#India
#covidvolunteers
If you are a non-professional volunteer during Covid times in India,
your own mental health may be under challenge.

Few thoughts on how to look after yourself and continue to be a valuable member of volunteer force.
1/n
Many telephone helplines and on ground help groups are working towards - advice on course of disease, finding beds/meds/food/support, arranging funerals and host of other services for the affected and their families.
This is excellent work. Much needed. People volunteering for such work online/on phone/on ground are noble souls.
They face uphill and sometimes hopeless task.
Manytimes their efforts draw a blank and sometimes patient passes away.
All this happening on everyday basis can lead to sense of hopelessness, anger, fatigue and even guilt.
Getting overwhelmed in face of all this is a natural and humane reaction.
If you don't look after yourself, you may not be able to continue this tiring work or worse, your mental health will be adversely affected.
Ideally - daily debriefing sessions are needed for volunteer force to help them cope.
I have experienced benefit of this measure in Latur earthquake in 1993 as volunteer and as designated de-briefer/psychiatrist working in relief camps after Gujarat riots in 2002.
And helping volunteers, psychologists working in countless tragedies on small and large scale till now.
Most important thing to remember - you can be useful only if you are able to preserve yourself. There is no shame in taking care of yourself. In fact it is most important to take care of the tool - yourself.
Some suggestions -
1. If you are on the logistics arrangement job, try to do as much work as possible in "text" mode. Live voice conversations are stressful.

2. Designate specific time of day for this work. Don't go on 24*7 crusade. It is important to work in team and take turns
3. Avoid getting personal with people who receive your help. This may seem counterintuitive. You have a specific role in their life and it is providing required help. Don't try to do emotional support work unless it is your designated work and you have some training in it.
4. Repeated enquiry after people helped by you or personal "follow up" calls are best avoided or done by other members of team if possible.

5. Share encouraging and success stories on volunteer communication groups.
6. Share problems and failures only with team leaders and let them filter learning points and share with group.

7. Don't post death news, messages / info on group for "everyone's knowledge" it harms.
8. Avoid un-necessary enquiry conversations with beneficiary of the service. They feel obliged to indulge you but may be unwilling in reality.

9. Empathy is not always helpful unless you are trained. Compassion + concrete action is most useful in crisis situation.
10. Work actively on avoiding repetition of work - multiple volunteers working on same issue with same beneficiary is bad management.

11. Avoid draining conversations with co-workers.

12. Respect beneficiary's own resourcefulness and emotional support network.
13. Don't try to do everything all by yourself. Boundaries protect and make effective workers

14. Watch for signs of fatigue/breakdown/burnout in yourself. They are - sleep disturbance, poor appetite, pervasive sense of fatigue, crying spells, uncontrollable anger, contd..
repetitive thoughts and ruminations, feeling of guilt and personal responsibility in complex situations, irritability, inability to focus, inability to enjoy your own life/relations/good fortune.

15. Take frequent breaks and de-stress daily in any way that works for you.
16. Avoid talking about your work all the time with colleagues, friends, family.

Preserving yourself and your ability to help is important as you are vital resource in this fight.
Your family needs you. Counts on you. They are primary responsibility. Don't let this important fact slip from your mind.

Don't get into fights with friends who disagree with you on political opinions.

Weakening your own support network is most harmful of all.
Please, please look after yourself so that we all can continue this fight.

Take care.
#JaiHind
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More from @docbhooshan

9 May
#Thread
#Covid info for all

Everyday brings more complexity and more confusing information in public and professional domain.

Here I make an attempt to bring some clarity in my own understanding of this issue.
Basics -
In a complex, complicated, evolving, changing, poor-data situation, best policy is to stick to absolute basics to minimise harm caused by foolish intervention.

What does it mean in practical terms for Covid?
1. Focus on prevention - mask up all the time, avoid socialization and closed spaces, avoid places where you meet mask-less people.

2. Long term - lose extra weight, get blood sugar in normal range, keep other illnesses in good control. This reduces risk if you get Covid.
Read 8 tweets
6 May
#IMS
Indian Medical Service is doctors' demand for a long time.
As a doctor, I understand need to be NOT managed by non-medicos.

If I step back and think critically, few points emerge and we need answers for that before new system is demanded.

#thread
1. Fact - Someone needs to manage.
Due to complex nature of society, politics and modern medicine, that person has to be full time manager. Essentially unable to treat individual patients.
2. This person needs training in Public health and managing complex systems.
So all glorious clinical specialities are out of question.

3. Understanding finance is really the key. So is supply chain management !

Looking at all of this it is unlikely that basic/specialist medical training is enough for the job.
Read 7 tweets
25 Apr
#Culture
#India
#Healthcare

One of the reasons of Covid fatigue for doctors in India is "multiple consultations".

So far in entire year I have not come across EVEN ONE patient who consulted ONLY ONE doctor.
Even asymptomatic people or people with mildest of symptoms contact multiple doctors.

This is how we are.

Therefore I am totally against working for telephonic helplines. If they really audit their calls..
they will realise that most callers are calling up helpline "just to confirm" what 10 other doctors + actual treating doctor has already told them.
Read 8 tweets
23 Apr
Getting psychological help for children locally.
Indians settled in developed countries.
#Thread
Focus - mal treatement of child by a family member
Since I started practice in 2000, every year I receive 5-10 calls from Indians settled in EU, UK and north america about help for a child who is at risk from a family member (mostly father but occasionally mother too).
This involves the parent being emotionally and physically abusive towards child (almost always under 10 years of age).
These families are highly educated and well settled.

One of the parent usually has an anger issue/alcohol problem or long standing mental health issue.
Read 13 tweets
21 Apr
#Covid #healthcare
Thread

First 🌊 of Covid was pure shock for all health systems and societies.

We had little knowledge of what hit us.

People died by large number in developed nations.
By the end of first few weeks we sized up the enemy very well. We also knew that there would be more waves.

As they say in 🎾 you are only as good as your second serve.
And this turns out to be truth about health care.

After doing okayish (?luck) in first 🌊, how is India facing second wave?
What has directed our response, if we can call that?

How do we compare with the world in terms of managing second 🌊,

You are the judge and the victim.
Read 4 tweets
19 Apr
If you are worried about catching Covid while at home, you can try these simple steps to reduce your worry -

1. Use small chunks of time (15-30 min) by allocating to specific activity

2. Do not re-work plans - e.g. if you are buying grosseries once a week stay with it.
3. Stop looking for more info - avoiding crowd + closed spaces and wearing mask all the time is enough.

4. Washing hands ONCE after returning home is good enough.
5. Watch your emotions - distract yourself from worry, anger, sadness by involving in physical activity, art, music, etc.
Read 9 tweets

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