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covid-19

The imact of the Covid-19 pandemic has not been gender neutral. There has been a differential impact on women, which is cause of serious concern. Emerging data and reports from those on the front lines, have shown that women and girls have been subjugated to all types of violence, especially domestic violence.

If one were to wade through the annals of history, it is noticeable that violence against women tends to increase in any emergency, including epidemics. Immense stress, disruption of social and protective networks, economic vulnerability and dwindling access to services can exacerbate the risk of women being susceptible to violence.

Understandably Covid-19 has dominated the world’s agenda. Especially in the case of COVID-19, prolonged isolation, restricted physical movement and work-from-home measures to contain the spread of the virus have a particularly acute impact on women. The risk of women and their children being exposed to violence has dramatically increased as members of the family spend more time in close contact. Household stress intensifies, and the risk grows even greater when families also have to cope with potential economic uncertainty or job losses.

Closures of schools and child care facilities have increased the burden on parents, especially women. Distance learning or virtual classrooms often requires the supervision of parents or caretakers. Despite the penetration of internet globally, some families still don’t have access to a reliable internet connection, and childcare obligations may fall on friends, neighbors, or family members while parents work or are in search for work. Some occupations are considered essential and physical presence at work is mandatory while others have the freedom to work virtually. The cumulative stress of balancing work, child care, and children’s education has led to a rise in child abuse. Teachers, child care providers, and clinicians are having fewer interactions with children and families which is significantly reducing the opportunity to assess or recognize any signs of child abuse.

“Before the pandemic, 1 in 3 women would already experience gender-based violence in their lifetime. However, the COVID-19 pandemic has exacerbated this already critical issue”, cites an extremely concerned Melissa Alvarado, UN Women Specialist.

A staggering increase in the number of cases of domestic violence have been reported globally including the developed world. Several reports suggest that cases of domestic violence have tripled in countries like France, Cyprus and Singapore. In France, police reported a nationwide spike of about 30 percent in domestic violence. Christophe Castaner, the French interior minister, said he had asked officers to be on the lookout for abuse.

The Eastern Mediterranean Region has the second highest prevalence of violence against women (37%) worldwide. This is due to structural systems that maintain gender inequalities at different levels of society, compounded by political crises and socioeconomic instability in the region. The Covid-19 pandemic has only aggrevated the situation.

In India, where domestic violence has been a perennial problem, there has been a sharp rise in cases ever since the stringent lockdown was announced by the government. National Commission for Women’s (NCW) data showed that domestic violence complaints doubled after the nationwide lockdown was imposed in India. Tamil Nadu Police have reported an increase in domestic violence complaints. They received approximately 25 calls every day during the lockdown period and registered at least 40 such cases. Similarly, Bangalore Police reported a spike in complaints from 10 calls to 25 calls every day from the victims of domestic violence.

In Spain, the emergency number for domestic violence received 18 percent more calls in the first two weeks of lockdown than in the same period a month earlier.

Around 42% of the Australian practitioners noted an increase in first-time family violence reporting by women.

Mahase reported a 60% increase in emergency calls related to violence against women by their intimate partners in Europe.

Similarly, Agüero (2020) found a 48% increase in helpline calls related to domestic violence in Peru.

In China, a Beijing-based NGO dedicated to combating violence against women, Equality, witnessed a a sudden surge in calls to its helpline, when the government locked down cities in Hubei Province, which was the epicenter of the pandemic outbreak.

A study on Ethiopian women found that almost one in four women experienced any form of domestic violence during the COVID-19 pandemic. Housewives aged less than 30 years, and with arrange marriage were at greater odds of experiencing domestic violence

At the heart of it, domestic violence has always been about power and control. Home isolation, however quintessential to prevent the spread of the virus, is giving still more power to the abuser. The isolation has also shattered support networks, making it far more strenuous and sometimes even impossible for victims to get help or escape. Sexual harassment and other forms of violence against women continue to occur on streets, in public spaces and online. Survivors have limited information and awareness about available services and limited access to the much needed support services.

In some countries, resources and efforts have been diverted from violence against women response to immediate COVID-19 relief, thus compounding the problem.

One interesting study reveals that the stricter the lockdown, the greater the risks of domestic violence. The most stringent lockdown was enforced in South Africa. Amongst other bans, liqour and cigarettes were strictly banned during the country-wide lockdown. One study claims that this has adversely affected the mental health of men and the incidences of domestic violence has increased significantly in South Africa. The magnitute of the problem is so significant that women are having to leave their homes along with their children to nearby shelter homes and distress centers. However, the fear of getting infected with the Covid-19 virus at these centers is dissuading others to tolerate the abuse and abuser at home.

Some advocates have raised concerns about a potential increase in intimate partner violence (IPV) ever since people were confined to their homes and personal movement was limited. Stay-at-home orders, even though rightly intended to protect the public and prevent widespread infection, has left many IPV victims trapped with their abusers. One in 4 women and one in 10 men experience IPV, and violence can take various forms: it can be physical, emotional, sexual, or psychological. Studies show that people of all races, cultures, genders, sexual orientations, socioeconomic classes, and religions experience IPV.

