8/10/2019 Remembering the Tsunami Disaster, 10 Years Later

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Remembering The Tsunami Disaster, 10 Years Later

| by Ruwan M Jayatunge( December 25, 2014, Colombo, Sri Lana !uar"ian# $%e ma&&i'e eart%uae o)) t%e we&t

coa&t o) *n"one&ia on December 2+, 2004, regi&tere" a magnitu"e o) nine on t%e Ric%ter &cale$%e e))ect o) t%i& eart%uae ma"e ma&&i'e ti"al wa'e& t%at "e&troye" t%e co&tal belt o) t%enort%ern an" &out%ern Sri Lana -er%a.& t%i& mu&t %a'e been t%e mo&t cata&tro.%ic natural"i&a&ter e'er e/.erience" by Sri Lanan& in t%eir recent %i&tory $%e "amage wa& colo&&al$&unami %a" ille" o'er 50,000 .eo.le in Sri Lana number o) 'illage& %a'e been wi.e" o))an" more t%an 100,000 %ou&e& were "e&troye"

-o&ttraumatic Reaction& ollowing $&unami Di&a&ter in Sri Lana

$%e t&unami %a" "amage" t%e .%y&ical an" mental %ealt% o) t%e &ur'i'or& $%e 'ictim&

e/.erience" multi.le inten&e &tre&&or& *n3ury an" li)e t%reat cau&e" .&yc%ological im.airment$%e magnitu"e o) e/.o&ure to t%e $&unami "i&a&ter wa& 'a&tly relate" to t%e ri& o) .&yc%ological illne&&e& $%e in"i'i"ual& wit% .re'iou& trauma became more 'ulnerable $%e$&unami "i&a&ter 2004 generate" a &igni)icant number& o) 'ictim& wit% -$SD

$%e re&earc% &ur'ey "one by Dr -a"mini Rana&ing%e (De.re&&ion an" -$SD among $&unami

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&ur'i'or& li'ing in tran&itional cam.& in Sri Lan# in"icate" t%at a &igni)icantly %ig% .re'alenceo) "e.re&&ion (+2# an" -$SD (556# in t%e&e "i&.lace" .o.ulation& &i/ mont%& in to t%ereco'ery, com.are" to e&timate" 10 .re'alence o) .&yc%ological "i&or"er& among general .o.ulation

$%e *mme"iate e))ect o) t%e $&unami Di&a&ter 

Soon a)ter t%e ti"al wa'e& t%e &ur'i'or& .anice", &ome went all o'er in &earc% o) t%eir )amilymember& $%e .&yc%ological .roblem& t%at re&ulte" )rom $&unami "i&a&ter inclu"e )eeling& o)&%oc, )ear, grie), anger, re&entment, guilt, %el.le&&ne&&, %o.ele&&ne&&, an" emotionalnumbne&& mong t%e cogniti'e reaction& con)u&ion, "i&orientation, in"eci&i'ene&&, worry,"i))iculty in concentrating, memory lo&& an" un.lea&ant intru&ion& were .rominent Lo&& o)%ome&, 'alue" .o&&e&&ion&, li'eli%oo" an" community ma"e many "e&titute among .eo.le w%owere &el) &u))icient be)ore t%e "i&a&ter $%e li)et%reatening .er&onal e/.erience&, lo&& o)relati'e& an" .ro.erty %a'e cau&e" .&yc%ological "i&turbance& &uc% a& acute &tre&& reaction&,-$SD, "e.re&&ion an" 'ariou& ot%er an/iety relate" illne&&e&

*n December 2004, t%e Sout% &ian $&unami "e&troye" not only .eo.le an" .ro.erty but t%emental %a..ine&& o) t%e &ur'i'or& -eo.le e/.erience" grie) reaction& an" t%ey were &%attere" by t%e .ro.erty "amage $%e &ur'i'or& %a" little &al'age &oon a)ter t%e $&unami De.re&&ionwa& &trongly relate" to t%e accumulation o) .o&t$&unami li'ing con"ition&

Mr L %a" been a &ucce&&)ul )i&%erman be)ore t%e t&unami 7it% t%e "i&a&ter, %e lo&t %i& %ou&e,li'eli%oo", an" .er&onal i"entity a& a .ro"ucti'e member o) &ociety Mr L an" %i& )amilymember& %a" to li'e in a re)ugee cam. wit% minimum )acilitie& )ew mont%& a)ter t%i&unbearable cata&tro.%e, Mr L became "e.re&&e" 8i& &ym.tom& inclu"e" .er&i&tent "e.re&&e"

