhtJ nraw;ghl;by; <LgLj;Jjy;) cly;hPjpahd gyte;jf; fl;Lg;ghL (filrp Kaw;rpahf) kpff;Fiwe;j Neuj;jpw;F jdpikg;gLj;jp itj;jpUj;jy;. tpiuthf mikjpg;gLj;j kUe;Jfs; toq;Fjy; (ghJfhg;ghd topfspYk;> topfhl;ly;fspd; gpufhuKk;) rk;gtj;Jf;Fg; gpd;duhd kPsha;T

35

td;Kiwahf khwf;$ba xU #o;epiyapd; Muk;gj;jpy;> Nehahspapd; ftdj;ijj; jpirjpUg;Gk; VjhtJ topKiw Njhy;tpaile;jhy;> jPtpuj;ijf; Fiwf;Fk; eltbf;ifapd; mbg;gilahf NehahspAld; NgRtJ - Kaw;rp nra;J ghHf;f Ntz;Lk;. ,J gad;juhtpby;> cj;jpNahfj;jpdUs; Fwpg;gpl;l xUtH epiyikiaf; fl;Lg;ghl;bDs; vLj;Jf;nfhs;Sjy; Ntz;Lk;. rk;ge;jKw;w Nehahspf;Fk;> mUfpYs;s VidNahUf;Fk; jhk; vd;d nra;fpd;Nwhk; vd;gij tpsf;fNtz;Lk;. cjhuzkhf> Fwpg;gpl;l jhjp VidNahiu mt;tplj;jpypUe;J mfd;W nry;YkhW Nfl;fNtz;Lk;. Nehahspfs; jkf;Fj; njhpT xd;W cs;sJ vd;gij czuitj;jy; Ntz;Lk; (Vnddpy; ePq;fs; vtiuahtJ fhag;gLj;jf;$Lk;). cjhuzkhf> mikjpailtjw;Fk;> jkJ nrhe;jg; gLf;iff;F my;yJ mikjpahd Xhplj;Jf;Fr; nry;tjw;Fkpilapy; (mt;thwhd Xhplk; ,Ug;gpd;)> Crp kUe;njhd;iw Vw;Wjy; my;yJ jdpikg;gLj;jy; miwf;F mfw;wg;gLjy; Nghd;wit. fl;Lg;ghl;ilg; gpuNahfpf;Fk; jhjp mr;RWj;jnyd;W Nehahsp czuf;$ba vijAk; $WjyhfhJ. ,e;j Kaw;rpfs; vJTNk gadspf;fhtpby;> NtW VjhtJ top mtrpag;gLk;. NgRtJ gadspf;fhtpby;> gpd;tUk; tpUg;G Kd;Dhpik mbg;gilapy;> Vida mikjpg;gLj;Jk; topKiwfis Kaw;rpj;jy; Ntz;Lk;: Nehahspia mtjhdpj;jy;> egH NtW vtiuahtJ fhag;gLj;Jtijj; jLf;Fk;tifapy; cly;hPjpahf mtiuf; fl;Lg;gLj;Jjy;> kUe;J toq;Fjy; (Jhpj mikjpg; gLj;jy;)> egiu xU jdpikg;gLj;jy; miwf;F mfw;Wjy;. ,e;j mZFKiwfs; egiu mikjpg;gLj;j cjTk; topKiwfshftd;wp> xUnghOJk; xU jz;lidahfg; gad;gLj;jg;gLjy; MfhJ. mit Vida topKiwfs; Kaw;rpf;fg;gl;L (tpNrlkhff; fijj;J mikjpg;gLj;Jjy;)> mit gadspf;fhj re;jHg;gq;fspNyNa gad;gLj;jg;glNtz;Lk;. ,e;j NtW topKiwfs; gad;gLj;jg;gLk; fhuzj;jpdhy; jhjp me;j egUld; Ngrp mikjpg;gLj;j KaYtij epWj;jf;$lhJ. vd;d nra;tnjd;W jPHkhdpf;ifapy; jhjp me;j eghpd; Njitfs;> ghJfhg;G (cjhuzkhf Nehahspf;F ,ja Neha; Nghd;w cly;hPjpahd ghjpg;Gfs; ,Uf;ff;$Lk;) kw;Wk; xU kdpjg;gpwtp vd;wtifapy; mthpd; chpikfs; Fwpj;Jr; rpe;jpf;fNtz;Lk;.

36

vd;d nra;ag;glNtz;Lnkd;W Nehahsp Vw;nfdNt xU Ntz;LNfhis tpLj;jpUe;jhy; (cjhuzk;: ,jw;F Kjy; ele;j rk;gtk; njhlHghff; fUj;Jj; njhptpf;ifapy;) ,aYkhapd; ,ijf; ftdj;jpy; nfhs;Sjy; Ntz;Lk;. Vida Nehahspfs;> cj;jpNahfj;ju;fs; kw;Wk; tUifjUNthH kPJ ,r;#o;epiyapd; jhf;fj;ijAk; ftdj;jpw;nfhs;Sjy; Ntz;Lk;. Fwpj;j #o;epiy kw;Wk; rk;ge;jg;gl;l egH tplaj;jpy; msTf;F mjpfkhd tplaq;fis cj;jpNahfj;ju;fs; nra;af;$lhJ. cly;hPjpahf kl;Lg;gLj;jy; Nehahspia mikjpg;gLj;Jk; tifapy; jPtpu Fiwg;G eltbf;iffs; Njhy;tp fz;lhy; khj;jpuNk xUtiu cly;hPjpahf mOj;jpg; gpbj;J kl;Lg;gLj;jy; Nkw;nfhs;sg;gLjy; Ntz;Lk;. cly;hPjpahd kl;Lg;ghL me;j egiuf; fl;Lg;gLj;Jtjw;Fg; NghJkhd mstpy; khj;jpuk;> ,ad;w msTf;F mjpFiwthd Neuj;Jf;Fg; gad;gLj;jg;gLjy; Ntz;Lk;. ,t;thW kl;Lg;gLj;jy; ,lk;ngWk;Ntisfspy; Nehahsp cly;hPjpapYk;> cshPjpapYk; vt;thW cs;shnud;gij mbf;fb nrt;itghHj;Jf;nfhs;Sjy; Ntz;Lk;. kl;Lg;gLj;jy; ,lk;ngWk;Ntisapy; gjtp mq;fj;jpdH xUtH KONeuKk; me;j eghpd; jiyiaAk;> fOj;Jg; gFjpiaAk; ghJfhg;gjw;Fk;> jhq;fpg; gpbg;gjw;Fk; nghWg;ghf ,Uj;jy; Ntz;Lk;. ,e;j egH Nehahsp xOq;fhfr; Rthrpg;gijAk; cWjpnra;jy; Ntz;Lk;. cj;jpNahfj;ju;fs; xUnghOJk; kl;Lg;gLj;jg;gLk; eghpd; fOj;ijNah> khHigNah> tapw;Wg;gFjpiaNah mOj;jf;$lhJ. xU egH cly;hPjpahf kl;Lg;gLj;jg;glNtz;ba #o;epiy Vw;gl;lhy; cjtp toq;Ftjw;F ,ad;w msT tpiutpy; xU itj;jpaH mq;F tUjy; Ntz;Lk;. jdpikg;gLj;jy; ,jd; fUj;J xU egH mikjpailtjw;fhf mtiu xU ghJfhg;ghd #oypy; itg;gjhFk;. jdpikg;gLj;jy; ,ad;w msT mjpFiwthd fhyg;gFjpf;F ,lk;ngWtNjhL> Nehahspia mbf;fb ghHitapl;L> tplaq;fisr; nrt;it ghHf;fNtz;Lk;. Nehahspapd; Milfs; mfw;wg;glyhfhJ. mtHfs; jk;ikj; jhNk my;yJ NtnwhU egiuf; fhag;gLj;jg; gad;gLj;jf;$ba

