REHABILITATION OF DISASTER VICTIMS – Challenges of Rehabilitation, Kinds of Reactions and Psychosocial Interventions
In the post-disaster period, along with relief, rehabilitation and the care of physical health and injuries, mental health issues need to be given importance. Apart from material and logistic help, the suffering human beings will require human interventions.
CHALLENGES OF REHABILITATION
- Ensuring that people living in the relief camps have access to regular food supplies, additional set of clothes, sanitation drinking water, public health intervention immunization, preventive health care, heat and rain proof shelters, child care and education facilities and support.
- Ensuring access to basic entitlements in terms of their compensation, government schemes and credit institutions so that they can rebuild their homes and livelihood back to the same levels as before the disaster.
- Ensuring livelihood reintegration
- Ensuring legal right and social justice to the disaster victims including filing of FIRs, investigation and contesting cases in the court
- Providing psychosocial counseling and support for dealing with loss, betrayal and anger.
- Community based rehabilitation for widows orphans, elderly, children and physically disabled
- Actively rebuilding a culture of communal harmony and trust
KINDS OF REACTIONS SHOWN BY DISASTER VICTIMS
- Physical impact: stomach aches, diarrhea, headaches, and body aches, physical impairments (limbs, sight, voice, hearing), injuries, fever, cough, cold, miscarriage etc.
- Emotional reactions: anger, betrayal, irritability, revenge-seeking, fear, anxiety, depression, withdrawal, grief, addiction to pan masala, cigarette, beedi, drug abuse (flask back, numbness, depression)
- Socioeconomic impact: loss of trust between communities, lack of privacy, single parent families, widows, orphan state with loss of both parents, discontinuity in educational plans (e.g. loss of employment, homelessness migration, disorganization of life routines, material loss).
PSYCHOSOCIAL INTERVENTIONS
Principles
- Ventilation
- Empathy
- Active listening
- Social support
- Externalization of interest
- Lifestyle choice
- Relaxation and recreation
- Spirituality
- Health care
- Work with individuals (willing to talk immediately unwilling to talk)
For people who are willing to talk immediately
Listen attentively
Do not interrupt
Acknowledge that you understand the pain and distress by learning forward
Look into the eyes
Console them by patting on the shoulders or touching or holding their hand as they cry
Respect the silence during interaction; do not try to fill it in by talking
Keep reminding them I am with you. It is good you are trying to release your distress by crying. It will make you feel better
Do not ask them to stop crying
For those unwilling to talk (angry, or remain mute and silent)
Do not get anxious or feel rejected, remain calm
Maintain regular contact and greet them
Maintain interaction
Acknowledge that you understand they are not to blame
Tell them you will return the next day or in a couple of days
Tell them you are not upset or angry because he or she did not talk
Once the person starts talking, maintain a conversation using the following queries like how you are and how are your other family members, what can individuals do to recover?
Work with Families
- Share their experience of loss as a family
- Contact relatives to mobilize support and facilitate recovery
- Participate in rituals like prayers, keeping the dead persons photographs
- Make time for recreation
- Resume normal activities of the pre-disaster days with the family
- Try and do things together as a writ and support one another
- Be together as a family member. Do not send women and children and the aged too far off places for the sake of safety
- Restart activities that are special to your family like having meals together, praying, playing games, etc
- Keep touching and comforting your parents, children, spouse and the aged in your family
- Keep in constant touch with the family member who is hospitalized
Work with the Community
- Group mourning
- Group meetings
- Supporting group initiatives
- Cultural aspects
- Rally
- Group participation for rebuilding efforts
- Sensitization process
Rehabilitation of Special Groups
- Aged people can be helped by
- Keeping them with their near and dear ones
- Visiting them regularly and spending time with them
- Touching them and allowing them to cry
- Re-establishing their daily routines
- Making them feel responsible by giving them some work to carry out which is not too difficult
- Getting them involved in relief work by requesting for their suggestion and advice, etc.
