China: MSF in Sichuan Province, Three Months After the Earthquake

Since a devastating magnitude-8.0 earthquake hit China’s Sichuan province three months ago, Doctors Without Borders/Médecins Sans Frontières (MSF) has provided surgical and basic medical care, offered expertise in kidney problems to reinforce the treatment of the “crush syndrome¹” , donated medicines, medical supplies, and other relief items, including heavy-duty tents and plastic sheeting, to the affected population. Currently, MSF continues to provide mental health care to the survivors in Hanwang, Mianzhu city. Dr. Misa Sugawara, field coordinator for MSF in Sichuan, gives an update on MSF’s relief efforts.

Three months after the earthquake, how do people respond to mental health care?

Many people are still experiencing a deep sense of loss, grief, and mourning after such a terrifying event. On the other hand, most of our patients are showing signs of recovery and we no longer come across emaciated patients who have not eaten for days, or those suffering from persistent sleep disturbances. Until now, our team of three psychologists has followed 113 patients and carried out 196 psychological consultations, and most patients do not need to come back after two or three consultations. At this stage, MSF is assisting the victims to help make a natural recovery, which is within the capacity of most victims.

How is MSF’s mental health care accepted by people in the area?

Before the earthquake struck, there were no psychologists in Hanwang and mental health care was non-existent there. In the aftermath of the earthquake people were in shock with intense fear and clearly in need of psychological care. But mental health care was unfamiliar to them, and in the beginning it was seen in such a negative way that some people thought it is shameful to seek help, it would make them look like a weak person etc. MSF is offering mental health care at three consultation sites around Hanwang—Xia Luozi, Wudu and Jiulong—but the team is also visiting surrounding villages to reassure people that fears and anxiety are normal reactions, and that anyone can experience such problems. Together with “village doctors” who have in-depth knowledge about villagers’ health and hygiene, the team is also visiting patients in remote areas who cannot access our consultation sites due to lack of transportation or because they are sustaining injuries.

Over five million people have been left homeless by the earthquake. Have the needs for shelter been met?

The response of the national authorities, local and international NGOs, as well as individual volunteers has been enormous and efficient, and the needs for shelter have been largely met in towns around Hanwang. However, we have also identified people without proper shelter in some remote villages. When I visited four villages near Wudu two weeks ago–each with a population of 3,000 to 4,000–around 90 percent of villagers were still living in makeshift shelter made of sticks and plastic sheeting. The rain has started in the region, and this year’s precipitation is reported to be higher than usual. The water can easily leak inside shelters and such living conditions could trigger respiratory infections. These shelters will not withstand the cold weather in the coming months, either. We believe that China has the capacity to continue to mobilize resources to assist earthquake survivors, but we will follow the situation closely to see whether there is a gap in aid delivery.

What is the next plan for MSF in Sichuan?

Our assessments indicate that some critical needs, including food, water, sanitation and hygiene, are largely met in most affected areas, and as an organization focusing on emergency medical and humanitarian assistance, MSF is not planning long-term reconstruction efforts in Sichuan. Meanwhile, around 10,000 patients are returning to Xia Luozi, one of our psychological consultation sites, after being treated at hospitals across China. And many of them will now require post-operative care and physiotherapy. MSF will undertake an evaluation of activities in early September, and we will reorient our intervention as appropriate.

Although the initial shock is wearing off, many people have lost everything in a flash, including their loved ones, and they are struggling to come to grips with what their lives have become. Besides medical and psychological care, people are in need of assistance in various forms towards long-term recovery and reconstruction.

MSF has worked in China since 1988. At the time of the earthquake, MSF staff members were working in Nanning, Guangxi Zhuang Autonomous Region, where the organization has been running an HIV/AIDS streatment program since 2003 in collaboration with the Guangxi Public Health Bureau and the Nanning CDC. In early 2008, MSF handed over another HIV/AIDS program in Xiangfan, Hubei Province, to the Chinese authorities. Currently, MSF has five international and five national staff working in Sichuan.

¹ Crush syndrome is a condition in which muscle tissue damaged by severe internal injury may release massive quantities of toxins into the bloodstream and lead to kidney failure. Left untreated, crush syndrome can be fatal.