Canadian Red Cross trains health workers to provide psycho-social support to tsunami survivors

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By Pamela Davie, Canadian Red Cross

When Sumitra Sumi heard on December 26 about the tsunami striking several kilometres from her home, she knew her skills would be needed.  The 27-year-old mother works in a health centre supported by the Canadian Red Cross and International Committee of the Red Cross (ICRC), providing first aid and hygiene awareness to the community of Ootu Pulam in Sri Lanka. 

Sumitra rushed to the coast that day where, together with 48 other Red Cross health workers from similar centres, she provided first aid to the injured.

In addition to treating physical wounds, she now will address another significant threat for survivors—the psychological impact of the tsunami. 

The Canadian Red Cross will train Sumitra and her colleagues to provide psycho-social support, along with first aid and hygiene awareness to the displaced people living in transit camps.

Coordinating the training is Judi Fairholm, director of abuse prevention services for the Canadian Red Cross and Canadian Red Cross health delegate, Dr. Lily Montano.  They are part of a Canadian Cross assessment mission to determine long term recovery programs for the thousands of people affected.  Judi and Lily’s field assessment for health programming began in March in the north of the island.

Fred Robarts, head of the ICRC operations in Jaffna reports that the psychological effects of the disaster have been profound.  In the north, more than 90% of the population has been displaced at least once prior to the tsunami due to the conflict between the government and the Liberation Tigers of Tamil Eelam (LTTE).

Now the latest cause of devastation and loss was the source of their livelihood and an integral part of their existence. 

“People directly impacted by the tsunami lived by the sea and thought they knew it. They had felt the effects of conflict but now have discovered they are not safe from nature either.  They are asking,`what is left?’”

Dr. Daya Somasundaram of Jaffna University confirms that psycho-social assistance is a critical priority in order for people to recover from devastating losses.   

According to the Head of Psychiatry for the Department of Medicine, the significant issues now threatening the communities in the aftermath of the tsunami are an increase in depression, sleeping disorders, suicide and alcoholism. 

This is a serious problem in a country that already rates seventh highest in the world for suicides according to the World Health Organisation (WHO).

Men represent a group at high risk. Many were witness to the demise of their family members, as women and children constituted a large percentage of those killed. In a society where gender roles are clearly defined, men now find themselves confronting a double burden as heads of single parent households. Their personal loss, combined with the destruction of their livelihoods, leaves them at great risk from the psychological impact of the disaster.

Dr. Somasundram notes that children and youth are also suffering, as evidenced by nightmares, fears and heightened emotions.

But he stresses that well meaning organizations must take into account the type of psychological assistance required as well as the cultural context in which it is delivered.

He notes that less than 10% of people suffering from depression or trauma following the tsunami require professional help—rather they need community-based interventions such as befriending, listening and sharing activities. 

“Survivors struggle with guilt, replaying the event. There is a need for support groups, and an understanding of stress and tension and how to relieve it.”  He also recommends rituals and remembrance events in order to help the mourning process. 

Accordingly, Dr. Somasundaram has adapted a training program he developed for delivering psycho-social support to the conflict-affected population to now meet the needs of tsunami survivors. 

Recently,Sri Lankan Red Cross volunteers from Ampara, Batticoloa, Tricomalee and Jaffna completed the training in order to deliver support to their communities.

In March, the Canadian Red Cross and ICRC will support Sumitra and her colleagues to undergo the training and plans to expand the team to 1,000 health workers who will deliver assistance throughout the country.

Father Damien agrees that cultural appropriate training is critical. The priest, who holds a degree in psychology from the University of Ottawa, runs a non-governmental organization, the Holistic Health Centre, which provides psycho-social programs for school children and their parents. 

He supervises 60 community workers who carry out the program in the Jaffna region.  “There were instances where well meaning individuals arrived to deliver psychological help to survivors. They took children to the sea.  It traumatized them a second time,” he says.

The Danish Red Cross also supports war-affected children together with the ICRC, delivering a psycho-social program for school children in the region since 2003. The Red Cross has trained teachers in 20 schools to provide after school sessions for children, grades six and eight. Each student attends the program weekly for a period of six months, learning about such topics as reconciliation and cooperation. 

The Canadian Red Cross team continues their assessment with their next stop in Ampara on the east coast.