37

nghUl;fis khj;jpuNk mfw;Wjy; Ntz;Lk;. VidNahUf;Fj; jPq;F tpistpf;fg; gad;glhj> kjhPjpapy; Kf;fpakhd nghUl;fis mtHfs; itj;jpUg;gjw;F mDkjp toq;fg;gLjy; Ntz;Lk;. xUtH mt;thW jdpikg;gLj;jg;gl;lhy; ,ad;w msT tpiutpy; itj;jpaH xUtH me;;j ,lj;Jf;F tUjy; Ntz;Lk;. Jhpj mikjpg;gLj;jy; NehahspnahUtiu mikjpg;gLj;Jtjw;F kUe;J toq;fg;glNtz;bapUe;jhy; ,e;j eltbf;ifKiw myfpdhy; jPHkhdpf;fg;gl;l topfhl;ly; njhFjpf;F ,zf;fkhdjhf ,Uj;jy; Ntz;Lk;. tof;fkhf Crp kUe;njhd;iw Vw;Wk; Kd;ghf Nehahsp tha;%yk; kUe;Jfis cl;nfhs;s xU re;jHg;gk; toq;fg;gLjy; Ntz;Lk;. jdpikg;gLj;jy; miwapy; Jhpj mikjpg;gLj;jy; gad;gLj;jg;gl;lhy; KONeuKk; me;j egiug; ghuJ}ukhd gf;f tpisTfisf; fz;lwptjpy; gapw;rpngw;w xUtH njhlHr;rpahff; fz;fhzpj;jy; Ntz;Lk;. mikjpg;gLj;jy; gadspj;jhy;> ghJfhg;ghf ,Uf;Fnkdpy;> me;j egH jdpikg;gLj;jy; miwapypUe;J ntspNa nfhz;Ltug;gLjy; Ntz;Lk;. rk;gtj;jpd; gpd;duhd kPsha;T ml;ltiz 4.3: rk;gtj;jpd; gpd;duhd kPsha;T tpirf; fhuzpfs; vd;d ele;jJ? xt;nthU eghpdJk; ghj;jpuk; me;jNtisapy; mtHfspd; czHTfs; vt;thW Nehahsp ,r;rk;gtk; jtpHf;fg;gl;bUf;fyhnkd;W epidf;fpd;whH? vd;d ghlq;fis ehq;fs; fw;Wf;nfhs;syhk;? rk;gtk; Kbtile;j gpd;dH ,ad;w msT tpiutpy; ,r;rk;gtj;Jf;Ff; fhuzkhd tplaq;fs; kw;Wk; ,r;rk;gtj;jpd;NghJ epfo;e;j tplaq;fs; Nghd;wtw;iw kPsha;Tnra;jy; Ntz;Lk;. ,J xU fw;wy; mDgtkhfNt ,lk;ngWtjhy; ,f;fye;Jiuahlypd;NghJ mtHfisf; Fw;wk; nrhy;tjw;Nfh my;yJ tpkHrpg;gjw;Nfh vt;tpj Kaw;rpAk; Nkw;nfhs;sg;gLjyhfhJ. Neubahf rk;gtj;NjhL

38

rk;ge;jkpy;yhj xUtH kPsha;Tf;Fj; jiyikjhq;FtJ kpfr; rpwg;ghdjhFk; vd;gNjhL> ,aYkhapd; kPsha;TFwpj;j Nehahspapd; fUj;JfisAk; cs;slf;Fjy; Ntz;Lk;. ,e;;j tifahd kPsha;Tfs; ,j;jifa rk;gtq;fs; Vd; epfo;fpd;wd> kw;Wk; vjpHfhyj;jpy; mit vt;thW jtpHf;fg;glyhk; vd;gJ rk;ge;jkhf xU nghJthd tpsf;fj;ijj; jhjpkhUk;> VidNahUk; mgptpUj;jpnra;Jnfhs;s cjtf;$Lk;. kPsha;tpy; Nehahsp rk;ge;jKw;wpUe;jhYk; rhp> my;yJ mthpd; fUj;Jf;fisg; gpd;dH ngw;Wf; nfhz;bUe;jhYk; rhp> xU kPsha;T mj;jifa xU rk;gtk; kPz;Lk; vOkhapd; jiyaPLfs; rk;ge;jkhf Nehahspapd; nrhe;j tpUg;gq;fs; vit vd;gJFwpj;J jfty; toq;ff;$Lk;. vtuhtJ xUtH kPz;Lk; kPz;Lk; Fog;gepiyfSf;F cs;shdhy;> ,e;jr; rk;gtq;fis mjpFiwthf;Fk;tifapy; Fwpg;ghd tpdhf;fs; vOg;gg;gLjy; Ntz;Lk;. ml;ltiz 4.4: vtuhtJ Nfl;fg;;glNtz;ba tpdhf;fs; Fog;gepiyf;F Mshfpdhy;

fhuzk; vd;d? vg;nghOJ mtH Fog;gepiyf;F Mshfpd;whH? mtH Vd; Fog;gepiyf;F Mshfpd;whH? Fog;gepiyia NkYk; Nkhrkhf;Fk; #o;epiyfs; vit? ,J eilngwhky; ehk; vt;thW jLf;fyhk;?

39

5. jhjpapay; nraw;ghl;L mZFKiwfs;

1. cstsj;Jiz toq;Fjy; cstsj;Jiz vd;gJ mwpTiu toq;FtJ rk;ge;jkhdJ my;y. mJ nrtpkLj;jy;> gpur;rpidfis ,dq;fz;L njspTngWtjw;F egHfSf;F cjTjy;> kw;Wk; NkYk; rpwg;ghd XH vjpHfhyj;Jf;fhf mtHfsJ ,yf;Ffis eilKiwg;gLj;JtJ Nehf;fpg; gzpahw;Wjy; vd;git rk;ge;jkhd xd;whFk;. MfNt> cstsj;Jizahsu; xUtH nrtpkLj;jy; my;yJ thHj;ijfs; my;yhj elj;ijfis mtjhdpj;jy;> nghUj;jkhd Nfs;tpfisf; Nfl;ly;> kPz;Lk; rpe;jpj;jy;> ,Wjpapy; gpur;rpidfisAk; ,yf;FfisAk; rhuhk;rg;gLj;jy; Nghd;w jpwd;fisf;; nfhz;bUj;jy;. ml;ltiz 5.1: cstsj;Jizj; jpwd;fs; (rkurpq;f> 2010) nrtpkLj;jy; mtjhdpj;jy; nghUj;jkhd tpdhf;fis vOg;Gjy; kPz;Lk; rpe;jpj;jy; rhuhk;rg;gLj;jy; ml;ltiz 5.2: cstsj;Jizahshpd; rpwg;gpay;Gfs; (rkurpq;f> 2010) jhd; kw;Wk; NehahsHfs; rk;ge;jkhfj; njspthd czHr;rpfs;rhH vy;iyfisf; nfhz;bUj;jy; VidNahiug; nghWj;jtiuapy; mtHfSf;Fj; toq;Fk;tifapy; ele;Jnfhs;shjpUj;jy; kw;wtHfs;kPJ nfhz;bUj;jy; jpzpf;fhj> jdpg;gl;l jPHT

tpOkpaq;fisf; NeHikahfTk;>

jhd; kw;Wk; VidNahiug; nghWj;jtiuapy; cz;ikahfTk; ele;Jnfhs;Sk; Mw;wy;

