Introduction
Methods
Conceptual framework
Setting
Indicator | India national | Uttarakhand state | Tehri Gharwal district | Dehradun district |
---|---|---|---|---|
Total population | 1200 million | 10.1 million | 618,931 | 1,696,694 |
% population rural | 72.2 | 69.5 | 88.8 | 44.5 |
% Households with access to improved sanitation (toilet) | 44.9 | 64.5 | 65.8 | 75.6 |
% Prevalence of disability | 2.1 | 1.5 | 1.2 | 1.7 |
% Prevalence of psychosocial disability | 15.1 | 14.15 | NA | NA |
% Prevalence of widowhood | 4.6 | 4.6 | NA | NA |
% Population residing in informal settlements | 5.5 | 5.0 | NA | NA |
Data collection and formats
Participants
Characteristics | People with disability (n = 8) | People with psycho-social disability (n = 8) | Widows (n = 8) | Total (n = 24 participants) |
---|---|---|---|---|
Age (mean) | 47 | 32 | 43 | 41 |
Education level (mean years of schooling completed) | 7 | 8 | 1 | 6 |
Number of members in the household (mean) | 5 | 5 | 3 | 4.5 |
Sex | ||||
Men | 5 | 3 | 0 | 8/24 |
Women | 3 | 5 | 8 | 16/24 |
Main Activity (n) | ||||
Employed full time | 0 | 1 | 2 | 3/24 |
Self-Employed (farming) | 8 | 1 | 6 | 15/24 |
Daily wage Earner | 0 | 4 | 0 | 4/24 |
Looking after home | 0 | 1 | 0 | 1/24 |
Student | 0 | 1 | 0 | 1/24 |
Religion (n) | ||||
Hindu | 8 | 5 | 8 | 21/24 |
Muslim | 0 | 3 | 0 | 3/12 |
Christian | 0 | 0 | 0 | 0 |
Sikh | 0 | 0 | 0 | 0 |
Caste (n) | ||||
General | 0 | 3 | 0 | 3/24 |
ST | 0 | 0 | 0 | 0 |
SC | 1 | 2 | 3 | 6/24 |
OBC | 7 | 3 | 5 | 15/24 |
Marital Status (n) (Total in [%]) | ||||
Married | 6 | 5 | 0 | 11/24 |
Widowed | 2 | 0 | 8 | 10/24 |
Separated/ divorced | 0 | 1 | 0 | 1/24 |
Never Married | 0 | 2 | 0 | 2/24 |
Region (n) (Total in [%]) | ||||
Rural | 8 | 0 | 8 | 16/24 |
Urban | 0 | 8 | 0 | 8/24 |
Data analysis
Ethical considerations
Findings
Mental distress and coping level | Mental distress linked to COVID19 | Coping with COVID19 |
---|---|---|
Intra-personal | Overwhelmed and bewildered | Finding sense and meaning |
Stuck locally, connected globally | Looking for positive ways forward | |
Distressed and despairing | Innovating with new practices | |
Interpersonal relationships | Feeling socially isolated | Seeking psychosocial support by connecting with others |
Social and environmental | Intersecting disadvantage | Supporting others individually and collectively |
Othering, discounting and discriminating | Engaging with the natural world |
Six themes related to mental distress during the COVID crisis
Overwhelmed and bewildered
This is a very dangerous disease. I have never heard about it in my life and now we have forgotten about all other diseases. We can only recall corona now. () Now there are no more diseases like dengue, malaria. There used to be so many diseases in summer, but now we have only this one disease and all the other fevers have vanished.M, 42, Carer of person with disability
Stuck locally, connected globally
(When I heard about corona virus) I thought what can actually happen to us out here? We don’t feel like much would happen as we live in a remote place but we heard about it happening in the plains, like from my brother who is stuck down there.F, 37y, Widow and carer of person with disability
Distressed and despairing
I was really tensed and scared, every time I was thinking about what we would eat next and how is this all actually happening. I also was thinking that the world would end soon, and the only question was where we would die. At home or in the jungle.F, 37y, Carer of person with disability
Feeling socially isolated
It doesn’t feel good to keep ourselves at home only. We cannot roam around at all as it might lead to infections and this situation has apne paraye sab door ho rakhe hain (kept us from our own folks).F, 55y, person with disability
Intersecting disadvantage
We are eating a lot of fried rice cakes and drinking tea but we are also hungry ( ) In the lockdown I went to the market and I had a single rupee, and there I found a man from our village. He was buying things from a shop. I asked him to help me with Rs200 and I purchased and took some more items on credit.F, 28y, Widow and carer of person with disability
Othering, discounting, discriminating
