Survivors need trauma care
NGOs in Tamil Nadu have identified trauma care as the next healing step for survivors of the tsunami, especially children, to rebuild the human spirit along with infrastructure in the affected areas.
Relief work is comparatively easy for volunteers as no training is necessary to pack food, sort clothing, distribute relief material, or even pick up bodies.
However, not every NGO field worker knows how to impart trauma care. CARE India, one of the first NGOs to send an emergency survey team to Chennai by December 26 night, is concerned about the psychological health of the tsunami victims.
Victims of post-traumatic stress disorder can be identified even a month from the disaster, say experts.
The NGO, which has provided relief worth $1.7 million to Tamil Nadu alone, is now involved in areas of psycho-socio counselling in at least four of the coastal districts here that have seen great devastation.
CARE, in partnership with the National Institute of Mental Health and Neuro Sciences (Nimhans), is involved in a "trainer of trainees" (TOT) programme, which allows a core group to teach trauma care to grassroots field workers who, in turn, will teach others.
The ultimate beneficiaries of this know-how will be the local people who need to take care of traumatised community members.
CARE has chosen anganvadi workers, or women and child welfare activists, primary sector childcare workers, and voluntary health workers as trainers.
Sanjay Awasthi, head of the CARE team for tsunami relief, said: "We chose 200 anganvadi workers in Kanyakumari district for the TOT programme in the second phase of our rehabilitation work."
About 900-odd staff are required to train anganvadi workers for tackling trauma-affected people in Kanyakumari, Nagapattinam, Cuddalore and Karaikal, CARE officials said.
"This (the use of anganvadi workers) will be more effective than outside counselling as this will work on a long-term basis," they added.
According to Unicef, at least 100,000 children have been affected by the tsunami in India.
The most vulnerable are not only those who lost kin but also those who saw the sea rise and giant waves rush towards them on December 26.
CARE has begun distributing field observation manuals prepared by Nimhans on "psychological care in disaster management" for its trauma care staff.
According to Nimhans project director K. Sekar, this manual is a tool to empower community-level workers in psycho-social care of disaster survivors.
WHO describes disaster as "severe disruption, ecological and psycho-social, which greatly exceeds the coping capacity of the individual".
Interestingly, though published a few weeks before the December 26 disaster, the manual lists tsunami among natural major disasters and "festival and pilgrimage disasters" among manmade disasters.
The manual was evolved after drawing from CARE's and Nimhans' experiences in the 1999 Orissa cyclone and the 2001 Gujarat earthquake.
Printed before the tsunami and the temple stampede in Wai village of Maharashtra on January 25 that took a toll of more than 250 lives, the manual proves the adequacy of disaster knowledge available with the Indian authorities.
CARE and Nimhans are translating the manual into Tamil so that trauma care staff at the grassroots level have an elementary manual for reference.