40

ml;ltiz 5.3: cstsj;Jizapd; ,yf;Ffs; (rkurpq;f> 2010) gpur;rpidfis ,dq;fhz;gjw;Fk;> njspTgLj;Jtjw;Fk; cjTjy; NehahsH jkJ fijfisf; $Wtjw;F cjTjy; NehahsHfs; jkf;Fr; rthyhd elj;ijfisr; rpe;jpf;f cjTjy; NehahsHfs; rhpahd tplaq;fspy; gzpahw;w cjTjy; Nehahspfs; NkYk; rpwg;ghd XH vjpHfhyj;ij cUthf;fpf;nfhs;s cjTjy; rhj;jpaf;$Wfis Ma;Tnra;jy; kpfr;rpwg;ghd cj;jpfisf; fz;lwpjy; jpl;lq;fs; kw;Wk; nray;epfo;r;rpj;jpl;lq;fis tFf;f cjTjy;

ml;ltiz 5.4: cstsj;Jizapd; gbKiw (rkurpq;f> 2010) Nehahsiu kjpg;gJk;> kd mOj;j Ntisfspy; mthpd; Vw;Wr; rkhspf;Fk; cj;jpfis kjpj;jYk; cstsj;JizahdJ gpur;rpidfisj; jPHf;Fk; xU toptifahfj; jpzpf;fhjpUj;jy; Nehahspapd; gykhd mk;rq;fisf;; fl;bnaOg;Gjy; 2 mwpthw;wy; elj;ijr; rpfpr;ir (Cognitive Behaviour Therapy CBT) cseyg; gpur;rpidfs; my;yJ kdf; Fog;gq;fshy; ghjpg;GWk; egHfs; xU Fwpj;j #o;epiy rk;ge;jkhfg; gy;NtW topfspy; gpujpgypg;igf; fhl;Lfpd;wdH. ,J gjfspg;G kw;Wk; kdr;NrhHT vd;gtw;wpypUe;J> mOjy; my;yJ jw;nfhiy vz;zk; Nghd;w tbtq;fs; tiu xU tPr;rpyhd tplaq;fshfj; jd;id ntspg;gLj;jpf;nfhs;sf;$Lk;. mwpthw;wy; rpfpr;ir xU eghpd; elj;ijkPJ jhf;fk;nrYj;jf;$ba cjtpaw;w ghq;fpyhd rpe;jidfis ,dq;fhz;gjw;F cjTfpd;wJ. ,j;jifa rpe;jidfs; kdr;NrhHT czHTfs;> gjfspg;G kw;Wk; Nfhgk; vd;gtw;Wf;F ,l;Lr;nry;yf;$Lk;. ,jw;fhd fhuzk; ,j;jifa rpe;jidg; ghq;Ffshy; cUthf;fg;gLk; jphpGngw;w

41

fhl;rpahFk;. elj;ijr; rpfpr;ir ,luhd #o;epiyfSf;Fk;> mtw;Wf;fhd toikahd gpujpgypg;GfSf;Fk; ,ilapyhd ,izg;igg; gytPdg;gLj;j cjTfpd;wJ. xU Fwpg;gpl;l #o;epiy Fwpj;j xU jdpeghpd; tpahf;fpahdk; ,j;jifa mwpthw;wypd; gpd;duhd jhf;fq;fs; kw;Wk; tpisTfis mstPL nra;tjpy; jPHkhdfukhdjhFk;. ml;ltiz 5.5: mwpthw;wy;elj;ijr; rpfpr;ir (Parry, 2010) mwpthw;wy; rpfpr;ir ,J tho;f;ifapy; vd;d elf;fpd;wJ vd;gJ rk;ge;jkhd jphpGw;w xU fhl;rpia toq;Ftjd;%yk; rpy rpe;jidg; ghq;Ffs; vt;thW Neha; mwpFwpfSf;F ,l;Lr;nry;yyhk; vd;gijf; fw;gpf;fpd;wJ. ,J ,g;ghq;Ffs; vt;thW kdr;NrhHT> gjfspg;G kw;Wk; Nfhgk; vd;gtw;Wf;F ,l;Lr;nry;fpd;wd vd;gijf; fw;gpf;fpd;wJ. elj;ijr; rpfpr;ir ,J ,luhd #o;epiyfs; kw;Wk; mtw;Wf;fhd toikahd gpujpgypg;Gf;fs; vd;gtw;Wf;fpilapyhd gpizg;Gfisg; gytPdg;gLj;Jfpd;wd. ,g;gpujpgypg;Gfs; mr;rk;> kdr;NrhHT> Nfhgk;> jdf;Fj;;jhNd jPq;fpiof;Fk; elj;ij vd;gtw;iw cs;slf;ff;$Lk;. ,J ehk; NkYk; njspthfr; rpe;jpj;J KbTfis Nkw;nfhs;Sk;tifapy; kdj;ijAk;> cliyAk; mikjpg;gLj;Jfpd;wJ. mwpthw;wy;rhH kw;Wk; elj;ijrhH mZFKiwfis xd;wpizg;gjd;%yk; ehk; CBT I XH jiyaPlhfg; ngw;Wf;nfhs;fpd;Nwhk;. ,J Ml;fs; gpur;rpidfisAk;> tpUk;ghj tpisTfisAk;> tpNrlkhf Neha; my;yJ kdj;JaHFwpj;j mwpFwpfisAk; ifahStjw;F cjTfpd;wd.

42

ml;ltiz 5.6: CBTapd; ika fUg;nghUl;fs; (Parry, 2010) ehk; xU #o;epiyia vt;thW tpahf;fpahdk; nra;fpd;Nwhnkd;gijg;;nghWj;J ehk; mr;#o;epiyFwpj;J vj;jifa czHit ngw;Wf;nfhs;fpd;Nwhnkd;gJ mikfpd;wJ. vkJ jd;dpaf;fkhd rpe;jidfSf;Fk;> elj;ijiag; ghjpf;Fk; vkJ czHTfSf;Fkpilapy; xU njhlHG cs;sJ. NehahsH jkJ tho;f;ifiaf; nfhz;Lelj;Jtjw;F cjTk;tifapyhd xU CBT mZFKiwapd; fUj;J NehahsHfspd; epahatpsf;fj;Jf;Fg; Gwk;ghd kw;Wk; vjpHkiwahd rpe;jidfisAk;> mtHfspd; ek;gpf;iffisAk;> Cfq;fisAk; ,dq;fhZtJ vd;gjhFk;. ,tw;NwhL> jhjp Nehahspapd; gykhd mk;rq;fisAk; ,dq;fhz Kaw;rpnra;jy; Ntz;Lk;. mtH ,tw;iw Nehahspf;Fr; Rl;bf;fhl;b> gpur;rpidfisj; jPHg;gjw;F ,e;j tYthd mk;rq;fisg; gad;gLj;JkhW mtiu Cf;Ftpj;jy; Ntz;Lk;. mj;NjhL> jhjp Nehahsp vt;thW clw;nwhopw;ghl;bay; kw;Wk; cstpay;hPjpahfg; ghjpg;GWfpd;whH vd;gijAk; fz;lwpjy; Ntz;Lk;. Nehahspiag; ghjpf;Fk; gpur;rpidfis xd;wpizj;Jg; ghHg;gJ vJ xU Fwpg;gpl;l elj;ijia tpirAld; gpwg;gpf;fpd;wJ> kw;Wk; ve;j ,lj;jpy; jiyaPL nra;jy; Ntz;Lk; vd;gJFwpj;j rpwg;ghd Cfq;fSf;F ,l;Lr;nry;Yk;. eilKiwapy; CBT vd;gJ Nehahspapy; elj;ij khw;wj;ij Vw;gLj;JtNjhL> epahakw;w elj;ijfis Vw;gLj;Jk; fhuzkw;w rpe;jidfis ntspg;gLj;jp> mitFwpj;J tpdhntOg;Gk; jpwd;fis mthtp epw;fpd;wJ. cjhuzkhf> NehahspnahUtH capH tho;tjpy; vt;tpj gaDkpy;iynad;W $Wk;NghJ> xU CBT mZFKiwiag; gad;gLj;Jk; jhjp xUtH Vd; mt;thW $Wfpd;whH vd;gijg; ghprPyid nra;tNjhL> Nehahspfs; jkJ rpe;jidfs;Fwpj;J NkYk; rpwg;ghd czHitg; ngw;Wf;nfhs;Sk;tifapy; mtHfspd; rpe;jidia khw;Wtjw;F Kaw;rpnra;a Ntz;Lk;. xU Nehahspapd; rpe;jidr; nray;Kiwia khw;Wtjw;Fj; jhjp njhlHr;rpahf tpdhf;fis tpdTjy; Ntz;Lk;. gpd;dH gpujhd cstpay; gpur;rpidfs; vitnad;gijf; fz;lwptjpy; NehahspAld; NrHe;Jiof;fNtz;Lk;. gpur;rpidfSld; tho;tjw;F my;yJ

