FIG1 Indonesia's mental health
minister announced last month he wants to reach the 650,000 refugees from
December's tsunami in Aceh province in northern Sumatra.
David Ratnavale, M.D., will assess the need for trauma training and meet
with psychiatrists who are experts in disaster response.
Aceh was the nearest land to the earthquake's epicenter and bore the brunt
of the raging tsunami that overtook its coastline, killing more than 100,000
people there as of last month.
Indonesia has rudimentary mental health services, with only 600
psychiatrists to care for more than 238 million people. In addition,
psychiatry is disdained by the medical profession, and psychiatric illness is
heavily stigmatized, according to news reports from there.
The Indonesian Psychiatric Association and other mental health groups are
collaborating with the government's mental health division to set up trauma
treatment guidelines for tsunami survivors, according to a January 13
Syed Arshad Husain, M.D., an APA member and director of the University of
Missouri Trauma Center, left for Jakarta, the capital of Indonesia, last month
with a team of psychiatrists, psychologists, and educators to train 50 to 75
teachers, nurses, general practitioners, and humanitarian workers in trauma
treatment. Husain told Psychiatric News that the team will also
conduct trauma training workshops for local professionals in Colombo, the
capital of Sri Lanka.
"We know that mental health services are rudimentary at best in these
countries and cannot meet the tremendous needs that traumatized people will
have in the coming months," said Husain.
APA member David Ratnavale, M.D., a disaster expert originally from Sri
Lanka, went to Colombo last month to assess the mental health needs of tsunami
survivors and advise the government about how to respond to those needs. He is
APA's liaison to Sri Lanka's psychiatric community and will report back to
Ratnavale told Psychiatric News that he also advised a previous
government in Sri Lanka on addressing trauma at the height of the longstanding
conflict between the Sinhalese government and the Tamil minority who are
demanding their independence.
The Tamil separatists reside in the northern and eastern parts of the
island, and the Sinhalese majority live in the central and southern parts. A
fragile ceasefire has been in effect since 2002, and the two sides are
cooperating on relief distribution, according to Ratnavale. He pointed out
that the two groups differ in ethnicity, language, and religion.
"As a result of the tsunami's indiscriminate destruction in both
government- and rebel-controlled areas, their respective militaries are
working together in relief operations. Politicians are hoping that this will
continue and enhance the peace process," Ratnavale commented.
The Sri Lankan government has established a psychosocial division and sent
medical and mental health workers to the hard-hit coastal areas. Ratnavale
will assess the need for trauma training and meet with psychiatrists with
expertise in disasters while there.
Another APA member, Manoj Shah, M.D., is in India, his country of origin,
to assist with the mental health aspects of the tsunami that ravaged India's
southern coastline and killed more than 10,000 people there. Shah is an
advisor to the board of the Mental Health Research and Education Trust in
Ahmedabad, his hometown.
"I plan to coordinate the tsunami mental health aspects with the
philanthropic organization," Shah told Psychiatric News. The
trust funded Shah to establish a group-counseling center in his home city
after a severe earthquake killed thousands in 2001.
Meanwhile, the Indian Psychiatric Society (IPS) has established the Task
Force on Tsunami Disaster made up of psychiatrists from the four southern
states that were the hardest hit.
IPS President J.K. Trivedi, M.D., told Psychiatric News. "We
will collaborate with the National Institute of Mental Health and
Neurosciences in Bangalore. The government has designated the institute as the
main psychiatric center to help tsunami victims." ▪