Rescuers and volunteers in the tsunami-wrecked countries face the prospect of post-traumatic stress disorder (PTSD), impairing their daily lives once they return to their homes, experts warn.
The immediate focus of counsellors at the disaster sites in the Indian Ocean countries is the wave of despair enveloping the surviving victims — those who lost family, homes and livelihood.
Thwarting potential suicides is a priority, but the threat of PTSD looms next.
When the rescue teams arrived, their senses were assaulted, said Dr Adrian Wang, chief of psychiatry at the Institute of Mental Health (IMH) in Singapore.
Volunteers from the city-state and elsewhere have poured into the Indonesian city of Banda Aceh, the hub of the massive relief effort to help the country worst-hit by the December 26 tsunamis.
Nearly all the 104 000 Indonesians killed were in Aceh province.
Wang mentioned ”the sight of destruction, the smell of rotting flesh, the sounds of wailing families and touching the bodies when they helped to recover them.” Driven by a sense of ”duty and adrenaline”, they function well during the operation itself.
”But once they return, that is when emotions set in and there is a need to diffuse them,” Wang said.
If nightmares and flashbacks last for more than a month, then sufferers are experiencing from PTSD and need professional counselling, Wang said.
”People who are not trained in the field might make matters worse by bringing on PTSD,” Wang warned, while trained counsellors will be able to enhance the coping skills of the rescuers and normalise the grieving process for them.
Family and friends can assist by lending a shoulder to cry on and a listening ear.
”What the trained counsellor does is to reconstruct the event, walk the PTSD suffers through it, and at the same time reassure them that they have control over the fear and anxiety,” he said.
”That way, they will learn to take charge of their fear.
PTSD can occur following the experience or witnessing of life-threatening events such as military combat, terrorist incidents, serious accidents, violent personal assaults and natural disasters.
Sufferers often relive the experience through nightmares and flashbacks, have difficulty sleeping, and feel detached or estranged. These symptoms can be severe enough and last long enough to significantly impair the person’s daily life.
Not everyone who experiences or comes in contact with extreme crises develops PTSD, Wang said.
”Only a small percentage will suffer PTSD and this varies from situation to situation,” he said.
Research on the September 11, 2001 terrorist attack in the United States and the Vietnam War found it can affect as little as 4% to as high as 33% of victims.
PTSD tends to become chronic, and can last for years if not treated. This in turn can lead to more problems such as depression, alcoholism and drug abuse, which interfere with the ability to work, socialise and go about a daily routine.
Vincent Oh is back in his Singapore home after surviving the wall of water that smashed into the Thai resort island of Phuket.
The 21-year-old, describing his emotional scars, told of nightmares of going to the beach and dead bodies lying in front of him.
”I can imagine a lot of bodies lying on the roadside,” he said.
”I may not want to go (into water) because it is a bad memory in my heart.” During the first few weeks since the worst natural disaster in living memory, experts said these sentiments are normal.
”By and large given six months to a year, most people will find their feet and recover again,” Wang added. — Sapa