TENNIS

Juan Martin del Potro could miss Shanghai Masters semi-final with wrist injury

The sixteenth seed fell awkwardly and injured his wrist during his quarter-final win over Viktor Troicki.

Juan Martin del Potro could be forced out of his Shanghai Masters semi-final on Saturday against Roger Federer after the Argentine suffered a wrist injury in an awkward fall on court.

In the other last-four showdown Rafael Nadal will play Marin Cilic after the red-hot world number one had to fight his way past Grigor Dimitrov 6-4, 6-7(4), 6-3.

Sixteenth seed Del Potro heroically clambered off the floor and from a set down to knock out Serbia’s Viktor Troicki 4-6, 6-1, 6-4.

But it came at a cost and he was due to see a doctor straight after the match to see the extent of the damage to his left wrist, which has been operated on three times and badly disrupted his career.

“I felt something wrong in that moment but I continued to play with slices to try to finish the match, but now it’s time to see what the MRI (scan) and also what the doctor says,” Del Potro, the 2009 US Open champion, said.

“I’m a little worried but I know to deal with all of these things as I have been through them in the past, but I will see what the doctor says now and then we will take a decision for tomorrow.

“Of course I would like to play, I would like to be 100 percent, but we will see in a moment what’s happened.”

The 29-year-old Argentine’s foot appeared to get stuck on the floor and he crumpled down, landing on his left hand and bending it backwards.

He needed several minutes of medical attention and sat on a chair at the back of the court, wincing in distress.

Incredibly, he broke the serve of the unseeded Troicki on his immediate return to action.

Swiss legend Federer booked his spot as he eased to a 7-5, 6-4 victory over the unseeded Frenchman Richard Gasquet.

Federer, the second seed, has not dropped a set all week and he and old rival Nadal appear headed on a collision course.

“We all hope it’s a precaution more than anything,” Federer said when learning that Del Potro was off to see the injury assessed.

“For me, at the end of the day, nothing changes, I’m ready to come out here tomorrow and see the match like it’s a revenge chance for the US Open,” Federer added, referring to when Del Potro beat him in the quarter-finals this summer in New York.

Gutsy Nadal battles on

Nadal, who has never won the Shanghai Masters, is chasing a seventh title in a brilliant season and a hat-trick of triumphs on the trot, having been crowned US Open and China Open champion in recent weeks.

The 16-time Grand Slam winner saw off the Bulgarian Dimitrov in Beijing last week but suffered some hairy moments in getting the better of him again in a nervy quarter-final played in overcast conditions.

“Very happy, it was a very tough match, both of us played a very high level of tennis,” said the 31-year-old Spaniard, the top seed.

“I enjoyed it, a great battle between two players that are playing all the time very focused and intense points.

“A lot of matches in a row winning and very happy with everything, let’s see what happens tomorrow.

“Just focus on holding that momentum.”

Nadal edged in front when he got the break of serve in the ninth game of the first set and there was nothing between him and his good friend Dimitrov as they entered a tense second-set tie break.

The Spaniard got the mini-break for a 3-0 lead in the tie break, but sixth seed scrapped back to level, and then stunned Nadal to clinch the tie break.

Dimitrov sensed another opportunity in the fifth game of the third set, but Nadal survived the break point.

Nadal took the momentum into the next game to immediately break Dimitrov and finally end the Bulgarian’s resolve.

The Croatian fourth seed Cilic – who has defeated Nadal only once in five matches – beat unseeded Spaniard Albert Ramos-Vinolas 6-3, 6-4.

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Removing the layers of complexity that weigh down mental health in rural India

Patients in rural areas of the country face several obstacles to get to treatment.

Two individuals, with sombre faces, are immersed in conversation in a sunlit classroom. This image is the theme across WHO’s 2017 campaign ‘Depression: let’s talk’ that aims to encourage people suffering from depression or anxiety to seek help and get assistance. The fact that depression is the theme of World Health Day 2017 indicates the growing global awareness of mental health. This intensification of the discourse on mental health unfortunately coincides with the global rise in mental illness. According to the latest estimates from WHO, more than 300 million people across the globe are suffering from depression, an increase of 18% between 2005 and 2015.

