Mental distress and quality of life among the adult

Rag pickers play an important role in our society. Rag-pickers are term for someone who makes an existing by rummaging through refuse in the streets to collect material for salvage. The ragpickers in previously time did not recycle the resources for themselves; they would simply accumulate whatever they could find and turn it over to a “ master rag-picker”.(M. C. da Silva, Fassa, Siqueira, & Kriebel, 2005). Over fifteen lakh people across India work as scrap, ragpickers and waste collectors, earning their livelihood from the collection and sale of paper, plastic, metal and glass scrap to recycling industries.(Agarwalla, Pathak, Singh, Islam, & Parashar, 2017)

Most of Ragpickers never attend school and don’t have any proper education. Their families are generally in need of extra incomes from their children. Mainly children of slum dwellers and poor people are becoming as ragpickers. (Bruskas, 2008). There are two categories of rag pickers:

The street pickers- They collect garbage in housing areas and street bins.

Dump pickers- They work on dumping lands.

Both the categories of rag pickers have diverse lifestyle. They live in urban slums in poor, unhygienic conditions, and the nature of their occupation exposes them to potentially pathogenic bio-aerosols that may lead to the spread of various diseases. They also easily pick up addictive habits like chewing tobacco and betel nuts, smoking, use of narcotics and alcohol. It is unfair to mention that the rag-pickers do not use protective masks or gloves for waste-picking. Instead they use their bare hands. They wear cheap rubber sandals (usually collected from trash bins) during their work. The work process of ragpickers will be brief in three phases: collection, separation, and sale of materials.(Chandramohan, Ravichandran, & Sivasankar, 2010).

The waste and by-products of production and consumption are considered territorial phenomena and can be defined as an excess supply of waste materials resulting from a mismatch between the costs and benefits of material use in general, and generating and managing waste material in particular. It includes the diverse mass of waste from the community as well as more similar accumulations comprising of countless different materials such as construction wastes, food wastes, industrial process wastes and pathological wastes etc(Joseph, 2004; Turk, 1984). Ragpickers, waste pickers, or scavengers as they are commonly called, constitute that segment of the people involved in the waste trade who make a living by collecting and selling recyclable materials out of solid waste. Though they play a pivotal role in the larger waste management systems they remain most vulnerable in the society. Any effort to categorize them meets with limited attainment as they represent varied demographic and social characteristic. Often the children assist their parents during waste picking. A study conducted by National Labour Institute (NLI) in 1997-1988 found Rag-picking to be the fourth largest occupation. (Sandhya, 1994).

Quality of life:

Poverty, urbanization, rapid economic growth, the breakdown of families, and domestic violence are considered to be some of the most immediate causes of the problem. The living conditions and quality of life of such population appear to be miserable as they usually bear endless hunger and suffers from malnourishment, which make them vulnerable to health related problems.(Antoniades & Tarasuk, 1998). For the sake of their survival, adolescents working on street and perform variety of jobs including the aluminium, paper, collection of plastic, and anything else that can be resold. Sometime even ragpickers are also found to be engaged in begging.(Hussian & Sharma, 2016). Their poor quality of life expose them too many health related risk and derive them to be involved in illegal activities like drug trafficking, organ trades, prostitution and slavery especially in metropolitan cities. Such type of situations makes their life complex which in turn develops many psychological problems such as anxiety, psychological trauma, alienation, and feeling of hopelessness as a result they become psychologically vulnerable as well.(Aptekar, 1994).

The World Health Organization defines Quality of Life as ‘ The individual’s perception of his or her position in life, within the cultural context and value system he/she lives in, and in relation to his or her goals, expectations parameters and social relations. Every culture has different factors affecting quality of life and measures psychological, physical, social as well as economic well-being of the individuals. (Group, 1998). The general concept of quality of life was basically overlapping with the traditional concepts of health and functional status. An ideal health assessment, which would include a measure of the person’s physical health, a measure of physical, social and psychological functioning, and a measure of quality of life. Poverty is one of the most serious social concerns across the world today. Among the poor, the most vulnerable section of the society is people living on the streets.(DiBiase & Waddell, 1995).

Whether they are gangs of street youth or panhandling drifters, no society is unaffected by the social problem of homelessness. The existing literature on street children or adolescents strongly suggests that there are many problems associated with life without a home. Studies have shown that homelessness is also associated with behaviour problem in children(Edelman & Mihaly, 1989), higher exposure to trauma, increased anger and depression. (Marshall, Burnam, Koegel, Sullivan, & Benjamin, 1996).

