Sunday, December 20, 2020

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

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Raya Tripathi

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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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March 4, 2021 4:43 PM

Does giving the Lieutenant Governor more authoritative power have an impact on India's Federal structure?

On 3rd of February 2021, the NCT bill cleared by cabinet along with 20 other bills proposed to be introduced in the parliamentary session. The amendment was passed on 9th of February in the Rajya Sabha.

“The Bill proposed to amend the Government of National Capital Territory of Delhi Act, 1991, in the context of judgment dated 14.02.2019 of Hon’ble Supreme Court (Division bench) in Civil Appeal No 2357 of 2017 and other connected matters.”

The article explains the timeline and the practical implications of the NCT Amendment Act 2021 on the federal structure.

The Centre's amendments to the NCT of Delhi Act, gives more powers to the Lieutenant Governor and Delhi’s Kejriwal government were totally against the amendment as due to their bitter experience with the previous and current LG.

The Arvind Kejriwal government described the NCT Bill, as a murder of constitutional democracy and accused BJP of secretively drafting the amendments so as to govern Delhi in an unconstitutional manner using the LG's office.

The new amendment is expected to now clearly define the powers and functions of the Lieutenant Governor and the Delhi Government based on the 2019 judgement. The amendments add a category of bills, which fall outside the ambit of Delhi legislative assembly and which the Lieutenant Governor must reserve for consideration of the President. This category is supposedly added for the sake of “better governance” and to reduce potential conflicts. The amendments also specify that the elected government needs to send legislative proposals to Lieutenant-Governor (LG) at least 14 days in advance to seek his opinion and avoid any delays.

The tussle between the Delhi government and the Centre reached the Supreme Court 2017. The honourable Supreme court defined the role of the LG in Delhi and ruled that the LG cannot interfere in every decision of the Delhi Government. The tussle between the Union and Delhi government has that Article 239 AA of the Constitution at its core. The Article 239 AA gives Delhi the special recognition of a Union Territory with a Legislative Assembly that has a lieutenant governor as its administrative head.

In July 2018, a five-judge Constitution bench of the Supreme Court led by Chief Justice Dipak Misra stated that the lieutenant governor’s powers in the National Capital were only limited to land, police and public order.

“The lieutenant governor must work harmoniously with the elected government. The LG is the administrative head but can’t act as an obstructionist”, the bench stated. The supreme court also stressed upon the fact that the power and status of the LG was different from the state governors. They mentioned that the Lieutenant Governor must not be an obstructionist and must work harmoniously with the Delhi government. “There is no room for absolutism and no room for anarchy,” the bench stated. The verdict is not complete yet as the issue of services divided the bench that delivered the order and the matter is now addressed by a three-judge bench on the Supreme Court which has not concluded the hearing yet.

So far, the AAP has argued that former LG Najeeb Jung and the current LG Anil Baijal are undermining the federal structure of the Republic of India by objecting the decisions made by the Delhi government and overruling their authority in bureaucratic matters.

Former LG of Delhi with Prime Minister Modi | Source: Wikimedia

In July 2013, Najeeb Jung took charge as the LG of Delhi and Arvind Kejriwal swore in as the Chief Minister (CM) of Delhi in December 2013. After 49 days of governance, Arvind Kejriwal stepped down as his minority government was unable to pass the anti-corruption legislation due to lack of support provided by other political parties. In February 2015, the Aam Aadmi Party came back to power by a staggering majority of 67 out of 70 seats. However, the party faced a higher veto obstruction while making several decisions. In May 2015, LG Jung annulled all the bureaucratic postings by Delhi government and stated that power to appoint and transfer rests with him.

In June 2015, five officers of Bihar Police joined Delhi Government’s Anti-Corruption Branch (ACB). Jung rejected their employment at the ACB claiming that he was the person in charge even before the new amendment. In the same month, the Delhi government replaced the Home Secretary Dharam Pal and Jung obstructed the decision by vetoing the order. When the AAP government decided to hike circle rates in Delhi for agricultural land, the former LG Jung objected to the decision although the State government has the complete authority to take such decisions. In another instance in 2016, Jung set up a panel to probe over 400 files related to decisions taken by Delhi government. The CM of Delhi deemed it to be illegal.

Kejriwal and the AAP government blamed the former LG and Prime Minister Narendra Modi for the CBI raids of his office, FIRs filed by ACB against Arvind Kejriwal and former Delhi CM Late Sheila Dikshit in water tanker scam, restriction of control on appointing state bureaucrats and general obstruction of decisions.

Anil Baijal, the now LG of Delhi with Defence Minister Rajnath Singh | Source: Wikimedia

On 31st December 2016, Anil Baijal swore in as the Lieutenant Governor of Delhi. While the tussle between AAP and the LG continued, the alleged assault of Chief Secretary Anshu Prakash by AAP leaders at CM Arvind Kejriwal’s residence in February 2018 gave a new momentum to the tug of war.

Following the incident, the IAS association reportedly skipped routine meetings with ministers as a mark of protest but claimed that they have not suspended work. Before that, on December 2017, the turf war between Kejriwal and Baijal reached Parliament, with a Rajya Sabha member claiming that the CM was being treated like a “peon”.

In 2018, the AAP government demanded LG’s approval for the proposal for doorstep delivery of rations and also demanded grant of complete statehood for Delhi and installation of CCTVs. Baijal did not approve both the demands directly and further complicated the process. Kejriwal stated that the LG rejected the demands over “petty-politics”.

In June 2018, Delhi CM Arvind Kejriwal sat in a nine-day long hunger strike at the Lieutenant Governor’s office against the “strike” by IAS officers and Kejriwal wrote to Prime Minister Narendra Modi, requesting him, “with folded hands”, to intervene and end the agitation of the IAS officers.

The Aam Aadmi Party argues that the BJP is hell bent on ruining efficient governance of Delhi through the LG. Critics believe that the tussle has failed the federal system of our Democracy.

Chief Justice Dipak Misra, Justice Sikri and Justice Khanwilkar, in their written opinion devoted a significant portion to explain the understanding of federalism, and its fusion with democracy to achieve an “egalitarian social order”. According to our Constitutional scheme neither the States isolated islands, with their distinct vision, nor the Union government can make decisions that are meant to affect the interests of the States. The Chief Justice highlighted that there should be a sincere effort to avoid conflict and not encroach on each other spheres in a collaborative framework of federalism. To exercise authority, “there should be perception of mature statesmanship so that the constitutionally bestowed responsibilities are shared by them.” To attain the ideal balance in a federal structure, the Chief Justice suggested the Union and the States to have “mutual respect and deference to actualise the workability of a constitutional provision.”

Collaborative federalism involves healthy negotiation and coordination between the Union and State governments to ensure that the governance works within the circumference of the Constitution and in harmony.

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