Sunday, December 20, 2020

Mental Health of India’s Corona Warriors: An often overlooked aspect of the pandemic

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Raya Tripathi

Article Title

Mental Health of India’s Corona Warriors: An often overlooked aspect of the pandemic

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Global Views 360

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December 20, 2020

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Mental Health Representative Image

Mental Health Representative Image | Source: rawpixel.com via Freepik

It’s been almost a year since the Covid 19 first started spreading in Wuhan, China and spread to all parts of the world, turning into a pandemic. This has brought along with it an unusual situation for everyone around the world—people were locked up inside their homes and everything was shut. Only the doctors,  healthcare workers and other emergency service workers were working long hours, often going without proper sleep and food. Working day and night, like robots, is not natural for human beings, and therefore, has its consequences.

Mental health in India

Mental health of people is deteriorating globally, and the worst impact can be seen for the corona warriors.

Many people in India do not care about mental health and rubbish it off due to lack of awareness about the problem. They don’t consider it as a health problem just like any other illness, these are not much discussions or consultations with the experts, even when there is a clear sign of a person suffering from it. This state of affir is one of the major contributing factor for the high suicide rates in India.

The taboo associated with discussing mental health, dissuades the person who is suffering or their family members to discuss and take the help from experts as they fear that any revelation of mental health issues can tarnish their image in the society. There are still instances that people seeking professional help are labelled mentally weak or simply ‘‘mad’. Due to superstition still persisting in society, many believe mentally ill people to be 'possessed' by some evil spirit. This forces a large number of people to visit some Godmen or Exorcists to get it cured, rather than going to a professional.

This pandemic and the subsequent lockdown has exacerbated the mental stress and resulted in a spike in the instances of anxiety and depression among the population all over the world. The healthcare workers, fighting the pandemic in the frontline as Corona Warrier, are more exposed to the dangers associated with it. Although the frontline healthcare workers are now sufficiently protected from the direct impact of the virus, their deteriorating mental health still remains an unforeseen challenge.

What are the problems faced by corona warriors in India?

Healthcare workers are responding quickly and moving in vans in many places for testing the Covid patients. They are working hard to take care of everything from regular check- up to specialised testing for the ailing people. But, what about the physical and mental health of these health workers who are serving the patients with highly contagious disease, day and night, despite feeling homesick and tired.According to a report in Indian express, Dr. Kinjal Nadia, a doctor in Gujarat's Jamnagar, said, “Spending eight hours in a PPE suit is the toughest thing to do. One can’t even drink a glass of water though has to speak loudly to be heard by patients and assistants”.

There are incidents of suicide among thejunior doctors from AIIMS Delhi and RG Kar Medical College, Kolkata, which in itself describe the mental status of doctors and healthcare workers. Furthermore, around 80% of the doctors, especially younger ones, are at a very high risk of burning out due to constant pressure by the people, press and the administration to manage the extraordinary workload of testing, diagnosing, treating and curing  the patients, successfully.

In order to manage the huge influx of patients, at many places, doctors and healthcare workers are being hired temporarily, which acts as a catalyst for stress which they are already facing. This has also led to protests by the healthcare workers, including the nurses of AIIMS Patna, for making their employment permanent.

There had been a lack of PPE kits and proper protection against the virus for the healthcare professionals in many places, which increased the danger of exposing them to the virus and putting their lives in danger. There have been many incidents narrated by the doctors and the patients about dirty floors and filthy bathrooms in government hospitals of India.

A report on Firstpost mentioned about the usage of unhygienic food and dirty bed-sheets at government-run Kasturba hospital in Mumbai. An online petition against this situation had garnered over 100,000 signatures.

A news article from the New Indian Express tells that in Bengaluru, Dr. Manohar KN, with his colleagues, conducted a survey to assess the impact of COVID-19 pandemic on the mental well being of the healthcare workers. Over two thousand doctors, nurses and technical staff, aged between 20 and 65 years, participated in this survey, which was conducted in 26 states and union territories of India. This incidentally was the largest survey of its kind in the world.

The most shocking finding of the survey was that the healthcare workers were mostly in a sad mood, and the most optimistic ones (around 70%) were also becoming pessimistic. Even after wearing heavy PPE kits, masks, gloves, face shields all day long, which in itself is exhausting, they were constantly afraid of catching the virus.

Even the families of these corona warriors are worried. Many of them have succumbed to the coronavirus while saving people from it. They don’t get to meet their families while working during the pandemic, and sometimes end up never meeting again.