43

mit Neha; mwpFwpfisAk;> kdj;JaiuAk; Vw;gLj;jhjtifapy; mtw;iwf; ifahs;tjw;F cjtpnra;tNj ,Wjpg; gbepiyahFk;. ml;ltiz 5.7: CBT jpwd;fs; cs;slf;Ftd (Parry, 2010) rpe;jidfs; kw;Wk; rpe;jidg; ghq;Ffis mtw;Wf;F epaha tpsf;fkspj;jYk; Mf;fg+Htkw;w ek;gpf;iffisAk;> mtw;Wf;Fr; rthy; tpLj;jYk; Ez;zha;Tf; Nfs;tpfis vOg;Gjy; elj;ijia khw;wpaikj;jy; Ez;zha;Tf; Nfs;tpfs; vd;gJ: egH jdJ Muk;g Kbit epaha tpsf;fj;Jld; kPz;Lk; rpe;jpf;f cjTtjd;%yk; jHf;fhPjpaw;w rpe;jidia ntspf;nfhzUk; jpwd; ml;ltiz 5.8: CBT mZFKiwiag; gad;gLj;jp NehahspfSld; gzpahw;Wjy; (Parry, 2010) nghwp tpirahf mike;jJ vJ? mJ rk;ge;jkhd mtuJ rpe;jidfSk;> ek;gpf;iffSk; vit? mtUf;F Vw;gLk; czHr;rpfs; kw;Wk; czu;Tfs; vj;jifait? clw;nwhopw;ghl;bay; rk;ge;jkhf mtH vt;thW ghjpg;gilfpd;whH? mthpd; elj;ij vj;jifaJ? vq;F kw;Wk; vt;thW ePq;fs; jiyaPL nra;tJ mtrpakhFk;? xU CBT mZFKiw jhjpkhUf;F xU gzp rk;ge;jkhd #o;epiyapy; my;yJ jdpg;gl;l tho;f;ifapy; jdJ nrhe;jg; gpur;rpidfisf; ifahs;tjw;F cjtyhk;. cjhuzkhf> fPo;epiyg; gzpahsHfs; rk;ge;jkhf jhjpkhHfspd; gpujhdkhd kdf;Fiw mtHfs; Ntz;ba msTf;F MjuT toq;Ftjpy;iy vd;gjhf ,Ue;jhy;> rpw;W} opaHfspd; elj;ij tplaj;jpy; vij khw;w Ntz;Lnkd;W jhjpkhH tpUk;Gfpd;wdnud;gijj; jPHkhdpg;gJ Kf;fpakhdjhFk;. tpUk;Gk; khw;wk; csg;ghq;fpyhd xU khw;wkhapd;, tpUg;gkhd tpisitg; ngw;Wf;nfhs;tjw;F vd;d nra;ayhk; vd;gJ Fwpj;Jr; rpe;jpf;fTk;. ,dq;fhz;gJk;> fz;lwpjYk;>

Cfq;fisAk;

44

,U FOtpdUf;Fk; cseyk; rk;ge;jkhd mbg;gil tplaq;fspy; gapw;rp toq;FtJ ,U FOtpdUk; xd;whf mkHtjw;Fk;> NkYk; jpwe;jKiwapyhd ciuahliy toq;Ftjw;Fkhd re;jHg;gj;Jf;fhd xU KjyhtJ gbahf mikayhk;. ,e;;j Kd;Kaw;rp ntw;wpailaNtz;Lnkdpy;> Kf;fpakhd tplak; rpw;W} opaH gjtp mq;fj;jpdHfisr; re;jpf;Fk; xU Nehf;fk; ,Uf;f Ntz;Lnkd;gjhFk;. CopaHfsplkpUe;J fUj;Jf;fisg; gpwg;gpg;gJ XH Mf;fg+Htkhd cwTf;Fk; toptFf;Fk;. ,jdhy; gpur;rpidf;fhd jPHitAk; mtHfNs toq;ff;$Lk;. ,jd;%yk; mtHfs; jkJ nrhe;jg; gpNuuizfis eilKiwg;gLj;JkhW cl;fpilahf mtHfis typAWj;JtjhfTk; ,Uf;Fk;. gpur;rpidfSf;Fj; jPHTfhz;gjpy; rpw;W}opaH kj;jpapypUf;Fk; tYthd mk;rq;fis ,dq;fhz;gJ kpfTk; Kf;fpakhdjhFk;. kdg;ghq;Ffspy; khw;wNk ,yf;fhf ,Ue;jhy;> re;jpg;Gf;fs;;%yk; ,ad;wsT mjpf vz;zpf;ifapyhd jPHTfisg; gpwg;ghf;fk; nra;tJ Kf;fpakhFk;. ,jw;Fg; gpd;dH> kpfr;rpwe;j jPHit Vw;Wf;nfhs;tjw;F Kd;dH rhjf> ghjfq;fis Ma;Tnra;aTk;. NehahsHfspd; gpur;rpidfs;Fwpj;Jg; gzpahw;Wtjpy; my;yJ gzpnra;Ak; ,lj;jpy; gpur;rpidfSf;Fj; jPHTfhz Kaw;rpg;gjpy; my;yJ xUthpd; jdpg;gl;l tho;f;ifapy; ntw;wpf;fhd top gpur;rpidfisf; ifahs;tjpy; Ml;fs; Nkw;nfhs;Sk; mZFKiwahFk;. CBT I XH mZFKiwahfg; gad;gLj;Jjy; mNdfkhd re;;jHg;gq;fspy; xU ntw;wpfukhd tpisitg; ngw;Wf;nfhs;tjw;F kpfTk; gaDs;sJk;> tpiuthdJkhd topahFk;. 3. Fzkiljiy Kd;Ndw;Wjy; (GdHtho;T cs;spl;ltifapy;) fle;j fhyj;jpy; mNdfkhd re;;jHg;gq;fspy; cs eyg; gpur;rpidfisf; nfhz;l xUtH> my;yJ kdNeha; xd;wpdhy; ghjpf;fg;gLk; xUtH> vg;nghOJNk ,j;jifa ,lHfisAk;> tpahjpiaAk; nfhz;bUg;gH vd;gJ Cfpf;fg;gl;lJ. ,J kdNeha; rk;ge;jkhd mtg;ngaUf;fhd gpujhd fhuzq;fSs; xd;whFk;. MapDk;> jw;NghJ Muk;gj;jpypUe;Nj Fzkiljy; Fwpj;Jg; NgRtJ kw;Wk; rpe;jpg;gJ vd;gtw;wpNyNa typAWj;jy; cs;sJ.

