Traumatized

Now that food, water, clothing and other relief goods are moving to Tacloban City and other areas in the Visayas hard-hit by Supertyphoon “Yolanda,” another front in the campaign to help the survivors of the tragedy has opened with the recent deployment by the Department of Health of a 55-member team of psychologists.

Tending to the mental health of shattered survivors may appear like second priority, given the overwhelming need to provide them first with the basic necessities. But health professionals have long recognized that the trauma of disaster tends to have a deeper, more debilitating effect on survivors. The loss of loved ones and the destruction of home and property all in one blow can shake people to their core, and the effect of that battering may manifest over time in various ways: irrational behavior, unrelieved anxiety, sleeplessness and nightmares, hyperventilation and panic attacks, psychosomatic illnesses, a sense of paralysis.

Richard Bryant, professor and director of Traumatic Stress Clinic at the University of New South Wales, wrote in an online article: “Most people consider the immediate threat of tsunamis washing people away or buildings falling on people as the source of trauma. In actual fact, the greater source of persistent distress comes from the more subtle long-term effects of disasters.

“When economies are undermined by infrastructure damage, the effects on people can last for years, [with] the capacity for people to work and for communities to sustain an adequate level of productivity… severely undermined.

“This can result in insidious rises in depression, anger, and conflict as people cannot earn enough income and communities cannot rebuild. In this sense, the mental health effects of a disaster can be felt for years afterwards, even though the causal link between the disaster and the observed mental health problems may not be obvious.”

In the case of Tacloban, survivors are not only confronted with devastated homes and lost loved ones, but the unimaginable sight of an entire city erased from the map. With it has gone entire lifetimes of economic activity, human effort and painstakingly built communities. The question that now haunts survivors, on top of having to survive from day to day, is an existential one: Should they stay in Tacloban, when Tacloban seems no more? Even the mayor is urging residents to leave and seek shelter elsewhere, because clearing away the rubble and rebuilding the city would take years, not to mention herculean effort and resources.

Already, the horrifying effects of the tragedy have begun to manifest in incidents of anarchy and lawlessness, as survivors search for a way out of their hunger and desperation. “We are worried that in the next few days, there will be anarchy,” said Annabelle de Veyra, chief health administrator of the region. “Two big stores have already been looted. It’s not just food that they are getting… They are hoarding everything. These are psychological effects.”

The pillage not just of food but even of such nonessentials as TV sets and refrigerators is a reaction of people having lost everything in the disaster, said De Veyra. “There is a justification: ‘I do not have anything, but now I have the means to acquire them.’ It’s all about knowing that they are in control—that they call the shots.”

Such deep psychological scarring will require much attention and care—the earlier, the better. Physical wounds can be healed, and the body may be made whole and healthy again, but without the proper psychological intervention, survivors living with horrific memories of Yolanda’s wrath are in danger of more long-lasting ailments. “It could lead to mental breakdown, emotional imbalance, confusion and depression,” said De Veyra.

More health professionals should be tapped by the government to conduct therapy and counseling sessions for the survivors, who would need some form of release from their nightmarish experience. A number of performers and artists have also started a move to visit the devastated areas and engage residents cooped up in evacuation centers in exercises and activities that would help address the emotional logjam.

The odds remain overwhelming, and the urgency will not abate in the days and weeks to come. But every responsible bit will help get fellow Filipinos back on their feet.