Tsunami raises questions about disaster mental health, Science reports

are of them all, and there are very few psychologists, psychiatric nurses or other people trained to handle mental health problems. Many experts I talked to are hopeful that the attention to mental health that has been raised by the tsunami will provide political leverage to push for much-needed improvements in the mental health care systems in the affected countries.

One of the most interesting surprises in your story was the suggestion that while millions of people will suffer some degree of psychological impact from disaster, many people in the tsunami zones that you visited were doing reasonably well, psychologically, given the magnitude of what happened. What factors-social, cultural, spiritual, even economic-might be behind that resilience?

Family and community ties are hugely important in many Asian cultures, and they tend to put less emphasis on individual self-reliance than we do in the West. Many people I talked to, both locals and Westerners, felt that this collectivist spirit and the strong social ties it fosters were helping people cope.

Others suggested that some tsunami survivors are coping better because they're used to adversity and see the tsunami as just the latest obstacle life has thrown their way rather than as a cataclysmic event. Many of the areas affected by the tsunami are very poor by Western standards and some-notably Sri Lanka and Aceh, Indonesia-have seen a lot of violence in the recent past. Several people I interviewed thought that people in these war-torn areas were doing surprisingly well considering all they've been through and attributed that to coping mechanisms they've built up through years of hardship. I think this is a bit speculative because it's based on the impressions of people working in the field, not on any scientific research, but it's an interesting consideration. It certainly runs counter to the common notion that people who have been under stress are more likely to snap when somethi


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