Tsunami raises questions about disaster mental health, Science reports

Nearly eight months after a ferocious earthquake and tsunami left hundreds of thousands of people dead and millions homeless on the rim of the Indian Ocean, the disaster continues to claim a more quiet toll among those suffering psychological aftershocks, according to a news story in the 12 August issue of Science.

For two weeks in July, journal Staff Writer Greg Miller toured the destruction zone in Sri Lanka and India. While experts have predicted that hundreds of thousands of survivors will suffer from depression, post-traumatic stress disorder and other long-term mental health problems, Miller discovered that many people in the region also have shown remarkable resilience. He also found that the massive international effort to provide "psychosocial aid" has had its share of problems.

In an interview, he describes travels among the survivors and teams of mental health workers-and the human repercussions of the disaster.

Miller discovered that many people in Sri Lanka and on the East Coast of India are doing better than might be expected. Many apparently are bolstered by the strong family and community ties common in Asian cultures; some may have been inured to a life of severe hardship even before the deadly 26 December earthquake off the coast of Indonesia.

But people in South Asia almost never speak of sadness or mental anguish, many psychiatrists working in the area told him. Instead, they complain of aches, pains and discomforts that have no apparent physical cause. Even if the symptoms are masked, one therapist said, many people living in the camps are suffering from mental problems-and many could benefit from counseling or medication.

Yet Western-style therapy is a foreign concept in many of the hardest hit areas, and the massive international effort to provide "psychosocial" aid has had its share of problems. The situation highlights the need for more research on what interventions are most important for psy


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