ONLINE SCHOOLS and HOW GROWN UPS GOT BUSTED

For more than a decade now, we have been preaching to parents and kids about the harmful effects of electronic devices. The last revision of Diagnostic and Statistical Manual has come up with the new diagnosis of ‘Gaming disorder’. Special deaddiction departments like S T O P at NIMHANS, Bangalore have been established to treat disorders related to excessive use of electronic devices.

Then COVID 19 happened.

Now we are all for ‘ONLINE EDUCATION’ and what about the children’s health and safety? The excessive enthusiasm for online schooling has uncovered the double- standards that we grown-ups have- we change our positions when it suits us. Is it really so? Or it is a time for us to understand the finer points and reconcile with the situation?

ARE ELECTRONIC DEVICES SAFE?

The short answer is ‘NOT SAFE’.

Electronic devices harm children’s body, eyes, brain and personality. They can cause chronic health problems like obesity, depression and cancers.There is ample and unequivocal evidence that electronic devices are not safe for children because of their physical and psychological immaturity and that they have a greater vulnerability to the general harmful effects.

Guidelines clearly recommend zero screen exposure till the age of 2 years. Thereafter exposure should be minimized to few short spells on a weekly basis and can be upto an hour daily by the teenage years.

AND ONLINE SCHOOL

I am much happy about the Maharashtra Govt Guidelines which has said no online schooling for children upto the second standard. Thereafter the SOP recommends upto 2 hours daily till standard 8 and then 3 hours daily for high school students. This is touching the limit of safety.

I guess- the way to understand it is to compare it with the danger of attending school in person on one hand and complete break from learning on the other hand. (other modes of learning like home schooling are rarely possible in India).  In India, there is a great pressure for school and academic performance- mainly parents find that school keeps children busy and out of trouble. And if they see children doing school, parents feel more secure about them. So authorities are generally under pressure to start the schooling process somehow or the other. In reality, if children do not go to school for one year- and work only on sustaining their previous levels of learning- nothing drastically bad will happen. They may need to work harder next year though. This is especially true for kids below 12 years. But it will lead to massive amounts of parental stress, economic distress for educational institutions and administrative headaches when schools resume. So, the easier way out is to start school by whatever means available- and online schooling is an elegant and attractive option.

Electronic gadgets are still unsafe for children and my hope is for the online schooling hours to reduce further for every age group and that children should have the sessions only few times a week instead of everyday.

HOW TO ENHANCE SAFETY?

If we accept that online school is necessary due to overwhelming circumstances and that it is a temporary option, then we need to work on enhancing the safety by minimizing the risks. In our culture we are accustomed to feeding children special diet with almonds, milk, etc if they are attempting something that requires more strength, concentration. If children are weak or vulnerable as during illness, then too we feed them special foods and arrange special comforts for them. This situation is similar- it requires a greater concentration alongwith constant risk of damage to health to do online school. Therefore certain special measures should be taken.

11.

CONTROL DOSE

After online schooling, teachers should be careful to give homework that does not involve further use of electronic devices. Parents also should insist on children making handwritten notes and assignments. After school, children should not be allowed to use electronic gadget-based activities to relax. Further learning like tuitions, art classes etc through electronic media should be minimized. Child should be given access to only one device at a time.

For this to work, even parents will need to set an example through their own behavior.

2.      PHYSICAL MEASURES

Good ergonomic charts demonstrating proper seating and distance from screen can be downloaded and displayed next to the child’s work station. Proper seating arrangements, light source, desk for writing, noise cancelling ear muffs, etc should be provided. Child should be reminded to follow the safety precautions until it becomes a habit.

Attention should be paid that child will suffer no ill- effects to eyes and vision, hearing, neck-back and posture, hand and shoulder while being at online school

3.      IMPROVE HEALTH

Children should be encouraged to build their health and immunity through healthy habits. These are balanced diet, adequate fluid intake, regular vigorous physical exercise, hobbies and recreation, good restful sleep at night and social interactions with family (and friends through phone calls)

HOW TO DO IT?

