One Voice for Neurology
One Voice for Neurology
Episode 15: Living with Neurological Disorders Amid Displacement
In this episode, host Sam Pauly explores the healthcare challenges faced by displaced people, particularly those with neurological disorders. Sebastian Einseidel from the UN OCHA discusses global displacement in regions like Sudan, Syria, and Ukraine. Yulia Ostapenko shares her experience being displaced from Ukraine, highlighting the human side of these crises. Dr. Bindu Menon offers insights from India on the impact of environmental disasters on neurological care. The episode emphasizes the urgent need for long-term solutions, global coordination, and community resilience in addressing the healthcare needs of displaced populations.
Welcome to the One Voice for Neurology podcast, a series of podcasts exploring why it's time to make neurology a priority, how that can be achieved with a global and uniform approach, and what that could mean for the future of neurology and those living with a neurological disorder. I'm Sam Pauly and you're listening to episode 15, living with Neurological Disorders Amid Displacement. Hello, and a very warm welcome to the One Voice for Neurology podcast. It's great to be back. Well, if it seems difficult to pick up a newspaper or listen to the news without hearing about conflict or environmental disasters causing huge numbers of people to leave their normal lives behind them, then you'd be right. Indeed, according to the UN Refugee Agency, unhcr, the number of displaced people has increased every year for 12 years.
Sam Pauly:And if you've listened to any of our other episodes, you may well be familiar with the next figure that, according to the WHO, the World Health Organization, one in three people of all ages will have a neurological disorder in their lifetime, and that this is the highest figure among all non-communicable diseases or NCDs.
Sam Pauly:So we know huge numbers of people who are currently displaced are already living with, or could develop, a neurological disorder. So what is the global situation in terms of displacement, what causes it, what impact is there on healthcare provision, and what's it like to be displaced or be serving a displaced community? In this episode, we'll be trying to answer those questions and more. Later on in the episode we'll be hearing from Dr Bindu Menon, a senior consultant neurologist in India, about her experiences after flooding, and we'll also be hearing from Yulia Ostapenko, who has started a new life in Poland after fleeing Ukraine. But first let's find out more about the global toll and the causes and challenges of responding to displacement, including the healthcare response. Well, I'm delighted to be joined by Sebastian Einseidel, senior Advisor on Internally Displaced Persons at United Nations OCHA. Sebastian, thank you so much for being with us.
Sebastian von Einsiedel:Thanks, Sam, great to be on the show.
Sam Pauly:So we wanted to talk very much from the humanitarian perspective and it's such a pleasure to have you here with us. I wonder if you could first introduce yourself and explain a little bit more about what your role is and the remit of the United Nations Office for the Coordination of Humanitarian Affairs.
Sebastian von Einsiedel:Happily, Sam, ocha is the humanitarian arm of the United Nations Secretariat and we're responsible for bringing together the major humanitarian actors to ensure a coherent response to emergencies, whether they're caused by conflict or natural disasters. So we're not an operational humanitarian agency ourselves, but we coordinate and facilitate the action of operational actors like UNICEF, unhcr, the Refugee Agency or the World Health Organization, but also big NGOs like Save the Children, médecins Sans Frontières or Oxfam. And now that coordination and facilitation role is quite a big effort. That takes place both at headquarters in New York and also in our country offices we have around 30 of them where the bulk of OCHA's roughly 2,000 staff is located, and that's where we lead on the development of humanitarian response strategies, coordinate needs assessments or negotiate access for humanitarian actors.
Sam Pauly:Could you tell us in terms of globally and the causes of displacement of people? Can you paint a picture of what the main causes are that mean that people are becoming displaced and what the situation is globally at the moment?
