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Tsunami prompts Sri Lanka to tackle mental health
Written by: Emma Batha
A woman weeps as she sits on the destroyed beach at Karaitivu, Sri Lanka. January 2005 file photo by REUTERS/Kieran Doherty
The Indian Ocean tsunami has led to a marked improvement in mental health services in Sri Lanka, according to health experts.
Disasters and conflicts often trigger depression, anxiety, post traumatic stress syndrome and other mental health disorders.
But humanitarian crises can also spur major developments in mental health care, says Dr Shekhar Saxena of the World Health Organisation (WHO).
The tsunami is not the only example. The crises in Kosovo and the Palestinian Territories have both brought about improved care.
But people's enthusiasm to help after a disaster can sometimes be more harmful than helpful.
Counsellors are increasingly turning up in the immediate aftermath of a disaster. In theory, early intervention is a good thing, but it has to be organised and culturally appropriate.
When Saxena arrived in Sri Lanka after the tsunami he was shocked to find numerous counsellors who could not speak Sinhalese, Tamil or English.
"Two weeks after the tsunami there were hundreds of counsellors doing nothing or getting in the way," he told me.
Sending mental health workers with no understanding of the local culture who can't even speak the language is as pointless as sending the wrong medicines, Saxena says.
WHO scientist Mark van Ommeren also stressed that post-disaster relief should be carried out in such a way as not to exacerbate the potential for mental health problems.
Keeping communities together when they are rehoused and enabling people to carry out traditional burial rituals to help them grieve are important in helping to reduce suffering.
Saxena and van Ommeren were speaking at the London launch of a major drive to strengthen mental health services around the globe.
Not surprisingly, the number of nurses, psychiatrists and social workers available in low income countries is tiny compared to rich countries.
At the time of the tsunami, Sri Lanka had just 40 psychiatrists or so for a population of 20 million, according to a report in Science magazine. Most care was in mental hospitals in and around the capital.
The government has since approved a national mental health policy, more medical workers are receiving psychiatric training and more hospitals now have mental health units.
Sadly though, such is not always the case. Economist Jeffrey Sachs, who also spoke at the launch, says that two years after Hurricane Katrina struck New Orleans the mental health burden continues to rise and there is a shocking lack of interest in addressing it.
A disaster may create the opportunity, but politicians and donors need to care enough to seize it.
The global mental health drive was launched in conjunction with a series of articles on mental health in the Lancet medical magazine. Click here to read more.
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6 responses to “Tsunami prompts Sri Lanka to tackle mental health”
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04 Sep 2007 18:11:29 GMT
Operation USA was one of several major relief NGOs which focused in part on training trainers in treating Post Traumatic Stress Disorders in Sri Lanka immediately after the Tsunami. We sent 24 US trainers who were fluent in Sinhalese, Tamil and English and focused on community leaders (which, in the absence of locally trained mental health workers, consisted of social workers, religious leaders, teachers, local govt officials). We feel this underpined the thrust in the above article...Sri Lanka had few mental health professionals, needs more in light of war and natural disasters affecting its people, and we were proud to demonstrate the usefulness of our approach.
www.opusa.org for more05 Sep 2007 08:56:03 GMT
Wave Aid a projected sponsored by the Sarasota Sunrise Rotary Foundation in Florida,the Students of Pine View School for the Gifted & the Global Foundation for Integrative Medicine was and is very active in both Sri Lanka after the Tsunami and was one of the First responders following the Pakistani Earthquake. Noting the lack of proper counselling services, we trained a number of Local Medical Practioners, Social Workers, Religious Leaders and Health workers in using Neuro Linguistic Techniques to address the aftermath of the Tsunami and the on going problems with the Civil Strife within the Country. Post Traumatic Stress Disorders is a major problem in these areas and we are glad that we were able to contribute to reducing its consequences. We continue to return regularly to these countries to help. Your article is accurate from first hand experience and we are proud that we were able to assist liasing with local Rotarians to ensure that we accessed areas that desparately needed our services off the beaten track. Pictures of a few of our missions are on http://naturalipro.com/waveaid/mainpg.htm
05 Sep 2007 09:02:00 GMT
If proper mental health workers are available in SriLanka,Even the ethnic conflict can be avoided.Like of proper mental health needs to be developed very soon.village level health workers should be extensibly trained on mental health education.Security forces,teachers and politicians must undergo sever mental test periodically.2005 Tsunami victms are still living in temporary shelters.Worst tusnami victims are from the east of sriLanka.They were victms again by the local security forces ethnic clencing this year.Many of them lost all their belongings and moved out from their original develings.Many International aid groups were not allowed to help them.Many aid workers got killed by the security forces for helping them.In nut shell ethnic conflicts has done more harm than the tsunami damage.
06 Sep 2007 18:56:40 GMT
Drs. Saxena and Van Ommeren are right on, with their comments. The impact of the three year psychosocial program, implemented by Sri Lanka Red Cross Society shows the sustainability of interventions identified, planned, implemented and monitored by the affected communities. For the Red Cross and Red Crescent movement, the tsunami response has provided a platform for psychosocial support to become a valuable intervention for post disaster recovery and reconstruction.
The Red Cross and Red Crescent movementâs tsunami response to the psychosocial needs of the population in Sri Lanka was immediate and decisive. The tsunami in Sri Lanka destroyed life, property, livelihood, social fabric and communitiesâ infrastructure. It is what is known in the psychiatric literature as âroot shockâ. The American Red Cross coordinated with the Sri Lanka Red Cross Society, and took several steps (1) operational training for volunteers per target district in conducting participatory assessment, psychological first aid and self care, (2) capacity building of local resources such as teachers, spiritual guides, traditional healers and social workers, (3) collaborated with the affected population for planning of psychosocial services in communities and schools well into recovery and early reconstruction. The tsunami provided the Mental Health community in Sri Lanka with an opportunity: the development of, and approval of the national mental health policy as a first step in institutionalizing mental health. What was needed after this terrible event was to look at ways to re-establish a âsense of placeâ, the mechanism of people coming together and beginning to see themselves, and to act as a community. The Civil Society, including the Red Cross family initiated, with other partners, an attempt to develop a longer term psychosocial support program focused on community based interventions. The bottom ups efforts, from the civil society in Sri Lanka to develop a psychosocial support program, provides a model that can be replicated in other resource poor countries.21 Sep 2007 08:24:03 GMT
It was with great pleasure to work with Rotarian Dr Ali Tahiri and his teams in bringing both medical relief and mental health counseling to the neglected areas in the North of Sri Lanka. Sadly many avoid helping the suffering people in the North due to the on-going civil conflict. It was amazing to see victims, brutalised by the civil conflict and the Tsunami, visibly change in outlook with 20 to 30 minutes of Counseling. Those counseled have been found to have resumed normal life thereafter.
May God Bless him for the tireless manner in which he helps those in need around the world following disasters. What is special is that he keeps returning to help after the news media has long forgotten the tragedies and moved on to some other headline grabbing story25 Sep 2007 07:52:42 GMT
Dr Tahiri from USA is an amazing compassionate person. He arrived in Pakistan the day after the earthquake, with over $150,000 of Medicines, Drugs, Sutures and Splints. Local Rotarians joined him to in assisting in bringing desparately needed relief to areas that were cut-off. He has been back 5 times since and trained local Dr and Counsellors in using NLP techniques alongside with Alternative Medicine in treating Post Traumatic Stress Syndrome. He acheives wonderful results over a very short time. He is now busy with the floods in Bangladesh and earthquakes in Indonesia