The best way to implement and habituate safe online schooling is through adequate supervision of the child. In the beginning, parents should sit next to the child and attend the school without participating or interfering in the schooling. They should observe the child and give cues about posture etc- so moulding healthy habits. It also gives idea to the parents about what else needs to be provided. Slowly parent can do their own tasks quietly sitting near the child and later can leave the child to attend school by himself/ herself for short periods of time. Completely leaving the child alone while he/ she is on the screen is not recommended.

I can offer no solutions in this blog to parents who are unable to implement their plan because child does not listen to them. They will need to consult good books or counselors for guidance.

NEGATIVE TRENDS

Unfortunately, all schools are not following the SOP given by Govt. ECA has in fact stated that pre- schoolers must be enrolled in online schooling ‘without pressure’. But how will they protect the young eyes and brain from screen radiation and risk of addiction and hyperkinesis- that they have not mentioned. It is for the parents to choose not to enrol children in schools following this guideline.

Some schools have 6-7 hrs of online school daily with or without homework that requires further use of electronic gadgets. I can only feel sorry for the kids and parents of such  schools- they don’t have a choice but to comply with such unhealthy schedules.

Education, school and learning are extremely important. But a little delay or slack will not kill the child or his/ her future. We need to temper our desperation for school with the knowledge that electronic gadgets exposure is basically harmful to the child. With this thought in mind, we must design the online school to do what is absolutely essential only. 

COVID PANDEMIC- A mental health condition

A pandemic occurs when a disease spreads across large populations across countries, races and continents. When COVID occurred in one person it was an infectious viral disease. But when it transformed into a pandemic it has become a behavioral problem- the cause of the body damage in individuals is the virus but the cause of spread is the people’s behavior.

CULTURAL FACTORS

India has been a crowded country for ages. And we have practiced social distancing in the form of ‘UNTOUCHABILITY’. I am absolutely against untouchability and regard it as a blot on our culture- but the point is- it can be done. So also the hygiene measures- we have myriad of purity rituals. And the mask use- we have imposed the purda system on women for centuries. So overcrowding and poor resources is a difficult but not impossible problem to solve. According to me the real problem is a lack of understanding. People have not been able to understand the nature of the problem and hence their response is lacking.

In general, we are a culture with a poor habit of reading.  And the illiterate folks have a major disadvantage on that front. With literate people, the information that gets attention should be to be religious or have some ability to elicit shock or amazement. A disease that can be controlled by simple measures of behavioral change- no that information is not likely to be consumed or believed. The only way to overcome this issue is to involve community leaders and repeat the information.

POOR COMPREHENSION

Among seniors, my personal experience is that due to ageing factors- there is considerable impairment of judgment. So even now, when I got out, I see a very large number of seniors- some even unable to walk- out in the open. Their masks are barely there. Upon enquiring if they had to go out due to being alone- most said they were out due to boredom and also a feeling that they did not need to fear death. Is this silent suicide? But its definitely a form of poor comprehension.

Younger folks with anti social traits, hyperkinetic nature and intellectual challenges also find it difficult to follow precautions. These are the cases of the infamous ‘corona parties’ in the US. Youngsters who don’t feel the empathy for seniors and do not take precautions like wearing mask- citing flimsy reasons like inability to exercise outdoors wearing a mask. The complex comprehension of risk vis a vis individual rights is missing here.

IMPAIRED JUDGMENT

 I would say the key element of dysfunctional behavior is an impaired judgment. Many folks with absolutely zero symptoms of mental illness can have a poor judgment. I see impaired judgment more in the community than in my clinic. Especially folks who are highly qualified or have a good financial or social status are prone to believe that they have nothing to fear from anything that is essentially killing the poor and those who are in contact with them. They are happy with banning domestic workers from their premises and then they don’t believe in following any precautions. . It is harder to modify their behaviors because they are up to date with google research and alternative medical philosophies- plus have a tendency to take offence easily. The problem is- that the virus is highly opportunistic and any small slip-up can lead to infections.

MENTAL ILLNESS

The pandemic also increased the stress levels in all. People who had some vulnerability in the form of prior mental illness or a genetic pre disposition- they did develop the symptoms of mental illness. This would not have happened without the pandemic situation- not definitely in such large numbers in such a short period of time. So this is another the dimension of the behavioral impact. But unless the person is in a manic episode- where the person leaves caution to the wind- most people with mental illness will be socially withdrawn and the infection part of the pandemic reduced. Manic episodes are extremely rare. So mentally ill people did not contribute to the pandemic at all.

