Preparation and recovery – What is the trauma of living through a natural disaster?

In June 2020, the city of Mumbai was plagued with uncertainty and anxiety as Cyclone Nisarga was reported to be nearing. Days after Cyclone Amphan ravaged the east coast, Mumbaikers recognised the need for being on guard and ready for the worst to come. The pandemic had already paralysed the city. Movement had been restricted, Section 144 had been imposed and news outlets were providing minute by minute updates. Although Mumbai was not significantly affected by Nisarga, feelings of anxiety and dread were reported to be on the rise. The anxiety about loss of life, loss of agriculture, financial loss and vulnerability to homelessness were few of the many factors that the city felt immense dread about. According to the disaster profile for India conducted by this study, India is one of the most disaster prone areas in the world due to its location and geo-climatic conditions. About 58.7 % of the total land mass is prone to earthquakes of moderate to very high intensity,  12% of Indian land, is prone to floods, and 68 % of the land is vulnerable to drought. India’s hilly terrain is vulnerable to landslides and 8% of Indian land is vulnerable to cyclones.

Ecological disasters are recurring with an alarmingly frequency. Every disaster creates a significant impact on the coping resources available to local communities. Socio-economic loss, vulnerability to illness, homelessness, physical and psychological injury caused by trauma, displacement and prolonged disruption are some of the many factors that are correlated with impacting emotional and behavioral health. Resources for the prevention of disasters are necessary but enhanced planning for the various crises that arise due to the recurrence of disasters is also the need of the hour.

Natural disasters are often unpredictable. Communities that experience disasters also become vulnerable to Post Traumatic Stress Disorder, Anxiety disorders, Depression and Adjustment Disorder. Shock being a typical response in these circumstances can have its own manifestations when it comes to survival. The psychological impact of disasters is even greater in children, women, the elderly and those with disabilities. Individuals may try to numb the pain from loss and psychological distress by resorting to substance abuse, experience flashbacks, nightmares and psychosis correlated with the trauma, become vulnerable to suicidality and have increased difficulties with day to day functioning.

Research shows that areas for mental health research, practice, policy and interventional care look different in the ASEAN region. Dr. Somchai Chakraband in his 2006 study explained that 30% of Tsunami affected victims showed signs and symptoms of mental health concerns for 2 months after the Tsunami had occurred. The Thailand government had to develop initiatives that provided assessment, referral, treatment, psycho-education and group activities were also provided as outreach services up to three months. Mental health recovery centres and mental health operation centres were established to focus on community resilience, address quality of life for vulnerable groups and to provide sustainable care for those with heightened mental health concerns. Similarly, Dr. Zhang and Dr. Ho investigated in this study and found that 84.8% of the survivors of the Wenchuan earthquake showed symptoms of Post Traumatic Stress Disorder one to two months after the earthquake. In India, studies surrounding the Bhopal Gas Tragedy have shown that a prevalence of anxiety based neurosis, depression and adjustment based emotional distress was found within 3 months of the disaster.

A study conducted by Bharatiya Stree Shakti after the floods in Mumbai, in 2005, examined the various psychosocial stressors experienced by the affected communities in Santacruz. The organisation went on to address these concerns in the community by administering mental health interventions to aid response and recovery post the disaster. They found that insomnia and startling responses were common, but so were feelings of elation associated with surviving the disaster. Increased fear when it rained, followed by the anxiety of the disaster repeating itself in the following years coupled with other symptoms of Post Traumatic Stress disorder were also observed. However, an interdisciplinary and community centric approach to relief work that counseling, networking with teachers and physicians in the community, psychiatric interventions, family visits and more led to a positive impact on the recovery process post the disaster.

Local communities place their trust on governing bodies for effective preparedness when it comes to disaster management and mitigation of resources. Communities elect representatives, pay their taxes, vocalise their expectations and resist initiatives that will not benefit their well being. As explained here, effective preparedness  improves response and recovery following a disaster and may reduce overall resource requirements. It escalates feelings of security and reassurance, thereby reducing feelings of heightened distress before, during and after a disaster strikes. It is imperative that we consider the primary and secondary risks that impact the physical and psychological health of communities in order to listen, prepare and effectively meet their needs when disaster strikes.