China: MSF Continues Mental Health Care For Sichuan Quake Survivors

On May 12, 2008, a devastating earthquake hit Sichuan province, leaving more than 80,000 dead and 10 million homeless. One year on, displaced people who lost their families, homes, and jobs in the quake are still suffering from psychological disorders and are in need of support to rebuild their lives. Doctors Without Borders/Médecins Sans Frontières (MSF) has been continuing psychological care to theearthquake victims.

The process of rebuilding collapsed houses has been underway since December 2008. But even after one year, a majority of people do not see big changes in their lives. “Schools and hospitals are the first priority, which will be completed in one or two years,” said Tamara Pierson, MSF Field Coordinator in Sichuan. “A large number of people are still living in a temporary housing and unsure of when they can rebuild their houses. While this can be seen as a chronic situation, the overall level of living conditions is quite stable in terms of basic water and sanitation, security, good electrical facilities, and civil structures.”

With the quake's one-year anniversary, people become sensitive and afraid of another natural disaster. In September 2008, heavy rain caused floods in Beichuan county, and landslides swept away temporary housing in Leigu. As rainy season has begun this year, there is heightened anxiety about further flooding.

Erica Pellizzari, MSF's Psychological Manager in Sichuan, said people are suffering mental disorders not only from quake-related trauma but also because of constant anxiety for the future. “People are having difficulty  adopting and accepting the reality. It’s not only that the past experience came out as a nightmare or flashback, but people are having insomnia, lots of headaches and complaints due to stress, constant anxiety, and feelings of hopelessness about the future,” said Pellizzari.

To address these needs among earthquake victims, MSF has been providing psychological care in Beichuan County and Mianzhu city, in collaboration with the Chinese Academy of Science and Crisis Intervention Center since November 2008. Under the supervision of MSF psychologists, 10 Chinese counselors provide psychological counseling at the consultation rooms set up in five temporary housing sites in Bayi School, YonXhin, Wudu, ZhuLin, and Leigu, located in the area of Mianzhu and Beichuan. Counselors conduct home visits and offer consultations to assess and screen possible patients.

“When our counselors assess people, more or less, 50 percent become our patients,” said Pellizzari. “Most common symptoms are sleep disturbance such as insomnia, constant worry or anxiety, fear that something else could happen again, constant sadness, crying, persistent re-experience through nightmares or flashbacks, and memory or concentration difficulties. The symptoms are typical in people who experience such an unexpected and devastating event. Little by little the symptoms decrease, but there will be always part of the affected population that will need specialized psychological help to regain their former mental health condition.”

Lou Junwei, an MSF counselor working in Leigu, saw how one of his patients recovered after receiving consultations. “He lost his wife in the earthquake. Before coming to the consultation, he couldn't sleep until 1AM and woke up at 3AM everyday, which means he had only two hours sleep. He was very anxious and had no plans for the future. He was very sad and desperate, but he couldn't express his feeling because he has two children and had to act like a brave man. After receiving the consultations, his attitude became very positive. Now, he is running a business with his children in Leigu.”

Before the earthquake, psychological support was very new in China. In areas where MSF works in Sichuan, MSF is the only organization providing individual and group psychological care. Erica Pellizzarii said clinical approach is very important to diminish patients' symptoms. “If someone is suffering, participating in community activities such as a handcraft is positive, but will not really reach the essence of the problem. There’s people who will only be able to improve with clinical psychological approach,” said Pellizzarii. “Our project gives a constructive example to the community that therapy works and has good effects.”

By March 2009, MSF teams had assessed more than 650 people, followed 300 patients, and conducted about 1,500 consultations. MSF also provides training and supervision of Chinese counselors to help them dealing with patients and assure a good quality of care.

MSF has been working in the earthquake-affected area of Sichuan, China since May 2008. Currently, 13 national and 3 international staff are working to provide psychological assistance. MSF has also been providing HIV/AIDS treatment in Nanning, Guangxi Zhung Autonomous Region since 2003. MSF has worked in China since 1989.