Are there any mental health services in India?

India, at the moment doesn’t have adequate infrastructure to diagnose and treat the people suffering with mental health issues. also there are not enough organisations or programs which can help in raising the awareness and mitigating misinformation regarding mental health issues. The availability of psychologists in India is grossly inadequate to take care of the mental health of a population of more than 130 crores.

However, the wide adoption of online meetings during the pandemic has come as a big boost to increasing the reach of online psychological counselling through video conferencing. This has enabled the patients to consult the doctors and counsellors  remotely through video links, which reduced the chances of spreading the virus. But not everyone has access to such facilities.

What is the government doing about it?

The government issued a guide in April 2020 for general medical and specialised mental health care settings to be followed during Covid 19 pandemic and also launched a helpline for mental health issues during lockdown. However, when it comes to regular mental health care, India is behind most of the countries. If a country does not even have basic health care for each and every of its citizens, how can it provide them with ‘world class' mental health services?

According to WHO, India ranks second among countries with the greatest burden of disease for mental and behavioral disorders. Most of the mental health disorders go unreported, as people never let others know about it, because in India, this becomes a matter of shame and losing their pride.

Clearly, the healthcare professionals seem tough from the outside, and fight bravely, but on the inside, they’re struggling with their own issues which need to be attended.

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February 4, 2021 5:18 PM

The Persian Gulf Crisis and the Security Dilemma

This article explains the recent tensions between Iran and the United States, and presents it as a case of the ‘Security Dilemma’ theory in practice.

The Persian Gulf Crisis 2019-20

To understand the current crisis in Persian Gulf, we must look at the Iran Nuclear Deal of 2015, also called the Joint Comprehensive Plan of Action (JCPOA).

The JCPOA was signed between The E3/EU+3 (France, Germany, the United Kingdom, the Russian Federation, and the United States, China, with the High Representative of the European Union for Foreign Affairs and Security Policy) and the Islamic Republic of Iran, to permit nuclear capabilities for Iran exclusively for peaceful purposes, in exchange for the lifting of crippling sanctions.

JCPOA terms:

International Atomic Energy Agency representative in Tehran, Iran for talks on JCPOA implementation | Source: Tasnim News Agency

Under this accord, Iran had to reduce its Uranium stockpile by 98% to 300kg, maintain its level of enrichment at 3.67%, reduce the number of centrifuges, and only keep one of its Uranium enrichment plants active. It also had to redesign its reactor at Arak, so it could not produce weapon’s grade Plutonium. Until 2031, Iran is not permitted to make heavy-water reactors.

Further, it was to permit itself to regular inspection of their nuclear site by the global nuclear watchdog, the International Atomic Energy Agency (IAEA).

In return, Iran gained over $100bn of frozen assets overseas, and was permitted to allow trading in oil in international markets and use the global financial system for trade.

Trump Administration’s Revoking of the JCPOA

In 2018, the Trump administration reimposed some of the sanctions in Iran, despite Trump's election promise to reduce involvement in the Middle East. Countering the re-impositions, Iran threatens to resume Uranium enrichment. In May 2019, Iran suspends nuclear deal commitments, and gives other signatories a 60-day deadline to protect it from US sanctions, before resuming Uranium enrichment. The International Atomic Energy Agency (IAEA) reported that Iran had already increased Uranium production, but is unclear by how much.

President Trump signing executive orders, imposing sanctions on Iran | Source: Shealah Craighead via White House

In May 2019, the US increased military deployment in the Persian Gulf, reportedly to prevent what the termed was a “campaign” between Iran and its proxies to threaten US oil shipping in the Strait of Hormuz.

The Tanker Crisis

In June 2019, two tankers were set ablaze in the Gulf of Oman, using mines. The US blamed Iran for these blasts, but Iran denied the charges.

In the same month, Iran Islamic Revolutionary Guard Corps (IRGC) shot down a US surveillance drone, escalating tensions and causing the US to name the IRGC as a terrorist organization.

In July 2019, the British Royal Marine Commandos seized an Iranian tanker off the coast of Gibraltar, as it was suspected to be en route to Syria, in violation of EU sanctions. The US declared that anyone assisting the ship would be considered an accomplice of terrorist groups, namely the Iran’s Islamic Revolutionary Guard.

In retaliation, Iran seized British-flagged tanker in the Strait of Hormuz.

The Iranian tanker was released six weeks later, on the condition that they do not unload their cargo of 2.1million barrels of oil in Syria.