CONCLUSION

In countries where people were able to practice sustained behavioral change, they were able to control the pandemic earlier and more robustly. But where the people’s judgment was impaired due to various reasons- they didn’t practice healthful behaviors and the virus has moved in for the kill. Just as the infection is spread by the asymptomatic and the pre- symptomatic virus carriers- it is amply aided by those mentally impaired people who don’t have features of mental illness- but whose judgement is clearly impaired. Thus covid is an infectious disease but covid pandemic is a mental health issue.

DUTY...that never was....

I spoke to a friend DR TS a Psychiatrist. Sometime last month, he received an email asking him to join for COVID Duty. He got ready with the idea of contributing to the fight. But he got stumped when he discovered he had been assigned ICU management.

Now Psychiatrists are medical doctors, but after internship we did not get any much practice in medical interventions. We can do a good general and neurological examination and give intramuscular and intravenous injection if the occasion so demands- but beyond that we rely on our better equipped colleagues. In today’s world ICU management is beyond just TPRBP (Temp, pulse, respiration and blood pressure monitoring) which was the key thing when we did our training in general medicine. Of course, we have the general idea and having practiced rigorously in internship- a few weeks of good training may improve us. But I humbly admit that we cannot handle ICU for COVID patients.

So DR TS wrote back to the administration explaining the situation. He offered to work in screening out patient departments and in quarantine centres- where Psychiatrists can really do a good job. That was a month ago and no body’s replied to his email yet.

I felt DR TS was somewhat disappointed that he came so close to doing COVID duty and still missed the chance.  Its true, when so many people are calling helplines and all they need is reassurance- Psychiatrists can definitely play a role. A number of suicides have been reported in COVID wards- the mental health problems must be a lot. 

I think, the administration is so overwhelmed and also ignorant about medical issues- these things are getting missed. Meanwhile DR TS is recounting his experience of the duty that never was….

CAME AWAY INSPIRED.........

It occurred to me this morning that an Anaesthetist colleague of mine, DR SV, must have some idea of the COVID duty. Turned out that she had just returned from doing her posting of the COVID duty and talking to her today was a revelation.

Her initial reaction upon being served the posting was of being confused and she called her classmates for more information. Someone told her that Physicians and Anaesthetists were to be called first and therefore she had got her posting now. When she went there, the treatment centre had not even started functioning. The first 2 days were just spent assessing the facilities and requisitioning equipment. So far being done by non- medical people, she had to step in to advise them and they cooperated whole- heartedly. They began receiving patients on day 3. Patients who had improved and needed further care were being referred here and the facility filled up quickly. They were a group of herself and 3 Physicians functioning as team leaders of the 1000 bedded facility. Other team members were fresh medical graduates, fresh nursing graduates and newly recruited helpers. So the team leaders also worked on assigning duties, training the staff and setting up of systems to implement treatment protocols.

Clinical management consisted of a hub and spoke model with tech assistance. Patients being distributed in about 28 wards- the ground staff would be assigned to their care dressed in complete PPE. Team leaders were required to take clinical rounds in PPE and monitor continuously through remote feed given by cctv in each ward and continuous input through phones- at that time they did not need to be in PPE. Any indication of patient worsening or clinical doubt, they had to don the PPE and step in again. Dr SV mentioned that it was continuous work and significantly stressful due to the continuous monitoring and talking to give inputs. Considering that each dr was seeing 250 patients, this is really a feat of medicine!

The physical experience of wearing the PPE was very unpleasant- she being posted during the worst weather weeks of end May- starting June. Since then the weather has improved considerably. Everyone was cooperative and calm and went about their work diligently. The arrangements for healthcare workers were good. There was no shortage of PPE and the they were of high quality. Arrangements for stay, food and transport were comfortable. She did not choose to stay over. But others who did were not reporting any problems  with the accommodation provided, she said. And the administration has taken all documents to process her remuneration, so it will be coming.