Sebastian von Einsiedel:Right now we have around 130 million people that are displaced worldwide as a result of conflict, violence or natural disaster. That is one in 63 people around the globe roughly double the number from a decade ago. So we're really dealing with staggering numbers here, and let me break down that big number just a little bit. So roughly a third of these displaced people close to 45 million are refugees and asylum seekers. These are people who crossed an international border in the search for safety from persecution, and roughly two-thirds of the displaced population that's roughly 80 million people they're internally displaced people, or IDPs as we call them. These are people who fled their homes but didn't cross an international border. Instead, they remain displaced within their home countries.
Sebastian von Einsiedel:The majority of people who live in displacement for prolonged periods of time, they had to flee their homes as a result of war and violence. So of the 80 million IDPs I've mentioned, 70 million are displaced as a result of conflict in places like Sudan. As a result of conflict in places like Sudan, the Democratic Republic of Congo, syria, ukraine or Gaza. And the rise in conflicts we've seen around the world over the past 15 or so years is also what explains the massive increase in displaced people, the number of which have more than doubled over that period. One point I'd like to add, because it's an important one, is that conflict displaced people in particular tend to remain displaced for long periods, sometimes for 10 years, for 15 years or even longer, and that's what we call protracted displacement.
Sam Pauly:You've touched on conflict there, Sebastian. Are there any other causes of displacement, maybe more environmental, that we can be considering as well?
Sebastian von Einsiedel:Absolutely Natural. Disasters, especially weather-related ones, tend to displace actually within any given year, a lot more people than conflict, but disaster-related displacement tends to be more short-term. So a flood occurs, people have to move out of harm's way and then within a few months they often come back. So this is why, of the 80 million people living in protracted displacement today, only 8 million people were driven from their home by disaster, but that number is, of course, certain to grow with progressive climate change is, of course, certain to grow with progressive climate change, and the World Bank has estimated that by 2050, up to 216 million people might have to move within their own country as a result of climate change.
Sam Pauly:Wow, which is almost double the figure that you quoted earlier of 130 million globally, which includes both conflict and climate.
Sebastian von Einsiedel:A staggering number, as you say absolutely, which includes both conflict and climate.
Sam Pauly:A staggering number, as you say. Absolutely, what sort of impact do we see on people who are displaced and also the communities that they come from?
Sebastian von Einsiedel:The shock of becoming a displaced person is really comprehensive and deeply traumatic, because when you become a displaced person, you lose pretty much everything that defined your life.
Sebastian von Einsiedel:Often, from one day to another, suddenly, you lost not only your home, you lost your livelihood.
Sebastian von Einsiedel:Your children can't go to their school anymore.
Sebastian von Einsiedel:Along the way, you might have been separated from your spouse or parents.
Sebastian von Einsiedel:In the rush, you might have left behind your identity card, which you need to find work elsewhere or access social services or vote in elections.
Sebastian von Einsiedel:You lost your neighbors, you lost your friends, you lost your community and, on top of that, you lost any sense of safety and security and you're vulnerable to all kinds of further violence and exploitation, and that's, of course, particularly true for women and children. So, what's very important, but often underestimated, you've also experienced huge mental stress and might suffer from PTSD, and just one quick example to illustrate that, not least because this is a medical podcast, the population that got displaced as a result of the Fukushima nuclear disaster following the 2011 earthquake in Japan has long had significantly elevated mortality rate compared to the community which hosts them, and the initial suspicion was, of course, that they might have suffered from radiation exposure, but upon closer investigation, that does not seem to be the case. Instead, it seems to be a result of the health effects of the trauma of displacement. So the key takeaway here is displaced persons tend to have specific, elevated and multidimensional needs. They're particularly vulnerable, and these specific needs and vulnerabilities call for a targeted humanitarian response that takes that into account.
Sam Pauly:What is the impact, if any, on the communities that are receiving displaced people?
Sebastian von Einsiedel:For starters, it's important to point out that roughly nine out of 10 displaced people around the world are displaced to, or live in, low and middle income countries. So this means that displaced persons often find themselves in places and communities where resources tend to be already more constrained, where access to basic services might be more constrained, where livelihood opportunities might be more constrained, where there might be high poverty, where there might be social and political strife that's preexisting. And when, in those places, you have a sudden influx of displaced persons, there's often competition over scarce resources, there is sometimes intercommunal tension and there might be the potential for interethnic conflict. And because of this dynamic, the humanitarian response cannot only be targeted at the displaced persons themselves, but must take the wider host community into account.
