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Mental Health Crisis Looming For Tsunami Survivors, Warns Psychologist Just Back From Indonesia

As the death toll from the Dec. 26 earthquake and tsunami climbed above 200,000, a University of Washington psychologist who just returned from Indonesia warned of a new danger among the survivors - a mental health crisis.

"We are seeing children petrified by seeing water in a tub or cowering when large airplanes are flying overhead because they sound like rushing water," said Randall Kyes, a research associate professor of psychology and head of the division of international programs at the UW's National Primate Research Center.

Kyes said some children had begun to stop talking and adults were beginning to experience nightmares and severe insomnia. "The critical period is now and for the next six months. You don't meet a single person who didn't lose someone," said Kyes, who spent a week in Banda Aceh, once a city of more than 250,000 people that was the hardest hit by the twin disasters. He worked in Indonesia helping to set up an emergency psychological trauma center and in recovering bodies of victims.

"People are past the tears and the immediate loss, and now reflection sets in and trauma is beginning to surface. We are talking about hundreds of thousands of people, and that's just in the province of Aceh. The number jumps into the millions when you consider the scope of the disaster in all of the countries involved."

Kyes has ongoing ties to Indonesia, where he has done work for 15 years. He heads a collaborative program between the UW and Bogor Agricultural University that includes research and training components, as well as an effort to conserve a number of endangered primate species. Of the 370 students from Aceh province at Bogor Agricultural University, at least 200 lost some or all of their family, their home or any hope for family assistance in completing their education.

Kyes does not specialize in clinical treatment, but has experience as a trained emergency medical technician and as a member of a national Disaster Management Advance Team that provided rescue and medical support.

"When you talk about a disaster of this scale, the extent of psychological damage is enormous," he said. "Many individuals may never totally recover and will have concerns and fear that will not be completely resolved. But if people can get treatment early on, the prognosis for improvement is much better.

"The real concern is for children. So many lost their families and have no support to reach out to for help. They really suffered twice, first the loss of parents and siblings and now coping with surviving the tsunami."

While in Aceh province, Kyes worked with the Indonesian relief groups Yayasan Ekosistem Lestari (Ecosystem Conservation Foundation) and Media Group Posko Indonesia Menangis (Indonesia Is Crying) to set up the emergency psychology trauma center in a Banda Aceh mental hospital that was flooded by the tsunami. He conducted workshops and gave lectures to volunteers on basic education and treatment for psychological trauma and the importance of referring people to trained Indonesian mental health experts who are expected to be on hand soon. He also counseled a number of victims.

"I tried to emphasize in both my workshops and in dealings with victims that experiencing trauma is normal for anyone under these extreme circumstances and should not be viewed as a sign of weakness."

He also participated in recovering bodies of victims, and expects the death toll to continue to rise, ultimately reaching as high as 300,000. Kyes said 200 to 300 bodies are still being recovered each day around Banda Aceh and he expects this to continue for two or three more months.

"People didn't drown. They were pummeled by debris in the water. There are still huge expanses of debris piled roughly 8 to 10 feet high with bodies buried in them. And there also are large tracts of land that are still flooded, making it difficult to recover bodies. I've done body recovery before, but the scale of this is unimaginable."

Kyes had nothing but praise for the Indonesians and the national government which is trying to operate in conditions of total chaos, often in areas where local governments have been totally wiped out. He will be returning to Indonesia this spring following a previously scheduled trip to Nepal.

"The thing that surprised me the most was the extent of the devastation in human loss and to the physical loss in homes, boats and buildings. It never subsided. Every time I went out I was saying, 'My God, My God,'" Kyes said.

For more information, contact Kyes at rkyes@u.washington or (206) 543-3025

Joel Schwarz - joels@u.washington.edu
206-543-2580
University of Washington

Reprinted with permission from http://www.medicalnews.com January 22, 2005

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