45

ml;ltiz 5.9: Fzkiljy; (Welstand-Keryk, 2010) ,J gpd;tUtdtw;iwf; Fwpf;fpd;wJ: jdpegu;; mDgtq;fs; Kd;Ndw;wf;$ba Nritfs; mDruiz toq;ff;$ba Kiwfs; ,ijg; gpd;tUkhW ,dq;fhzyhk;: 1. kf;fspd; gpd;Gyj;ijAk; csg;ghq;FfisAk; Muha;tJ. 2. cj;jpNahfj;ju;fspd; Nritfs; vt;tifapy; xOq;fikf;fg;gl;Ls;sJ 3. Nrit toq;Fk; ek;gpf;iffSk; cj;jpNahfj;ju;fspd; csg;ghq;FfSk;

Fzkiljy; vd;gJ jdpegH nra;Ak; tplaq;fshFk;. Fzkiljy; gazk; vd;gJ mtH vLf;Fk; ghijahFk;. Fzkiljy; mZFKiw vd;gJ Fwpg;gpl;l egH jdJ Fzkiljiy <l;bf;nfhs;tjw;F cjTk;tifapy; cj;jpNahfj;ju;fs; nra;af;$ba tplaq;fshFk;. Fzkiljy; vd;gJ mwpFwpfspypUe;J tpLgl;bUf;Fk; xU tplak; khj;jpuky;y. mJ mHj;jKk;> ek;gpf;ifAk; cs;s tho;f;ifiaf; fl;bnaOg;Gk; rpy Mf;fg+Htkhd mk;rq;fis cs;slf;ff;$bajhFk;. If;fpa mnkupf;fh(USA), epa+rPyhe;J> kw;Wk; If;fpa uhr;rpak;(UK) Nghd;w ehLfspy; cseyr; Nritfisg; gad;gLj;JNthuhy; tFj;jikf;fg;gLk; Fzkiljy; mZFKiw vd;gjd; fUj;J Jujp~;lk; my;yJ rk;ge;jKw;w egH vjpHNehf;Fk; Neha;f;F> Kfq;nfhLf;ifapy; mtH jdJ nrhe;j tho;f;ifiaj; jdJ iffspy; vLj;Jf;nfhs;Sk; epiyia Nehf;fpg; gzpahw;Wtjw;F MjuT toq;FtJ vd;gjhFk;. ,e;;j mZFKiw jdpeghpd; ,yf;Ffspy; ek;gpf;ifAzHTld; ftdk;nrYj;Jtjw;fhd NjitiaAk;> mDgtq;fspd; mHj;jj;ij (Neha; mwpFwpfs; cs;spl;ltifapy;) mwpe;Jnfhs;tjw;Fk;> tsHr;rpf;Fk; my;yJ jdpegH mgptpUj;jpf;Fk; kw;Wk; Nehf;fk;Fwpj;j XH czHit mgptpUj;jpnra;tjw;Fk; typAWj;jy; toq;Ffpd;wJ.

46

ml;ltiz 5.10: Fzkiljy; mZFKiw vjpHfhyj;Jf;fhd xU ek;gpf;ifia mgptpUj;jpnra;jy; tho;f;ifapd; mu;j;jk; Fwpj;j czHT VidNahhpd; cjtpAld; my;yJ mJ ,y;yhky; xUtH jdJ nrhe;j tho;f;ifiag; nghWg;Ngw;Wf;nfhs;Sjy; (fyhr;rhuj;ijg;nghWj;J ,e;j kl;lk; NtWgLfpd;wJ) RahjPdkhf epw;gJk;> nrhe;jf; fhypy; epw;gJk; (fPioj;Njrq;fistpl Nkw;F ehLfspy; mjpf Kf;fpaj;Jtk; tha;e;jJ) FLk;gj;jplkpUe;Jk;> r%fj;jplkpUe;Jk; Mjuit Vw;Wf;nfhs;tJk;> gu];gu hPjpapy; jq;fpepw;gJk; (Nkw;F ehLfistpl fPioj;Njrq;fspy;) $Ljyhd Kf;fpaj;Jtk; tha;e;jJ jdpg;gl;l ,yf;Ffis Vw;gLj;Jjy;> MapDk; FLk;gj;Jld; NrHe;j epiyapy; ,tw;wpd; kl;lk; fyhr;rhug; gpd;dzpapd; gpufhuk; NtWgLfpd;wJ kj ek;gpf;iffSld; ,izg;ig Vw;gLj;Jjy; (Nkw;F ehLfistpl fPioj; Njrq;fspy; mjpf Kf;fpaj;Jtk; tha;e;jJ) FLk;gj;JlDk;> r%fj;JlDk; ,izg;ig Vw;gLj;jpf;nfhs;Sjy; (Nkw;F ehLfistpl fPioj;Njrq;fspy; mjpf Kf;fpaj;Jtk; tha;e;jJ) Fzkiljy; vd;gJ vijf; Fwpf;fpd;wJ vd;gJ fyhr;rhuq;fisg;nghWj;J NtWgLfpd;wJ. ,J Nkw;F ehLfistpl xU ,ul;ilf; fyhr;rhur; #oypy; kpfTk; tpj;jpahrkhd xd;whFk;. Nkw;fj;jpa r%fq;fspy; VNjhnthU tbtpyhd jdpegH rhjid FzkiljYf;F mbg;gilahff; fUjg;gLfpd;wJ. vt;thwhapDk;> gy fPioj;Nja fyhr;rhuq;fspy; (c-k;: ,yq;if fyhrhur; #oy;) kj ek;gpf;iffs;> tPL> FLk;gk; kw;Wk; r%fk; vd;gtw;Wldhd ,izg;Gfs; NtnwjidAk;tpl $Ljyhd Kf;fpaj;Jtk; nfhz;litahFk;. fPioj;Njrq;fspy; Nkw;fj;jpa fyhr;rhuq;fspy; fhzg;gLtJ Nghd;W VidNahhplkpUe;J tpyfpr; RahjPdkhf ,Ug;gnjd;gJ mt;tsT Kf;fpakhdjy;y. ,yq;if kf;fisg;nghWj;jtiuapy; mtHfs; FLk;gj;JlDk;> r%fj;JlDk; xj;jpirthf tho;tjhYk; - mtHfspy; jq;fpapUg;gjhYk; ,J RahjPdk; kw;Wk; Ra Kaw;rp vd;gtw;iwtplf; $Ljyhd Kf;fpaj;Jtk; tha;e;jjhFk;. ,uz;L fyhr;rhuq;fspYk;

47

rk;ge;jKw;w egUf;F vJ Kf;fpakhdnjd;gJ me;j egUlDk;> mthpd; FLk;gj;JlDk; XH mHj;jKs;s ciuahly;%ykhf khj;jpuNk Ghpe;Jnfhs;sg; glyhk;. ,j;jifa XH ciuahly; mtHfspd; Fzkiljy; gazj;jpy; mtHfspd; Kd;Dhpikfs; kw;Wk; tpOkpaq;fs;Fwpj;J mwpe;Jnfhs;tjw;F cjTk;. MfNt> cseyg; gpur;rpidfs;nfhz;l egHfSf;F Fzkiltjw;F mDruizaspj;jy; vd;gjd; fUj;J vjpHfhyj;ij ek;gpf;ifAld; vjpHNehf;Ftjw;Fk;> jhk; kjpg;ig kw;Wk; jk;ikg; g+uzg;gLj;Jgitnad epidf;Fk; tplaq;fNshL ,izj;Jf;;nfhs;tjw;F my;yJ kPspizg;Gr; nra;tjw;fhd topfisf; fz;Lnfhs;tjw;F kw;Wk; ey;tho;TFwpj;j jdpg;gl;l czHTfis kPsTk; jhgpg;gjw;Fk; mtHfSf;F Cf;Ftpg;G kw;Wk; MjuT toq;FtJ vd;gjhFk;. ,jd; fUj;J mtHfs; vjpHNehf;ff;$ba ,lHfis Vw;Wf;nfhs;tJk; mtw;iw ntw;wpnfhs;Sjy;> jtpHj;Jf;nfhs;Sjy;> mtw;Wld; thog; gofpf;nfhs;Sjy; kw;Wk; mtw;iwj; jPHj;jy; rk;ge;jkhd topKiwfisf; fhZjy; vd;gjhFk;. Gdu;tho;T fle;j fhyj;jpy; GdHtho;T vd;gijr; rpfpr;irapypUe;J gphpj;Jg; ghHf;Fk; xU tof;fk; ,Ue;jJ. MapDk;> ,g;nghOJ mit ,uz;Lk; xd;wpizAk; Nghf;F fhzg;gLfpd;wJ. Nehahsp rprpf;irf;fhf mDkjpf;fg;gl;lTlNdNa GdHtho;T Muk;gpf;fpd;wJ. GdHtho;T vd;gJ Fzkiljy; mZFKiwapd; xU gphpf;f Kbahj gFjpahFk;. MapDk;> ePz;lfhyk; rpfpr;ir epWtdq;fspy; mDkjpf;fg;gl;bUe;jtHfs; GdHtho;tpd; Fwpj;j fhyg;gFjp gy;Jiwrhu; FO xd;wpdhy; Nkw;ghHit nra;ag;glNtz;bapUf;fyhk;. ,J jPHf;fkhd kdj;JaH my;yJ tpahjpahy; ghjpg;Gw;w egHfsplkpUe;J gphpj;J xU tpNrlkhd gpd;dzpapy; toq;fg;gLtNj kpfr; rpwe;jjhFk;. (vj;jifa Jiwiar; NrHe;jtuhf ,Ue;;jNghjpYk; GdHtho;tpy; rk;ge;jKw;Wg; gzpahw;Wk; vtUk; NtW Jiwfisr;; NrHe;NjhUld; NrHe;J gzpahw;WtJ mtrpakhdjhFk;). Muk;gj;jpy; xU GdHtho;Tj; jpl;lk; xt;;nthU Nehahspf;Fnkd tFf;fg;gl;L fz;fhzpf;fg;gLfpd;wJ. ,J Kd;Ndw;wj;ijg; nghWj;J my;yJ eghpd; nrhe;j Kd;Ndw;wq;fisg;;nghWj;J fpukkhf khw;wg;glyhk;. rk;ge;jKw;w egH Kd;Ndw;wk;> njhpTfs; kw;Wk; gpur;rpidfs; rk;ge;jkhf ahUld; fye;Jiuahlyhk; vd;gijj;