As I spoke to Dr SV, I realized that she went in there with a good attitude. Considering that she arrived when nothing was in place yet, she didn’t think of complaining. She just saw what was needed to be done- and did it. She and her team organized the place and had it up and running. Her whole description of the experience was very matter-of-fact and completely devoid of any complaints. In fact, she expressed great satisfaction that she could contribute. Her concerns mainly those of a working mother- how can I be looking into the kids online school, will he be ok, etc? In closing she mentioned that she had not looked into the matter of the salary as yet- she considered that this was her duty and she may not even pursue it much.

Since 4^th May, when the COVID DUTY notification appeared, I have been getting lot of negative feedback about how things were going. Some of the descriptions were downright scary and I was thinking if its even safe for Doctors anymore. I called Dr SV with these fears in my mind and came back inspired.

ANGEL- only of that moment

Last Sunday, a friend called me. His father’s oxygen levels were falling steadily and there were no beds available anywhere to hospitalize him….could I do anything to help? A lucky chain of events followed and we were able to hospitalize him and now the patient has recovered and is back home.  My friend appreciated me by calling me ‘an angel’. He is my good friend and I know his regard for me doesn’t depend on anything I can do or not for him. But whenever I get effusive thanks for a life saved, I remind myself – ‘its only for that moment, the next moment I could be condemned as the Devil incarnate’. Such is the experience of a doctor.

Nothing special really….

Most of the times when folks come to me for a problem, I know exactly what is to be done. Because I spent all my life learning about it and practicing the same. For the common man, it is a rare experience. The fact that I can give an accurate prognosis and guide them seems amazing to them. As a Psychiatrist, I have the advantage of having some communication skills which makes things that much smoother. Even when there is uncertainty, I am able to prepare the person for it.  When things go as I had suggested they will…..they think its miraculous and I have some special powers. Its nothing special really. Completely within the abilities of any doctor.

Angel for the day

For most doctors, things work out, especially if the patients are sensible. (which is the case for every doctor- otherwise why would they be in business still?) . On the such occasions, I have taught myself to be humble and say to myself ‘its not me who is the angel; its just the chain of events that made me look like one’. Therefore, yes I feel very happy and gratified for the compliment. But I know tomorrow is different and I am not an Angel.

Devil incarnate

I am not perfect and sometimes things go wrong in unexpected ways. Many years ago I prescribed medication to an 18 year old in a Manic episode. It appears that the doses were inadequate due to which he was up the whole night making his father prepare endless portions of instant noodles. Next day the exhausted father called up his family physician who told him that the medication was extremely dangerous and could have killed him. Bass- the next call was to me and cursing me to all kinds misfortunes- I was the Devil incarnate to him. More recently, after the lockdown my patients and their relatives suddenly began to call me up at all odd times of the day and night to discuss covid. I could understand their stress and anxiety- but being only human I could not answer all of them. Plus some of them needed more than few words of comfort- and this being the professional service I provide, I asked them to pay me. I was faced with their disappointment, disgust and people designated me as the Devil (who is after money)

Learning…

People cant understand what we doctors are upto. They find it unfair that we can earn through spending 20 mins of examining them- a process that seems so simple and not at all heroic. For Psychiatrists its worse- pay for talking? Well, that’s the issue. If it was only about spending time with the patient or merely talking to them why would you come to us? So many folks to spend time with and talk to- free and willing. The difference is- that we worked extremely hard all our lives to understand what is happening to you and are trained to make it look smooth and effortless- if every consultation is like Munnabhai scene where we get histrionic and appear to do heroics- imagine what would happen to your blood pressure? So even if it appears cool and effortless there is a massive amount of hard work that’s gone to make it that way and it saves your life. Its not miraculous but its definitely worth the money.

So we doctors- well we are a shameless lot. But we cultivate that quality under the euphemism of ‘Equanimity’. Call us Angels, call us Devils- after few moments of feeling something about it (though not showing it on the face at all) we just let it go and move on to the next thing on our schedule. Drs cant afford to take these things seriously, not for themselves and not for those few wise patients who value them.

COVID- Times. SCHOOL FOR THE CHILD

A large part of the child’s day is spent in school and in completing learning tasks assigned at school. School is the place where the child finds stimulation, companionship, security, self esteem and a sense of identity. School is a habit that must be cultivated and sustained. Consistent school attendance throughout childhood not only equips the child with skills and knowledge to pursue a means of livelihood- but it also promotes the child’s development which is critical for survival in the real world. It is therefore to be expected that children will be worried about what is going to happen to school in the context of the covid epidemic.