- Keeping them informed of positive news
- Attending to their medical ailments
- Organizing small group prayer meetings
Disabled People
- Removing them to places of safety
- Keeping them informed what is happening
- Getting them involved in activities
- Integrate them in group discussions
- Attend to their specific needs (wheel chairs, hearing aids)
- Helping them overcome their feeling of insecurity
- Taking cognizance of the fact that mentally challenged people, especially the women and children are vulnerable to sexual abuse and help them
Women
- Help them to be with their families
- Keep informing them what is happening
- Involve them in activities
- Involving them in relief and rehabilitation activities
- Initiating self-help formation
- Involve them in recreation
- Making them to spend time with young widows or people who have lost their children and supporting them
Children
- Letting him/her to be close to adults who are loved and familiar
- Re-establishing some sort of a routine for them like eating, sleeping, going for programs
- Actions like touching, hugging, reassuring them verbally
- Allowing them to take about the event
- Encourage them to play
- Involve them in activities like painting and drawing, where then can express their emotions
- Organize story telling sessions, singing, songs and games
- Praising coping behavior
- Provide referral if required
- Spending time on their studies once they return to school
Policies Related to Emergency and Disaster Management
This policy aims at:
- Promoting a culture of prevention, preparedness and resilience at all levels through knowledge, innovation and education
- Encouraging mitigation measures based on technology, traditional wisdom and environmental sustainability
- Mainstreaming disaster management into the developmental planning process
- Establishing institutional and technological frameworks to create an enabling regulatory environment and a compliance regime
- Ensuring efficient mechanism for identification, assessment and monitoring of disaster risks
- Developing contemporary forecasting and early warning systems backed by responsive and fail-safe communication with information technology support
- Ensuring efficient response and relief with a caring approach towards the needs of the vulnerable sections of the society
- Undertaking reconstruction as an opportunity to build disaster resilient structures and habitat for ensuring safer living and
- Promoting a productive and protective partnership with the media for disaster management
Policy Statement
To develop and implement an integrated action plan that will create an effective disaster management system at local, national and international levels.
Focus Areas and Strategies for Intervention
- Making disaster risk reduction a development priority:
To incorporate disaster risk principles in the development agenda and other country programme
To enhance institutional capacity in disaster risk reduction
To develop national platforms for disaster risk reduction
- Improving early warning systems:
To monitor continuously the hazard and vulnerability threats
To develop standard risk and monitoring instruments
Do a risk and hazard mapping
To foster an understanding of disaster management mechanisms through dissemination of information and advocacy
- Addressing priority development concerns to reduce underlying risk factors:
To integrate disaster risk reduction in poverty reduction strategy paper
To address sources of vulnerability especially outbreak of diseases and pests (HIV/AIDS, Avian Flu, locusts, etc)
To sensitize both local and traditional authorities with a view to understanding disaster prevention as a development challenge
Mainstream gender and youth policies in the development agenda
- Effective disaster response through disaster preparedness:
To promote contingency planning in all government departments and all other sectors to ensure alignment of national, local and district disaster management plans
To review and periodically rehearse national preparedness and contingency plans for major hazards
To ensure that operational capacity exists within disaster management systems to enhance community resilience
Policy Implementation Agencies and Structures
The policy will adopt various approaches to ensure that risk reduction in particular and disaster management in general is a national and local priority with strong involvement of local actors, the victims of disaster and institutional basis for implementation
Agencies
- NGOs
- Civil Society Organizations
- Government Agencies
- UN Agencies
- Private Sector
Functions
- Identify, assess and monitor disaster risks and enhance early warning systems
- Use indigenous knowledge, innovation, practices and education to build a culture a safety and resilience at all levels
- Strengthen disaster preparedness for effective response at all levels
- Creation of Disaster Prevention Volunteer Corps at local and national levels to be fully trained and equipped to identify, assess and monitor disaster events
Operational Mechanism
This policy will be implemented through the following strategic actions:
- Sensitization programmes and advocacy on disaster prevention
- Mainstreaming disaster prevention and management in school curricula and development programmes
- Factor disaster scenarios into economic planning and programmes
- Capacity building and information sharing
- Monitoring and Evaluation