A Glimmer of Hope:

Not all seems to be lost though. Women are being creative about how they seek support. In some places women are going to Pharmacies and grocery stores to reach out for help. In some countries they are setting up pop-up crisis centers at pharmacies and grocery stores to help women subject to harrassment reach out for the much needed help. This is especially helpful when the abuser has confiscated the victims’ phone and other forms of communication are not accessible.

UN Women, the United Nations entity dedicated to gender equality and the empowerment of women, has launched the Shadow Pandemic public awareness campaign, focusing on the global increase in domestic violence amid the COVID-19 health crisis.

The French Government has allocated 20,000 hotel rooms for abused women. Additional Control rooms have been setup by the French Police to distress calls.

Dr. Kemi DaSilvaIbru, a qualified physician with more than 15 years of experience in private practice, dedicates her time to addressing the needs of girls and women. Her unmitigated passion for women’s rights and protection led her to found Women at Risk International Foundation (WARIF) in Nigeria. The foundation addresses the prevalence of rape and gender-based violence through intervention and treatment for girls and women and by providing effective educational and community-based initiatives. She has been helping women and children who have been subjected to physical and sexual abuse during the pandemic.

Community gatekeepers who are at the forefront of rescuing abused women and children opine that the perpetrators get moved to the shed instead of the survivor. This indeed is a wise suggestion. Why should the abused person bear the brunt of shifting to a different location while the abuser gets away with the crime.

Despite all these praiseworthy initiatives during these precarious times, women subject to domestic violence are trapped at home with their abusers and the perpetrators are at a ear-shock distance. Phones and other assets of the victims have been confiscated making it very hard for them to seek support or help. The abusers are using the stringent lockdowns as an excuse to prevent their victims from moving out of their homes.

Ironically, since the pandemic erupted, it is heartwrenching to know that home is no longer the safe place for women, the true homemakers.

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By Dr. ELSA LYCIAS JOEL

From time immemorial women have been considered to be better caretakers. Nothing unusual about it. History has provided us with many examples of women as nurses and their contributions to our communities. Be it the lady with the lamp or the angel of the battlefield or sojourner truth or the first black woman general of USA or the first lady of nursing, there is no dearth of inspiration. All of us, at least when pandemics hit us come to know what the word ‘nurse’ stands for. The word is derived from the fifth-century post-Classical Latin nutrice a wet-nurse hired to provide an infant with breast milk when the infant’s mother would not or could not do so. Etymologically it is related to our modern word nourish.

As Britain prepares to celebrate Florence Nightingale’s 200th birthday on May 12, the whole world cling to nurses as their saviours and would not let go of them. In today’s scenario, despite intensive care many die. That doesn’t stop anyone from believing that nurses are a courageous lot under the most adverse conditions. Uncomplaining resilience and calm professionalism displayed by them make known that they should be considered essential elements of all societies, at all times. With a long history, they are everywhere as members of the largest health care profession in diverse settings and fields. Stories of army nurses have reinforced the fact that they do their best withstanding hardships at the front and have been awardees of ‘The Purple Heart’. We all know how vulnerable they are under the present circumstances as a vital link between the patient and the rest of the healthcare system. Raincoats and helmets in lieu of coveralls and masks, claps and clanging pots instead of PPEs and a pay raise, it’s a struggle day in and day out. Being around critically ill patients even when the surge hits is an act of self-denial. A listening ear and a calming touch even as they keep their senses alert for one small subtle change to determine what or who needs to be called reflects their flexibility, innovativeness, patience and adaptability.

Severe shortages of nurses characterizing  the current and post pandemic periods is a result of governments’ lethargy and unpreparedness of governments in addition to an uneven battle with the deadly virus in turn threatening the delivery of health services to the public. Though nursing’s image takes on an heroic cast during pandemics and wars,  the reality for most nurses is that the work is incredibly demanding with few financial rewards and poor working conditions. Nursing fails to keep up economically with other occupations. For the sake of four words – Humanity, Fortitude, Devotion and Sacrifice which describe this profession the best and for these words to ring true, the cracks in the current edifice of healthcare safety should not continually grow. For those thousands who died on duty leaving their colleagues and families shaken, their contributions are acknowledged as essential to victory against this evil called COVID19. If we think, nurses report for work in the most challenging of circumstances anyway, because that is their job we should rethink. Well, it’s also because they believe that respect for the inherent dignity and of human lives is a fundamental principle of their profession.