Sam Pauly:And what are the key elements of a successful humanitarian response?
Sebastian von Einsiedel:persons- themselves, but must take the wider host community into account. And what are the key elements, then, of a successful humanitarian response? That's a good question. The ultimate goal of the humanitarian response is, of course, to save lives of affected people, to protect them from further harm and to help them on the path back to self-reliance. So what are the key elements here to allow us to achieve these goals? Let me just highlight three.
Sebastian von Einsiedel:First, humanitarian assistance needs to be delivered speedily because, when disaster strikes, time is of the essence. The faster you can act, the more lives you will save. Indeed, the ideal response puts in place anticipatory measures even before disaster strikes. Second, the response must address the actual needs and priorities of the affected population. So, especially as displacement situations get more protracted, those needs shift from immediate life-saving assistance to support that helps them get back on their feet and to know what their needs and priorities are. You need to systematically engage with displaced populations and consult them. Third, you need to ensure that the response is conflict-sensitive and does no harm. To ensure that the response is conflict sensitive and does no harm, and this means it should not exacerbate existing tensions you also always need to ensure that we don't allow aid to become politicized, meaning we need to ensure it's not channeled in ways that it favors one conflict party over another or one group affected people over another, and that's why the humanitarian principles that guide our work are so important Humanity, impartiality and neutrality.
Sam Pauly:You mentioned earlier how displaced persons have increased vulnerabilities. Are there, though, any specific groups within that with further vulnerabilities?
Sebastian von Einsiedel:any specific groups within that with further vulnerabilities? Absolutely, and that's a very important point, because displaced populations are not one homogenous group. There is a huge diversity within those populations and those diversities often imply further vulnerabilities. Women, girls and boys are first and foremost among them. They comprise over half of the displaced population and tend to be particularly vulnerable while on the move.
Sebastian von Einsiedel:Other groups among the displaced with specific vulnerabilities and needs include the elderly, indigenous communities, ethnic minorities, lgbtq plus people and, of course, people with disabilities. We very much try to take these factors into account to ensure these groups are included and their specific needs are met. There has been a particularly dedicated effort in recent years to be more sensitive towards affected people with disabilities, which of course, include chronic illnesses, including neurological disorders. The World Health Organization estimates that the share among displaced populations with disabilities is around 15%, so it's a big share of the people we serve. But the truth is, sadly, that disabled people still often fall through the cracks, that they lack adequate access to basic assistance and services such as water, shelter, food or health for that matter, or that we miss more complex or less visible chronic illnesses, and that's largely a function of the humanitarian response being overstretched and underfunded. We're trying to do better, but it's a work in progress under difficult circumstances.
Sam Pauly:When you're making considerations for the healthcare provision, what sort of considerations are taken into account? What's the approach that's taken?
Sebastian von Einsiedel:for much greater scale and scope of services that we can provide and, by contrast, if there is limited or no health system including in terms of health monitoring, data, pharmacology, et cetera that we can build on, the quality and efficacy of the humanitarian health services will be severely limited and the costs for us to build that are much higher. This is why it's so important to develop and strengthen health systems in fragile contexts before a crisis hits. Beyond this, access is a key consideration, both physical and social access to health care. People must be able to physically access safe health facilities. People must also be able to afford health care, as well as the auxiliary costs of accessing care, such as transport to get there or time of work, etc. And then, finally, the presence of skilled health care staff, including and especially, women, is also essential for reaching populations of concern. And again, women are crucial to this, particularly in contexts such as Afghanistan or Yemen, where women are needed to treat other women.
Sam Pauly:Are there any challenges that you particularly face, and are these generally the same, or do they differ by geography or the cause of displacement?