In the initial days all schools were kept closed and it was easy to explain to children of all ages about the whys and hows of the situation. By now, children are missing their school and their friends. In some places where schools have been re-opened both parents and children are frightened of going to school. They are afraid for themselves and afraid of bringing home an infection that can harm their valued family members like grandparents who live with them. In a way, children are happier to stay at home because their schedule is less demanding now and being around parents is (mostly) comforting. Children want to know if its really necessary to go to school now? Cant they postpone it by a bit and go when they feel safer?

For some children school provides a refuge from difficulties at home. These difficulties may be in the form of poverty, hunger, poor quality of physical surroundings, lack of facilities like toilets and lack of space. Immediate challenges from family such as abuse, living with a person with difficulties (like illness/ disability/ etc) and burden of housework and caretaking. These children look forward to school for more than just learning.

Schools also provide a strong sense of self esteem and identity. The different rituals followed by a school- like appointing students to committees, making them captain of school groups etc promote ambition and striving among students and provide role models. Celebrations of national festivals, competitions in different categories are things that children enjoy and add to their confidence. Children benefit both by participation and spectatorship.

A school means all these and much more to the child….and in lockdown they are missing it mostly and relieved from it somewhat. People who want to plan about school should really do a survey about what children are missing because their schools are closed. This ‘customer experience’ should be considered before making the plan of schooling during covid so that children feel attracted to the experience.  

SURVIVING COVID- A recovered Dr's account

I heard,read,talked about the covid pandemic, till it hit home. Till I exeprienced it myself it was something that would happen to someone else, not me. Denial helps us to keep anxiety at bay but denial also keeps reality at bay.

First when my 78 years old  father was diagnosed as covid positive, l already developed my first  bout of fever spike. Getting a bed for my father was a task in itself , with me lying in the back seat of the car shivering with chills, helpless, not knowing whether my father would be shifted from a non-covid to a covid hospital or what awaits me in the next 20 days.

With admission of my father in a  a covid hospital, and simultaneously my symptomatic condition progressing, slowly time started seeming unreal. Father's condition was deteriorating and mine too. My husband, Sujit transformed our bedroom to ICU. Talking to physician friends, whose immense help and guidance helped him to sustain me at home for almost 9 days. Then on the 10th day, my condition deteriorated. I was in such a fogged state of mind with my father's condition going downhill and my own general medical condition seeming to go downhill. Finally sujit decided to get me admitted. He and his close friend drove me around in the car calling doctors, friends anf acquantainces in search of a bed for at least 6 hours . I was sitting like a dead body in the car listening to the concersations these two were making  trying desperately for a bed  Finally a friend (Dr Vikrant Shah) managed to secure a bed in Surana hospital in chembur. I remember myself sitting at at around 2 am or so, on a chair at the hospital gate, totally unaware what part of Mumbai it would be. Iin the darkness and  silence of the night I wondered if I would just probably sit there forever.  Sujit did the formalities of getting me admitted. As no relative was allowed inside the hospital premises, finally a wardboy escorted me inside the hospital, leaving behind my dear ones, as if I am entering some unknown strange place totally secluded from the rest of the world. I turned back to Sujit  and our friend again and again and bade them goodbye with weak gestures till they disappeared from my sight.

The moment I entered the hospital building at around 3 am, a ppe donned exhausted doctor standing at thhe elevator enquired about me. He took my history in short, and that was the first time I realised i could not speak a word without getting breathless. I had not spoken for so many days due to fever, bodycahe, dullness that I didn't realise that I was breathless. The doctor patted my shoulder and said not to worry, told the wardboy to take me to my room, told me he would meet me in the morning.

It was around 3:30 am. 27th may 2020

I was kept in a single room. The staff came, put iv, checked all my parameters, took blood for testing. The rmo Dr. Vikas came and attended to me. It all seemed unreal. I was put on oxygen. That morning I tried to sleep but couldn't,  but felt safe that I was in a hospital.

