Disaster's definition:
"A situation resulting from an environmental phenomenon or armed conflict that produced stress, personal injury, physical damage, and economic disruption of great magnitude." - US disaster relief specialist, Frederick C. Cuny (1944-1995)
"The result of a vast ecological breakdown in the relations between man and his environment, a serious and sudden (or slow, as in drought) disruption on such a scale that the stricken community needs, extraordinary efforts to cope with it, often with outside help or international aid." - World Health Organization (WHO)
How will you respond?
Feeling sad, lost and shaken are the normal responses right after disaster, starts with the critical phase of less than 1 month prior to the disaster. When not handle or manage poorly, the condition worsens to the second phase of post traumatic syndrome disorder. Next, prolonged stressor will produce negative responses to these three aspects; behavioral, physiological, emotional and cognitive. Traumatized individual leads to decrease productivity, become burdens to family, people and community and have higher risk of suicide.
What is the role of public mental health systems in disaster managements?
“People have access to social and mental health services to reduce mental health morbidity, disability, and social problems.” SPHERE Project: Humanitarian charter & minimum standards in disaster response
The minimum standards are based on two key indicators:
(1) Social intervention
- Access to an ongoing and reliable flow of credible information on the disaster and associated relief efforts. ( the survivors of the disaster should be informed clearly about what will happened to them, what they should do before, during and after the events and must always be updated thoroughly by a trusted sources and not listening to random speculations and rumors. Peace of mind is the key.)
- Maintenance of normal cultural and religious events, e.g., funeral ceremonies
- Access to schooling and normal recreational activities for children and adolescents. ( fun school and recreational activities like football had been done in many places where the survivors stay and it work wonders! The children and adolescent spend their time doing beneficial and fun things that can help them forget about the tragedy.)
- Participation of the in the community efforts for adults and adolescents
- Inclusion in the social networks for the isolated persons, e.g., orphaned children.
- Reunification of separated people and families. (every person will be worried about the conditions of their family members. Knowing that our family is safe and can be with them during this crucial time will bring great moral supports.)
- Shelter and community organization for the displaced people
- Involvement of the community in the decisions regarding religious and other community facilities.
(2) Psychological and psychiatric intervention
- Access to psychological first aids at health service facility and in the community for the people experiencing acute mental distress
- Availability of care for urgent psychiatric complaints through the primary health care system
- Continuous treatment for individuals with pre-existing psychiatric disorders. Sudden discontinuation of medications is to be avoided.
- Plans for community-based psychological interventions for the post-disaster phase.
Dealing with post disaster conditions is as crucial as facing the disaster itself. The question that we always have to ask ourselves as we lend a helping hand: what more can I do?
References:
1. Lecture Note: Panel Discussion Global and Mental Health System (Capacity Building) on Disaster and Public Mental Health by Dr. Rahmat Hidayat.
2. Lecture Note: Disaster Management in Mental Health by Dr. Bambang Hastha Yoga
3. WHO websites
4. Additional information from respected doctors during lectures.
