Short story of the impact of pandemic on ordinary people who are not on Twitter.
A few days back, Arjun (name changed) called my wife & asked to come & meet her.
Arjun is someone I have known for ~ 2 decade. An owner driver, I have used him for my frequent travels..1/n
to Mumbai & nearby places. He is honest, hardworking guy who my family & I trust a lot. He has ferried my kids when they were as small as 5-10 yrs old to Mumbai to my sister's place all alone with no adults in tow.
A devout God fearing man. Over the yrs, he got married..2/n
had two daughters & got himself a small place for his family.
I had no travel last 15 months, so he would call once in a few months to ask if I had any travel planned.
When he came to meet my wife 2 days ago, the most noticeable thing was how thin he looked. Asked him..3/n
if he was well and left him to talk to my wife.
Turned out that he needed money. He was broke. Wanted a loan to replace the tyres of his car & get the annual RTO passing done. Said he wanted ₹25k which my wife immediately agreed to give.
I just got talking while she...4/n
made the transfer to his account. Turned out he & his wife had been having only one meal a day, but ensuring the girls were fed. School was a problem - he could not afford 2 smart phones for both girls. He had already pawned the jewellery & used up his savings..5/n
He was however only 3 months behind on his car loan & the bank was being patient.
I wondered why he needed ₹25k for tyres & 'passing'. Turned out he actually needed ₹40k but was embarrassed to ask. Apparently the RTO officials will not pass his car without a hefty...6/n
bribe. About ₹10k. Had to be done through an agent or they would fail the car on a minor pretext. Pandemic or not, India's rent seeking govt officials have not learnt any humanity.
Anyways, I transferred an additional ₹15k from my account.
Arjun burst out crying..7/n
I think he was just overwhelmed. He did not know where the remaining ₹15k would come from, so this was a relief.
He kept promising to return the money and thanking us. My wife said he did not need to return the money, but could treat it as an advance for future journeys..8/n
Arjun is a proud man & we did not want to destroy what was left of his pride & self image by treating it as a loan.
He said he was eternally grateful & would be available for any travel anytime. He did not need to say it, but I think it mattered for his pride & self-image..9/n
The worst thing that this pandemic has done is not just the financial destruction to ordinary lives, but it is breaking confident, proud men & women who never in their lives had to beg for financial help. People who had managed their finances sensibly upto now but ...10/n
found they were at the end of their tether.
This damage is going to be long lasting & have more pernicious effect than the temporary disruption in our lives.
All this makes me sad, upset & angry. As a human being & as a mental health professional.
The sheer abdication by..11/n
our policy makers who seem more concerned about appearances & irrelevant stuff, than put in place a system which can support countless Arjuns in the country.
It's people like Arjun who are at highest risk of suicide in coming mths/yrs.. END.

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More from @netshrink

17 Apr
Thread: Indian understanding of quality & effectiveness of medicines.
Many moons ago, I was contacted by a father from Bihar for his 35 yr old son. Had schizophrenia for nearly 15 years & not getting better since many years. Had seen many Drs but no benefit. He had heard ++
of me from a relative in Pune. "Can I please get my son to see you" he sounded desperate. I normally dissuade people from making such long journeys esp when they have already seen so many Drs + chronic illness. Don't want to raise their hopes. In this case, the father ++
a senior government official was quite insistent. He also had relatives in Pune to stay with for few days.
He took an appointment & arrived (with his wife & son) a few weeks later.
We did our usual assessment for new patients incl checking past treatment papers & current +++
Read 11 tweets
4 Apr
THREAD: My personal experience working in India's public health system.
Regular readers of this timeline will know I am a supporter of a public healthcare system.
So naturally I get asked, why don't you work in the public health system, if you think it is so good?
Here's why ++
I trained in a public medical school Seth GS Medical College & KEM Hospital 1982-91 & left in 1991 to go to UK having completed a MD (Psychiatry).
I worked in the NHS in UK from 1991-1999, when I returned to India.
During my time in UK, I got to see first hand & closely ++
what a treasure the NHS is. From the millionaire to the homeless, everyone got the same treatment - free of cost at point of delivery & based on medical need. The primary care GP system was amazing. Anyway, I was determined that when I return to India, I would ++
Read 19 tweets
21 Mar
Thread: I tweeted about Ekalavya & this Assistant Prof Savitribai Phule Pune University tweeted the reply below.
So let me tell you my own experience. I think 1st person accounts are important.
Disclaimer: I am not a savarna nor am I a Dalit. Honestly, I don't know my caste ++
I grew up in Mumbai in 70-80s studied medicine at G S Medical College (KEM Hospital). Proudly got in there with "merit". Reservations & caste really did not impinge on my life except occasionally when savarna classmates said I had "wasted" a seat by not taking admission++
under OBC category. I didn't much pay attention to it Had many savarna friends. I do remember a group of seniors referring to students who had come in through reservations as "bhangis" & laughing. To me this was all irrelevant. Didn't bother me at all. I had some great +++
Read 17 tweets
19 Feb
Thread: This is a long thread about my wife's grand-father: Vinayak Apte.
Born, brought up & lived in Pune. Aptewada, Sadashiv Peth. Qualified as an engineer in 1920s or so. Married around same time.
I promise you this is worth reading, so settle down with your cup of tea....1/n
Around 1921, young Vinayak writes to Mahatma Gandhi expressing his desire to join Bapu & work for freedom struggle.
Bapu writes back saying sending money for the ticket (₹5) & get your backside up here (not exactly these words, but you know what I mean!).
Bapu adds a PS...2/n
"If you change your mind, please return the ₹5 by money order to Sabarmati Ashram" Typical Bapu, you might say! Careful with money.
Vinayak quits his job & decides to go to Sabarmati. Entire extended Apte clan is horrified. Joining that fakir? Giving up your job? Ostracised.
Read 15 tweets
21 Nov 20
I find ppl have difficulty understanding #evidencebasedmedicine (EBM) & how Science works.
EBM doesn't try to "prove" anything but is focused on REFUTATION. Let's say u have a new medicine which you believe works better than previous medicine/no medicine. Thats your theory...1/n
#EBM sets out to refute this theory. Hence all trials start with a null hypothesis: New Treatment A is no better than placebo/treatment B.
You then use statistics to find out whether the difference between the two was likely to happen by chance. P < 0.05 only means that...2/n
there is less than 5% chance that the difference (if any) between the 2 treatments was likely to be due to chance, & is a real difference.
In this case, you reject the a priori Null hypothesis ( that there is no difference between 2 treatments) You accept...3/n
Read 4 tweets
31 Oct 20
THREAD: for academics & researchers wanting to influence policy makers. Mostly India specific advice. Based on my reading & experience of doing this stuff for > decade now.
At the end, I have also given a link to a very useful Nature paper on this subject
So let's begin..1/n
Rule 1: Policy makers are smart people, smarter than researchers/academics/clinicians. In most countries, its harder to become a senior civil servant than get admission to medical college or a proffesorship. Don't be fooled by the dumb look. That's training. So respect them..2/n
Rule 2: Civil servants/policy makers are busy people. If you do not get their attention in the first 5 min, you are never going to make it. So have a very sharp & effective "elevator pitch" ready before you step into their office. I practice in front of the mirror...3/n
Read 11 tweets

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