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Time to heal mental wounds
By Esther Williams
A young man lost 12 members of his family to the tsunami. They had been getting dressed to leave to Kataragama for a wedding when the deadly wave struck. He recalls being swept away and getting stuck in a bush. When he regained consciousness, he was in hospital but all others in his family were dead. He had nothing left but the shirt on his back. Feelings of denial were initially uppermost as the young man refused to come to terms with reality and identify his dead relatives.

In the aftermath of the tsunami that has crippled the lives of thousands, there is an urgent need to focus on the mental health of the survivors while catering to their physical well-being. Professor of Psychiatry, University of Colombo, Dr. Nalaka Mendis says, "There are bound to be emotional responses that will vary depending on the nature of loss and the circumstances." He insists that it is a normal reaction to such situations. Those who receive adequate support services will recover sooner emotionally. Grief is a private process and different people respond to it in different ways. Some may like to talk about it while others may be in too much pain to even speak. Post-traumatic stress according to experts can last for weeks, months or even years.

"Shock, bewilderment and numbness are the predominant emotions that a person experiences during the first few days," Dr. Nalaka explains, all of them normal given the circumstances.

"Once that settles, other emotions will surface such as anger, guilt, frustration, emptiness and sorrow," he continued. "Why did I have to go near the sea that day? Why couldn't I have stopped the trip to Galle? Why couldn't I have saved my daughter? Why should I be alive when my family is gone? are among the many questions that crowd into their minds."

In addition, some may have recurrent dreams or nightmares and develop a fear of the sea. A few may even have suicidal tendencies while others may want to leave their villages. All the above would happen before they accept the new reality, according to the psychiatrist.Prof. Mendis assures that the vast majority of people will go through various moods and move on with life, especially those who are well supported, employed and socially accepted. It is the vulnerable group - children, elderly, single or isolated women, the impoverished, disabled and those without support who are likely to retain scars and emotional feelings. Some have seen their parents, siblings or friends die. For children the secure environment of family and school has changed forever.

"They need someone to listen to them, to reassure them, an agent who can communicate with them, be a companion, someone to test their feelings and speak of the positive aspects."

Such support along with help in finding relatives and employment, Mr. Mendis assures would make it easier for the victims to get back to normalcy. Do we need professional counsellors for this task? Prof. Mendis feels such services at a primary level should be entrusted to those already engaged in relief work. "As they provide aid and relief services, teachers, doctors, religious leaders, community leaders, social workers, police and volunteers should adopt a psycho-social approach in dealing with the affected communities."

But they would need some basic training. Prof. Mendis arranged for a team of specialists from the Ministry of Health, in Israel who are experts in disaster management with specialisation in psychosocial approaches to train a core group here in Sri Lanka. "Our aim is to train existing human service providers to integrate such an approach into their work."

On January 11, the Israeli team was in Galle speaking to a group comprising coroners, Islamic and other religious heads, probationary officers, police, representatives from the education, health, social service, university sectors, NGOs and volunteers.

The group addressed the Medical Faculty, Colombo on January 12, the psychiatrists on 13th, community leaders at Sahanaya on the 14th and university academics on 15th. With those sessions a core group of 200 from different parts of the country were trained, some of whom will be delegated to train others.

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