August 4, 2008

Mental Health Workers Becoming Standard in Disaster Relief Efforts

By Joshua Norman

COLOMBO, Sri Lanka - It was morning when the water unexpectedly rose and rushed ashore, destroying nearly everything in its path. The human toll was inexplicable and fears of a mass mental health crisis were profound.

Those are just some of the many similarities between the Indian Ocean Tsunami of 2004 and Hurricane Katrina in 2005. While the number of victims was vastly larger in Asia - more than 250,000 people were killed in the tsunami; 1,836 were confirmed dead with 705 missing after Katrina - the aftermath presented comparable challenges.

In one such similarity in Sri Lanka, which had the second- highest death toll from the tsunami, the world responded to the crisis not just with a deluge of bottled water, food and clothes, but also with psychiatrists, trainers and counselors. This is a pattern emerging for disasters worldwide.

Within a month of the disaster, according to reports, there were an estimated 300 aid organizations like the Red Cross and Oxfam in Sri Lanka, a fourfold increase. They all offered some way - sometimes unique, sometimes competing - through the grieving.

Besides occasionally contradictory agendas usually not coordinated with each other, only half of those aid organizations in Sri Lanka even registered with the government, said John Mahoney, the director of the World Health Organization's mental health initiative in Sri Lanka since the tsunami.

"Sri Lanka just opened its doors ... there was no checking," Mahoney said. "We found one organization just handing out anti- depressants to people."

Many locals began questioning whether the vast resources being poured into how to heal people were effective.

Within six months, committees were formed by pre-existing aid organizations to figure out exactly what was needed and who was offering services, Mahoney said. Before long, an overall picture of the mental health situation emerged.

"I was very frustrated after the tsunami because I lost everything," said Randombage Soma, 56, through a translator. Soma is a secondary-school religion teacher from the village of Wattegama in southern Sri Lanka.

From pre-tsunami to today, there were and are only about 50 licensed, practicing Sri Lankan psychiatrists and psychologists in the country to help catch that 5 percent of survivors who might be ailing greatly.

One of those psychiatrists, Dr. Mahesan Ganesan, was the only psychiatrist for more than 1.4 million people in eastern Sri Lanka when the tsunami hit.

The Northeastern Province he practiced in received some of the worst damage.

Because of his expertise, he and other local professionals formed an unofficial committee and began coordinating local disaster response.

"We didn't take a mental health approach," Ganesan said. "We took a psychosocial approach, more kind of a preventive [approach]. There is no way we can hold back the effects of the tsunami, but what we can do is to make sure that that burden" is lessened.

Originally published by McClatchy Newspapers.

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