Sebastian von Einsiedel:If there is one thing we don't lack, its challenges, but let me just highlight the three most salient ones here. The first one and that's key is funding. Humanitarian needs around the world far outstrip the resources we have available. Last year, for instance, we were appealing for more than $50 billion in humanitarian funding on behalf of the humanitarian system to assist 190 million people around the world, but we received only well below 50% of what we needed. And that of course, affects the quality of our response, including the health response to internal displacement, and it has forced us to scale back operations and make the toughest choices, with real humanitarian costs and human costs. In Syria, for instance, we had to cut food assistance by 80 percent last year. We had to cut food assistance by 80% last year.
Sebastian von Einsiedel:The second challenge is specific to conflict settings, which is the growing disregard for international law and humanitarian norms.
Sebastian von Einsiedel:We see the laws of war increasingly flouted in many settings. We see arbitrary displacement, we see denials of humanitarian access, displacement, we see denials of humanitarian access and in an increasing number of settings we see systematic attacks on health facilities and the health infrastructure, and humanitarian workers themselves find themselves increasingly targeted. And what that erosion of norms does is it helps drive displacement up, all while hampering our ability to respond to it. And the third challenge has to do with the fact that most of today's humanitarian crisis are very protracted ones and go on in some cases for 10, 15 or 20 years, and in those places we have to do better to approach assistance with a more long-term view, an approach that fosters self-reliance, because most displaced persons, when you ask them what they want or need most, will not that they want more food packages or plastic sheets for tents or water trucking. What they want is education, livelihood, wells, a piece of land to till. But that's, of course, quite difficult when you're chronically underfunded and when your primary mandate is to save lives in humanitarian emergencies.
Sam Pauly:Looking to the future, we've got these growing challenges. The numbers of displaced people are likely to continue growing. Can we end on a positive note in terms of what the vision is and any potential challenges that we see in the future?
Sebastian von Einsiedel:I think, in terms of development investments, the ones for which you get the biggest bang for the buck long term is investments in education and investments in public health systems, and they also have huge ability to strengthen resilience to people when disaster strikes. Ideally, in the future, we don't have to respond to so many humanitarian emergencies because, ultimately, we as a humanitarian community are only the band aid that mitigates suffering in the face of disaster. My ideal future is that we have less of those disasters and less of those emergencies for which we need to provide Band-Aid because the humanitarian community is not in a position to address the causes of conflict or disasters. For that we need more effective political interventions, more effective Security Council, more effective conflict prevention. And on the climate side, what we need is serious steps towards climate mitigation, serious investments in climate adaptation, in particular in countries that need it most, which will probably be the one single intervention to reduce the numbers of displaced in the future more than any other.
Sam Pauly:And do you feel optimistic that that is or will happen?
Sebastian von Einsiedel:It is hard in the current environment to keep up one's optimism, I have to say. But we have to because there is no alternative.
Sam Pauly:Sebastian, on that note, thank you so much for joining us on the One Voice for Neurology podcast. Thank you. It was great to be with you, thank you so we've heard about the enormity of the challenges, the causes of displacement and the response to it, but what about the individuals impacted, and can we find hope there? Our next guest is yulia ostapenko, originally from ukraine and living with a neurological disorder. Very generously, yulia has sharedenko, originally from Ukraine and living with a neurological disorder. Very generously, Yulia has shared this audio diary with us.
Yulia Ostapenko :Hi, my name is Yulia. I'm 33 years old. In the spring of 2022, from a small town in Ukraine, I had to pack my life in a suitcase and leave for Poland, as it was extremely unsafe to be at home because of the war. Since birth, I have been suffering from a rare genetic snail muscular disease spinal muscular atrophy type 3, also known as SMA. It is a condition in which the muscles throughout my body are severely weakened and I literally have the strength of a seven-year-old child. Leaving the house in Ukraine, I had a stifling sense of dread. Would I be able to overcome this? We drew for three days. During this time, the route was constantly changing, the weather was getting more and more frosty and the sirens were blaring, reminding me that there was no turning back. My strength was enough to just accept it. Almost three years later, I can safely say I met. It is for because of the support of people. Everyone who I met on my way gave me strength. People who didn't know each other suddenly became family.