or irritable moo", lo&& o) a..etite, &lee. "i&turbance wit% o)ten earlymorning awaening,greatly "imini&%e" intere&t in li)e acti'itie&, )atigue an" lo&& o) energy, )eeling& o)wort%le&&ne&&, )eeling& o) %o.ele&&ne&&, an" &ometime& t%oug%t& about &uici"eMr 9 wa& a &ol"ier w%o %a" come %ome )rom wor t%at morning an" wa& en3oying a cu. o)tea 7%en %e %ear" .eo.le &creaming, %e went out an" &aw a large wa'e coming towar" %i&%ou&e 8e imme"iately went to re&cue %i& &i&ter an" %er c%il"ren & t%e wa'e& came, %egrabbe" t%e &i&ter an" %er two c%il"ren 8e wa& able to %ol" onto %i& &i&ter but two girl& weretaen by t%e wa'e& $%ey were ne'er able to )in" t%eir bo"ie& Mr 9 became e/tremely &a" an"&tarte" blaming %im&el) )or not re&cuing t%e two little girl& 8i& grie) reaction& were o)tene'oe" by remin"er& 8i& "e.re&&i'e reaction& became uite &eriou&, lea"ing to a traumaticgrie)

8i& initial reaction wa& "i&belie) an" "i&a&&ociation 8e t%oug%t t%at t%e c%il"ren woul" be)oun" ali'e )ter t%e &ea became calm, %e &tarte" &earc%ing )or t%em 8e &aw a large numbero) "ea" .eo.le mong t%e "ea" bo"ie&, t%ere were c%il"ren !ra"ually be became )rantic an"&tarte" &creaming an" &earc% )or t%em :ut %e "i" not &ee t%em Mr 9 e'en went to Matara8o&.ital in &earc% o) %i& &i&ter& little c%il"ren 8e blame" %im&el) )or not &er'ing t%e li'e& o)two girl c%il"ren

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$&unami Relate" -$SD

$%e $&unami %a" a "irect e))ect on t%e mental %ealt% o) t%e &ur'i'or& large number o) .eo.le"e'elo.e" -$SD a& a re&ult o) $&unami relate" cata&tro.%ic e'ent& $%e 'ictim& o)ten reli'e"t%e e/.erience t%roug% intru&ion&, nig%tmare& an" )la&%bac& $%ey become le&& re&.on&i'eemotionally "e.re&&e", wit%"rawn, an" more "etac%e" )rom t%eir )eeling& Many 'ictim&

recei'e" coun&eling an" .&yc%o&ocial &u..ort )rom 'ariou& organi;ation& number o) clinic&were o.ene" in t%e a))ecte" area& lt%oug% t%e rate o) -$SD in c%il"ren an" -$SD &ym.tom&in a"ult& "ecrea&e" o'er time &ome in"i'i"ual&, &till e/.erience .o&ttraumatic &ym.tom& e'enmany year& a)ter t%i& natural cata&tro.%e

$%e *nternational -o&t$&unami Stu"y !rou. e/amine" .&yc%ological &ym.tom& e/.erience" by .eo.le )rom t%e -eraliya area (a "i&trict in t%e &out%ern .ro'ince o) Sri Lana# 20 to 21mont%& a)ter t%e t&unami an" )oun" t%at 21 %a" -$SD, 1+ %a" &e'ere "e.re&&ion, <0 %a"&e'ere an/iety an" 22 %a" &omatic &ym.tom&

$%e "egree o) e/.o&ure to a "i&a&ter "etermine& ri& an" le'el o) .&yc%ological morbi"ity-ro)e&&or ="na : oa o) t%e 9ni'er&ity o) -enn&yl'ania accentuate& t%at mo&t a))ecte"in"i'i"ual& reco'er wit% time *n &ome ca&e&, %owe'er, reco'ery i& incom.lete, lea"ing to anumber o) .&yc%iatric con"ition&, o) w%ic% -$SD i& t%e mo&t )reuently encountere" -$SDo)ten coe/i&t& wit% a 'ariety o) .&yc%iatric an" .%y&ical "i&or"er&, w%ic% )urt%er increa&e t%e bur"en o) &u))ering e/.erience" by t%e .atient

$ime "oe& not %eal t%e trauma

Recent re.ort& &ugge&t t%at a)ter natural "i&a&ter& mental %ealt% .roblem& can emerge in

'ulnerable grou.& $&unami cau&e" .eo.le to grie'e >'erloa"e" "y&)unctional grie) .roce&&a))ecte" t%e 'ictim& to a &igni)icant le'el an" t%eir .o&ttraumatic &ym.tom& "i" not "imini&% )or a long time Some 'ictim& &till carry t%e %orri)ic memorie& o) t%e 2004 $&unami Di&a&ter Mr ?/4 i& one o) t%em