While nurses are looked upon as those holding the fort and expected to go on and on their psychosocial well-being is a concern. At these times, even behind a mask the nurses are not wholly successful in altering their outward demeanour and the presentation of what they see as their ‘detached’ face does not serve to mask feelings of exhaustion, demoralisation, anger or sorrow. Recently, with too many failings and deaths to handle, however, nurses find themselves having to perform a different kind of emotion management than that prescribed by their profession. They have to present the detached face of the professional career as fear of losing grips them. Next moment, they also have to handle intense joy on liberating someone from a ventilator, when another one stabilises and could breathe on her/his own again. ‘Smiling happiest faces’ also means they have to work hard on their emotions especially with families of patients whose expectations of a quality service have been raised beyond anything better than the best. An impending doom or an existing gloom, the overall effect is physically and psychologically palpable. Wobble rooms are indeed “rainbow rooms” that offer peace and quiet plus a space to have a safe conversation. Above all, nurses need not go home thinking, ‘I could have been the kindest to so and so’.

If we think nurses’ experience alternate between periods of intense activity, sleep and anxiety, we are wrong. It’s much more than that. Underpaid, under- resourced and overworked, they are barely holding it together. Patients who arrive in severe shock, others very sick demanding a high level of nursing care and many others on the verge of death needing a kind look or words of comfort, surrender themselves with ‘that’ look in their eyes. ‘Stoicism’ is the ruling word in times of profound upheaval, risk, and strain. Is there anything more traumatic than seeing the one you cared for in the previous shift with lot of hopes and prayers, in a body bag hours later? These soldiers who display courage in the face of duty are more than deserving of a ‘Maidstone Medal’ or “The Christiane Reimann Prize”. What’s more, they put the wellness of others before their own, and many accept their fate with incredible dignity.  Bold voices clearly articulate ethical positions with an astute understanding of human rights, careful discernment of human rights violations and bold acceptance of professional responsibility.  When push comes to shove, many expose racism despite knowing the ordeals ahead with their livelihood at stake, as more than life savers who are willing to advocate for victims and to collaborate with right thinking people in finding solutions to ethical and racial issues. Whatever, deafening sounds of oxygen will accompany them for years to come.

Forget Covid19 for a moment. In normal circumstances, to smooth the often turbulent path of interaction between patient and an overworked health specialist, nurses become able to tolerate differences, willingly keep aside potential perceptions and whole heartedly contribute to shared care plans even when multiple patient handoffs play foul in establishing a trusting and collegial relationship. Nurses must re-define stressful situations, carry on and do their job in any situation with or without resources. There seems to be no recognition anymore of the collective goodwill involved in providing a service, many a time selfless one. A bad job is definitely not excusable, but others involved with nurses ought to understand and appreciate the struggles or shortcomings. At the end of the day, they don’t feel like heroes but rush back home as a daughter, wife, mother, lover or a friend to feel belonged, to care and be cared for. 

Still, everybody fights, nobody quits. 

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Saba Rajkotia

As the number of confirmed Coronavirus cases in India continue rising, Kerala, which had some early success in dealing with COVID cases, saw a steep rise in COVID cases with more and more people flying in the State. Kerala’s mortality rate still remains one of the lowest as the state has now tweaked its strategy to deal with COVID cases.

It’s important to note the role of Kerala’s Health and Social Welfare Minister, Ms. KK Shailaja, in efficiently dealing with the COVID challenge.

Since the first case of Coronavirus was reported in Wuhan, China, Shailaja has been keeping a close eye on the development and spread of the virus. Taking into consideration the fact that many students from Kerala travel regularly to Wuhan for their studies, the Minister ensured that the State was well-equipped to deal with the arrival of the virus. Quarantine facilities were prepared and medical aid and equipment was made readily available. Furthermore, the Minister ensured that decisions were made according to scientific reasoning, and with the advice of subject experts.

Over a month before Modi declared a nation-wide shutdown across India in response to the threat of Coronavirus, Kerala had already declared a State-wide Emergency – in the first week of February. Shailaja recognised the gravity of the situation, and ensured that the State took the threat seriously. All public events were cancelled, movie theatres and schools were shut down and more doctors were sought out and appointed. Now, as the whole country struggles to deal with the effects of the lockdown, Shailaja is ensuring school children don’t miss out on their afternoon meals by serving them in their homes.

Shailaja has been open about her lack of trained medical knowledge, and she makes a conscious effort to ensure her people are well informed about the progression of the virus through her social media account (@shailajateacher) and daily conversations with the press. Since coming into power in 2016, Shailaja has faced multiple tragedies alongside the people of Kerala. In 2018, Kerala dealt with the outbreak of the Nipah Virus, followed by devastating floods in both 2018 and 2019. In the face of all this adversity, Shailaja stood out as a capable, compassionate and effective leader who was able to lead her State out of crisis.

In the aftermath of the floods, Shailaja did her best to ensure easy access to food and medication for the underprivileged sections of society. In order to avoid the onset of water-borne diseases, the Minister brought in homeopathic and ayurvedic doctors and through her meticulous planning she successfully avoided further disasters for the people of Kerala.

Shailaja’s commendable track record in resolving public health issues and compassionate approach to crisis management make her a reliable leader for the people in Kerala. In these scary and uncertain times, Shailaja inspires confidence.

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