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India Earthquake: MSF Develops Local Counselors For Mental Health Program
February 14, 2001
With the official death toll expected to exceed 20,000 - a figure that means nearly every family in Bhuj and the surrounding area has experienced personal loss - Doctors Without Borders/Médecins Sans Frontières (MSF) is focusing on the development of crucial mental health programs to help the local population deal with the aftermath of the earthquake.
MSF is training local nurses, teachers and social workers to counsel trauma victims and cope with the emotional effects of the quake.
Nineteen volunteers received training last weekend (Feb. 3- 4). Half of the group experienced the earthquake, and three of them were caught in the debris. After training the counselors will start working in villages throughout the region under MSF supervision.
These counseling programs will be crucial to the region's recovery. When people experience a traumatic event such as a natural disaster they may suffer post-traumatic stress. The MSF mental health program can prevent problems like post-traumatic stress disorder, depression, psychosis, isolation, and feelings of guilt among the affected people.
"The most important thing is to explain to the people here that all these things they are experiencing now â€¦ are all normal reactions to a totally abnormal situation and experience," explained MSF psychologist Reine Lebel, currently working on the mental health program in Bhuj.
Victims may experience emotional reactions - anger, anxiety, nightmares or flashbacks-or physical symptoms such as heart palpitations, difficulty sleeping, muscle aches, or headaches.
The recovery of individual victims is further complicated as the natural support system of the community has collapsed. The usual support structures -- family, community and religious institutions - have suffered damage from the traumatic event. Individuals first need to get some self-control and feel secure before they can help their family members, friends and neighbors begin to heal.
"I met this old woman, 90 years old, in Padhar village, east of Bhuj," said Lebel. "She had two fractures as well as an infected wound on her hand. She was screaming with pain, not because of the wounds, but with mental anguish. During the quake she went back into the house to save her two month old grandchild. But the child died. She wasn't able to save it and she was tortured by guilt. She had her sons there taking care of her and I had them explain to her that is wasn't her fault. She did what she could to save the child. But then also the eldest son needed taking care of, he was the father who lost the baby..."
It is important for trauma survivors to re-establish familiar routines to restore normalcy to their lives. This is especially important for children.
"The children will go back to their schools February 26th, one month after the quake, and they really need that kind of normalcy to come back into their lives to end the survival phase," Lebel said.
MSF efforts have targeted mothers of young children, the children themselves, the elderly, marginalized groups, and people without support of family, friends, and the community.
Mental health will also be an issue for the people providing the counseling. The counselors are trained to provide an empathetic ear to people who have suffered a near-inconsolable loss and their job may quickly take a toll on them. Daily debriefings with colleagues are mandatory within the counseling group.
As a part of the MSF mental health program, another workshop is planned for a group of 20 counselors in the town of Bhauchau.