From next day onwards, as things started sinking in, as I got more aware of my breathlessness,I started assimilating things around me, inside me,  my being alone in a hospital , with no one by my side, with no one to hold my hand, no one to put hand on my forehead, an altogether different reality started developing. And the last straw on camel's back was the news that my dad passed away.

I felt the gravity of one singular reality, being alone, unable to breath, face to face with death,my dad's, my own. As evening light seeped through the huge window of my hospital room, I started experiencing darkness more intently than ever. Light was sustaining me to face my fears in the daytime but as night approached, the fear of death and darkness would a start a dance in my mind ,an eternal dance of life and death.

My ears would crave for the slightest human existence around me. The staff going about  doing their tasks outside, someone talking down the road, someone's steps approaching my room. I realised how important human company is, especially in a situation where uncertainty rules  and one is on the verge of life and death and all alone. That night I sudeenly woke up startled, at around 1 am and panicked. The oxygen mask , my saviour seemed like someone holding my mouth, not allowing me to breathe. A panic attack...I called the nurse and the staff of the hospital stood beside me holding my hand and I shall never forget that comforting touch ever in my life. The staff was in ppe, I didn't know the person, I knew only one thing, I have someone to hold my hand when my morale, mental strength, physical strength had hit rock bottom. All barriers of self and other disappeared. A feeling of calm dawned upon me.

My treating doctor Dr Sameer had been so encouraging throughout my journey that I cannot thank him enough. He himself used to be exhausted when he would come at around11 pm for his rounds. But relentlessly, without a  frown of irritation or annoyance he would encourage me to do the prone awake position to improve the perfusion of lower parts of lungs, guide me through the progress I am making and then talk to Sujit on phone to give him the updates of my progress. What  a blessing he had been through out this journey I made! I ssurrendered myself to my doctor. I trusted that whatever he would do would be the best for me and i don't have to worry about any medical apsects of mine. In fact, I deleted the fact from my mind that I am a doctor. I was just a sick living being wishing to live.  I experienced first hand how doctors are the frontline warriors in this pandemic along with  their team of nursing staff. How their lives need to be protected with right protective gears and why it is so necessary for the concerned authorities  to provide them with the utmost care and protection.The nobility of the profession struck me really hard and respect  for my fraternity grew multifold.

As I was suspended in the interim of life and death, the most striking realisation was that of kindness. How much love and kindness the world is filled with! People came forward to provide us with any support we needed, friends went out of the way to provide us with help in a very difficult lockdown situation, the hospital staff, right from the wardboys, mavshis, nursing staff, the canteen, the doctors took the responsibly of not only their respective tasks but went ahead beyond the call of their duty  to keep the morale of patient up so that they don't lose  hope.

How each every and every fibre of the fabric needs every other fibre to hold the fabric of humanity!

Gradually as blended with the surroundings, I started rooting myself in my one and half year long insight meditation practice. The mindfullnes practice teaches to witness everything eight in this moment, as it is, without judging. I started centering myself in the present moment, just witnessing what is happening niw. If i an breathless now, i am breathless. If ihace pain, i hace pain. If I am scared, I am scared. Nothing less, nothing more. Buddha's words used to ring in my heart 'In what is seen, there is just the seen. In what is heard, there is just the heard. In what is sensed, there is just the sensed. In what is thought, there is just the thought'. I held dearly to this 2500 years old wisdom. It's  nit that I was not scared, at times, fear did step in, but I was no longer scared of fear. Mind used to wander, chatter, think about untoward consequences but I used just witness those  and not draw any conslusions from that. I was being in the rawness of the present moment, not bothered about what arises in it. What arises, passes away.

It was a nightmare but it taught me more than a pleasant dream. It taught me about the kindness each one of us carries inside us, all the tilme, about  compassion, an innate human trait, an absolute contrary picture that we are made to believe in today's  times that world has lost love and kindness. 

Humans shall survive this pandemic greatly because of it's ability to reach out and help others with kindness and compassion, and that's  an absolute need of the hour.

It's  my humble appeal to each and every person to be responsible about one's own life as well as life of others, to stay safe themselves and help those who are in need.

It's in the worst of times that the best in humanity shines through the darkness and brightens up the world.

