IRIN
MYANMAR: Coping with cyclone trauma
12 June 2008


BANGKOK, 12 June 2008 (IRIN) - Survivors of Cyclone Nargis continue to
suffer from pervasive trauma, further challenging the process of
rebuilding shattered lives.

"I've seen a lot of people who are very sad, very anxious and afraid
that the wind will blow away everything that's left," said Kaz de Jong,
a trauma specialist with the medical charity Medecins Sans Frontieres,
who has just returned from a two-week assessment mission to the delta.
However, he said he was impressed by people trying to fight back,
despite the extent of the misery.

An estimated 133,000 people are dead or missing after the category four
storm slammed into Myanmar's Ayeyarwady Delta on 2 and 3 May, leaving an
estimated 2.4 million destitute.

Many survivors obsessively replay images of the disaster in their minds
- particularly the last sight of their loved ones, many of whom were
swept away or drowned by the tidal surge that swept up to 35km inland.

Others have trouble sleeping and suffer from palpitations and high blood
pressure - all symptoms of accumulated stress, De Jong said.

Psychological impact

According to De Jong, many survivors, including children, appeared
withdrawn or reported lacking any energy to face the future.

"You all are worried about rice, but people must have motivation to eat
it. But at this moment, my life isn't worth living - I've lost all my
family," one elderly woman told him.

Despair and despondency are "normal", given the extent of the losses
that people have suffered, but limit their ability to rebuild their
lives, MSF explained, adding that signs of acute psychological problems
were rare.

MSF is working to set up support networks to help victims deal with and
recover emotionally from their shocking losses, and to prevent more
acute psychological problems.

"We need to help people recover and make their lives worth living," he
said.

To do that, MSF is trying to identify community leaders and give them
basic training in stress management so they can monitor the most
vulnerable people, such as children and the elderly who are the only
survivors in their family, and help people manage their anxieties.

Such techniques include asking Buddhist monks to lead villagers in
meditation, encouraging people to openly express their feelings about
their experiences, and coaching survivors to think about lost family
members only during certain times of day - to prevent them from dwelling
obsessively on their memories.

In addition, MSF is deploying professional local counsellors to the
delta.

Many other NGOs are also working with local communities to try to help
them understand how they can provide psycho-social support for fellow
community members, so they can cope with the crisis and their losses.

"In Asia, people aren't typically very open about talking about their
feelings so people suffer in silence," James East, a spokesman for World
Vision, told IRIN.

"We will work with the community and train up people, and help them to
recognise the symptoms of trauma," East said.

Health concerns

Meanwhile, more than a month on, health workers in the Ayeyarwady Delta
are working hard to prevent outbreaks of water and mosquito-borne
diseases that could claim an even higher toll among the displaced
survivors, many of whom are now crowded into temporary settlements in
regional towns.

So far, MSF, which had a large operation in Myanmar before the disaster
and rapidly deployed many of its health workers into the disaster zone,
says its 43 health teams have yet to detect any major disease outbreaks,
although they have treated tens of thousands of storm-related injuries,
and are now seeing more cases of severe diarrhoea and acute respiratory
tract infections.

Heavy monsoon rains provide one of the main sources of clean drinking
water in the area, and aid workers have distributed jerry cans to help
survivors collect the rain, although concerns about waterborne disease
remain high, given ongoing problems with access to clean water, soap and
basic sanitation facilities.

On 10 June, the health cluster, led by the World Health Organization
(WHO), reported that its disease early warning system had detected 685
cases of acute respiratory infections, 117 cases of bloody diarrhoea,
and three cases of dengue fever.

While a high number of cases of dengue fever is normal for this region
at this time of year, greater numbers are expected this year given the
living conditions after the cyclone, WHO said.


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