7%en t%e $&unami wa'e wa&%e", t%e Sout%ern coa&t o) Sri Lana Mr ?/4 wa& in Colombo7%en %e %ear" t%e calamity, %e ru&%e" to %i& %ou&e in Matara Since t%e tran&.ortation wa&cri..le", %e too muc% e))ort to come %ome 7%en %e came %ome %e "i" not &ee %i& %ou&e, %e&aw t%e broen wall& an" t%e )oun"ation o) t%e %ou&e 7%en t%e "i&a&ter occurre", %i& .regnantwi)e an" &e'enyearol" &on were in t%e %ou&e

8e went in &earc% o) %i& )amily ='entually %e )oun" t%e bo"y o) %i& .regnant wi)e an" t%ec%il" among t%e "ea" bo"ie& 8e wa& utterly "e'a&tate" an" coul" not o'ercome t%e emotional&orene&&

)ter t%e )uneral, %e went to li'e wit% %i& uncle an" %a" no aim in li)e $wo mont%& a)ter t%e"i&a&ter %e trie" to commit &uici"e by %anging $%en %e wa& %o&.itali;e" an" later "iagno&e"wit% -$SD 8e wa& treate" wit% =lectro Con'ul&i'e $%era.y lt%oug% %e wa& on longtermt%era.y Mr ?/4 e/.erience" .o&ttraumatic &ym.tom& )or a con&i"erable "egree 7%en %e wa&

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clinically, re a&&e&&e" < year& a)ter t%e $&unami "i&a&ter it wa& )oun" t%at Mr ?/4 &till %a"nig%tmare&, intru&ion&, &uici"al i"eation, emotional numbing an" many ot%er -$SD &ym.tom&

""iction relate" be%a'ior 

Di&a&ter& generally %a'e ot%er longterm mental %ealt% con&euence&, )unctional "i&abilitie&,

an" "i&or"er& a&&ociate" wit% &ub&tance abu&e -o&ttraumatic &tre&& "i&or"er may be a ri&)actor )or nicotine an" "rug u&e "i&or"er& (:re&lau ?, Da'i& !C, Sc%ult; LR@ -o&ttraumatic&tre&& "i&or"er an" t%e inci"ence o) nicotine, alco%ol, an" ot%er "rug "i&or"er& in .er&on& w%o%a'e e/.erience" trauma# Many .&yc%ological 'ictim& o) t%e $&unami "i&a&ter continue toe/%ibit a""iction relate" be%a'ior *ncrea&e& in alco%ol, cannabi& an" tobacco u&e were&igni)icantly increa&e" )ollowing t%e trauma e&.ecially among t%e male&

Mr DA5 lo&t &e'eral )amily member& an" mo&t o) %i& .ro.erty in t%e $&unami "i&a&ter in 2004wa& "iagno&e" wit% -$SD in 2005 8e gra"ually lo&t will to .er)orm "ay to"ay acti'itie& an"&tate" abu&ing alco%ol "aily ba&i& 8i& .rogre&&i'e alco%ol a""iction cau&e" Cirr%o&i& o) t%e

li'er

Mr $A2 lo&t %i& .arent& an" t%e ance&tral %ou&e in t%e Sout%ern Sri Lana a& a re&ult o) t%e2004 $&unami, mani)e&te" intru&i'e memorie& o) t%e gigantic wa'e an" t%e "ea" bo"ie&B)eeling& o) inten&e "i&tre&& w%en remin"e" o) t%e trauma became more an" more alienate" 8econ&tantly abu&e" alco%ol an" in 200+, %e wa& "iagno&e" wit% lco%ol De.en"ence

=))ect& on Social wellbeing

Social wellbeing i& a &en&e o) in'ol'ement wit% t%e community an" about being acti'ely

engage" wit% li)e $%e t&unami "i&a&ter continue" to %a'e "e'a&tating im.act on &ocial well being o) t%e 'ictim& *t& a nown )actor t%at "i&a&ter& t%reaten .er&onal &a)ety, o'erw%elm"e)en&e mec%ani&m&, an" "i&ru.t community an" )amily &tructure& $%e .eo.le w%o weree/.o&e" to t%e $&unami "i&a&ter 2004 e/.erience" numerou& .&yc%o&ocial .roblem& -ro.ertylo&&, "eat% o) clo&e relation&, .roblem& o) tem.orary an" .ermanent %ou&ing, .oor incomegeneration, in&ecurity an" uncertainty about )uture ma"e gra'e im.act& on &ocial wellbeing

$%e im.act o) community lo&&e& on .&yc%ological wellbeing o) in"i'i"ual& a..ear& to "i))er)rom t%at o) .er&onal lo&&e&, in t%at community "e&truction i& more clo&ely correlate" wit%"ecrea&ing .o&iti'e in)luence&, w%erea& .er&onal lo&&e& are a&&ociate" wit% increa&ing negati'ee))ect& (?orri& 8, rie"man MJ, 7at&on -J, et al#

