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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April 13, 2021 7:47 AM

Are India's Antitrust laws effective at controlling monopolies?

On 15th of July 2020, Reliance Industries Ltd (RIL) held its annual general meeting of the shareholders. The chairman and managing director Mukesh Ambani, announced that global tech giant Google would be investing $4.5 billion in Jio Platforms. Facebook also has acquired a 9.99% stake in Jio Platforms. This is the first time in the world that both the global tech giants have invested in the same entity. These investments have boosted the confidence for Jio Platforms and also for India’s growth but there have been questions and speculations about the potential anti-competitive makeup of these deals.

The objective of this article is to explore the interpretation and the effectuality of Antitrust laws in India.

Anti-competitive practices are those business practices which firms engage in to emerge as the or one of the few dominant firms, who will then be able to restrict inter firm competition in the industry in a bid to preserve their dominant status. The Collins English dictionary defines antitrust laws as those laws that are intended to stop large firms taking over their competitors by fixing prices with their competitors, or interfering with free competition in any way. These laws focus on protecting consumer interests and promoting a competitive market. The word ‘Antitrust’ is derived from the word ‘trust’. A trust was an agreement by which stakeholders in several companies transferred their shares to a single set of trustees.

In present-day India, talking about market dominance Reliance Industries Ltd (RIL), resembles American company—John D Rockefeller's Standard Oil Company—of the early 20th century. Mukesh Ambani holds the highest ability to influence markets and policy in every sector in which RIL is present—petrochemicals, oil, telecom, and retail. Many industry experts and critics suggest that Ambani has used his political clout to twist the regulatory framework in his favor.

Gautam Adani, founder of Adani Group | Source: Twitter

Furthermore, economic power in aviation infrastructure is clustering into a few hands as well. In 2019, the Adani Group bagged the 50-year concession to operate all the six Airports Authority of India-operated airports—Lucknow, Jaipur, Guwahati, Ahmedabad, Trivandrum, and Mangaluru—which were put up for auction. The company also obtained a controlling stake in ‘The Chhatrapati Shivaji Maharaj International Airport, Mumbai’ from GVK Airports. Moreover, Adani Group is now set to construct the Navi Mumbai International Airport. The group is now eyeing Indian Railways while they have already established an alarming monopoly in green energy and sea ports. While Airports are natural monopolies, one private company controlling more than 8 important airports is not good news to airlines.

India has established antitrust laws to promote competition. For 40 years, India followed the Monopolies and Restrictive Trade Practices Act 1969 (MRTP). This act was based on principles of import substitution and a command-and-control economy. However, over time several amendments had to be made to the act. In 2002, the Indian approved a new comprehensive competition legislation. This is called the Competition Act 2002. The act focused on regulating business practices in order to prevent practices having an appreciable adverse effect on competition (AAEC) in India. The act primarily regulates three types of conduct: anti-competitive agreements (vertical and horizontal agreements), abuse of a dominant position, and combinations such as mergers and acquisitions. The act lists out the cartel agreements that it intends to prevent. This list includes price-fixing agreements, agreements between competitors seeking to limit or control production, market-sharing agreements between competitors and bid-rigging agreements. These agreements are called “cartel” arrangements.

The competition Act is enacted by the Competition Commission of India (CCI), which is exclusively responsible for the administration and enforcement of the Act. It comprises a team of 2 to 6 people appointed by the government of India. The CCI has previously handled high-profile cases. In 2018, CCI imposed a fine of Rs135.86 crore on Google on the grounds that Google misused its dominant position and powers to create a search bias. In another important case, the CCI, ordered a probe into Idea, Vodafone and Airtel when Reliance Jio owner Mukesh Ambani lodged a complaint against the three for forming a cartel and denying Jio the POI required for network connection, causing multiple call failures. The Cellular Operator Association of India was also probed for encouraging the same.

In some cases, the Competition Commission has been successful in tackling activities that are against the free competitive market. However, critics and economists believe that the act is now unable to adapt to the changing business environment in e-commerce, telecom, technology and the government’s role in distorting competition. Demonetization and GST drove the formalization of the economy. One consequence of them was that bigger, better organized players gained at the cost of smaller ones with lesser resources. The Insolvency and Bankruptcy Code (IBC) was designed to solve the problem of non-performing assets (NPAs) of banks. But consequentially, it has also led to a consolidation in many sectors.  

However, CCI has expressed inability to consistently adjudicate punitive measures due to obligation in several cases. This points to the loopholes in the very provisions of the Competition Act 2002. In an Economic and Political Weekly (EPW) article, Aditya Bhattacharjea—an Economist—argues that even though the 2002 Act represents an improvement from the MRTP Act which was extremely restrictive, the present act also remains riddled with loopholes and ambiguities. According to Bhattacharjea, this creates unnecessary legal uncertainty, which acts in advantage of lawyers and law firms. For instance, the act allows the CCI to leave some scope of flexibility for “relative advantage, by way of contribution to the economic development.” Bhattacharjea argues that this may allow large firms to justify their anti-competitive practices in the name of development.

Mark Zuckerberg and Mukesh Ambani having online interaction after Facebook invested in Jio Platforms | Source: NDTV

Data portability plays a significant role in determining market power of certain firms. In 2017, the CCI closed cases against both WhatsApp and Jio involving allegations of predatory pricing and privacy violations. In both these decisions, the regulator did not consider the restrictions around data portability as a competitive advantage. The possible data leveraging advantage for the attempted monopolization could be the ‘portfolio effect’. Portfolio effect refers to increasing the range of brands, by bundling of telecom or messaging service and other service offerings or illegal vertical restraints, even predatory pricing. This in turn may lead to greater ability of further leveraging, deterring innovation and results in degradation of quality. Another possible advantage is explained as the theory of leveraging. The best example of leveraging is when Microsoft entered the media-player market by extending its quasi-monopoly on the operating systems market by taking advantage of the indirect network effects. In case of Facebook acquiring 10% of Jio’s shares, it is a concern that both entities could potentially use WhatsApp’s market dominance in telecom and social networking services and establish dominance in e-commerce market through anticompetitive acts.

There was a consensus among Indian policymakers at the time of the 1991 economic reforms that economic liberalization would eliminate the nexus between the business elites and the policymakers. On the contrary, the relationship between these two groups got further strengthened.

On the other hand, few critics and industrialists argue that extreme restrictions on growing companies hampers the progressive growth of the national economy. While RIL’s Jio looks like a cause for concern, the company has also saved Rs. 60,000 crores for annual savings in India. In addition to that, the entry of Jio to the telecom industry has led to a rise in data consumption and improved accessibility and affordability of the internet across the nation.

However, the concern still lingers as the question of whether this growth is a result of actual innovation or crony capitalism remains unsolved.

However, the fact that telecom, organized retail, ports and airports have two or three players controlling the bulk of the sector needs to be addressed. A healthy competition is quintessential for long-term growth and innovation. Harmful trade practices and cartelization does not only affect small manufacturers but also the general public.

The government, CCI and other lawmakers must closely examine the present laws and provisions and need to see if they are required to amend the act.

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