Dr. Rijusmita Sarma
(The writer is a counseling Psychologist. She can be reached at firstname.lastname@example.org or 7578014066-m)
At a time when the entire world is fighting with the pandemic of COVID 19, another pandemic is surging in the form of stigma. In Andhra Pradesh, a trader and his wife were reported to have died by suicide, unable to bear the stigmatization which followed their diagnosis with COVID 19. As per a report in The Hindu, they were able to overcome the financial crunch by selling away a small shop and had started a new kirana shop. They were also able to win over the virus but the stigma posed as the insurmountable hurdle.
As theorized by Canadian sociologist Erving Goffman, "Social stigma is an attribute or behaviour that socially discredits an individual by virtue of them being classified as the 'undesirable other' by the society". The association of illness and social stigma is age-old. Pandemics of infectious disease outbreak and stigma and prejudice have an ancient relationship. For example, the Asiatic flu and cholera, Ebola outbreak in Africa all have witnessed ostracism and discrimination. The current pandemic is no exception. It has created huge stigma and discrimination against people who are perceived to have any contact with the disease, irrespective of them being healthcare workers, essential workers or people who have been diagnosed with COVID-19, along with their family members. Besides having the impact on the psychological well being of people and creating stress, fear, anxiety, depression and suicide, stigma can also have an impact on the social structure, enforcing segregation and denting cohesiveness. It can also negatively impact the management and implementation of strategies to control the spread of the virus as people are more than unwilling, afraid to undergo tests which can lead them to face stigma. This can prove to be a barrier in providing help and poses a serious threat to the society. Hence the effect of social stigma is multidimensional and pervasive.
In March 18th 2020, the World Health Organization (WHO), revealed that 'Some healthcare workers may unfortunately experience avoidance by their family or community owing to stigma or fear. This can make an already challenging situation far more difficult' Unfortunately, soon after, such incidents no more remained a rare experience. There are countless instances of healthcare workers being forced to evict rented premises, publicly harassed, labeled and even physically abused. Along with the psychological impact of such incidences, they can also potentially harm the caregiver and beneficiary relationship. People who had been diagnosed with COVID-19 and their families' share of struggle with stigma are no less. Even after being cured they are not allowed to enter their localities and rented houses leaving them in despair. They are called names, deprived of essentials, not accepted back at workplaces and also there are cases of people being deserted by family after having the illness. Certain reported instances also reveal that even dead bodies of people who had died of COVID-19 were not accepted by family and had to be cremated by the Government. Cases also unveiled with time, where people did not allow family members to perform the last rites of the deceased. As if this was not enough to exacerbate the situation, a case was reported to MONON (a Government of Assam initiative under National Health Mission), where a person suffered from severe stress, anxiety and fear, followed by being intimidated with death threats after going back to his locality from the hospital. In an attempt to reach out to people through MONON, counselors have encountered numerous instances of people sharing wrong phone numbers with authority, hiding information about travel history, and also refraining from seeking medical help even after having symptoms. This can lead to a damaging shortcoming in the management of the crisis. Such enormous is the stigma against COVID-19.
Still a lot about the virus is not known although research is going on at a breakneck pace. And the stigma is possibly because of the fear of the unknown and the lack of awareness about the illness. Quoting Asis Manna, a Microbiologist, "Social stigma in COVID 19 pandemic is attributable to unscientific belief and improper understanding of common masses". The lack of cognizance about the illness creates a lot of myths and misconceptions, fuelling the fear and stigma.
Since experts have shared that fear and lack of knowledge about the illness is mostly triggering the stigma, creating awareness about the illness is of paramount importance. In creating awareness collaborative effort at different levels can prove to be very effective. Discussions about the virus by experienced healthcare professionals can be useful. Awareness can also be created through creative ways like art, dance, music, poetry, stories etc. Prominent figures of the society can also make impactful contributions to it. We need to be sensitive in using words related to people suffering from COVID-19 so that they do not reinforce the stigma. Labeling should absolutely be avoided. People who have faced stigma can be made heard about their experiences related to COVID-19 and stigma. They can also share ideas about stigma mitigating strategies. And also about how they coped with it. Stories of recovery should also be shared as that can be pivotal in creating hope among people. In the midst of such debilitating stigma, there are also instances where health care workers, people diagnosed with COVID-19 and their families are welcomed, appreciated and supported by people. I had the privilege of hearing one such experience from a person, I had talked to through MONON. When asked about social stigma he said that his neighbours were nowhere close to discriminating him and his family. In fact, they were empathetic, accepting, concerned and supportive towards them. Such incidents can stimulate and propel pro-social behavior. Promoting such inspiring stories can be helpful in our combat against stigma. Another important aspect about dealing with the stigma is the responsibility of the people who have recovered from COVID-19. Along with the above mentioned strategies, it is equally important that people who have contacted the virus, religiously follow the rules of quarantine explained at the time of discharge and contribute towards protecting the society. Quoting Mahatma Gandhi, "Begin with the charter of Duties of Man and I promise the rights will follow as spring follows winter. I write from experience. As a young man I began life by seeking to assert my rights and soon I discovered I had none – not even over my wife. So I began by discovering and performing my duty by my wife, my children, my friends, companions and society and I find today that I have greater rights perhaps than any living man I know. If this is too tall a claim, then I say I do not know anyone who possesses greater rights than I." So let's focus on our duties and responsibilities towards ourselves, our families and the society and hopefully the rights will follow. Although the situation is grim, we can do a lot as a community. We can be hopeful that through our collective efforts we will be able to battle both COVID-19 and stigma and emerge as a victorious human race.