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 28, 2021 11:13 AM

Internet Shutdowns in India: From Kashmir to Haryana

India has one of the world’s largest internet user base and also has the maximum number of internet shutdowns. In 2018, India recorded 134 shutdowns which is the highest the country has seen yet. The article delineates the implications of Internet shut-down—while looking at specific cases of Kashmir, CAA-NRC, and Farm Bill Protests—and the legal procedures associated with the same.

The internet shutdown imposed in Kashmir on 4th August 2019, when Article 370 of the Constitution was abrogated by the Parliament of India recorded the longest shutdown in India.  In the initial days, landline and mobile services were restricted as well. While the ban on landline and mobiles was lifted soon, 2G services were restored for “verified users” on 25th January 2020. Only whitelisted websites could be accessed and social media remained prohibited. A new order was passed on 4th of March 2020, by the administration of J&K, according to which the whitelist was removed but internet could only be accessed using 2G on verified SIM's. As Kashmir is still languishing without high-speed internet, at least 7 million have been affected due to the shutdown.

Anti CAA-NRC Protests in Lucknow | Source: Youtube

In December, 2019, during the notable protests against the Citizenship Amendment Act, the authorities in the states of Assam, Meghalaya and Tripura severed internet connection as they supposedly cited a threat of violence and false rumors. Parts of West Bengal and Uttar Pradesh were also under a digital lockdown. Internet shutdowns come with a great cost. Every time the central or state government decides to cut the internet, a large number of students, businesses, travelers, online journalists and influencers are affected resulting in a huge monetary loss. According to a report by TopVPN, India has lost nearly $2.7 billion due to all the 83 internet shutdowns in 2020 alone. This loss is greater than the combined loss of the next 10 countries in the list. The report also revealed that India also stayed offline for longer than any other country, at 8,927 hours last year. The largest contributor to this figure is the 213-day shutdown in Kashmir.

The Kashmir Chamber of Commerce reported that the cumulative loss due to the internet shutdown and restriction in the region was $5.3 billion. The authorities say that these shutdowns are simply to stop the spread of dangerous misinformation which they believe moves faster in social media like Facebook and messaging apps like WhatsApp. However, the internet shutdowns are usually enforced after a piece of misinformation has been spread widely. In 2018, 33 of the shutdowns were justified by the government claiming that they wanted to curb dis/misinformation. The problem is that, when you cut people off from being able to access information, the only access they have is to previous misinformation. In fact, cutting off the internet can turn a previously predictable situation into a highly volatile one. A study conducted by Stanford suggested that mass mobilization in India can occur even in the absence of social media and digital platforms. Another report published by Stanford stated, “Rumours and disinformation continue to spread with or without access to digital communication networks, whose primary role is that of accelerators of information diffusion.” In addition to this, the study found that internet shutdowns force protesters to substitute non-violent tactics for violent ones which are less reliant on effective communication and coordination. In April 2019, Sri Lankan government shutdown all social media platforms as a result of the Easter Suicide Bombings. The IFCN (International Fact-Checking Network) reported that fake news was rampant despite the shutdown. IFCN also noticed an increase in false reports on Facebook from that area. However, the above mentioned facts did not have the potential to stop India from once again disregarding the negative implications of Internet shut-down. India continues to be indifferent.

Protesting farmers at Singhu Border | Source: Harvinder Chandigarh via Wikimedia

The ongoing farmers’ protest in India against the three farm bills (now acts) passed in the parliament turned violent on 26th of January. A group of the protesting farmers who were on a tractor rally, deviated from their route and entered the Red Fort. The Union Ministry of Home Affairs temporarily suspended internet in Singhu border, Ghazipur border, Tikri border, Mukarba Chowk and Nangloi for 24 hours. On 29th of January, the State government of Haryana ordered telecom operators to shut down all mobile internet services, all SMS services, and all dongle services in 17 of the 22 districts of the state until 5 pm on January 30, 2020.

The shutdown was based on the grounds of preventing protestors from mobilising through social media and to constrain the plague of disinformation, which was spread due to the tensions at farmer camps between unidentified miscreants, farmers and later the police. But there was a lack of media coverage of the police violence while they highlighted the protestors’ response to it, essentially disseminating biased disinformation which they ‘intended’ to curb with an internet shutdown.

The Indian Telegraph Act, 1885 permits the government to block internet access in case of a public emergency. After 2017, Temporary Suspension of Telecom Services (Public Emergency or Public Safety) Rules was deployed in cases of internet shutdowns. The Rule 2(1) describes the protocol and powers for the ‘competent authority’ to issue a direction for the suspension of Internet.  The ‘competent authority’ here refers to the Home Secretary of the Union government or the State government. If obtaining prior directions from either of these authorities is not feasible, the order may be issued by an officer, not below the rank of a Joint Secretary to the Government of India. This officer should be duly authorized by the competent authority to issue suspension order and must receive confirmation from the competent authority within 24 hours of issuing such order. In January 2020, the Supreme Court directed that in addition to the Telecom suspension rules, all internet shutdowns must be made public and the orders must be a committee must review all internet shutdown orders once every seven working days to ensure if it is in accordance with the Telecom suspension rules. In November 2020, a new rule was introduced stating that a single order cannot authorize a shutdown for a period exceeding 15 days. Despite several regulations, the Internet Freedom foundation found out that there is low compliance by state governments. Even in 2019, in multiple cities, including the national capital, the suspension orders were issued by the State Police. The New York times reported there were instances where local authorities of India ordered the shutdown with just a few phone calls to the local service providers.

In addition to repression of dissent, telecom shutdowns also have an impact on healthcare services, doctors and ambulances especially in the cases of violence when they certainly have a harder time communicating with people on the ground hence creating a vacuum of information.

Arbitrarily shutting down the internet is a fundamental right violation. The frequencies of internet shutdowns in India are highly alarming. Besides, it is ironic that in 2020, the government announced its plan to bring high-speed fibre-optic based broadband to all Indian villages in the next three years. While it is most certainly beneficial to those living in these villages and to those wanting to spread propaganda, all the effort would be insignificant if the nation continues to shut down the internet at this rate of recurrence.

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