I have tried to make my own little mark in this world. My career as a Medical Educator and Clinician in Gastroenterology (see www.gastroindia.net) and my flirtations with Health Promotion, especially amongst school children (see www.hope.org.in) are shown elsewhere.This blog contains my attempts at creative writing, most being write-ups for Health Adda column of HT City of Hindustan Times (also see www.healthaddaindia.blogspot.com) as well as a few others, and some reflections and thoughts that have struck me from time to time on my life journey.Please leave your footprint on this blog with your comment.


Thursday, October 31, 2013

Wounds of the Mind

Failure to address the emotional trauma and psychological impact of survivors of natural disasters, such as the recent Uttarakhand Tsunami, often leaves a glaring hole in rescue and relief operations undertaken by state agencies.

For most of us, it would be impossible to imagine the emotional trauma and agony of those who have seen loved ones been dragged away by flood waters or buried alive by landslides, or perhaps even worse, just missing! How and what can be done for them?

At the outset it is important to know that pattern and sequence of reaction that a traumatized person goes through. The first stage is one of denial or disbelief at the suddenness of the upheaval. It is followed usually by anger, often directed at people around, government, at oneself or even God. The 3rd stage is of emotional bargaining. A typical thought in this phase is “Why did it have to be my son and not me?” The 4th is of depression: that deep sense of loss, hollowness and despair. It is only in the 5th stage that one accepts, and begins to cope by trying to pick up the broken pieces of life.

Psychological support is now accepted as an essential component of disaster management in developed countries. During the disaster, its needs to be merged with the more practical rescue efforts. A lot can be achieved by moving stranded people to safety, providing shelter, food and water, helping re-unite families and friends, and providing accurate information.

One of the reasons for the overwhelming gratitude and warmth that the defence personnel engaged in daring rescue operations received was due to their convincing actions directed towards these objectives. On the other hand, the possible reasons why government agencies and personnel drew ire was due to their slow response in the face of desperate demands, as well as lack of training in how to deal with the emotional needs that arise in such occasions.

The setting of natural disasters does not provide the luxury of “one hour on the couch” kind of psychological counselling, says Divya Jain, a young counsellor at Fortis Memorial Research Institute, who feels the goal needs to be supportive rather than therapeutic at this stage. The way best way to deal with victims in such occasions is to listen with empathy, and legitimize their feelings. If someone is angry for instance, it is best to say “ I can understand. I would be angry too”.

What often works well is for people to realize that they are not alone in their grief. They often find solace in sharing their experience with fellow victims in relief camps, with disaster counsellors, NGO workers, religious heads and with doctors. Some need medicines to cope with anxiety and depression.

Wounds of the mind take long time to heal often for life. The government needs to be sensitive and keep psychological support in mind in its long term rehabilitation program.

 As published in HT City ( Hindustan Times) dated 14 July, 2013.

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