48

njspthf mwpe;J itj;jpUf;Fk;tifapy; xt;nthU egUf;Fk; xU ngaHFwpg;gplg;gl;l Kf;fpa gzpahsH ,Ug;gJ mtrpakhFk;. MHtKs;s FLk;g mq;fj;jpdHfs; ,Ug;gpd; cwtpdHfSf;fhd cstpay;fy;tp GdHtho;Tj; jpl;lj;jpd; xU Kf;fpa gFjpahf tpsq;fyhk;. GdHtho;T mspf;fg;gLgtHfs; r%fj;Jld; njhlHr;rpahd njhlHG itj;jpUg;gJ kpfTk; Kf;fpakhdjhFk;. (filfSf;Fg; Ngha; nghUl;fs; thq;FtJ> my;yJ r%fj;jpd; VidNahUld; tpisahl;L epfo;r;rpfspy; gq;Fgw;Wjy;) mNdfkhd re;;jHg;gq;fspy; ,j;jifa njhlHGfisg; NgZtjpy; mtHfSf;F cjtp Njit. ml;ltiz 5.11: GdHtho;Tf; Nfhl;ghLfs; ,ad;w msTf;F NehahspfisAk;> guhhkhpg;G toq;FNthiuAk; <LgLj;jy;; (,J fyhr;rhug; gpd;dzp kw;Wk; r%fr; #oy; vd;gtw;iwg; nghWj;jjhFk;) Kf;fpa gzpahsH xUtiu epakpj;jy; FLk;gr%f Mjuit epuyply;; #o;epiyf; fzpg;gPL: Nehahspapd; Mw;wy;fs;> gyq;fs; kw;Wk; gytPdq;fisg; gy;NtW #oy;fspy; epuyply;;. jdpegH rhHgpyhd nghJthd mZFKiwia epuyplTk; (c-k;: jq;fpepw;wiy Kd;Ndw;Wjy;RarhHig Kd;Ndw;Wjy;> jtpHf;fNtz;ba #o;epiyfs;Cf;Ftpf;fNtz;ba #o;epiyfs;) gykhd mk;rq;fis mjpAaHthf;Fk;tifapYk;> Njhy;tpfisj; jtpHf;Fk; tifapYkhd xU jpl;lj;ij tiuaTk; (c-k;: mtrpag;gLk; gapw;rp> njhopy;rhu; mwpTiu vd;gtw;iw epuypLjy;) FiwghLfis eptHj;jpnra;Ak;tifapy; Vw;gLj;Jtjw;F mtrpakhd MjuT Kiwfis epuyplTk; (c-k;: FLk;g> r%f MjuT kw;Wk; cstsj;Jiz vd;git ,y;yhj epiyik) NehahsHfs; kw;Wk; fw;Wf;nfhs;Sjy; Kd;dhs; NehahsHfsplkpUe;J

csey Nritapd; juj;ij Nkk;gLj;Jtjw;fhd xU Kf;fpakhd top NehahsHfsplkpUe;Jk;> Kd;dhs; NehahsHfsplkpUe;Jk;

49

NritFwpj;j mtHfspd; mDgtq;fs;> tpNrlkhf cs;NehahsH guhkhpg;gpd;NghJ mtHfspd; mDgtq;fs;Fwpj;j jfty;fisg; ngw;Wf;nfhs;tjhFk;. Kd;dhs; NehahsHfis NeHKfk; fhz;gjD} lhfTk;> rhpnra;ag;glNtz;ba tplaq;fis ntspf;nfhzHtjD} lhfTk; ,ij Kiwahfr; nra;tJ Muk;gpf;fg;gl;Ls;sJ. ml;ltiz 5.12: Kd;dhs; NehahspfSldhd NeHfhzy;fs; gpd;tUk; tplaq;fis ntspg;gLj;jpd (ngNuuh> 2010) mNdfkhd jhjpkhH caHthd guhkhpg;ig toq;Ffpd;wdH. MapDk;> mtHfSf;F mjpfhunkJTk; ,Ug;gjhfj; njhpatpy;iy. jhjpkhH Fog;gkilAk; NehahspfSf;F cjTtjpy; rk;ge;jKWtjpy;iy. jhjpkhhpd; ghj;jpuk; gpujhdkhf kUe;Jfis toq;Fk; xd;whfNt Nehf;fg;gLfpd;wJ. Mf;fpukpg;G kdepiyapYs;s NehahsHfs; mNdfkhd re;;jHg;gq;fspy; rpw;W}opaHfshy; (attendants) kpfTk; Nkhrkhf elj;jg;gLfpd;wdH. Nehahspfs; rpw;W}opaHfSf;Ff; gyte;jg;gLj;jg;gLfpd;wdH. juf;Fiwthd Nfl;fg;gLk;NghJ czHfpd;wdH. Ntiyfisr; NehahsHfs; fPo;g;gbAkhW

nra;AkhW NehahsHfs; jhk; Vsdg;gLj;jg;gLtjhf

FLk;g tptfhuq;fisf; fye;JiuahLtjpy; itj;jpaHfs; Neuj;ijr; nrytpLtJ Fzkiltjw;F kpfTk; cjtpahf mikAk;. itj;jparhiyapy; mDkjpf;fg;gLtJ XH cUthf;Ffpd;wJ. ,jdhy; gpd;dH r%fj;jpy; Nehf;fg;gLfpd;wdH. tPl;bypUe;J MjuT fpl;bapUe;jhy; mNdfkhd NkYk; rpwe;jKiwapy; Fzkile;jpUg;ghHfs;. mtg;ngaiu ghugl;rj;Jld; NehahsHfs;

Nehahspfs; jhk; mDkjpf;fg;glf;$lhJ vd;gijf; $wyhkh> vg;nghOJ $wyhk;> kw;Wk; vt;thW $wyhk; vd;gJFwpj;J mtHfSf;Fj; njspthd epiy mNdfkhd re;jHg;gq;fspy; fhzg;gLtjpy;iy. Nehahspfs; vg;nghOJ> kw;Wk; vt;thW jkf;Fr; rpfpr;ir Njitapy;iy vd;gijj; njhptpf;fyhnkd;gjpYk; mtHfSf;Fj; njspthd epiy ,y;iy.

