Brazil: Mental Health Care in the Wake of Floods

An MSF psychologist trains a group of local psychologists in Nova Friburgo, Rio de Janeiro

BRAZIL 2011 © Daniel Kfouri

Sérgio Cabral, who coordinated MSF’s activities in response to widespread flooding in the region north of Rio de Janeiro, talks about the work that was done.

Sérgio Cabral, who coordinated the activities of Doctors Without Borders/Médecins San Frontières (MSF) in response to widespread flooding in the region north of Rio de Janeiro, talks about the work that was done. After training more 150 psychologists in four different towns, MSF prepares to leave the area knowing that the work will be continued.

Why has MSF decided to respond to the floods in Brazil?

We came soon after the floods to do an assessment and were shocked by the extent of the disaster. I was also impressed by the volume of aid arriving in some towns, resulting from a massive mobilization by the population, other organizations, and the State itself. However, in more isolated places, the population was stranded and their access to basic medical care was limited. In those places, like Sao Jose do Vale do Rio Preto, aid was much slower to arrive.

What has MSF done?

We have sent two additional teams with doctors, psychologists and a nurse to provide medical and psychological care in the most affected areas. But the volume of aid increased quickly, even in the isolated places. Unfortunately, mental health care was virtually inexistent so that is where we decided to focus.

How have you done it?

There were many skilled psychologists but most had never worked in a context of natural disaster, so they felt unable to help the survivors. Many had also been affected by the floods or mudslides and were extremely shaken by the disaster, and that initially hampered their ability to provide mental health care to those who had gone through the same experiences. We started by meeting groups of psychologists who were working in the area and, together with them, we decided that the best thing to do was to provide training on how to deal with survivors of this type of disaster. These psychologists were working for other organizations or for the public health system. And they will remain in the area after MSF leaves.

How big is the MSF team now?

We have three psychologists with previous experience in other natural disasters like the Haiti earthquake or another flood response in Brazil. When you work with other psychologists, the impact of your work multiplies. We have also seen an increased interest in the training. At the first meeting in Friburgo there were 20 people. On the second day, the number doubled. In total, more than 150 psychologists have participated in the training sessions we provided.

Is this a usual strategy for MSF?

In this case, where there were very skilled local workers and a large number of committed volunteers who are able to respond quickly, it was an appropriate strategy to adopt. MSF also works on capacity building.

What has been the main lesson learnt?

It was great to see the local and national mobilization to respond quickly to this type of emergency. But it is crucial that mental health care is integrated into the response early on to reduce the risk of other reactions such as post traumatic stress disorders at a later stage.