Beauty lies in the eyes of the beholder

Bhushan Madke¹ , Chitra Nayak¹ , Uday Khopkar²

¹ Department of Skin and VD, Topiwala National Medical College and B.Y.L. Nair Hospital, Mumbai, India
² Department of Skin and VD, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India

Correspondence Address:
Bhushan Madke
Department of Skin and VD, OPD 14, Second Floor, OPD Building, Topiwala National Medical College and B.Y.L. Nair Hospital, Mumbai Central, Mumbai 400 008, Maharashtra
India

Sir,

The Marathi film, "Nital," was a sincere attempt to portray the inner turmoil in the life of the people having vitiligo and the people who have to deal with vitiligo-affected individuals. Literally, the word Nital means crystal clear and transparent, which reflects the inner beauty of an individual irrespective of color of skin. The film, directed by Sumitra Bhave and Sunil Sukthankar, and produced by Dr. Maya Tulpule (who has vitiligo herself) ^[1] takes a hard-hitting look at the attitude of society towards people having leukoderma and vitiligo at large. The movie has won many accolades and has bagged the prestigious "V Shantaram Award" in nine different categories. The main protagonist of the movie, Dr. Neeraja, a confident ophthalmic surgeon played by Devika Daftardar, was living with vitiligo since early childhood and was working in the city of Bangalore. Since childhood, she had gone through inner turmoil and had been discriminated by the society. Her own family prohibited her from attending her elder sister′s marriage ceremony as she was considered ′inauspicious′ for the newlywed couple and also because a sister who has vitiligo might not be acceptable to the groom′s family. Ultimately, she comes to term with herself and accepts the skin blemishes as a part of her individuality. However, the society was not so kind and humane to her and she was made to suffer humiliation at every front of life. In spite of her good surgical skills, an ill-informed Father of a patient prohibits Dr. Neeraja from operating on his daughter′s eye though the alternative is to risk his daughter losing vision.

Her friend and colleague Dr. Ananya, played by real-life Dr. Shekhar Kulkarni, works with her as an anesthetist in the same hospital. Both develop affection and mutual respect for each other at the work place. Neeraja visits Dr. Ananya′s elite and high-class family, where every member of the family is well educated and well placed in society. The family is taken aback at the possibility of Neeraja becoming their family member as Ananya′s wife. In the movie, Neeraja′s interaction with every member of the family is emotional and has been picturized in an exquisitely nuanced manner. Neeraja′s narration about her experience and humiliation due to the skin blemishes to the youngsters of the family is really heart-rending and brings a lump in the throat. The unbiased acceptance of Neeraja by the youngsters of Ananya′s family is heartwarming. Ananya is on the horns of a dilemma swinging pendulously between the stereotypical preferences of the family and his own sensibility. However, at the end Ananya is able to release himself from the shackles of orthodox societal thinking and decides to make her his life partner driven sheerly by Neeraja′s confidence about herself.

However, the picture is not so rosy for millions of individuals living with vitiligo who are psychologically depressed and suffer from humiliation and social stigmatization. Many studies have repeatedly proven that vitiligo patients suffer from various psychological disorders like depression and domain-like function, emotion etc. and have low quality of life indices. ^[2],[3],[4] Youngster are more likely to have clinical depression and face criticism and nasty comments from peers. ^[5]

The visual media are a powerful tool to create awareness among general masses. Dermatologists from Maharashtra, and especially those catering to predominantly rural areas, should screen this film in their waiting lobby at least once a week to create awareness among the general population and dispel the common misbeliefs and misunderstanding about vitiligo.

The film should be dubbed in other regional languages and in Hindi to disseminate the messages in the film and reduce the stigma behind this condition. Dermatologists, being in an advantageous position to understand the science and emotions behind this condition, should contribute their mite in this effort by forming a vitiligo support group in their city. The Indian Association of Dermatologists, Venereologists, Leprologists (IADVL) has already taken a lead role in this effort by marking 19 ^th May as "Vitiligo Day," ^[6] thereby stimulating and channelizing efforts in this direction. The IADVL, an apex body of Dermatologists in the country, is probably well placed to show solidarity behind the vitiligo-affected persons by financing or arranging finance through well wishers and pharmaceutical industry for such activities.

1.	Official Website for movie Nital. Available from: http://www.nitalthefilm.com/p.html. [Last accessed on 2011Dec 28]. [Google Scholar]
2.	Bilgiç O, Bilgiç A, Akiþ HK, Eskioðlu F, Kiliç EZ. Depression, anxiety and health-related quality of life in children and adolescents with vitiligo. Clin Exp Dermatol 2011;36:360-5. [Google Scholar]
3.	Ahmed I, Ahmed S, Nasreen S. Frequency and pattern of psychiatric disorders in patients with vitiligo. J Ayub Med Coll Abbottabad 2007;19:19-21. [Google Scholar]
4.	Choi S, Kim DY, Whang SH, Lee JH, Hann SK, Shin YJ. Quality of life and psychological adaptation of Korean adolescents with vitiligo. J Eur Acad Dermatol Venereol 2010;24:524-9. [Google Scholar]
5.	Palit A, Inamadar AC. Childhood vitiligo. Indian J Dermatol Venereol Leprol 2012;78:30-41. [Google Scholar]
6.	Official Website of Maharashtra State Branch of IADVL. Available from: http://www.iadvlmaha.com/circular1.html. [Last accessed on 2011 Dec 30]. [Google Scholar]