This pandemic may be the worst the world has seen in a century but I am also hopeful that this pandemic will see the best in the human species, the common singular foundation of which rests in kindness and compassion. And I am sure there would be many individuals like me all over the world who would have witnessed kindness in their own life right through all the uncertainty of sickenss, dying and death and would carry the light of kindness ahead to brighten up other's lives.

I write this as I await my discharge from the hospital in a day's time. I have been off oxygen mask since more than  a day now, without any discomfort or breathlessness. Sice three days cyclone Nisarga had changed the weather and from my window, I watched gushing winds, a downpour, grey skies. Today I look out the window, my only bridge to nature outside, and see bright warm sunlight hugging the trees, water-drenched leaves reflecting golden light, butterflies fluttering around merrily and a magpie robin singing. The cyclical nature of rain and sun, pain and pleasure reminded me of one thing, the joy of life.

Post-discharge

After coming back home and settling in the small comforts of home, I realised that I am not all well yet. I am able to do my daily tasks but breathing is still a bit laboured. I am continuing spirometry exercises. I have started my daily meditation  practice. I have started doing breathing exercises like pursed breathing exercise and abdominal breathing exercise. I am eating well, resting  well, sleeping well and taking the medicines prescribed by doctors. I am allowing my body to heal, keeping my mind calm. Now things  will take it's own course slowly. Our body has it's  own innate intelligence, what Alan Watts calls "innate intelligence of an organism". If we don't  meddle with it too much, and if we listen to our body and mind quietly and calmly, this 'intelligence' helps us at every step. 

Schooling in COVID- Summary of concerns

SCHOOLING DURING COVID PANDEMIC- CHALLENGES AND POSSIBLE MEASURES OF MITIGATION

A WRITE UP FOR THE STUDENTS OF THE STATE OF MAHARASHTRA STUDYING IN SCHOOLS OF THE STATE BOARD

                              

INTRODUCTION

Schools in Maharashtra have been closed since the second week of March 2020 due to the COVID Epidemic. This period was the least challenging as decision regarding impending exam was taken immediately and then schools took a break for vacations.

Several documents about maintaining safety from the CORONAVIRUS have been issued by various authorities. They can guide the measures for safety from virus. This write- up is exclusively about the issues related to child mental health- namely learning, development and prevention of mental illness.

STAKEHOLDERS AND POSSIBLE CONCERNS

1.      CHILDREN- Learning, Socialisation, co-curricular activities

2.      PARENTS- Safety, academic challenges, motivation for schooling, child minding

3.      TEACHERS- changed modes and teaching methods, job security, financial security, safety

4.      SCHOOL ADMINISTRATION- Safety of all, logistics of organizing, maintaining financial stability, ensuring compliance with regulations

5.      AUTHORITIES- ability to foresee and plan, be fair to all stakeholders, timely action

6.      MENTAL HEALTH PROFESSIONALS- prevention of mental health disorders, prevention of detrimental psychological reactions in all stakeholders but particularly in children, ensure adequate learning outcomes in children, maintain developmental trajectories in children, promote resilience and learning of coping skills

CHALLENGES

1.      Extreme heterogeneity of school settings- rural, semi urban and urban. And accompanying culture and priorities

2.      Wide disparities in facilities in schools- space, time, teaching aids

3.      Lack of examples that can be followed or at least used as a benchmark

4.      Children are low priority group and education is low priority sector and in context of pandemic and economic chaos- their importance has further gone down

APPROACH

1.      Children’s well- being must be the first priority

2.      All stakeholders should get a fair consideration. However, in case of conflict of interest, the child’s well being must be given precedence

3.      Guidelines should be timely and time bound. They need to be revised periodically to ensure gradual return to normal

4.      Feasibility should be considered

5.      All schooling methods should be considered

6.      Based on literature available about children’s health, development, learning and related areas

MITIGATION STRATEGIES

1.      Adjustment of syllabi

2.      Adjustment of pace of teaching

3.      Multiple modes of teaching- live online, recorded video, etc. should be flexible and contextual

4.      Consider greater contribution of parents and siblings including home schooling

5.      Modify role of schools as mentors and guides rather than only directly imparting education

6.      Include indicators of irregular school-work and learning problems

7.      Provide for assessments and remediation of learning problems

8.      Consider reasonable concessions for all stake holders