Wednesday, September 30, 2009

Helping survivors deal with trauma

This is my column today, September 30, 2009.

Last Monday I wrote about how utterly unprepared we all were in dealing with major disasters and catastrophes. Our years of experience with other disasters—and we have had our ample share of them from super typhoons to earthquakes and other acts of god— have not made us any wiser.

But as we have been noting in various media reports since Sunday, what is even more tragic is our unpreparedness to deal with the aftermath of such disasters. It seems we’re doing everything oido style, based purely on gut feel and intuition rather than on systematic thinking.

It was widely expected that the post-disaster picture would be grim although I don’t think anyone was prepared for the extent of the devastation that we are seeing now. Much of the focus of relief efforts has been in ensuring that basic necessities are delivered to those who need it the most.

This is understandable and we should continue to do this. However, we really need to coordinate our emergency responses better. What we are seeing is the lack of a structure at the national, regional and even local levels to manage information and coordinate assessment activities. The various major media networks are doing a great job in terms of coordinating their own relief activities. However, there seems to be no mechanism in place to ensure that everyone is moving in a more synchronized way so that priorities are mapped out and addressed and not everyone is doing the same thing such as visiting the same places.

I also hope that people are just as mindful of the other consequences of major disasters such as the one that we have just been subjected to and are sensitive to them as well.

At a time like this, newscasters must eschew the hyperventilation that has come to be associated with broadcasting in this country. It really does not sit well with many people when Ted Failon delivers the news about more dead bodies being discovered or more people going through another day without water or food in a booming and resonant voice as if such is a cause for celebration. Celebrities, particularly the ones manning those telethons and those going on relief missions should, for the moment, hold off on the designer outfits and the expensive jewelry as these distract from the message and decrease the potential for real empathy.

People, particularly those who were severely affected by the flood, are emotionally vulnerable right now and prone to certain emotions such as anger and frustration. Anger is a normal, healthy emotion—it is the generally accepted emotion of survival. When people cannot make sense of what they just went through, anger is the most common way in which they try to express themselves. Inciting them to become more anxious is not exactly an inspired idea since it adds to the trauma that they are already experiencing. So obviously this is not the time for politicking and those snide remarks and thinly concealed criticism directed at certain politicians can wait until things have normalized.

I wish that people, particularly those in a position to provide a voice, a face, or any physical presence to the various relief efforts are armed with the basic skills to help survivors cope better with trauma. A major consequence of disasters is the psychological trauma it brings to survivors. While it would require the expertise of psychologists and trained counselors to help survivors deal with severe trauma, there are many relatively simpler things everyone can do to help victims and survivors cope better with their situations.

Foremost among these is making sure that accurate information is disseminated to everyone—particularly to families and communities that have been affected severely. One of the mistakes that people continue to commit in the aftermath of the flood is offering false hopes and promises to survivors. There is this myth that giving false assurances—the metaphorical lifeline of hope—is the better course of action after crisis situations, but in reality it really often makes the process of coping more difficult. What happens is that in most situations victims spend more time in the denial stage of the process rather than in hastening their progress toward acceptance. As we all know, acceptance is the key that helps people deal more pro-actively with their situations, in effect jolting them into doing what is necessary.

Reporting accurate information likewise requires sticking to facts and scientifically sound data as well as ensuring that respect for victims is observed at all times. For example, the reportage on rotting bodies needs to be done with extra care. We hope that our television newscasts likewise stop showing bodies of the fatalities in various stages of undress or decay not only because it contributes to the trauma being experienced by survivors but more importantly, as a sign of respect for the dead.

People should likewise be careful about making careless statements. One reporter hyperventilated on television that the decaying bodies need to be retrieved immediately before these cause the spread of infections and diseases. This is a fallacy. Victims of natural diseases are normally killed by injury or drowning and not by disease. Corpses do not spread infections or diseases, as most infectious organisms do not survive beyond 48 hours in a dead body. Of course efforts must be made to retrieve dead bodies to relieve family members and communities of the psychological trauma associated with dealing with grief and uncertainty.

In times like these, we need to be cognizant that children are more likely to be affected by trauma than adults. Children respond differently to trauma and some do not show symptoms quickly. Because children have underdeveloped coping skills, they find it more particularly difficult to adjust to the consequences of disasters such as drastic change and loss. Adults must make sure that they make available the one key that helps children deal with trauma: Reassurance. Very young children need lots of cuddling. Parents and adult figures need to verbalize their support and concern and this means answering their questions honestly and sincerely. Other means of helping them cope with trauma include providing various opportunities for expression such as drawing, conversations, storytelling, but making sure that the frightening details are kept to a minimum. The object is to help them surface their fears and process them not relive pain and anxiety.

Helping others cope with trauma is hardly rocket science stuff. The most critical skill is empathy—the ability to communicate concern and care without assuming that you know everything. Thus, everyone can help survivors by simply being there and showing they care through words and action. One key element is to help survivors go through the stages of grief, namely, denial, anger, bargaining, depression, and eventually acceptance.

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