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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February 4, 2021 5:05 PM

Yemen's Multilayered War: The Failing Healthcare Infrastructure

This is the 6th and last part of a short explainer article series on the current crisis in Yemen. To read the earlier parts of the series click on the link.

To read the 1st part of the series click on the link.

To read the 2nd part of the series click on the link.

To read the 3rd part of the series click on the link.

To read the 4th part of the series click on the link.

To read the 5th part of the series click on the link.

The civil war in Yemen, more so after 2015 has taken a toll on the civic infrastructure of the already fragile and poor country. Among these, the healthcare infrastructure of the country was one of the worst affected.

Apart from the physical damage to the hospitals and clinics due to the aerial bombings by the Saudi Arabia led coalition, the naval blockades exacerbated the dire situation. In June 2015 itself, aid agencies warned of the humanitarian risks brought by the US and UK-backed Saudi blockades.

The humanitarian situation aggravated further as there was a consistent famine since 2016 and Yemen was dependent on foreign aid for feeding almost 80% of its population.  According to UNICEF reports, over 3.3 million children and pregnant or lactating women suffer from acute malnutrition.

In 2017, the World Food Programme estimated that an additional 3.2 million people would be pushed into hunger. If left untreated, 150,000 malnourished children could die within the coming months.

Save the Children, the international charity and aid agency, estimated that 85,000 children under the age of five have starved to death in between 2015 to 2018.

Major healthcare operatives are dying due to the active bombing and conflict in Yemen, including personnel from MSF and United Nations Office for Coordination of Humanitarian Affairs (OCHO).

The MSF (or Doctors Without Borders), who have been in Yemen since 2007, have reported that fears of stigmatization are causing people to stay away from hospitals, with misinformation and lack of medical services only compounding the healthcare issue during the pandemic.

As of 24th July, the country reports 1640 confirmed infections and 458 related deaths.  Al Jazeera reported that “Cemeteries in Aden are overflowing with graves, suggesting that the number of people killed by the new coronavirus is higher than the official count.” Yemen and its related aid agencies also suffer from lack of PPEs and adequate information about the pandemic.

As of April 2020, there are 800,000 internally displaced persons in just one province of Yemen Marib. The number of verified civilian deaths stands at 7,700.

The United Nations has been continually asking for donations, but has failed to collect as much as it requires. While it collected $4 billion last year, it has only received $700 million, halfway into 2020.

The UN urged for $2.4 billion this year to fight the humanitarian crises and the Coronavirus. As of 2nd June, 29 countries and the European Commission pledged a total of $1.35 billion to support humanitarian efforts in Yemen, just over half of the amount needed to sustain programs through the end of this year.

In April 2020, the Saudi deputy defence minister, Prince Khalid bin Salman, said Saudi Arabia “will contribute $500m to the UN humanitarian relief program for Yemen in 2020, and an additional $25m to help combat the pandemic. It is up to Houthis to put the health and safety of the Yemeni people above all else.”

There are 41 major UN programmes in Yemen, and it is estimated that more than 30 of them will close due to lack of funds. The UN stated, “Due to the COVID-19 suppression measures, all integrated outreach activities, which include the Expanded Programme on Immunization, Integrated Management of Childhood Illness, Maternal and Newborn Health,and nutrition activities, were suspended.”

Most of Yemen's 3,500 medical facilities have been damaged or destroyed in air strikes, and only half are thought to be fully functioning. Officials warn that monetary relief may not be enough to assist in the war against the pandemic alongside the Civil War. A solution to the war must be found soon, before the pandemic eviscerates more of the healthcare infrastructure.

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