In India, the National Mental Health Survey of India, 2015-16, conducted by the National Institute of Mental Health and Neurosciences (NIMHANS) revealed the prevalence of mental disorders in 13.7% of the surveyed population. The survey also highlighted that common mental disorders including depression, anxiety disorders and substance use disorders affect nearly 10% of the population, with 1 in 20 people in India suffering from depression. Perhaps the most crucial finding from this survey is the disclosure of a huge treatment gap that remains very high in our country and even worse in rural areas.

According to the National Mental Health Programme, basic psychiatric care is mandated to be provided in every primary health centre – the state run rural healthcare clinics that are the most basic units of India’s public health system. The government provides basic training for all primary health centre doctors, and pays for psychiatric medication to be stocked and available to patients. Despite this mandate, the implementation of mental health services in rural parts of the country continues to be riddled with difficulties:

Attitudinal barriers

In some rural parts of the country, a heavy social stigma exists against mental illness – this has been documented in many studies including the NIMHANS study mentioned earlier. Mental illness is considered to be the “possession of an evil spirit in an individual”. To rid the individual of this evil spirit, patients or family members rely on traditional healers or religious practitioners. Lack of awareness on mental disorders has led to further strengthening of this stigma. Most families refuse to acknowledge the presence of a mental disorder to save themselves from the discrimination in the community.

Lack of healthcare services

The average national deficit of trained psychiatrists in India is estimated to be 77% (0.2 psychiatrists per 1,00,000 population) – this shows the scale of the problem across rural and urban India. The absence of mental healthcare infrastructure compounds the public health problem as many individuals living with mental disorders remain untreated.

Economic burden

The scarcity of healthcare services also means that poor families have to travel great distances to get good mental healthcare. They are often unable to afford the cost of transportation to medical centres that provide treatment.

After focussed efforts towards awareness building on mental health in India, The Live Love Laugh Foundation (TLLLF), founded by Deepika Padukone, is steering its cause towards understanding mental health of rural India. TLLLF has joined forces with The Association of People with Disability (APD), a non-governmental organisation working in the field of disability for the last 57 years to work towards ensuring quality treatment for the rural population living with mental disorders.

APD’s intervention strategy starts with surveys to identify individuals suffering from mental illnesses. The identified individuals and families are then directed to the local Primary Healthcare Centres. In the background, APD capacity building programs work simultaneously to create awareness about mental illnesses amongst community workers (ASHA workers, Village Rehabilitation Workers and General Physicians) in the area. The whole complex process involves creating the social acceptance of mental health conditions and motivating them to approach healthcare specialists.

Participants of the program.
Participants of the program.

When mental health patients are finally free of social barriers and seeking help, APD also mobilises its network to make treatments accessible and affordable. The organisation coordinates psychiatrists’ visits to camps and local healthcare centres and ensures that the necessary medicines are well stocked and free medicines are available to the patients.

We spent a lot of money for treatment and travel. We visited Shivamogha Manasa and Dharwad Hospital for getting treatment. We were not able to continue the treatment for long as we are poor. We suffered economic burden because of the long- distance travel required for the treatment. Now we are getting quality psychiatric service near our village. We are getting free medication in taluk and Primary Healthcare Centres resulting in less economic stress.

— A parent's experience at an APD treatment camp.

In the two years TLLLF has partnered with APD, 892 and individuals with mental health concerns have been treated in the districts of Kolar, Davangere, Chikkaballapur and Bijapur in Karnataka. Over 4620 students participated in awareness building sessions. TLLLF and APD have also secured the participation of 810 community health workers including ASHA workers in the mental health awareness projects - a crucial victory as these workers play an important role in spreading awareness about health. Post treatment, 155 patients have resumed their previous occupations.

To mark World Mental Health Day, 2017, a team from TLLLF lead by Deepika Padukone visited program participants in the Davengere district.

Sessions on World Mental Health Day, 2017.
Sessions on World Mental Health Day, 2017.

In the face of a mental health crisis, it is essential to overcome the treatment gap present across the country, rural and urban. While awareness campaigns attempt to destigmatise mental disorders, policymakers need to make treatment accessible and cost effective. Until then, organisations like TLLLF and APD are doing what they can to create an environment that acknowledges and supports people who live with mental disorders. To know more, see here.

This article was produced by the Scroll marketing team on behalf of The Live Love Laugh Foundation and not by the Scroll editorial team.