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Sunday, December 20, 2020

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

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Raya Tripathi
Raya Tripathi
South Asia

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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 4:57 PM

India’s Transgender (Protection of Rights) Act: Why the activists are opposing it?

On July 13, 2020 the Ministry of Social Justice and Empowerment of India notified the release of draft Rules for the much-disputed Transgender (Protection of Rights) Act 2019, and has given citizens 30 days to submit suggestions and objections.

The Ministry first published the draft Rules on April 18, 2020 and asked for comments by April 30, later extended to May 18. Based on the central government’s consideration of the submitted feedback, the updated Rules were once again opened to critique.

As summarised in this analysis by PRS Legislative Research, the Rules lay out the detailed process regarding issuance of Certificate of Identity, and welfare measures, medical facilities and such for transgender people. It also specifies that the National Institute of Social Defence will act as secretariat for the National Council for Transgender Persons.

Analysis

  1. The Act is infamous for claiming to confer the right to self-perceived gender identity, which is also enshrined in the National Legal Services Authority (NALSA) vs. Union of India judgement, but continuously neglecting this right thereby going against both a Supreme Court judgement and its own statement.
  2. This manifested once again in Rule 4 of the first draft of Rules which required a psychologist’s report— while paradoxically insisting that it requires “no medical examination”— as part of the application process. This requirement was removed from the recent draft of the Rules after backlash.
  3. Also, as stated in the Act, it is the District Magistrate who will determine the final “correctness” of the application, essentially stripping transgender people of any supposed right to self determination. It is worth noting that this places the District Magistrate, an executive figure, in a judicial position, one of ‘judging’ the ‘authenticity’ of a person’s gender identity.
  4. The above mentioned application will only provide a Certificate of Identity that states a person’s gender identity as transgender. To be able to apply for a revised Certificate of Identity to change one’s gender to male/female as per Rule 6, a person must undergo gender reassignment surgery and on top of that provide a certificate stating this from the Medical Superintendent or Chief Medical Officer from the medical institution which facilitates the surgery.
  5. This is problematic for a large multitude of reasons, including but not limited to: many transgender people not feeling the need for medical or surgical intervention, the policing of transgender people’s identity as only being ‘valid’ if they undergo surgery, and the sky-high costs of surgery contrasted with large numbers of transgender people living in unsupportive environments and/or being unable to finance their surgery.
  6. The right to self-identification continues to be blatantly violated in Rule 8, under which a District Magistrate can reject an application, following which the applicant has a right to appeal the rejection only within 60 days of intimation of the same, as stated in Rule 9.
  7. The right to self-determination was also thrown out the window when the first draft Rules imposed a penalty on “false” applications, once again referring to the arbitrary power of the District Magistrate. This has also been removed following strongly negative reactions.

It is important to compare the two versions of the Rules despite the second one being arguably better and cognizant of some of the demands made by the citizens and other stakeholders.

The first version of the Rules quite clearly depicted the narrowly cisnormative perspective through which transgender lives are seen by the people in power. Despite the many changes as a result of relentless protests, the Act is nowhere near to truly respecting and empowering transgender people.

The decision to give the final say to the District Magistrate- which some argue made the process harder than it used to be before the Act- and the refusal to provide affirmative action or reservations to ensure representation in positions of authority that transgender people have historically been denied access to.

It also does little to counter discrimination, as is seen most clearly in the punishment of sexual assault and rape being much less than for the rape of a cisgender woman. It advocates for plenty of measures but does pitifully little to ensure or enable these changes.  

History of the Act

The history of the Act is a turbulent one. The 2016 Transgender (Protection of Rights) Bill, was almost immediately slammed by activists, NGOs, other human rights organisations, and citizens, for multiple reasons.

The most derided was the provision to set up a ‘District Screening Committee’ which included the District Magistrate, a chief medical officer and a psychiatrist among others, for the sole purpose of scrutinising a transgender person’s body and identity. It also criminalised organised begging, an activity specifically common among the Hijra community.

The Lower House of the Parliament, the Lok Sabha, rejected all the proposed changes by the parliamentary standing committee along with the demands of the transgender community, and passed the bill with some amendments in 2018. A short-lived victory came in the form of the lapse of the bill due to the 2019 general elections.

However, as soon as the NDA government was re-elected, the bill was reintroduced in the Parliament with some more changes, particularly the removal of the section on District Screening Committees, but was still unsatisfactory.

The full text of this bill was not released when it was approved by the Union Cabinet on July 10, 2019, but on the morning that it was tabled in the Lok Sabha, garnering another consecutive year of protest since it was first introduced.

This is the bill as it exists today, having been passed by the Lok Sabha on August 5, 2019. When the motion to refer it to a select committee failed in the Rajya Sabha, it was passed on November 26, 2019, and received presidential assent on December 5, 2019. Recent developments include a writ petition in the Supreme Court challenging the validity of the Act.

Despite it becoming the law of the land, transgender citizens and activists such as Esvi Anbu Kothazam and Kanmani Ray continue to criticse it and the insidious transphobic thinking that has always guided it.

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