March 01, 2001
Copyright Juan Carlos Tomasi/MSF

The ruins of Nagore village, India © Juan Carlos Tomasi/MSF 2001

"The needs here are simply enormous. Whole villages have been flattened, and more than 10 days after the earthquake, people are still sleeping in the streets or sitting huddled around fires to keep warm at night. It will take a long time before these people can achieve something like a normal life. In the meantime, they are dependent on the tents and blankets that we bring them." — David Trevino, MSF logistician in Bhuj, February 2001

When a massive earthquake struck the Indian state of Gujarat on January 26, 2001, MSF was ready to take action. An assessment team arrived on site the next day, and by February 5, MSF had flown in several medical teams and a total of 80 tons of relief supplies. The initial priority was first aid and surgical care for those injured.

The greatest need, however, was tents to shelter entire families from the cold. Focusing on the city of Bhuj and smaller villages to the north and east of the epi-center, MSF distributed plastic sheeting and rope for immediate shelter, as well as blankets and collapsible water cans. Although epidemic outbreaks were not a chief concern, mobile medical teams were set up because primary healthcare facilities were largely destroyed.

MENTAL HEALTH A PRIORITY IN INDIA

With the official death toll expected to exceed 20,000, nearly every family in Bhuj and the surrounding area had experienced a personal loss. An increase in anxiety, depression and anger was quickly detected among the survivors. After meeting immediate needs for shelter and medical care, MSF launched a program to train local nurses, teachers, and social workers to help trauma victims cope with the emotional effects of the quake.

Counseling can be crucial to a region's recovery, preventing problems that may emerge later, like post-traumatic stress disorder, depression, and psychosis.

"The most important thing is to explain to the people here that all these things they are experiencing now are normal reactions to a totally abnormal situation and experience," says MSF psychologist Reine Lebel.

INFRASTRUCTURE COLLAPSED IN EL SALVADOR

El Salvador is also reeling from two devastating earthquakes that struck on January 12 and February 13, 2001. When the first quake struck, MSF volunteers working in El Salvador immediately turned their attention to assisting victims at San Salvador's two major hospitals. Within seven days, there were 53 MSF aid workers on the ground, many of whom came to help from other Central American projects. That number grew to 85 following the second disaster. MSF has provided tent materials, health care, and sanitation services for tens of thousands of people left homeless.

As in India, immediate medical needs soon gave way to the challenge of emotional recovery. In Cafetalon, a sports center where over 10,000 people gathered, a team of five MSF psychologists and one psychiatrist began a mental health program, which provided therapy each day to more than 100 adults and 300 children suffering from emotional symptoms. Trauma was so widespread following the second quake that MSF broadcast messages on radio stations to educate people about psychological symptoms that may follow a traumatic event and to offer practical advice to overcome these symptoms.