Volume 5, No. 1, January 2023
Editor: Rashed Rahman
In the time of the coronavirus pandemic, we are all obsessed by the statistics of the number infected, cured or dead and advice to stay home, wash hands, use a hand sanitiser, wear a face mask when going out and keep social distance.
Surprisingly, people have not taken the warnings seriously and when they go out, the scene in the bazaars is the same as usual. Why is this so? Behavioural changes do not come by providing knowledge of the severity of the threat, even if the warnings are issued repeatedly. “Smoking causes cancer” printed on every pack of cigarettes made some impact over the decades. However, the tobacco industry is still thriving (thanks to the younger generations). Habitual smokers only give up smoking after life threatening coronary heart disease.
What is the reason? Psychology can briefly be described as the study of human behaviour. To expect changes in behaviour (which is equivalent to an almost radical change in lifestyle) by repeated warnings is not working. There is a missing link. It goes like this: Knowledge, Affect and Practice (KAP), meaning unless the knowledge or information moves people’s emotions (affect), change in behaviour is unlikely. There is another chain of events which determines the outcome of a threat: information – cognitive appraisal, meaning the seriousness of the threat may lead to the Fight (anger), Flight (fear) or Denial (indifference) response. The Pakistan Tehreek-i-Insaaf’s (PTI’s) slogan is “Darna Nahi – Larna Hai”. The message received is: “Do not worry – we are fighting”.
Undoubtedly the world is going through a crisis never before seen. It has not able to block the virus yet although the great powers have the capacity to block a missile in the air and destroy the world many times over. Yet the world does not have enough ventilators. The lessons to be learnt are quite clear: our health and education sectors are miserably inadequate. It is time to reflect and compare the budget allocations for health, defence and debt servicing. The real truth that needs to be learnt by the developing countries, people below the poverty line and those who cannot afford health insurance in the US is: investment in human beings.
The health and education allocations should not be at the expense of the development budget but from the massive defence, security and nuclear race funds. Freeze these wasteful expenditures. We have a great case provided by the coronavirus pandemic to highlight the current shameful provision of 0.7 percent for health and 2.0 percent of GDP for education respectively. Let us advocate collectively, effectively and forcefully to demand at least 10 percent of GDP for each sector.
Hopefully, after the coronavirus disappears, we should be prepared to face as yet unappreciated psychological morbidity never seen or imagined before. We should start planning to deal with these expected forthcoming widespread mental disabilities due to the lockdown.
The writer is an eminent psychiatrist and President, Pakistan Association for Mental Health