50

Nehahspfspd; guhkhpg;igj; jpl;lkpLtjpy; mtHfis <LgLj;Jtjd; mD$yq;fSk;> mtHfs; mt;thW <LgLtjd; mD$yq;fSk; kpfTk; mjpfkhditahf ,Ug;gjhy;> NehahsHfisf; fye;jhNyhrpg;gJ xU rpwe;j jhjpj;njhopy; eilKiwapd; xU gFjpahftpUj;jy; Ntz;Lk;. ml;ltiz 5.13: guhkhpg;G Nrit jpl;lkpLjypy; Nritiag; gad;gLj;JNthH rk;ge;jKWjy; NehahsH NkYk; tpiuthff; FzkiltJ rhj;jpakhFk;. td;Kiw kw;Wk; Fog;gkhd elj;ij ,lk;ngWtJ FiwtilAk;. FLk;gq;fs; NehahsHfis tPl;Lf;Ff; $l;br;nrd;W mtHfSf;F MjuT toq;Fjy; mjpfhpf;Fk;. NehahsHfsplkpUe;Jk;> mtHfspd; FLk;gq;fsplkpUe;Jk; fpilf;Fk; Kiwg;ghLfs; FiwtilAk;. kdpj chpikfs; Nkk;ghlilAk;. cseyr;; Nritfs; KOtJk; NkYk; gaDWjpAs;sjhFk;.

51

6. KbTiufs;
,yq;ifapy; csey Nritfs; mLj;j rpy tUlq;fspy; epWtd mbg;gilapyhd Nrit vd;gjpypUe;J r%f mbg;gilapyhd Nritahf khw;wkiltNj midj;Jklq;Fk; jpl;lkhFk;. ehl;bd; rpy gFjpfspy; r%f mbg;gilapyhd rpy Nritfs; ,lk;ngw;wNghjpYk;> Vida gFjpfs; ngUkstpyhd epajpr;rl;l NritfSf;F kdNeha; itj;jparhiyfspYk;> nghJ itj;jparhiyfspd; csNeha; rpfpr;irg; gphpTfspYk; gpujhdkhfj; jq;fpAs;sd. MfNt> r%f Nritfs; fl;bnaOg;gg;gLk;tiu> kdNeha; itj;jparhiyfNs njhlHe;Jk; cseyg; gpur;rpidfisf; nfhz;NlhUf;fhd Nritfis toq;Ftjpy; xU ghj;jpuj;ij tfpj;JtUk;. ,e;j E}ypd; gjpg;ghrphpaHfs; ,jd; cs;slf;fg; nghUl;fs; cseyj; JiwapYs;s njhopy;rhH epGzHfSf;Fk;> tpNrlkhf ,e;jr; Nritfis toq;Fk; kdeyj; jhjpkhUf;Fk; topfhl;bahfTk;> cjtpahfTk; tpsq;Fnkd;W ek;gpf;if nfhz;Ls;sdH. caH tUkhd ehLfspd; gy gFjpfspy; ngUksTf;F r%fg;guhkhpg;G epWtd mbg;gilapyhd guhkhpg;gpdplj;ij vLj;Js;sJ. nghpa kdNeha; itj;jparhiyfspd; ,lj;ij vkJ itj;jparhiyfSld; ,izf;fg;gl;l rpwpa myFfs; vLj;Js;sd. epWtdq;fspd; ntspf;fs epiyaq;fs; mgptpUj;jp nra;ag;gl;Ls;sd. mj;NjhL> r%f mbg;gilapyhd Nritfs; xd;wpizf;fg;gl;Ls;sd. ,yq;ifapy; r%f Nrit Kiwnahd;iwf; fl;bnaOg;GtJ UK,y; my;yJ Vida ,lq;fspy; ,lk;ngw;w tplaq;fisg; gpd;gw;wNtz;Lnkd;w mtrpakpy;iy. r%f %ytsq;fisf; fl;bnaOg;Gk; mNjNtisapy;> ntspf;fs Nritfis elj;Jtnjd;gJ (UK,y; ele;jJNghd;W) (m) xU r%f mbg;gilapyhd guhkhpg;igf; fl;bnaOg;Gk; kpfTk; nryT $ba xU topahFk;. (M) fyhr;rhuhPjpapy; nghUj;jkhdjhfTk;> ,yq;ifapd; r%f ajhHj;jj;Jf;Fg; nghUj;jkhdjhfTk; mikahJtplyhk;. mj;NjhL> ,yq;ifapy; ,d;W (m) kpfTk; rpwe;j Kiwapy; gapw;Wtpf;fg;gl;l njhopy;rhH epGzHfSf;fhd gw;whf;Fiwnahd;W epyTfpd;wJ (M) %ytsq;fs; vspjpy; fpl;lhjitahf ,Uf;fpd;wd (,) cseyg; gpur;rpidfSf;F kjhPjpapyhd Fzkhf;fy; cs;spl;ltifapy; gy;NtW tiffspyhd

52

cjtp kw;Wk; rpfpr;irFwpj;j RNjr %yq;fs; cs;sd (<) gyH mNyhgjp rpfpr;irKiwf;Fg; gjpyhfr; RNjr Fzkhf;fy; topKiwfis tpUk;Gfpd;wdH kw;Wk; (c) midj;Jklq;Fk; tifapy; ghHf;Fk;NghJ ,d;dKk; ,lHfis vjpHNehf;FNthUf;F cjTk; tifapyhd FLk;gg; gpizg;Gg; r%f czHTk; fhzg;gLfpd;wd. vjpHfhyj;Jf;fhd ghijfs; (Future Directions) midj;Jklq;Fk;tifapyhd cseyd;; vd;gJ ,yq;if ,yf;Fitf;f Ntz;ba kw;Wk; jpl;lkplNtz;ba xd;whFk;. mij ,g;nghONj nra;Jnfhs;s Ntz;Lk; (2011 eLg;gFjp). ehL ,g;;nghOJ cs;sepiy rkhjhdk; kw;Wk; ];jpu epiyFwpj;j xU fhyg;gFjpAs; Eise;Jnfhz;bUf;fpd;wJ. Vida ehLfspy; Nritfs; vt;thW njhopw;gLfpd;wd vd;gjpypUe;J fw;Wf;;nfhs;tjw;Fg; ngUkstpyhd tplaq;fs; ,Ue;jNghjpYk;> ,yq;iff;fhd XH cz;ikahd r%f mbg;gilapyhd Rfhjhu guhkhpg;G ,e;j kz;zpy; tsHr;rpAw;wjhf ,Uj;jy; Ntz;Lk;. #o;epiyfs; mDkjpf;Fk;gl;rj;jpy; ,yq;ifapy; r%f mbg;gilapyhd cseyg; guhkhpg;ig toq;Fk; eyd;gpujpepjpfs; gy;NtW %yq;fspypUe;J ngw;Wf;;nfhs;sg;gLjy; Ntz;Lk;. rhpahd xd;wpizg;G ,lj;Jf;fplKk;> mtHfSf;F fpilf;ff;$ba jd;ikiag; nghWj;Jk; tpj;jpahrkhf mikAk;;. r%f mbg;gilapyhd cseyg; guhkhpg;G Kiwiknahd;W rk;ge;jKw;w r%fj;jpd; Njitfs;> ,lHNeUk; re;jHg;gq;fspYk;> mtHfSf;F cseyg; gpur;rpidfs; Vw;gLk;NghJk;> mtHfspd; njhpTfs; vd;gtw;Wf;Fk; ,zf;fkhdjhf mikAk; Nritfs; r%fj;Jf;F neUf;fkhdjhf mikjy; Ntz;Lk;. mit mtHfspd; nrhe;j nkhopapYk; mtHfspd; ghuk;ghpaq;fSf;F ,zf;fkhd KiwapYk; toq;fg;gLjy; Ntz;Lk;. mit kUj;Jtj; NjitfSf;F khj;jpukd;wp tpahjpf;F rpfpr;iraspj;jy;> Md;kPf NjitfSf;Fk;> r%fg; gpur;rpidfSf;Fk;> fyhr;rhuj; NjitfSf;Fk; jPHTfhz;gjhf mikjy; Ntz;Lk;.

