Batticaloa, Sri Lanka, February 24, 2005: We have heard the dollar amount donated to Sri Lanka by countries such as the United States, Japan, and Germany after the tsunami devastated the country on December 26. Tsunamis, a series of great sea waves caused by an underwater earthquake, landslide, or volcanic eruption, have been relatively rare in the Indian Ocean but this Indian Ocean tsunami traveled as many as 3,000 miles (nearly 5,000 kilometers) to Africa, arriving with sufficient force to kill people and destroy property. International aid organizations are providing aid to victims for basic needs such as purified water, food, clothes, school supplies, and medical supplies. In spite of receiving mixed reports regarding the emotional and psychological needs, thousands of people who lost loved ones, homes, and livelihood have just begun to receive psychological aide.
The Mental Health Outreach Project (MHOP), a nonprofit disaster relief organization of the Association for Disaster and Mass Trauma Studies headquartered in New York and spearheaded by Dr. Anie Kalayjian, Treasurer of the United Nations Committee on Human Rights and Adjunct Professor of Psychology at Fordham University, organized teams of professional volunteers to go to Sri Lanka to deliver psychological first aid, training, and counseling to the tsunami victims. MHOP is hosted by the UNITED SIKHS, a worldwide humanitarian organization, in collaboration with the local Sri Lankan authorities and psychosocial workers. The first team has returned from its mission after working with hundreds of survivors in camps, refugee settlements, schools, and colleges.
MHOP is comprised of a series of six consecutive steps through which various aspects of traumatic exposure are assessed, identified, explored, and processed. The preliminary findings are reported below.
The predominant feelings expressed by almost all survivors were that of fear: fear of the sea, fear of going back to their homes, and fear of the tsunami reoccurring. Survivors consistently expressed shock and disbelief.
"I just could not believe that the sea was so black," "the wave was so high," and "I felt trapped" exemplify this feeling. They expressed tremendous feelings of helplessness and guilt: guilt of surviving and guilt of not doing enough to save their children, spouses, or relatives. Most survivors were haunted by repetitive nightmares of their loved ones, hands waving in the air as the waves took them away in the sea of black water as they called out "father, help me" or "mother, help me please." Flashbacks, avoidance behaviors, and sleep disturbances were also expressed.
The team provided empathy and validation to the survivors in groups as well as individually. It was reinforced that they did the best they could in circumstances above and beyond their control. Many team members were sad and overwhelmed as they heard survivors, one after the other, tell their stories of courage, creativity, survival, and loss. People expressed multiple losses that they could not endure. One man told the group that 48 members of his clan had died. He was one of the two who survived. Often MHOP members were perplexed as how to provide empathy when so much is lost. When trauma ruptures the individual's connection with the group, a strong sense of isolation, disarray, and helplessness occurs. Providing validation and empathy in such a group helped these survivors reestablish the mutual exchange between the individual and the group.
Survivors were eager to tell their stories, as they expressed feelings of wanting to feel normal again. When encouraged to express lessons they learned and meanings associated with this devastation, some expressed that they learned to be united, with Buddhist, Hindu, Christian, and Muslim living collaboratively and as brothers. Many expressed that they now want to spend more time with their family and relatives rather than pay attention to material goods. Others expressed that they learned to not rely on government but rather on self and the spirit of unity.
Why did the tsunami happen? There was one predominant response: Over twenty years of conflict between Tamil and Sinhalese races, ethnic strife, and civil war caused this devastating tsunami. Therefore, the lesson for them was to unite and appreciate one another. Since the tsunami did not discriminate Tamil over Sinhalese in death, they wanted to learn how to collaborate and unite in life. Of course as one 25-year-old Christian Tamil man stated: "This unity concept is in thought only and it needs a lot to have it put in practice." MHOP team members shared the technical information regarding how and why tsunamis are formed scientifically in the didactic part of the model. Survivors listened with great interest and with a thirst for more.
Several techniques were used to release fear, sadness, and guilt. Body, breath, and mind were incorporated in cleansing exercises. In this situation where people could not control Mother Nature, evil forces, and what happens outside of themselves, the team assisted survivors in focusing on and processing how they respond to the disaster. It is important to focus on things one can control. Breath was used to help the survivors establish an inner peace and inner strength. Visualization and positive affirmations were also used.
Survivors were encouraged to ask the empowering question "what can I do now" rather than the victimizing one of "why." If one asks why it happened, one is transformed to the past, to the tsunami, where feelings of fear, victimization, and guilt prevail. When one asks the question what can I do now, one remains in the here and now, the coping, present state.
As for the tsunami, almost all survivors described the tsunami as a "giant monster" of the sea. Parents used this phrase to deter their unruly children. "Behave, or else the Giant (Monster) will come from the sea." Now parents are confused as to what phrases to use to discipline their unruly children. Perhaps they learned that provoking fear is not healthy for the children.
MHOP provides daily group therapy, individual therapy, and art therapy with the children, and desensitization groups for those fearing the sea and the return to their homes near the sea. Some of the participants' expressions exemplified their empowerment and health. "This morning I had nothing to live for, I had no hope, but now, after the group, I feel so alive and so happy." "If you can come all the way from America to help us, we can find ways to help ourselves too." Members of the clinical team were Dr. Kalayjian, team coordinator and director; Dr. Kuriansky, Columbia University; Nancy Moore, Fordham University; and Hishara Godanka, University of Texas. Other team members were Drs. Christina Hoven and Ronald Mendall, Columbia University, and Lousine Shamamian, a documentarian. The second team of MHOP met with the first team in Colombo, before their departure to Batticaloa. Those interested in getting involved may contact Dr. Kalayjian at Kalayjiana@aol.com, or (201) 941-2266.