December Air Strikes

In December 2019, the K-1 Air Base in Iraq was attacked by an unconfirmed party, killing one American contractor. This base hosts Americans (amongst other nationalities) who are responsible for training Iraqi troops in counter-terrorism. The Americans alleged that the attack was carried out by Kataib Hezbollah, which denies it. Kataib Hezbollah is a rebel group (recognized as a terrorist group by the US) backed by Iran. The Iraqi’s alleged that ISIL was responsible.

In retaliation for the killing of the American Contractor, the US launched air strikes on the weapons depot and command centres of Kataib Hezbollah in Iraq and Syria in the same month, reportedly killing 25 militiamen.

Assassination of Iranian Major General

Late Iranian General, Qasem Suleimani | Source: Tasnim News Agency

Iraq and Iran condemned the attack, and on 31 December, 2019, Iraqi militia attacked the US Embassy in Baghdad. In response, the US conducted airstrikes at the Baghdad International Airport in January 2020, killing the Commander of Iranian Quds Force, General Qasem Suleimani, the second most powerful man in Iran.

These escalations, placed within the context of US invasions of Iraq and Afghanistan, provide a good example of the Security Dilemma theory and how it plays out in practice.

What is the Security Dilemma?

Before delving into the theoretical definitions it is worth reminding ourselves that States do not behave as they do because a theoretical model demands them to. Rather, most theoretical models are based on observations of real-world behaviour of states, and seek to explain said behaviour. The Classical Realist theory, of which the Security Dilemma is a part, is amongst one of these, and I endeavour to highlight some of the key points of this theory.

The Classical Realist theory holds that States (or State-actors) are the basic unit of any international system. They are the most important actors, as there is no authority higher than them. The international system is fundamentally anarchic, with every actor left to their own devices with no supranational oversight. Each State finds it in their own self-interest to provide their own means for security. Security comes with the ability of the State to exercise its power, and thus Power Hegemony and Security are inextricably linked. In other words, since no State can rely on a supranational authority to provide security (an every-man-for-himself scenario), it is in each State’s best interest to understand the power distribution across all state-actors and maximize power for themselves, as the ultimate security. This results in a zero-sum game, with one actor’s loss being another’s gain. In providing absolute security for one’s own State, one leaves others insecure. The resulting power imbalance manifests in conflict, and for the Realist it follows, therefore, that Conflict is the natural state of affairs.

This, in essence, is the Security Dilemma: Striving for absolute security leaves others absolutely insecure, thus providing powerful incentives for an arms race, leading to further conflicts. It is little wonder that this is also called the Spiral Model, for in the very process of striving for security, one gives birth to escalating conflict.

How does this relate to the Persian Gulf Crisis?

The US has long followed the Realist model, believing that in a state of fundamental anarchy, it is justifiable to have nuclear capabilities and have intense militarization, as a means of gaining absolute security (justified by ‘offense is the best defence’). However, the US is also known for disallowing Weapons of Mass Destruction and nuclear capabilities in other countries, despite having such resources by itself. Here we see the Security Dilemma: to maintain absolute security, the US cannot allow others to be similarly armed. This is seen clearly in the signing of the JCPOA.

Consider the case from Iran’s point of view. As a result of the US war against Al Qaeda and Taliban in Afghanistan and overthrow of Saddam Hussain in Iraq, there has been constant American presence in both the countries bordering Iran since almost two decades. That this poses a threat to Iran is obvious: the US caused fundamental regime changes in Iraq after the war; with its manpower and firepower, alongside its strategic placement on both sides of the Iranian border, the US is at a vantage point to attack Iran – placements that are, paradoxically, intended to guarantee American security.

The American show of strength and the impending danger of conflict leave Iran with two choices: Forge alliances with US adversaries, such as China or Russia, to deter Iran-US conflict, or be nuclear-armed. Iran managed both, causing, in effect, a nuclear arms race that culminated in the JCPOA.  In retrospect, the JCPOA seems like the perfect solution to the Security Dilemma in US-Iran conflicts: not only does it allow Iran to benefit from its suspensions of nuclear capabilities, it also ceases the arms race and de-escalates the conflict. In short, it is the Diplomat’s way out of the Security Dilemma, guaranteeing security without arms.

The Trump administration’s call to reimpose sanctions on Iran only serves to re-ignite security concerns for both countries. With Iran having ousted its JCPOA commitments as of January 2020, we can only hope that de-escalations will soon follow to prevent the otherwise inevitable spiralling into arms race and false absolute security.

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