Mohammed
Ahmed lost two of his children when the waves hit his island
– a five-year-old son and a seven-month-old baby girl.
His son was with his wife and the baby was in the arms of an
older sister when the entire family was swept out to sea.
Despite a leg injury, Mohammed was able to save his eldest daughter,
but the other two children were lost. The body of his son was
found in the sea three days later. The baby’s body has
never been recovered.
“Now it is better,” says Mohammed of his physical
injury as he shows us the scars on his injured leg. “But
my wife still can’t sleep at night and I keep thinking,
and dream bad dreams.”
Almost three months after the tsunami ravaged the scattered
island nation of the Maldives, the reconstruction of homes is
under way, the physical injuries are healing, but the mental
wounds will take much longer to disappear.
There are many stories similar to Mohammed’s in the Maldives.
Two thirds of the population of 300,000, spread over 199 inhabited
islands, was affected by the disaster. More than 80 people were
killed, 1,313 injured and almost 30,000 were displaced.
The effects of that traumatic day manifest themselves in various
ways. Children have started to wet their beds, some have become
quieter or more aggressive than normal, others cry or can’t
sleep.
In a camp for displaced people on Gan Island in Laamu atoll,
a little girl walks around hugging a football. Her face is serious
and she doesn’t interact with the other children. Some
of the adults do not want to talk or be photographed. Their
eyes are distant, betraying painful experiences that still are
too difficult to open up about.
Tsunami touched all
“We visited several islands in Laamu atoll 20 days after
the disaster. People were just sitting around in the ruins,
looking with empty eyes into the air,” Anthu Ismail recalls.
Anthu is a youth counsellor participating in the psychological
support programme run by the American Red Cross, with the support
of the Maldives’ Government National Disaster Management
Centre (NDMC).
While it is difficult to estimate how many people are suffering
from psychological problems following the disaster, most experts
agree that everyone has been affected in some way. The country
whilst widespread has a small population of close-knit communities.
Those who were not directly affected have relatives or friends
who were.
Dr Satya Brata Dash, a psychiatrist from India, is the country
manager of the American Red Cross psychosocial programme. He
stresses the need for organisations such as the Red Cross Red
Crescent to try to cover the psychological needs of the people
of the Maldives and to ensure those affected don’t “fall
through the cracks”.
“People with psychiatric diagnosis are normally referred
to the health system. However people who are distressed but
who do not fulfilling psychiatric diagnostic criteria, are not
covered by this system, and this would encompass many of those
affected by the tsunami,” says Dr Satya.
He says these people are having problems due to their personal
first-hand experience of the tsunami, the loss of loved ones,
displacement, financial difficulties, loss of livelihood or
feelings of guilt.
Dr Satya says that without help, many will end up with psychiatric
problems, which could leave the local infrastructure unable
to cope – a very real risk with just one trained psychiatrist
in the Maldives’ health system.
Restarting daily routines
The American Red Cross psychosocial team was in the Maldives
within ten days of the disaster. Its goal was to establish a
nationwide community-based psychosocial support programme. The
American Red Cross has a similar programme operating in Sri
Lanka, and is planning to replicate them in India and Indonesia.
The programme helps people to overcome stress and develop resilience
by providing psychosocial support. People are assisted in ‘processing’
their experiences by talking about what happened and restarting
their daily routines. Children are encouraged to express themselves
through drawings or making clay models.
The team quickly trained 57 counsellors in psychological first
aid who then visited seven of the most affected atolls. During
the visits, ‘emotional support brigades’ consisting
of community volunteers were set up and trained to continue
the activities on a local level.
In addition, a total of 321 teachers throughout the country
have been trained and are now implementing activities in schools
on their home islands. The teachers carry out exercises to assist
the children in parallel to normal school activities.
“Many teachers have not been able to deal with the children’s
changed behaviour. They say that everything is OK, but then
they see the children’s drawings and realize that it is
not OK. They now understand that this will take a long time,”
says teacher Fathimath Zeeshan Latheef.
Abdul Zamad, a school teacher on Fonadhoo Island, says the training
has been very beneficial. “When we started school after
the tsunami, some children were badly affected. The workshop
taught us how to reduce stress, how to overcome the children’s
problems. Now we make drawing exercises, they draw their fears,
their experiences from the tsunami,” she says.
Long term needs
The programme is achieving the important task of addressing
immediate psychosocial needs and the rapid response by the Red
Cross has been appreciated by the local authorities. Arif Rashid,
coordinator of the psychosocial support unit of the NDMC says
the assistance has been very important.
“None of our counsellors had trauma experience. We had
never faced anything like this. The Maldives had been a disaster-free
zone. We had no capacity and previous experience to deal with
such a disaster,” he explains.
But there is a realization that psychological support must be
ongoing. While the immediate response phase is now ending, both
Arif Rashid and Dr. Satya emphasize that there are long-term
needs which require long-term responses.
The American Red Cross and NDMC are initiating a two-year psychosocial
support programme in schools and communities. The experiences
gained in response to the disaster are being used to create
an emergency response unit at national level.
“This way victims become victors,” says Dr. Satya.
“The long-term programme will not only help people overcome
this disaster, but also help them create mechanisms for coping
with future problems in communities.”
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In
a camp for displaced people on Gan Island, a girl walks
around hugging a football. Many children have become withdrawn
as a result of the disaster (p12722)
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Two
boys make a clay model, a technique developed by the American
Red Cross to help children process their experiences (p12723)
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Anthu
Ismail, one of the Red Cross-trained teachers, passes
on her skills to colleagues on one of the affected islands
(p12725)
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An
important part of the American Red Cross activities in
the Maldives is helping children to overcome their experiences
through recreational activities (p12724)
The children’s drawings reveal the horrors they
experienced when the tsunami struck (p12726)
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