=motional wellbeing a)ter $rauma

=motional wellbeing "e.en"& on a nurturing en'ironment t%at en&ure& con&i&tent ba&icmaterial an" emotional nece&&itie& ?atural or manma"e "i&a&ter& can cau&e terrible .er&onallo&&, in3urie& an" illne&&, an" lo&& o) 'ital re&ource& 7%ile t%e &ur'i'or& o) &uc% trage"ie& mayreco'er )rom t%eir .%y&ical in3urie&, t%e emotional "amage may be .ermanent ( :rian $ra..ler  Reco'ering )rom $rauma #

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Hren&now an" %i& colleague& )oun" t%at t%at &uici"e rate& increa&e a)ter natural "i&a&ter& lie&e'ere eart%uae&, )loo"&, an" %urricane& $%e increa&e& in &uici"e rate& were )oun" )or bot%&e/e& an" )or all age grou.& :a&e" on t%e re&ult& t%ey con)irm t%e nee" )or mental %ealt%&u..ort a)ter &e'ere "i&a&ter&

$%e $&unami Iictim ill& %er t%reeyearol" &on

<0yearol" mot%er w%o wa& e/.o&e" to $&unami "i&a&ter in 2004 re&i"ing at t%e t&unami%ou&ing &c%eme in -ana"ura allege" to %a'e t%rown %er t%reeyearol" younge&t &on to t%eHalu !anga $%e inci"ent occurre" in 2010 Marc% o'er 5 year& a)ter t%e initial traumatice/.erience 8er %u&ban" %a" aban"one" %er an" &%e %a" )ace" utmo&t "i))icultie& in taing careo) %er )i'e c%il"ren $%e c%il" wa& t%rown to t%e ri'er "ue to "ire .o'erty an" lac o) &ocial&u..ort >n t%e "ay, t%e c%il" wa& t%rown to t%e ri'er t%e mot%er %a" trie" to %an" o'er t%ec%il" to a c%il"ren& %ome but t%e aut%oritie& %a" turne" "own %er reue&t

-o&t $&unami Re%abilitation 7or in Sri Lana

-o&t $&unami mental %ealt% re%abilitation wor too .lace &oon a)ter t%e "i&a&ter Renowne"mental %ealt% .ro)e&&ional& lie -ro)e&&or 7illiam ule, -ro)e&&or Rac%el $ribe an" manyot%er& o))ere" t%eir &er'ice& to Sri Lana to u.gra"e mental %ealt% &er'ice& Dr ?eil J ernan"o  Con&ultant -&yc%iatri&t con"ucte" mobile mental %ealt% clinic& treating a large number o)'ictim& w%o were &%attere" by t%e natural "i&a&ter Dr ?eil ernan"o al&o too a .rai&ewort%yinitiati'e to train coun&elor& an" &ocial &er'ice worer& in $&unami a))ecte" area&

$%e =MDR8umanitarian &&i&tance -rogram& (8-# w%o&e mi&&ion i& to buil" ca.acity )ore))ecti'e treatment o) traumatic &tre&& "i&or"er& in un"er&er'e" communitie& anyw%ere in t%e

worl" ga'e t%eir utmo&t &u..ort to Sri Lana )or t%e .o&t $&unami re%abilitation wor >n t%e"irection& an" gui"ance o) Dr rancine S%a.iro t%e creator o) =MDR a team o) &.eciali&t&came to Sri Lana to a&&i&t t%e local t%era.i&t& Dr ?ancy =rrebo an" %er =MDR 8- teamclo&ely wore" wit% t%e local "octor& an" %el.e" to treat t%e 'ictim& o) 2004 $&unami

lt%oug% mental %ealt% treatment .rogram& went e))ecti'ely, .&yc%o&ocial .romotional acti'ity"i" not go %an" in %an" Sri Lana recei'e" o'er 9SK22 billion (euro164 billion#, a& .o&tt&unami )oreign ai"9n)ortunately, large amount& o) )un"& were not &.ent e))ecti'ely an" nearly 500 million 9SD .ro'i"e" by t%e )oreign "onor& )or t&unami recon&truction %a& gone mi&&ing >nly a &mall .ercentage o) ai" reac%e" t%e inten"e" reci.ient )ter ten year& o) t%e t&unami "i&a&ter, &ome&ur'i'or& &till li'e li'e in new &ettlement& lacing ba&ic )acilitie&

$%e re'erberation o) t%e 2004 $&unami i& &till %arrying t%e Sri Lanan &ociety *n 2010 Marc%,a )ormer t&unami 'ictim %a" t%rown %er <yearol" &on to t%e Halu !anga Ri'er *) t%i& )amilyt%at wa& "i&.lace" by t%e 2004 t&unami %a" a..ro.riate .&yc%o&ocial &u..ort, t%i& trage"ycoul" %a'e been e'a"e"