INDEPTH: DISASTER IN ASIA
Dealing with the crisis: Q & A
CBC News Online | December 31, 2004
Mother and child wait to be evacuated to nearby Medan, at the airport in Banda Aceh, North Sumatra, Dec. 31, 2004. (AP photo)
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When disaster strikes, emergency service workers rush to the affected region to provide rescue, recovery, and basic needs. Governments and non-governmental organizations try to provide for the health and safety of the people involved. But there is another side to coping with a tragedy. People react in different ways, and sometimes the effects of a crisis on mental health take some time to become apparent.
Crisis mental health workers help people to accept and adjust, in order to be able to resume their lives.
Adrienne Carter, a clinical therapist based in Victoria, is heading to India for Médecins Sans Frontièrs (MSF) to help assess the need for mental health counselling in the wake of the tsunami, and provide it
where necessary. She agreed to do an interview via e-mail to describe her work.
What made you decide to go?
I have made myself available to go and serve for a limited time in some area that was requiring mental health assistance. After the tsunami hit in Asia I was approached by MSF Belgium to go overseas
for a month to assist and train local mental health professionals to provide assistance in some of the stricken areas.
India's hardest hit areas
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What will you be doing when you arrive?
Once I arrive I will be briefed by the Head of Mission of the particular country about the situation of the area where I will be going. Generally, first we make a quick mental health assessment to find out how the
people are coping and where we can be most helpful. This includes assessing the usual resources that are still available, i.e. family and community supports, local agency supports, etc.
Then usually a local team is set up and trained in counselling methods. This training program lasts perhaps eight to 10 days, and then the new counsellors spread out and assist whenever they are needed. People are generally very eager to talk about the trauma; however, they are never forced to talk when they are not yet ready.
Issues are frequently handled in groups. We try to listen, assist in problem solving, and help people resume their usual activities, for example getting children back into schools. At times after tragedies like this people may lose hope. In that case the job of the counsellors is assisting them in finding some meaning in life, something still worth living for.
It must also be noted that the local counsellors themselves often suffered from losses and have themselves been traumatized. Assisting them through their trauma is one of the first tasks if we want them to be strong enough to assist others.
Dealing with the trauma of the counsellors will happen during the training program and subsequent supervision sessions. We also reach out to the general population through radio and pamphlets
trying to answer the most frequently asked questions. Whatever ways are possible in the particular areas, we use those ways.
Why is it necessary?
Mental health counselling is helpful to assist people to slowly, when they are ready, resume life as before the tragedy. There are also ways suggested that can help ease the pain to some extent. People with serious mental breakdowns can be identified and provided with some professional help.
People who suffered such horrendous losses also want to know that they are not alone, that people all over the world care about them and want to support them. While here, we are exposed to their pain. They often do not realize that they are not alone and abandoned. Witnessing the trauma, recognizing the pain seems to assist in the healing process.
I have found that people are generally very resilient and I am in awe of their courage to carry on and manage. A little assistance and acknowledgement of their own strengths can also go a long way in the healing process.
News of natural disasters also affects people on the other side of the world. Trying to absorb the magnitude of the crisis is difficult. Trying to explain it to a child can be overwhelming. You have had some experience in talking to kids here about crises elsewhere in the world. What sort of psychological effects have you seen soon after this sort of disaster?
People here at home often feel extremely overwhelmed by the extent of the disaster and usually they feel helpless. Many people approached me and expressed their interest to go overseas and be useful in some ways. I think all of us would rather "do" something than stand by helplessly. Donating money is, at least, many people's only way of feeling helpful, useful.
Those who feel that they have nothing to contribute might become depressed, anxious and fearful themselves. They no longer feel that the world can be safe for them or their families. Often these feelings are expressed in anger and frustration. Children may then adopt the parental attitude of hopelessness and
depression.
Are children affected differently than adults? How?
Children might not always understand the full extent of the disaster. Allowing them to watch it constantly on the TV is not a good idea. Their psyches could become totally overwhelmed and, like adults, feel helpless and often depressed.
What is the best way to broach the topic with children?
It is OK for children to know something about what happened. However, depending on their age, it is recommended that not too much information is shared. Children will ask questions. It is helpful to just answer the question without giving much additional details. The child will then digest the response and may come back to ask more questions. In that case the parent can respond again.
Also, it is a good idea to stress the positives, i.e. how all the world is uniting to send assistance to the people. Share some of the happy stories where people did survive, they found their children alive.
Children here need to know that the world is not a hopeless place and here they are relatively safe and protected.
As parents we need to protect our children from too much news of trauma. Children, like adults, can become seriously depressed. We can guard against this by being hopeful ourselves and not allowing ourselves to become overly depressed about the present state of the world. Children often imitate
the outlook of the parents.
Are there special concerns for children living on the West Coast, near a fault line? (Many children are aware of the dangers of earthquakes in that region.) Should the message to them be any different?
If parents are concerned about earthquake zones they can take some realistic precautions and prepare as best as they can. This can be reviewed with the children. Parents can also talk with their children about what happens if there is an earthquake while they are in school, how will the parents get to the children and what precautions the school has taken.
The important thing is to emphasize that the parents will do everything possible to protect the child and they will not be left alone.
Are children here likely to be fearful that something like this could happen here?
Again, the parental attitude is the model for the children. They can share with the children that we are better protected here with a good warning system that will allow us time to escape, and the houses are built to better withstand disasters.
Don't dwell on all the disasters that may happen – stress the positives and stress that you as the parent will do everything possible to protect the child.
What if a child seems especially fearful, and can't seem to overcome it? What should parents do, and is there someone to turn to for help or guidance?
Children who suffer too much fear or anxiety may benefit from some counselling. Local mental health centres and private counsellors are well equipped to provide assistance if needed.
Parents themselves, if they are too depressed by the world situation, should themselves get some assistance.
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