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Still Touched by the Tsunami - Emotional Scars Run Deep

India West, News Feature, Bala Murali Krishna Posted: Jan 02, 2006

BANGALORE - It is not difficult now to imagine a tsunami-a wall of water crashing on to shore with gale force. What is difficult to imagine is the terror it brought. In the amateur videos that have been aired on many television channels around the world, what is far more revealing than the huge waves is the naked fear in the eyes of the trapped people and the expression on their faces. We could watch a million replays of the tsunami videos and never truly know fear.

It is for this reason that psychiatrists believe every single person who witnessed the tsunami is, in a manner of speaking, a "victim." A year after the worst natural disaster in recorded history, stories abound in the media of "resilience" shown by the affected communities and individuals. Such stories--anecdotal at best, and apocryphal at worst--suggest a false sense of well-being, reinforcing widespread "not me" misperceptions among the victims.

"Anybody and everybody who witnessed the tsunamis is affected," asserts Dr. K. Sekar, a psychiatrist at Bangalore's National Institute for Mental Health Sciences who has crafted counseling programs for disaster victims for over two decades.

Obviously, the waves touched one and all--in different ways.

A 19-year-old girl in Tamil Nadu's Nagapattinam who was wildly tossed around by the waves should feel grateful for being alive. But she is tormented by the thought that two adult men who rescued her had "touched" her naked body, after she had lost her clothes in the swirling waters. In her tradition-bound society, it is a shattering thought to live with. Similar stories abound in the region. So much so, Sekar has identified the women and adolescent girls as the most vulnerable group in many parts of the state-the worst-hit in the country.

In the Nicobar islands, a little boy remains haunted by images of a giant wave washing away his Hindi teacher. Many other children have been deeply affected by the loss of their pets. Sekar says nearly 85 percent of the islands' children remain "severely affected." The rest are "mildly affected."

Men have been no less scarred. Countless fishermen who bore the brunt of the tsunami's fury remain traumatized, unable to overcome a sudden fear of the sea. Sekar's group is targeting the men who they believe are the most disturbed group in Chennai.

Even though psychiatric social workers believe the problem to be widespread, one of the commonest reactions they face is this: "Not me, nothing is wrong with me. I am fine." Such perceptions rule. Even in the case of orphan children, guardians believe all is well in a misplaced hurry to forget the past.

A teacher-guardian at a state-run orphanage in Nagapattinam told India-West the 98 children under her care had "forgotten grief" and were now "excited about the future." Vasantha brought forward two children--aged 9 and 11--who said they were "happy" and "glad" to be here. Later, many children in a classroom smiled as they posed for photographs.

Things are far from hunky-dory, warns Dr. Subashish Bhadra, a NIMHANS psychiatrist who has worked for months together in Tamil Nadu's affected regions. Untrained people are unable to fathom the depths of grief, he said. In fact, simple psychological tests reveal underlying fear and decreased levels of concentration, among other things. When asked to write down their greatest fear, between 95 percent and 98 percent of the children still list the tsunami, and most find it difficult to "overcome their negative emotions," said Bhadra.

With patience and persistence, trained counselors have been able to reach out to many people including children. What they report belies popular perceptions of resilience and courage. Bhadra says a stunning 70 percent of the tsunami survivors suffer from "psychological disorders" of some kind. An even higher proportion is "dysfunctional"-unable to carry on with its professions or lives in the same manner as before. Independent surveys support such findings. For example, a World Health Organization-designed survey of victims on Nicobar islands revealed that 70 percent of men and 79 percent of women still express a (irrational) fear of the sea.

Fear, guilt, hyper-vigilance, palpitations, disturbed sleep patterns and even mild depression are some of the reactions commonly seen in most tsunami victims as they cope with the catastrophic change to their lives. Sekar says the survivors' reactions are invariably heightened, yet are "normal responses in an abnormal situation." People exhibiting these symptoms do not need drugs, but require counseling to help them achieve normalcy.

To illustrate the survivors' dysfunctional capabilities, Bhadra cites people in the village of Pattanamcheri, near Karaikal. In the village, men are loath to go to work, women suffer severe sleep problems. To most, "life has lost any meaning," said Bhadra. In Pattanamcheri, 63 of the 70 families lost at least one child, and many have been left childless. Bhadra says 70 percent of its residents suffer from what he calls "psychological distress."

Seven women in the village have undergone an operation-reversal of sterilization-allowing them to again have babies. While the state-funded surgery may seem like a boon, it is far from it. Bhadra says the women face increased pressure to conceive and an unrealistic expectation that they will deliver male babies. Their one-room homes afford little privacy. Under the stressful conditions, the women find it hard to have sex and harder still to conceive.

Traditionally, societies have depended on community support to cope with crises of any kind. But when almost every household is grieving, asks Sekar, who can provide the healing? That is why Sekar believes programs such as the one he runs are vital. These are funded by large NGOs and so ridiculously cheap to run-a mere Rs. 10 per person per year, says Sekar-that it is a pity more people can't be reached quickly enough.

Sekar began studying disaster victims in 1981 when scores died in a circus fire in Bangalore. Since then, he has marshaled the resources of the NIMHANS-the leading psychiatric center in India-to counsel victims of the Bhopal gas tragedy, the earthquakes in Latur, Maharashtra, and Bhuj, Gujarat, and Orissa's super-cyclone in the 1990s, and trained thousands of volunteer counselors.

With that wealth of experience, Sekar's team swung into action days after the tsunami because "all our tools were on hand." Three days later, a team of 27 mental health professionals were in the affected regions including Sri Lanka and Indonesia to deliver what Sekar calls "emotional first aid." In the year since the tsunami, Sekar's department has trained 6,000 volunteers who are out on the field counseling survivors.

Sekar says NIMHANS ran counseling programs for victims of Orissa's super-cyclone for three years. For survivors of the worst natural disaster, the normalization program could conceivably be much longer. That is why the ToT--Training of Trainers-workshops continue to be run in a cramped room at NIMHANS' Department of Psychiatric Social Help.

Days before the first anniversary of the tsunami, about 30 volunteers from Tamil Nadu huddled together in that room as Bhadra, with a doctoral student serving as his assistant and Tamil instructor, ran a three-day program. In one session, small groups of four or five people using plastic toys and Play-doh are narrating childhood incidents-seemingly trivial-that deeply impacted their lives. Bhadra says the exercise helps the volunteers gain empathy and fully comprehend the far more profound nature of the tsunami survivors' experiences-a tall order indeed for most of us.

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