Zimbabwe: Psychological Care for Cyclone Idai Victims Vital

28 March 2019

Cyclone Idai has left a trail of devastation, with hundreds losing their lives and thousands of survivors now faced with loss of many family members, all their possessions and homes.

As efforts to rescue stranded people and provide, food, sanitation and water for those at risk in Zimbabwe, Malawi and Mozambique are underway, the tragedy before our people is quite enormous.

Cyclone Idai's massive flooding has ravaged the three southern African countries killing more than 700 people, according to official statistics.

An estimated two million people have been affected with Mozambique, which was the worst affected recording up to 417 deaths, with 1 400 feared injured while in Zimbabwe, 259 have been killed and 200 injured.

In Malawi 56 have been killed, with 577 injured.

People in all these countries are still coming to terms with the deadly effects of the storm, which destroyed crops, livestock, infrastructure and left most houses ruined or damaged.

The tragedy is massive and major work will be needed to restore livelihoods, electricity, water and sanitation to prevent the emergence of water-borne diseases, as well as repairing public infrastructure.

To make matters worse, the death toll is rising daily as more bodies are discovered in the aftermath of this major disaster. This disaster has drawn great attention in the mass media and as the rain eases, residents are emerging to surveying the ruins that remain and begin their clean-up efforts.

Rescue and relief efforts have been massive too, with private individuals and companies, African countries, SADC, AU, the EU, Britain, US and United Arab Emirates donating millions of dollars of aid to Mozambique, Malawi and Zimbabwe for emergency shelters, hygiene, sanitation and healthcare.

Apart from this physical aid, potentially traumatic experiences have placed the lives and physical integrity of individuals and their loved ones in jeopardy. Prospective studies show that a significant number of disaster survivors develop intense psychological reactions immediately after these experiences.

Until recently, major focus was practically limited to providing material support for disaster victims, including calls for donations.

However, in recent years a new element has been incorporated into the set of resources offered to disaster victims -- immediate psychological care.

In this season of mourning, it is important that we provide support for those affected and this is not just the domain of mental health specialists, anyone can provide psychological support to someone who has survived a disaster of the scale of Cyclone Idai.

First responders, health workers, relief workers, family and friends can all offer psychological first aid in the wake of a disaster.

In the wake of a traumatic event, many people will have a psychological reaction which can be:

An acute stress reaction which is a transient reaction in the days following the trauma characterised by anxiety, insomnia, poor concentration, incoherent speech, nightmares, being on edge, feeling numb, being tearful, feeling angry.

Grief which is the suffering that follows the loss of a loved one characterised by deep sadness or despair, yearning for your loved one, intrusive memories and images of the loved one, social withdrawal.

Depression which is a common mental health problem characterised by pervasive sadness, lack of motivation and drive, lack of energy, low self-esteem, feeling helpless or powerless, feeling hopeless. Suicidal ideation and attempts, survivors' guilt.

Post traumatic stress disorder which is a persistent reaction to life threatening trauma which can be seen several months after the trauma. It is characterised by persistent re-experiencing the trauma through flashbacks or intrusive memories and nightmares; avoiding any reminders of the trauma, avoiding talking about the trauma or going back to the place of trauma and heightened sense of alertness to possible danger

What can one do to help or say to someone as they try to recover and heal from disastrous events that have destroyed life as they know it? Psychological first aid is a simple approach that we can all use in times of trauma.

When faced with someone who has been traumatised:

Ensure safety and provision of basic needs like clothing, shelter and food

Treat people with dignity and respect

Offer a private area to talk, listen attentively, remain calm, be patient

Acknowledge the loss that is being experienced, allow people to cry, respect cultural norms and grieving processes

Help people identify their strengths and how they have helped themselves in the past, build self efficacy

Encourage good coping strategies like sleeping, eating regularly, talking about how they are feeling

Discourage social withdrawal or isolation and the use of drugs or alcohol to cope

Link people with any surviving family as well as services for follow up care

We can all be part of the solution in this time of national mourning. Let us reach out to one another as part of our beautiful culture of "hunhu" that we saw through the outpouring of aid supplies in this crisis.

The article was co-authored by Dr Sacrifice Chirisa and Dr Chido Rwafa for The Herald.

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