Mental illness, fears stalk Aceh tsunami survivors

Mental illness, access to health services and the threat of disease remain daily challenges for residents of Indonesia’s Aceh province nearly eight months after it was hit by Asia’s devastating tsunami.

But huge progress has also been made in caring for the more than half a million Acehnese left grieving and homeless by the disaster, says David Nabarro, head of crisis operations for the U.N.‘s World Health Organisation (WHO).

“We are still talking about risk of communicable disease and problems associated with difficulty accessing health services,” Nabarro told Reuters by telephone on Thursday during a visit to the provincial capital, Banda Aceh.

“But I want to be pretty clear, we are not now talking about major health problems at the community level. Our current focus is on combing the place to make absolutely certain there are no islands of people who are still lacking services,” he said.

“We are worried about communicable diseases, about waterborne diseases, particularly with the rains coming on, but we are not sitting here thinking we have a time bomb.”

Nabarro said a key concern for the U.N. agency was the mental health of survivors living with relatives, or in makeshift camps of tents and wooden huts after the tsunami and the earthquake that triggered left around 170,000 people dead or missing on Sumatra island.

“The real increase has been in mental disturbance and psycho-social disturbance at the local level and surveys show that,” he said.

“People thinking they can’t cope and just going to bed, outbursts of temper, anger. People having disorders like not being able to go out of their homes.”

Up to a quarter of the children caught up in the Dec. 26 disaster have mental health problems that need professional treatment, according to a study by the WHO and University of Indonesia in May.

Most of the tsunami-affected adult population is also suffering from trauma-related distress, it showed.

“It’s in keeping with what we find in other places. In war, particularly protracted wars, we find that up to 50 percent of the population has distress. We got those figures from Palestine and places,” said Nabarro.

A 2002 survey showed many Acehnese already suffered trauma after nearly 30 years of rebellion in the province, which may now finally be drawing to a close after the destruction of the tsunami pushed the government and rebels into peace talks.

A formal peace deal is expected to be signed by the government and Free Aceh Movement on Monday in Helsinki.

Nabarro said that the mental health problems were far beyond the capabilities of Aceh’s lone mental hospital and so the WHO was working with the government to make Aceh the first Indonesian province to have community mental health services. “We predicted that because of the amount of trauma and bereavement there would be problems with coping capacity.”

But Nabarro said there was room for optimism.

“What I come away with from this short visit is the sense of an incredible determination on the part of the authorities and the U.N. and others to pull together.”

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