Within households, people with greater autonomy discounted the impacts for other family members. For example, male participants described how the crisis affected them the most, seeming to discount affects on family members who were women or disabled. A father of a child with disability illustrates this below:People from the Muslim community are all not following the rules ( ) and there is a change in our relations since COVID ( ). Earlier the women in the neighbourhood used to say ‘tum meri dharam ki behen ho’ (that you are my sister in faith) but now they are ready to run bulldozers over our homes. They threaten us over everything, and they are full of hatred.F, 41y, PPSD
(My wife and grandmother) do not feel much about COVID as they stay at home and don’t have much to do with these things (referring to COVID and national news). They are just busy with their work and for them it is all the same, they eat food and work in the fields. ( ) But I am affected as I am the one in this house who goes out.M, 31y, Carer of person with disability
Six themes related to coping with the COVID crisis
Making sense and meaning
Thirdly, participants described reassurance in closely complying with guidelines on handwashing and social distancing. Control measures for some were talismanic and rigid as a young man illustrates:“Just as we got through hardship after my back injury before, we will get through again. And in current pandemic all are suffering: this fight is not alone and others out there also going through the same thing.”M,40y, person with disability
(To cope with our fear) I put on a mask, and wear gloves and maintain social distancing. My mother gets scared and says we should not venture out of the house. I tell her that we should maintain two metres distance between each other instead of one. My father is staying home and also my brother and even wear their masks inside our house. Even while serving food we wear gloves, ( ) take our food and each sit in different corners of the room.”F, 20y, PPSD
Looking for positive ways forward
Participants described the value of finding benefits from the lockdown, such as greater time to play games with children, a new healthy habit (like a fitness programme) and more family time together. Participants even valued self-care practices over finances, for example a woman who continued with her newspaper subscription, although they didn’t even have tealeaves at home:These things [referring to financial hardship] keep playing on my mind but I distract myself otherwise it will affect me more. If we keep thinking about it, it will affect me and my family. It’s better to not think too much, it will not change anything.M, 48y, PPSD
“Every day I try to find something hopeful in the paper about the end of this lockdown situation ( ) Then my neighbours also read the same newspaper, and although my kids ask me to stop wasting money ( ), I tell them we can afford it.”F, 42y, PPSD
Seeking psychosocial support by connecting with near and far
If there were no mobile phones then only God knows how people would have kept themselves going and entertained too. And those away from their homes in these times would have died by now from missing their own people (Agar kisi ko mummy ya papa ki yaad aati toh vo toh sir patak patak ke hi mar jata)F, 18y, PPSD
Supporting others individually and collectively
Participants also described how they had taken collective action, for example, in one rural village, residents set up a roster to provide cooked meals to a migrant labourer from Kashmir who was marooned in their village. Rural participants described how in their village they had agreed to all contribute to travel for city workers to help them return to their rural homes and had also collaboratively agreed on where to house them and how to ensure they followed quarantine with a supply of food.“There is a lady who lives far away. She is alone. I keep sending her food. We also send ration to her. She is just like our grandmother. We want her to be well. Others in her neighbourhood also help her, they give her cooked meal, and it’s the least we can do for her right now”.F, 27y, Widow
Engaging with the natural world
(To get peace of mind my children) are going out to work in the fields and others are going to the jungle. When you take oats grazing you don’t remember that corona is happening.F, 27y, Widow