Yulia Ostapenko :Despite my love for my homeland, Poland turned out to be more adapted to the needs of people with disabilities. It's turned out that I can get around on buses and tram In my city. Public transportation is not adapted for the disabled because of its height and steps. And, more importantly, I stopped feeling inferior. I am not ashamed of myself. I am ready to share my experience.
Yulia Ostapenko :About five years ago, I wrote in my wishbook that I wanted to be treated for SMA. One injection cost $100,000 and my country could not afford such treatment. And now, two years later, Poland gave me the opportunity to receive it. This means that my decease will not progress, which means that I have changed the course of my life With the move. I have had to grow up to a large extent. Today I work as a coordinator in a large, clean company and in my free time I do my favorite hobby vocal. Despite all the beautiful things around me, migration a is always a feeling of loneliness. You don't get the chance to drop everything and relax. You no longer sit around with your family at Christmas. Now they are on your phone screen. Do I want to stay here? Definitely. The feeling of fear is always tightening, but once you take one step forward, you realize that it's turned out to be the door to your goals.
Sam Pauly:Thank you so much, yulia, for sharing your story with us, and we do wish you the very best for your future in Poland. Let's turn now to hear from the perspective of a healthcare provider. I've been catching up with Dr Bindu Menon, senior Consultant, neurologist and Founder of Dr Bindu Menon Foundation in India, and also a One Neurology ambassador. Dr Bindu Menon, thank you so much for joining us today.
Dr Bindu Menon:Thank you so much, Sam. Thank you for having me in this One Neurology podcast.
Sam Pauly:It's lovely to have you back. We have spoken before, we haven't touched this area before and I wonder if you could outline, to start with, which area you're from and the environmental events which have occurred and displaced people that you've had experience with, and explain that scale of displacement.
Dr Bindu Menon:I'm from the southern part of India, and India is a country which is frequently affected by environmental disasters floods, cyclones, heat waves which tend to displace millions annually.
Dr Bindu Menon:For example, in 2018, in the South India, we had Kerala floods, which displaced more than a million people, and the cyclone Amphan, which was there in 2020, it displaced more than 10 million people across the east of India, that is, west Bengal and Odisha. The floods in Azam, I should say, that's the east part of India, are almost becoming a near annual occurrence, and it tends to displace near-end people. In 2022 alone, having said that, in the place where I stay in, that's, Andhra, radesh, recently, in September 2024, the National Emergency Response Centre had reported that just about half a million people were affected by the floods and around 50,000 people were evacuated from over 400 villages in Andhra. Pradesh. Now, having said that, these sort of events tend to affect everybody who is there, but then it definitely tends to affect the vulnerable population disproportionately, but then it definitely tends to affect the vulnerable population disproportionately and particularly those with neurological disorders, because they require consistent access to health care.
Sam Pauly:Let's talk a little bit more about that. From your experience, what impact does being displaced have on the ability or priority of people living with neurological disorders to access treatment?
Dr Bindu Menon:Displacement does severely impact the ability of individuals with neurological disorders to access the treatment, and this could be multifactorial. You know there's the loss of stability and the healthcare infrastructure. The displacement often means they are relocated to temporary shelters or camps where healthcare facilities are rudimentary, are probably non-existent, especially the specialist care would definitely not be there. There is shift in priorities Now, needless to say, that at that point of time the immediate survival need is food, water and shelter, rather than going for a rehabilitation centre for your stroke care, so that takes precedence over your chronic disease management again. Then again, neurological care.
