PSYCHOSOCIAL ISSUES AMONG MIGRANTS DURING COVID-19

Migrants are less familiar in their new environment in which they temporarily live. They are prone to various social, psychological and emotional trauma in such situations, emanating from fear of neglect by the local community and concerns about wellbeing and safety of their families waiting in their native places. Migrants are forced to leave their native places in search of better opportunities and earnings, sometime leaving behind their families. In many instances, the families in native places depend partially or entirely on the money sent by the migrant earning members of the family. During outbreak of communicable diseases, such a COVID-19, and the restrictions imposed on routine activities as part of social distancing norms to prevent the spread of the disease, scores of migrant workers tend to move back to their native places. During the prevailing COVID pandemic also, many migrant workers used all possible means to reach their destinations. Many of them are however stuck at borders, including state, district and at national border areas. These are the most marginalized sections of the society who are dependent on daily wages for their living, and in times of such distress need sympathy and understanding of the society. Immediate concerns faced by such migrant workers relate to food, shelter, healthcare, fear of getting infected or spreading the infection, loss of wages, concerns about the family, anxiety and fear. Sometimes, they also face harassment and negative reactions of the local community. All this calls for strong social protection. As an immediate response, measures to be taken should include, ensuring community shelters and community kitchens, making other relief material available, emphasising on the need for social distancing, identification of suspected cases of infection and adherence to protocols for management of such cases, putting up mechanisms to enable them reach to the family members through telephone, video calls etc. and ensuring their physical safety.

Migrant workers faced with the situation of spending a few days in temporary shelters, which may be quarantine centres, while trying to reach to their native places, are filled with anxieties and fears stemming from various concerns, and are in need of psycho-social support. As part of such support, following measures can be adopted : 1. Treat everyone migrant worker with dignity, respect, empathy and compassion 2. Listen to their concerns patiently and understand their problems 3. Recognise specific and varied needs for each person/family. There is no generalisation. 4. Help them to acknowledge that this is an unusual situation of uncertainty and reassure them that the situation is transient and not going to last long. Normal life is going to resume soon. 5. Be prepared with all the information about possible sources of help. Inform them about the support being extended by Central Government, State Governments/ NGOs/ health care systems etc. 6. Emphasise on the importance of their staying in their present location and how mass movement could greatly and adversely affect all efforts to contain the virus. 7. Make them realise their importance in the community and appreciate their contributions for the society. 8. Remind them that they have made their place with their own efforts, acquired the trust of their employer, sent remittances to their families and therefor deserve all respect. 9. Reassure that even if their employer fails them, local administration and charitable institutions would extend all possible help. 10.Out of desperation, many may react in a manner which may appear insulting. Try to understand their issues and be patient. 11.If somebody is afraid of getting affected, tell them that the condition is curable, and that most recover from it. 12.Remind them that it is safer for their families if they themselves stay away from them. 13.Instead of reflecting any mercy, seek their support in the spirit of winning over the situation together.

Minding our minds during the COVID-19

These can be difficult times for all of us as we hear about spread of COVID-19 from all over the world, through television, social media, newspapers, family and friends and other sources. The most common emotion faced by all is Fear. It makes us anxious, panicky and can even possibly make us think, say or do things that we might not consider appropriate under normal circumstances.

Understanding the importance of Lockdown

Lockdown is meant to prevent the spread of infection from one person to another, to protect ourselves and others. This means, not stepping out of the house except for buying necessities, reducing the number of trips outside, and ideally only a single, healthy family member making the trips when absolutely necessary. If there is anyone in the house who is very sick and may need to get medical help, you must be aware of the health facility nearest to you.

Handling Social isolation

Staying at home can be quite nice for some time, but can also be boring and restricting. Here are some ways to keep positive and cheerful.

1. Be busy. Have a regular schedule. Help in doing some of the work at home. 2. Distract yourself from negative emotions by listening to music, reading, watching an entertaining programme on television. If you had old hobbies like painting, gardening or stitching, go back to them. Rediscover your hobbies. 3. Eat well and drink plenty of fluids. 4. Be physically active. Do simple indoor exercises that will keep you fit and feeling fit. 5. Sharing is caring. Understand if someone around you needs advice, food or other essentials. Be willing to share. 6. Elderly people may feel confused, lost and need help. Offer them help by getting them what they need, their medicines, daily needs etc. 7. If you have children at home, keep them busy by allowing them to help in the household chores - make them feel responsible and acquire new skills. Focus on facts, reject rumours and theories 1. Knowledge is power; the more you know about a certain issue, the less fearful you may feel. Make sure to access and believe only the most reliable sources of information for self-protection. 2. Do not follow sensational news or social media posts which may impact your mental state. Do not spread or share any unverified news or information further. 3. Do not keep discussing all the time about who got sick and how. Instead learn about who got well and recovered. 4. Stick to the known advice- hand hygiene and keeping a physical distance from others. It is being careful about yourself, and also about care of others. 5. A common cold is not Corona infection. The symptoms of Corona have been well described. Follow etiquette of sneezing, coughing, avoiding spitting in public places etc. 2 | P a g e 6. In most people, the Corona infection causes mild symptoms and the person only needs to follow social distancing till he/she stops being infective, usually 2 weeks. Mild infection does not require a person to be admitted in hospital. Only people who have breathing difficulties need to be in hospital. Most people recover. Handling emotional problems

