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Indian Journal of Medical Sciences, Volume 57, Number 8, August 2003, pp. 355-360 A STUDY ON MASS HYSTERIA (MONKEY MEN?) VICTIMS IN EAST DELHI S K VERMA, D K SRIVASTAVA, M.D., *Dept. of Forensic Medicine & Toxicology; M.D., **Medical Superintendent,
University College of
Medical Sciences & GTB Hospital, Dilshad Garden, Delhi-110095.
Accepted Date: 10-07-2003 Code Number: ms03014 ABSTRACT During the summer month of May 2001 east Delhi came in grip of an outbreak of mass hysteria. Initial reports alleged that some monkey like creature attacked and caused injuries among number of persons. A medical board was set up to examine and find out the cause of injuries in the victims of the outbreak as a part exercise to apprehend the culprit. The study describes the sociodemographic pattern and injuries observed in these cases. Majority of victims were adult males, belonging to low socioeconomic strata and having low educational level. The incidents occurred mainly during night at the time of power failure. The type, distribution and characteristic of the injuries suggested of their accidental nature. The paper also discusses the role of forensic experts and press in such outbreak. Key Words: Mass Hysteria, Forensic Medicine, Sociodemography. INTRODUCTION During the summer month of early May 2001, large number of persons reportedly got injured in alleged attack by monkey like creature. The problem that initially started in the city of Ghaziabad, U.P. soon affected the adjoining East Delhi. By middle of May, the incident took almost an epidemic dimension with entire city coming in the grip of different stories about the incidents. However, majority of the cases were reported from East Delhi only. The description of the assailant went on changing from monkey to monkey man and UFO (unknown foreign object). The newspapers and mass media were full of news on the whole episode. The city chief of police announced a reward of Rupee fifty thousand for providing clue about the assailant. He also ordered formation of a crack team to apprehend the culprits responsible for such incidents. Day and night patrolling was also started in the whole city. During the fortnight from 10th-25th May 2001, some 397 people made call to the police control room in Delhi for allegedly being attacked by monkey like or other creature with bizarre description. The present study describes the profile of the victims involved in these alleged attacks and who were examined from forensic point of view by the medical board in a tertiary care teaching hospital of East Delhi. Considering the various factors like examination findings, circumstance evidences and statements of the victims and investigating agencies, it was opined that the outbreak was not due to monkey menace. MATERIAL & METHODS The study is both retrospective as well as prospective conducted on the victims of the mass hysteria episode in a tertiary care teaching hospital of East Delhi. During the period of episode from 10th to 26th May 2001, a total of 51 medicolegal reports were prepared in the casuality of this hospital on the victims of alleged attack, out of these 18 cases (35.3%) were referred randomly for detailed medical and forensic examination by investigating agency were examined by the medical board consisting of 3 doctors i.e. 2 senior forensic medicine experts and one chief medical administrator of this hospital (two of whom are author of this paper). The findings of the study were analysed and are described in the results. RESULTS Some of the results of the study pertain to the findings in the total 51 cases that were examined in the casuality. However, detail findings are available in relation to the 18 cases only that were re-examined by the medical board. 1. Age & Sex Distribution The male & female ratio of the cases was 3:1 thereby meaning males were affected 3 times more then females. Majority of the cases were in their 3rd decade of life (20-30 years) with total 21 cases (41%) consisting of 18 males and 3 females. The cases in 4th decade and 2nd decade of life were almost similar with 13(25%) and 12(24%) cases respectively. Thus meaning that the episode affected young individuals mainly. Children less than 10 years and more than 40 years individuals collectively accounts for just 5% of cases. Figure 1 gives the details of the age and sex distribution of these victims. 2. Locality The area distribution of cases showed that out of total 51 cases, 48 cases (94%) belonged to East Delhi and rest 3 cases (6%) were from adjoining part of East Delhi (2 from Loni and 1 from Noida). Among the 48 cases from East Delhi 46 cases (96%) were from North East Delhi district, while only 2 cases (4%) were from East Delhi district. Thereby meaning that the episode mainly involved North East Delhi District. In the North East Delhi district itself the 4 main police stations of Usmanpur (10 cases). Gokulpuri (9 cases) Nand Nagri (8 cases) and Bhajanpura (7 cases) were the worst affected areas and all these police station caters to the poorest of poor population and consists of resettlement colonies and J. J. clusters. 3. Time of Reporting to Hospital Thirty-two persons (63%) reported in the hospital during 12:01 am to 6:00 am (i.e. night time & early morning). Five cases came in the evening and 3 each in morning & afternoon hours. However, in 8 cases the exact time of reporting was not available in hospital records (Figure 2). 4. Time of Incidence The exact time of incidence was available in 18 cases only that were examined by the authors. Twelve persons (67%) reported that incidence occurred between 12:01 am to 6:00 A.M. (i.e. midnight to early morning). The incidence occurred in evening to early night in 5 cases (28%). And only 1 case was reported in afternoon time, while no case occurred in morning hours (Figure 3). 5. Socioeconomic & Educational Status Only two persons out of 18 were having their family income more than 50,000/- per annum, rest all 16 cases (89%) were belonging to low socioeconomic strata of the society. None of the victims belonged to high or even middle-income group. Looking at the educational status only 2 cases (11%) were educated more than 11th standard (Higher Secondary). Majority of cases 5 (28%) did not have any formal education. Four persons (22%) were having only primary education i.e. up-to 5th standard only and rest 39% cases were having formal education having between 6th standard to 11th standard. (Figure 3) 6. History & Circumstances The most interesting finding among the victims was that 11 persons (61%) claimed to have witnessed/experienced a man/monkey like creature that lead to injuries (may be directly or indirectly). While, 7 persons (39%) told that they did not show any creature but sustained injuries just out of fear or fall. There was history of power failure in two third cases, while in one- third (6) case the power was present or they occurred during daytime. 