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Press Release
WHO warns of
widespread psychological trauma among Tsunami victims
19 January 2005, New Delhi, India/Geneva, Switzerland - The World Health Organization
(WHO) is warning that almost all of the people affected by the tsunami that
hit Southeast Asia on 26 December will be suffering from some form of
psychosocial trauma. Health workers report that virtually everyone in many of
the affected communities is suffering from some degree of psychological trauma.
WHO mental health experts fear that psychological trauma among the tsunami
victims is more widespread than initially believed.
"The mental anguish of those who narrowly escaped
the tsunami or lost close relatives is made far worse because many of them
have lost their homes, their jobs and their possessions. These people
urgently need support," said Dr Samlee Plianbangchang, WHO Regional
Director for South-East
Asia. "Many can cope and will gradually come
to terms with what has happened. But
many others will either sit motionless or cry for hours on end. If support is not urgently provided, the
long-term effect on these populations could be terrible."
The situation is further complicated by an acute
shortage of health workers trained in mental health care and counseling. In Banda Aceh, Indonesia, for example, more than 150
people worked at the mental health hospital before the disaster struck. Today, only one psychiatrist, three trained
counselors and six nurses remain.
WHO recommends that psychosocial support should be
provided by community-based workers who understand the needs of disaster
victims and have been trained in psychosocial support. According to Dr Vijay Chandra, WHO Regional
Mental Health Advisor, “We must ensure that this is not trivialized by permitting any untrained
person to do counseling, but is done by health workers who have been trained
under WHO guidelines.”
WHO has already begun to coordinate the appropriate
training of community workers. Focus
of the training is on role plays, empathizing with victims, providing support
and encouragement to affected individuals to talk through their problems.
Given the acute need, WHO is rapidly increasing its
support to countries to implement WHO Guidelines for Mental Health in Emergencies. The guidelines outline an increased
involvement of community outreach, taking into account the needs of special
groups such as children, women, elderly people and the severely injured,
while offering a culturally-appropriate approach to any offered support.
The primary need is not medication, nor the labeling of
individuals with a medical diagnosis which suggests the need for psychiatric
interventions, said Dr Chandra. "It would be inappropriate to fly in
numerous psychiatrists to provide support," he said. "Health workers from the affected
communities will be much more aware of what the victims are now going
through. As such, they are in a
position to provide much more empathic support than any external professional
could."
Dr Chandra said that for the loss of a loved one under
normal circumstances, there are social support systems built into community
life, such as prayers, rituals, a role for each family member and neighbors
sitting with the family members in support.
"However," he continued, "in the unique circumstances
of the present disaster, we must address the needs of people who have not
only lost loved ones, homes, means of earning, but their entire neighborhood
and with it their lives' context which essentially defines every individual. The best method of dealing with this would
be to find people in neighbouring villages or
communities, people of similar cultural background, who understand the
cultural norms to help them."
WHO has already sent four mental health experts to Sri
Lanka and Indonesia, to work with local mental health professionals and
ministries of health, and provide the technical guidance to ensure
psychosocial training focuses on: timely and appropriate interventions; honouring the dignity of survivors; identifying potentially
high-risk populations; helping survivors reunite with friends or family;
activities to re-normalize life as much as possible; and the importance of
self-help information materials.
In one province in Thailand alone, local authorities are
rotating 80 mental health workers on a weekly basis to support
particularly-affected communities.
"Some of these people are literally suffering a second
tsunami," said Aphaluck Bhatiasevi of WHO in Thailand.
"Today, we saw a son who was extremely distressed at the guilt he
feels for not having been able to save his father from the force of the
tsunami. Such people urgently need a
support system to help them cope with this traumatic experience. If such support is not provided, it could
very likely end in yet another tragedy for some of the families, and we
simply cannot allow this to happen."
Providing support to countries to implement the WHO
Guidelines for Mental Health in Emergencies is a key component of the
organization's long-term strategy to rehabilitate the damaged or destroyed
public health infrastructure. To
implement the strategy, WHO urgently requires US$67 million for activities
through the next six months.
For further information, please contact:
-Mrs Harsaran Pandey, WHO Regional Office for South-East Asia, New Delhi
Tel. +91
98 110 21001, email: pandeyh@whosea.org
For full information on WHO's response to the
tsunami in Southeast Asia, please visit www.who.int and www.whosea.org
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