It is generally accepted among the environmental geographers that there is no such thing as a natural disaster. In every phase and aspect of a disaster—causes, vulnerability, preparedness, results and response, and reconstruction—the contours of disaster and the difference between who lives and who dies is to a greater or lesser extent a social calculus.

                                                                                                                                                    —-Neil Smith1

As the day breaks in the nationwide pandemic lockdown, the common man’s psyche is subjugated to a monotonous recital of statistics and mathematical projections of those exposed and those positive with nCovid 19. A well orchestrated symphony of breaking information , synchronised with the outbreak of data and dispersal of numerical figures to the public domain feeds the newly evolved fear, the fear of impending doom,  and a sense of incertitude thus disrupting the social fabric and alienating the individual from the collective. The arena is created where the vulnerable and  distressed sufferer is painted as an irresponsible disease spreader, charged guilty by the reason of test positivity , stigmatised and discriminated. The social engineering experiment in this pandemic is a fertile breeding ground for the reconstruction of the ‘Other’.

Among the cacophony of voices in the main stream media dissecting the math and critically appraising the infectivity rates and fatality rates there is no space or time to speak or even think about the vulnerable population who are made invisible following the pandemic

lock-down and more so those who were already invisible to the public eye. This is especially  true of those behind bars and locked down for years. People who live inconspicuously institutionalised , their lives reduced to mere numbers bundled in case records , ‘socially dead’2 long stay patients in mental hospitals ,private rehabilitation centres, and  private mental health establishments, and also the trans-institutionalised patients in privately run homes.

When the rate of occurrence of a rare event  increases, the event becomes normalised and made acceptable and more palatable in the collective conscience, as in the visuals of bodies unceremoniously dumped in mass pits the lonely march of coffins and the narratives of world leaders on the pandemic war , where the mass psyche is prepared for mourning for their loved ones even before they are infected with Corona. Preparation for the pandemic is slowly turned into mentally preparing the individual  for losing their near and dear ones, and also the deliberate instillation of the idea that death from Corona is inevitable.

In this context the news about the Corona deaths of seven inmates of a psychiatric hospital in the Daenam Hospital3 in Cheongodo, North Gyeonsang Province South Korea  in the last week of February wouldn’t have caught the public eye. All the 101 inmates in the psychiatric ward tested positive with nCovid 19.The patients’ death in a psychiatric hospital is  a grim reminder that in any disaster the most affected are those who are most vulnerable. Deaths in the psychiatric hospital is a wake-up call for the civil society that the vulnerable and most neglected need to be protected and attended to in this pandemic.

Throughout the world the pandemic  had exposed the glaring weakness of the defunded public health care , and the crumbling health system’s inability  to prepare , cope with the crisis and protect its citizens . With  rapid mushrooming  of  licensed4 and unlicensed Private Psychiatric Rehabilitation Centres all over the country and  especially in the State of Tamilnadu, and reports of structural inadequecies in many government mental hospitals  all over India, it is important  to inspect and evaluate  the precarious lives of thousands of persons  endangered  by this pandemic and lock down and assure them that they are protected.

It is now the time to steer the  Rights of Mentally Ill from just sloganeering to immediate action. Is  there any information sharing happening with the long stay inmates about the  viral pandemic  and  the declaration of the lock down? Did anyone  lend their ears to the trembling voices stifled for years and whether their opinions were registered?  When social distancing based on mathematical modelling  was declared did the experts take into account the inhabitants of psychiatric establishments? The blocks inside the colonial wards of  mental hospitals or the dormitory type cots placed inside the cramped rooms of private rehabilitation centres,where these inmates are in perennial lock down under strict vigilance, would not have been taken into account. The concept of mandatory social distancing for containing the spread of the the pandemic is proving to be a luxury for many ,especially the inmates of psychiatric establishments.

In 2007, our country had ratified the United Nation Conventions Of Rights Of Disabled5. And the Article 11 in UNCRPD talks  about the state’s role in protecting and taking adequate measures in ensuring the safety of persons with disabilities in situations of risk and humanitarian emergencies including war and natural disaster. Hence it is  the duty and moral obligation of the government  to ensure the safety of all inmates of the psychiatric establishments both government and private , to take necessary steps to screen for any corona infection in this vulnerable group and also to ensure that basic facilities like food and water are not interrupted during this lockdown.

Also the mentally ill persons who are on long term psychotropic medications have multiple comorbid medical conditions and metabolic disorders  placing them at the most vulnerable category in this corona pandemic. The reports  around the globe state that the corona related deaths are high among people with multiple comorbid medical conditions.

The inmates of mental health care establishments  need immediate measures be taken to safe guard their lives. In particular ,inspecting teams need to be constituted to ensure :

  • There is no neglect in care delivery.
  • There is adequate availability of food and water.
  • To perform urgent screening and testing of the patients as well the staff for corona infection.
  • Immediate care has to be given as per protocol.
  • Transport arrangements should be made available for caregivers who want to visit their loved ones in the hospitals/ rehab centres.
  • That the physical distancing is in place to break the transmission chain, and steps are taken to alleviate anxiety among inmates.

Throughout the world the Corona pandemic has unmasked many things . The new age narratives of valorization and empowering the mentally ill remain an empty rhetoric. As the worldometer runs nonstop, giving live updates on corona statistics, the cry behind the rusted asylum gates is still unheard . A cry that says human lives are much more than just economic entities and statistical ciphers.

 Dr. Aravindan Sivakumar  Psychiatrist , Chennai

Email : spartacus1475@gmail.com

 

References :

1.Understanding Katrina ; There is no such thing as a Natural Disaster ; Neil Smith 11th June 2006

2.Slavery and Social Death ; Orlando Patterson

  1. ‘It was medical disaster ‘ : The psychiatric ward that saw 100 patients diagnosed with new corona virus ; INDEPENDENT ; 1st March 2020

4.List of Psychiatric Homes and Deaddiction/ Rehabilitation Centres; tnhealth.org/online_ notification/notification/N17121151.pdf; December 2017

5.www.un.org > conventions -on – the -rights-of -persons-with-disabilities Article 11

 


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