Dr Bindu Menon:Medication adherence is very important. As with any other disease, the person with epilepsy does not take a seizure medication. He gets a seizure in the camp and then there's nobody to look after him. So they are deprioritized, I feel Then there is resource scarcity. Because it's a displaced camp area, there would only be the essential medications that would be available. The diagnostic tools would not be available. What we need, then, the rehab care which for many of those patients let us say, stroke, parkinson's disease, peripheral neuropathy or any of the muscular dystrophy patients they need it every day. But that would definitely be cut off and that limited availability will again exacerbate the problem, but in terms of long term impacts.
Sam Pauly:if somebody stops taking that treatment, what can those sort of impacts be? Could you give an example?
Dr Bindu Menon:Well, yes, so when we look at any of the neurological disorders, there should be a consistency of treatment that ensures that the patient builds up on his recovery and if there is a break in them, there could be a worsening of the neurological condition. There could be progression of diseases the Parkinson disease. If they do not get access to their medications multiple sclerosis epilepsy patients, their medications, multiple sclerosis epilepsy patients Then there is an increased morbidity as well. For, let us say, for stroke patients, there is a rehabilitation cutoff or a delay that may lead to permanent disabilities. They may have their contractures. The patients who are having spasticity, that can increase. There can be a heightened injury risk as well because they are not able to walk as properly because the rehabilitation has been cut off, then over and all above all this, we should also consider that there's so much of psychological impact as well, you know, and the anxiety and the depression as to what is going to happen they often accompany the worsening of this physical problems they're compounding on the individual and the family as a whole.
Sam Pauly:And so what are the physical challenges that are evident when people need to be moved? For instance, what needs to be taken into consideration for people who are living with a neurological disorder, who have some mild or severe mobility challenges?
Dr Bindu Menon:When we look at neurological diseases, the mobility issues is something of a big concern here, because let us take stroke, multiple sclerosis, parkinson's disease, diseases of the muscles and nerves, where the mobility is restricted, where evacuation and relocation challenges, where there is no assistance provided to them. The inaccessible shelters, the temporary accommodations often lack the ramps, the wheelchairs or the mobility aids, which makes the navigation completely difficult for the individual to move around. Then there are transportation barriers. During the emergencies particularly, they hinder the movement back to the specialised care.
Sam Pauly:And in terms of diagnosis, do we see an effect on the number of diagnoses being made when people are being displaced.
Dr Bindu Menon:That definitely happens because during the displacement the focus is on the acute injury and the infection diseases that come along with these environmental disasters, which overshadows the diagnosis of the chronic conditions, including the neurological disorders. So there's a delay in the diagnosis. So let us say the patient has got early onset symptoms. Let us say the patient gets a transient ischemic attack. So that is just sort of submerged in all of these other conditions which take priority Disease progression also because there's no diagnosis. So during that I should say that bottleneck time, the severity of the disease also increases. That can lead to long-term complications and the response to the treatment also gets jeopardized.
Sam Pauly:And we've talked about the impact for people living with neurological conditions of not accessing treatment. But for those who have been displaced, are there any other particular risks that they are vulnerable to?
Dr Bindu Menon:Definitely, because now they are in shelter homes and especially having a neurological disorder in the background. They are in places where they are overcrowded, so the risk of respiratory and gastrointestinal infections becomes very high and this can worsen the pre-existing condition as well. Pressure sores because there's lack of mobility, there's lack of rehabilitation. Patients are not being moved around because navigation is so much difficult. They get confined to inadequate beddings. They are prone to bed sores and that can become infected as well. Mental health disorders are very common in this condition. So anxiety, depression and the post-traumatic stress as to they have lost a lot of things. And on top of that is malnutrition, because we know that every patient needs to be properly nourished so that he or she can take care of their primary disease. So this poor access to nutrition also impacts the recovery and that can increase the neurological symptoms of the disease.
Sam Pauly:I wonder if I could ask as well Bindu about the displaced population as a whole. What additional risks could they be exposed to? Could they be at high risk of developing a neurological disorder, for example, and if so, are there any specific groups which are particularly at risk?