1. At times of anxiety, practice breathing slowly for a few minutes. Try and distance the thoughts that are making you anxious. Think of something calm and serene, and slow down your mind. 2. When feeling angry and irritated, calming your mind, counting back from 10 to 1, distracting yourself helps. 3. Even when feeling afraid, deal with it by asking yourself: a. What is under my control? b. Am I unnecessarily worrying about the worst thing that can happen? c. When I have been stressed in the past, how have I managed? d. What are the things I can do to help myself and be positive? 4. Feeling lonely or sad is also quite common. Stay connected with others. Communication can help you to connect with family and friends. Call up people whom you haven’t spoken to and surprise them. Discuss happy events, common interests, exchange cooking tips, share music. 5. If any of these emotions persist continuously for several days, despite your trying to get out of it, talk about it with someone. If the feelings worsen, a person may feel helpless, hopeless and feel that life is not worth living. If that happens, call at helpline number (080-46110007) for advice from a mental health professional or contact your doctor / mental health professional.

What is NOT advisable

1. Avoid tobacco, alcohol and other drugs. Use of tobacco or alcohol or other drugs to cope with emotions or boredom can worsen physical, mental health and reduce immunity. People who already have a substance use problem may require professional help, especially when they feel low in mood or stressed. 2. Do not shun or judge people with a CoVid infection. While you need to maintain a physical distance and keep yourself safe to prevent such infection, remember they need care and concern. If you know someone who might have the infection, tell them about precautions, and how to get medical assistance, if required. 3. If you happen to get infected with Corona, remember most people get better. Do not panic. Practice self-isolation and take medications that are advised. Emotional issues after recovery

1. While it is wonderful to recover from Covid infection, you may actually face stress after you have recovered and wish to get back into the community. You may have fear about your loved ones falling ill. 2. People who do not understand the illness well may actually keep you at a distance, which is also very stressful and isolating. 3. You may experience feelings of guilt that you were not able to work or care for others. This may lead to feelings of depression, helplessness or frustration. 4. Use the ways mentioned earlier to deal with these feelings. Share your positive story that it is possible to recover from COVID infection. Recognise mental health problems in your near and dear ones Just as you can recognise your own mental health problems, be sensitive to such problems in your near and dear ones, which may include:

1. Changes in sleep patterns 2. Difficulty in sleeping and concentrating 3. Worsening of health problems 4. Increased use of alcohol, tobacco or drugs Be supportive to them. If the problems persist, please contact the helpline (080- 46110007) or contact your doctor or a mental health professional. Persons with mental illness Persons who had previous mental illness may face newer challenges during selfisolation or Covid infection: 1. They would also have the same fears and stress as others which may worsen their previous mental health condition 2. Social isolation may make them more withdrawn, moody and irritable 3. They may not seek/ get easy access to medicines and counselling Help and support is vital for persons with mental illness from their families and other care givers. Health helplines can provide support, in addition to regular taking of prescribed medication, a regular daily routine, keeping engaged and positive. Remember, good mental status in the difficult times may win you the battle more easily!

Health Advisory for Elderly Population of India during COVID19 Pandemic

Globally, COVID-19 has impacted several lives and is steadily increasing its reach. While Indian Government has taken stringent actions to contain the spread of COVID-19, including nation-wide lockdown, it is also critical for each one of us to follow the protocols and take necessary measures and precautions to break the chain of transmission of the disease.

Elderly people are at a higher risk of COVID-19 infection due to their decreased immunity and body reserves, as well as multiple associated comorbidities like diabetes, hypertension, chronic kidney disease and chronic obstructive pulmonary disease. Also, course of disease tends to be more severe in case of elderlies resulting in higher mortality.

However, COVID-19 transmission among elderly population can be reduced by taking following measures:

DO’s

. Stay at home. Avoid meeting visitors at home. If meeting is essential, maintain a distance of one meter. 2. Wash your hands and face at regular intervals with soap and water. 3. Sneeze and cough either into your elbow or into tissue paper / handkerchief . After coughing or sneezing dispose of the tissue paper/ wash your handkerchief. 4. Ensure proper nutrition through home cooked fresh hot meals, hydrate frequently and take fresh juices to boost immunity. 5. Exercise and meditate. 6. Take your daily prescribed medicines regularly. 7. Talk to your family members (not staying with you), relatives, friends via call or video conferencing, take help from family members if needed 8. Postpone your elective surgeries (if any) like cataract surgery or total knee replacement 9. Clean the frequently touched surfaces with disinfectant regularly. 10.Monitor your health. If you develop fever, cough and/or breathing difficulty immediately contact nearest health care facility and follow the medical advice rendered

DON’Ts

Do not cough or sneeze into your bare hands or without covering your face. 2. Don’t go near your contacts if you are suffering from fever and cough. 3. Don’t touch your eyes, face, nose and tongue. 4. Don’t go near affected/ sick people . 5. Don’t self-medicate. 6. Don’t shake hands or hug your friends and near ones. 7. Do not go to hospital for routine checkup or follow up. As far as possible make tele-consultation with your healthcare provider. 8. Don’t go to crowded places like parks, markets and religious places. 9. Don’t go out unless it is absolutely essential.