7. Injuries One of the most striking features observed in the injuries among these individuals was they were possible either by a blunt or a pointed object only. About 95% of the individuals showed abrasions. Two persons (11%) were having lacerations, while only one child sustained bruising over chest region. Among the 17 cases with abrasions, 16 were having them over having abrasions over both exposed parts and 2 over unexposed parts (one case was having abrasion over both exposed as well as unexposed parts). Multiple site involvement was observed in 10 cases (59%) and single site was affected in 7 cases (41%). Majority of the cases 15(88%) were having multiple linear abrasions whereas single abrasion was observed in 2 cases (12%) only. In 12 persons (67%) injuries were seen on bony prominences (Table 1). Almost common pattern of injuries in the form of parallel scratch abrasions was seen in 14 (78%) out of 18 cases examined and graze abrasions were found in 5 (28%) cases. DISCUSSION The outbreaks of mysterious illnesses have been observed reported time and again in the literature. Although the illness was identified only three decade ago, it has occurred through out the history. Haref in 1985 stated that more than 180 reports have been published up-to that year that describes the outbreak of such afflictions.1 More than 30 terminologies have been coined to name such outbreaks. Some of the popularly used terms are mass hysteria, mass psychogenic illness, mass hysteria, hysterical contagion and epidemic hysteria. Mass hysteria is defined as the occurrence in a group of people of a constellation of physical symptoms suggesting an organic illness but resulting from a psychological cause with each member of the group experiencing one or more of the symptoms.2 The key characteristic of masses Hysteria in lack of physical pathogen. The other features are:
All the above features were observed in the current outbreak. The commonly affected are group was 3rd decade of life with total 21 cases (41%). These figures are in tune with similar outbreak that occurred in a telephone operator building.4 About 1/4th of the cases were in adolescence and preadolescence age group. This relatively low distribution of cases in this age group is not in tune with the reported preponderance of this illness in adolescents or preadolescent.5-6 Another contrasting feature observed in the current outbreak was dominance of males while other studies reports preponderance of female patients.6-8 The possible explanation for adult male preponderance in this episode can be attributed to: (a) the fact that first case reported was of an adult male; and (b) majority of cases were reported from outside the covered area of house (i.e. open) where mostly male members of family sleep during summer time due to lack of proper housing. The publicity given to this male case in newspaper and media also facilitated stressed male individuals to have the illness. Investigating the locality of the victims in this outbreak revealed that almost all cases (94%) belong to the resettlement or Jhuggi-Jopri clusters i.e. very low socioeconomic strata, mainly clustered in single belt (region wise) having poor environmental sanitation and high level of pollution. This population is more vulnerable to such type of illnesses due to their low educational level as evident from the fact that only 2 victims were educated more than higher secondary level i.e., class XI standard. Review of literature also suggests that these outbreaks of mass hysteria often occurs among population with low educational status.1 Two-third (67%) of the incidents in the current outbreak were reported during night time (i.e. from 00:01hrs to 06:00 hrs). During this period, most of the persons are in deep sleep and chances of fall and sustaining minute injuries are quite common when such individuals go to call of nature. Chances of such accidental falls further increases when there is not proper lighting around and visibility is low. The fact that 67% of incident occurred during the power failure in the area can be a strong collaborating factor for such accidental fall/injuries. The type, pattern and parts affected by injuries suggests that they likely to be accidental in nature.9 The circumstantial evidences report of the investigating agencies and absence of reliable history and causative agents on indepth interview/examination of the victims also points towards an accidental nature of injuries among the victims of this outbreak. Factually, none of the victims actually saw the alleged monkey man. Every one described an imaginary figure giving vague description. Further, the victims also did not refute the chances of being injured accidentally. The role of press reports and media was of utmost importance in the current outbreak similar to the earlier report on this aspect.1,7 The press and media gave extensive coverage to the whole outbreak from the vary beginning.10 Photographs and interviews of the victims and other experts were telecasts and printed in media and newspapers respectively. All this facilitated and spread of the outbreak against the background of stress, as the phrasing in the press was emotionally laden. Hafez also reported that reporters far from being impartial observers of events usually state their viewpoint, which they try to substantiate by selectively filtering the available information.1 The victims shown in the mass media becomes the role model that were followed by susceptible individuals and thus helped in spreading the outbreak. The other important feature observed in the whole outbreak was sudden origin and disappearance of large number of cases. The day report stating that these is no monkey man and it was a myth, appeared in the press not a single case was reported there after.11,12 Thus the press not only played an important role in spread of the outbreak, it also played a crucial role in curtaining it. The study demonstrates clearly the role of forensic experts and a comprehensive team approach in dealing effectively with such outbreaks of mass hysteria. REFERENCES
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