Dr Bindu Menon:yes, there are certain particular risks, as I just mentioned that. They definitely are at risk for infective conditions and we have seen that when they are in crowded places it comes in sequences. So first there is a disaster, then they are displaced to a place, then their shelter homes, and then we get those patients in crops there. So meningitis, meningococcal, any of those conditions. And then we also see a lot of trauma cases coming from. Their trauma means it's not really trauma, it's like falls, getting a fracture or any of these nutritional deficiencies become very, very common, especially the B-complex vitamins. Because we understand that it's a shelter home, so food is being distributed.
Dr Bindu Menon:We tend to see Japanese encephalitis and other things coming off from camp and that leading to an acute neurological disorder as well. And definitely, yes, there are vulnerable population in this group. Everybody is prone to all of them. But then there are a group that is, say, in the extremes of age, the children and the elderly, and pregnant women as well, because they have a weaker immunity and their dependency level is also higher. And that is a place where everybody is trying to take care of themselves, so it sometimes becomes difficult to take care of another individual sometimes becomes difficult to take care of another individual.
Sam Pauly:As a healthcare professional yourself, how, for you and your colleagues, is that impact working with displaced people emotionally, physically, and also the services you can provide?
Dr Bindu Menon:I run my own foundation and we provide services to the underserved people and we do it every month. So during these flats in the month of September, we have patients who come to my clinic and then they are given medications. But last, when there was a flood, we had only 40% of patients coming in. So I was worried what's happening to the rest of the 60%? And unfortunately I'm not able to reach them because the connectivity was also not there because of the floods. So you can see that displacement.
Dr Bindu Menon:Individually, that person is more at risk and he's suffering. But then, as a healthcare professional, me and my colleagues also have emotional challenges when we witness patients suffering without being able to provide adequate care due to logistic challenges. This leads to frustration, you know. It leads to helplessness and I feel that there is a compassion fatigue I'm not able to extend. There's a physical strain as well. Some of the primary health center doctors are working in places with limited resources. Then the quality of the services is not as good as we might be able to wanting to provide them, because the number of challenges that we are facing want to reach them. Then it is not only the primary disease. They have been now engulfed with some other problems as well. They can't come back here. For us to reach out to them is also becoming difficult. So there are emotional challenges, physical strains and the service quality all of them that come along with us for healthcare professionals as well.
Sam Pauly:And just finally, to finish, we have spoken a lot about all the various challenges that come hand in hand with displacement, but in the past we've spoken about the real sense of community in India. Can you explain to us what you mean by that and in what way it's specific to India? And, with that in mind, what role does that play in supporting people living with neurological disorders who've been displaced?
Dr Bindu Menon:I believe that in India, the sense of community is the cornerstone of resilience during crisis and every time it has been tested and it has proved its worth. First it starts with the family support. We have these extended families who often step in to provide caregiving and share the resources and assist with relocation. Then we have the local networks that's there, like neighbors and community groups. They collaborate to distribute the food, provide transportations and assist the vulnerable individuals. Then we have these religious and social organizations as well, the NGOs, who frequently organize medical camps. They distribute the medication and offer rehabilitation services to be displaced. It has been shown in all of these floods and it becomes like a case study for the other generations to learn from it and how we can make it an example, to see how best we can do good for the people who are displaced during this crisis.
Sam Pauly:Bindu, thank you so much for joining us and explaining the situation and the work that's being done around displacement and the events in India. It's such an honor to have you with us, thank you.
Dr Bindu Menon:Thank you so much, Sam, for having me on this podcast.
Sam Pauly:Well, that brings us to the end of this episode and it seems appropriate, as we continue to discuss and build the One Neurology community, that we end on that theme of community. Despite the challenges, it's heartening to hear of the work being done to respond to displacement and the value and importance that community plays in that response. We will have more episodes of the one voice for neurology podcast later this year and I very much hope you'll join us again soon for them. Until then, goodbye.
