Kerala, after the flood: People at risk of PTSD, survivor syndrome may need help; state must brace for what TN faced after tsunami

There is no need for panic, but all major disasters bring in their wake hazards of both physical and mental health. Luckily, both can be brought under control with appropriate and timely intervention.

Rescue operations in Wayanad. Image courtesy Indian Navy

Rescue operations in Wayanad. Image courtesy Indian Navy

Dehydration, malaria, diarrhoea and a bacterial infection called leptospirosis are among the common risks that follow floods. Kerala’s health department is already on the job, issuing dos and don’ts to people and administering preventive medication to those at relief camps. But the state clearly needs to deal with a larger population outside the relief camps, who are vulnerable to these risks.

Tamil Nadu’s record in dealing with health hazards that followed both the 2004 tsunami and 2015 floods was commendable, largely because doctors and medical workers from unaffected districts were quickly deployed where they were needed. But with most of Kerala’s districts hit by floods, the state must necessarily depend on help from other states to organise stationary and mobile clinics to reach people.

The news of doctors from Maharashtra leaving for Kerala is hopefully a sign that more medical help will arrive from other states as well. Needed: psychiatrists too As was seen in tsunami-hit places, survivors of disasters could be prone to a mental health malady which psychologists call Post-Traumatic Stress Disorder (PTSD) or “survivor syndrome”. Health workers who are, or who will be, in touch with the victims, need to be sensitised to look out for symptoms among them such as loss of appetite and sleep, dizziness, nervousness and difficulty in concentration. Most will recover in a couple of months, but some may be haunted by bad memories for years and may need psychiatric help at least by way of counselling.

The Union health ministry, as well as some premier mental health institutes of the country, sent teams of psychiatrists to tsunami-affected areas to scout for and help psychological victims of the disaster. Psychiatrists from Chennai’s Institute of Mental Health were among those who visited Cuddalore and Nagapattinam and found mentally shattered victims. This is what the institute’s director M Murugappan told me at that time: “We first allow people to vent their feelings. Even if we hear them for 10 or 15 minutes, that itself is therapy. Then we ask pointed questions about any complaints that may be mistaken for physical illnesses but are manifestations of mental ill-health.” A study conducted in a village in Cuddalore district two months after tsunami found that 12.7 percent of the adults suffered from PTSD symptoms of irritability and emotional numbness. Other studies confirmed the incidence of PTSD among victims of 1993 Latur earthquake and 2005 Mumbai floods.

Problem of plenty?

It’s certain that help of all kinds will begin to reach Kerala now since road, rail and air traffic to the state is beginning to resume. But Kerala must guard against what Tamil Nadu faced after tsunami: the problem of plenty. There were simply too many things of the same kind that were arriving. Clothes were among them. As a result, heaps of clothes that came in from outside the state which nobody wanted were a common sight on the roadside. There was also a surfeit of rice, cooking fuel, stoves and utensils. An IAS officer told me that it was “nice to see” the families of many survivors blessed with four or five stoves. Reports of some villagers selling off rice and dal given to them were alarming. At one point, the state appealed to donors to stop giving things in kind and donate cash instead to the chief minister’s relief fund. What also helped was publicising the lists of things needed and not needed, something that is already being done in Kerala’s case too.

Tamil Nadu also surmounted this problem by insisting on routing all help from NGOs through a government-appointed team, though this arrangement didn’t work as well as it was expected to. Actor Vivek Oberoi, who adopted a tsunami-hit village near Cuddalore told me at that time: “It’s meaningless to give them things like clothes and provisions (beyond a point). Without homes, where will people keep these things?” He took up the task of building hundreds of modest homes.

And that brings us to the possibility of opening some of Kerala’s affected areas for adoption by the rich and the corporate, it and reminds us of the challenge of helping those who lost homes in the floods. This is a major responsibility that would need significant resources.

The Kerala government is planning to provide assistance to rebuild and repair damaged houses under its Life Mission project The centre is also likely to pump more funds into Mahatma Gandhi Rural Employment Guarantee Scheme (MGNREGA) and sanction houses in Kerala under the Pradhan Mantri Awas Yojana-Gramin (PMAY-G).

But considering the magnitude of the housing crisis Kerala has to confront, it’s likely that what both the state and the Centre are doing will fall short of requirements, unless private and corporate donors add to this effort significantly as it happened in Tamil Nadu after the tsunami.

No, disaster tourism please

As it happened after the tsunami, large numbers of people may visit affected areas in Kerala to “have a look” at the devastation. This “disaster tourism” will only hamper relief and rehabilitation work apart from putting pressure on infrastructure already rendered meagre by floods. This applies to even politicians of other states. They can express their sympathies by organising men and materials needed in the state instead.

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Kerala must learn lessons from 2004 tsunami relief work in neighbouring Tamil Nadu; task for rehab agencies is mammoth

The author tweets @sprasadindia


Updated Date: Aug 21, 2018 07:21 AM

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