53

ml;ltiz 6.1: midj;Jklq;Fk; cseyj;jpw;fhd gq;fhsu;fs; 1. gy;NtW Jiwiar; NrHe;j cseyr; Nritahsu;fs; csNeha;; rpfpr;ir> cstpay;> r%f Nrit> cstsj;Jiz toq;fy; kw;Wk; r%fg; gzp 2. kj mikg;Gfs; - Njthyaq;fs;> gs;spthry;fs; kw;Wk; Nfhtpy;;fs; 3. r%f mikg;Gfs; kw;Wk;my;yJ r%fj;jpd; gpujpepjpfs; 4. Nehahspfs;Kd;dhs; EfHNthH my;yJ miof;fg;gLNthH Nehahspfs; tof;fkhf Nritfisg; gad;gLj;JNthnud;W

5. Nehahspf;F my;yJ Kd;dhs; NehahspfSf;F ftdg;guhkhpg;G toq;FNthH 6. r%fj;jpy; gzpahw;Wk; ghuk;gupa Fzkhf;FNthu; 7. cs r%fg; guhkhpg;G my;yJ eyNdhk;Gj; jpl;lq;fspy; gzpahw;Wk; mur rhu;gw;w epWtdq;fs; (m.rh.ep.fs;). 8. rHtNjr mikg;Gfs;> tpNrlkhf cyf Rfhjhu ];jhgdk; (WHO) TGH epfo;r;rpj;jpl;lk; elhj;jpa Ma;TfspypUe;J ,yq;ifapd; fpuhkpa r%fq;fs; jkJ cseyj;ijAk;;> ed;dpiyiaAk; vt;thW vz;zf; fUthf;fk; nra;fpd;wdH> kw;Wk; Kuz;ghl;L Nkhjy;fs; kw;Wk; mdHj;jq;fspypUe;J vOk; kd mOj;jq;fis vt;thW Vw;Wr; rkhspf;fpd;wdH vd;gJFwpj;Jk; jfty;fis toq;Ffpd;wd (tPuf;nfhb kw;Wk; ngHdhz;Nlh> 2009). vkJ Ma;Tfspy; ehk; gad;gLj;jpa Kiwfs; ,yq;ifapYk;> fyhr;rhuhPjpapYk;> r%fhPjpapYk; ,yq;ifia xj;j Vida njw;fhrpa ehLfspYk; ntw;wpfukhfg; gpuNahfpf;ff;$ba cseyr; Nritfspd; r%f mgptpUj;jp mZFKiwnahd;iwr; Rl;bf;fhl;Lfpd;wd. xU gue;j> fyhr;rhu hPjpapy; nghUj;jkhd mZFKiwia Kd;Ndw;Wk;tifapy; Nkw;ftpthd gbepiyfis Kd;nkhopfpd;Nwhk;. (i) gq;Nfw;G Ma;T Kiwfisg; gad;gLj;Jk; tifapy; r%fq;fSld; ciuahlYk;> fye;jhNyhridAk; (ii) csNeha;r;rpfpr;ir itj;jpaHfs;> jhjpfs;> cstsj;Jizahsu;;> r%fg; gzpahsHfs;> r%fNritahsu;fs;; kw;Wk; jd;dhHtj; njhz;lHfs; Nghd;w epajpr;rl;l kw;Wk;

54

mur rhu;gw;w epWtd (m.rh.ep.) Jiwfspy; cseyd;; kw;Wk; csr%fj; Jiwapd; gy;NtW nraw;ghl;lhsHfspd; Mw;wiyf; fl;bnaOg;Gjy; kw;Wk; (iii) ghpzkpf;Fk; csr%fey Kiwiar; r%f mgptpUj;jp kw;Wk; nghJr; Rfhjhuk; rk;ge;jkhd gue;j KiwikfSlDk;> RNjr itj;jpar; nraw;ghl;lhsHfSlDk; Fzg;gLj;JNthUlDk;> kj mikg;GfSlDk; xd;wpizj;jy;. ,j;jifa xU nray;Kiwa+lhf mgptpUj;jpAWk; xU Kiwikapd; rhpahd jd;ik r%fj;jpdhy; ,dq;fhzg;gLk; Kd;Dhpikfs; kw;Wk; mZFKiwfisg; nghWj;jjhFk;. mJ r%fj;Jf;F Vw;GilajhfTk;> mtHfspd; mwpthw;wYf;F Vw;wtifapy; mtHfspd; Njitfisg; g+Hj;jpnra;af;$bajhfTk; mikAk; rhj;jpaKs;sJ. ,r;nray;Kiw xU r%f mDruiz mikg;Gld; - cjhuzkhf xU kj mikg;Gld; - ,izf;fg;gl;lhy; mjd; epiyNgw;Wj; jd;ikAk;> r%fj;jpd; nrhj;JilikAk; cWjpnra;ag;glyhk;.

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crhj;Jiz y;fs;
Fernando, S. (2009) Meanings and realities, in S. Fernando and F. Keating, F. (eds.) Mental Health in a Multi-Ethnic Society. A Multi-disciplinary Handbook second edition. London: Routledge pp. 13-26. Fernando, S. (2010) Mental Health, Race and Culture, third edition, Basingstoke: Palgrave. Ganesan, M. (2010) Presentation at Workshop at NIMH October 2010. Halliburton, M. (2004) Finding a fit: Psychiatric Pluralism in South India and its Implications for WHO Studies of Mental Disorder. Transcultural Psychiatry, 41(1): 80-89. Kusumaratne, S. (2005) Indigenous Medicine in Sri Lanka. A Sociological Analysis. Nugegoda. Sri Lanka: Sarasavi Publishers. NICE (National Institute for Clinical Excellence) (2005) Violence The shortterm management of disturbedviolent behaviour in psychiatric inpatients settings and emergency departments. Clinical Guidelines 25 London: NICE. Parry, L. (2010) Presentation at Workshop at NIMH October 2010. Perera, R. (2010) Presentation at Workshop at NIMH October 2010. Raguram, R., Venkateswaram, A., Ramakrishna, J. and Weiss, Mitchell G. (2002) Traditional community resources for mental health: a report of temple healing from India. British Medical Journal 325: 38-40 Tilley, S. (1977) The Mental Health Nurse: Views of Practice and Education Oxford and London: Blackwell Science. Treacy. O. (2010) Presentation at Workshop at NIMH October 2010. Vogt, B. (2005) Skill and Trust. The Tovil Healing Ritual of Sri Lanka as Culture-specific Psychotherapy Amsterdam: VU University Press. Weerackody, C. and Fernando, S. (2009) Mental Health and Wellbeing Experience of communities affected by conflict and 2004 tsunami in Sri Lanka Colombo (Sri Lanka): PRDA and Oxfam Weerackody, C. (2010) Presentation at Workshop at NIMH October 2010. Welstand-Keryk, T. (2010) Presentation at Workshop at NIMH October 2010.

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Barker, P. (2008) Psychiatric and Mental Health Nursing. The Craft of Caring, second edition. Oxford: Hodder Arnold Tilley, S. (1977) The Mental Health Nurse: Views of Practice and Education Oxford and London: Blackwell Science. Hough M. (1996) Counselling Skills, Harlow (UK): Longman. Egan G. (1994) The Skilled Helper. Salt Lake City (USA): Brooks/Cole