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

Publication Date

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 4:39 PM

Bedrock of US Democracy: Checks and Balances of Governing Branches

When the American Revolution ended in 1783, the United States Government was in a state of flux. The founding fathers (George Washington, Thomas Jefferson, Benjamin Franklin, John Adams, Alexander Hamilton, John Jay, and James Madison) did not want to establish another country that was ruled by a king. The discussions were centered on having a strong and fair national government that protected individual freedoms and rights and did not abuse its power. When the new Constitution was adopted in 1787, the structure of the infant government of the United States called for three separate branches of government, each with their powers and systems of checks and balances. This would ensure that no one branch would become too powerful because the other branches would always be able to check the power of the other two. 

The legislative branch is described in Article 1 of the US constitution. It has 100 US senators (two for each state), and 435 members in the House of Representatives, which is better known as the US Congress. Making laws is the primary function of the US Congress, but it is also responsible for approving federal judges, US Supreme Court justices, passing the national budget and declaration of war.

The executive branch is described in Article 2 of the US Constitution. The leaders of this branch of government are the President and the Vice President. They are responsible for enforcing the laws the Congress sets forth. The President works closely with a group of advisors known as the Cabinet. They assist the President in making important decisions within their areas of expertise, like defense, the treasury and homeland security. The executive branch also appoints government officials, commands the armed forces, and meets with leaders of other nations. 

The third branch of the US government is the judiciary and is detailed in Article 3. This branch comprises all the courts in the land, from the federal district courts to the US Supreme Court. These courts interpret the nation's law and punish the ones who break them. The Supreme Court settles disputes amongst states, hears appeals from states and federal courts and determines if federal regulations are constitutional. 

Separation of powers in the United States is the backbone of the Checks and Balances System which provides each branch of the government with special powers to check the other branches and prevent any branch from becoming too powerful. Congress has the power to make laws; the President has the power to veto them, and the Supreme Court may declare the laws as unconstitutional. If both the houses of the Congress have a ⅔ majority, they can override the President's veto. The idea of checks and balances is that it is not enough to separate the powers and guarantee the independence of three branches but also that each branch needs to have the constitutional means to protect the system in case of overreach by any other branch. 

 The Check and Balances system also provides the branches with special powers to appoint or remove members from other branches. Congress (Senate and House of Representatives) can impeach or convict the President of high crimes like bribery or treason. The House of Representatives has the power to bring impeachment charges against the President, and the Senate can convict and remove the President from office. Supreme Court candidates are appointed by the President and confirmed by the Senate. Judges can also be removed by impeachment in the House of Representatives and conviction in the Senate. 

The legislative branch, which consists of the Senate and House of Representatives, passes bills, controls the federal budget, and has the power to borrow money on credit on behalf of the United States. It also has the sole authority to declare war, as well as to raise and regulate the military. It oversees, investigates and makes rules for the government and its officers. The Senate can ratify treaties signed by the President and give advice and consent to presidential appointments to the federal judiciary, federal executive departments and other posts. It also has the sole power of impeachment (House of Representatives) and trials of impeachment (Senate). 

The executive branch consists of the President and the Cabinet. The President is the commander-in-chief of the armed forces, executes the instructions of the Congress, may veto bills passed by Congress (but the veto may be overridden by a two-thirds majority of both houses), perform the spending authorized by the Congress, declare emergencies and publish regulations and executive orders. They make executive agreements which do not require ratification and sign treaties, which require approval by the ⅔ of the Senate. They also have the power to make a temporary appointment during the recess of the Senate and can grant "reprieves and pardons for offenses against the United States, except in cases of impeachment."

The Judiciary determines which laws Congress intended to apply in any given case, exercise judicial review and review the constitutionality of laws, determines how Congress meant the law to apply to disputes and determines how laws should be interpreted to assure uniform policies in a top-down fashion via the appeals process.

The system of Checks and Balance was designed and implemented by the founding fathers with such diligence that even after more than 225 years, it is still effective in preventing undue outreach by one of the three branches.

Note: Sites that have been referred to: 

  1. https://www.law.cornell.edu/wex/separation_of_powers_0
  2. https://avalon.law.yale.edu/18th_century/fed48.asp
  3. https://www.britannica.com/topic/Congress-of-the-United-States
  4. https://www.britannica.com/topic/House-of-Representatives-United-States-government
  5. https://www.britannica.com/topic/Constitution-of-the-United-States-of-America
  6. https://www.britannica.com/topic/executive-government
  7. https://www.britannica.com/topic/checks-and-balances
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