Quality of life it’s difficult to cope with daily events and develop mechanism. They need to be self- resilient or build capacity to cope with daily stressors and adversity. Due to lack of proper bathing facilities and opportunities many non-beneficiary street people had to stay without bathing for 2-3 days together. (Hai, 2014). Rag picking occupation is not a begging and they works hard to earn livelihood. It supports them economically and provides sufficient amount of free time. They feels proud to be a rag-picker and considers themselves master of their own life. Their communication and process of socialization were very limited and as they socialized among themselves as they share food, shelter, money, problems and love with their age group children to cope with the daily life events. The Former President of India Dr. A. P. J Abdul Kalam in 2008 reported in the Hindu Daily that “ Child Rag-pickers are not Street Children” while addressing a programme PVR street to school: Child Rag-pickers are the children of hope, they are children of hope. We do not brand them as street children we have to give them confidence (India, 19 Sep, 2008)

Mental disstress:

Mental distress (or psychological distress) is used, both by some mental health practitioners and users of mental health services, to describe a range of signs and experiences of a person’s interior life that are commonly held to be troubling, confusing or out of the ordinary. Mental disorders, are patterns of behavioural or psychological indicators that impact multiple areas of life. It is a mental or behavioural pattern that causes either suffering or a poor ability to function in ordinary life.(Richardson & Waite, 2002)

The most prevalent risk factor is the presence of mental disorders, in particular, mood and anxiety disorders. (Foley, Goldston, Costello, & Angold, 2006). The onset of Major Depressive Disorder (MDD) is often during early adolescence and is associated with considerable functioning and psychosocial impairments in addition to high indices of suicide.(Rao & Chen, 2009; Shaffer & Pfeffer, 2001). Vulnerable people are those who have various risk factors that have been associated with mental health problems, such as low levels of education, large families, absence of one parent, frequent negative life events, family history of mental illness, and/or exposure to violence. The socio-emotional health of Ragpickers is worse when the physical condition of their residence and immediate neighbourhood is poor. Other factors, including low educational level of the parents, unemployment, or the presence of depression in the family may also affect the mental health of children, primarily through internalizing psychopathologies such as depression, anxiety, withdrawal, and somatic complaints.(Beautrais, Joyce, & Mulder, 1996). Poor socioeconomic conditions as well as adverse circumstances during childhood are important risk factors for suicide.(Beautrais, Joyce, & Mulder, 1998) In this more of the people have skin problem. Skin picking occurs more frequently in females than males although this may reflect differences in treatment seeking. The use of fingers that can occur on nearly all body surfaces.(Grant et al., 2012).

Picking may wax (intensify) and wane (diminish) throughout an individual’s lifetime, and for some women (approximately 44%), changes in picking appear to coincide with the menstrual cycle. Evidence also suggests that individuals who pick their skin may experience mild to moderate levels of depression and/or anxiety.(Hunt, 1996; Wilhelm et al., 1999).

Waste may be contaminated with faecal material. This may include biological pathogens such as parasites and bacteria related to the gastro-intestinal tract. This can be passed from hands to the mouth. Industrial waste may include toxic materials such as heavy metals and their associated health effects. Sharp objects can cause cuts which, in turn, may lead to tetanus or other infections.(Ismail et al., 2013). Waste delivers an ideal habitat for disease vectors comprising flies, other insects and rats. Ragpickers are in direct competition with dogs for the waste materials; this sometimes leads to dog bites and the associated threat of rabies. Harassment is something most rag pickers report among the negative aspects of their work. Sexual harassment of females by males, hounding by police, local residents and sometimes competition from other waste pickers over waste materials.(Hunt, 1996) The waste which Rag pickers collect can also contaminate the air, water and soil of the situation in which they live. These workers often live in informal settlements which are not serviced by local municipalities. The ragpickers starting this work at an early age, have a greater potential number of years in the occupation which may put them at an increased level of risk of low level chronic exposure.(Organization, 1987)

In developing countries such as Brazil and India, there are many people living in poor socioeconomic conditions.(Marcelo Cozzensa Da Silva, Fassa, & Kriebel, 2006). While the ragpickers play a fundamental role in maintaining a healthy environment, studies addressing the mental health of these workers and their children who often accompany their parents to work are sparse.(Silva et al., 2006) To the best of our knowledge, there has been no studies have compared the quality of life and mental distress in the ragpickers population and this study address how the adult ragpickers life’s are affected by both.