Scarred by consecutive floods, how Kerala is helping survivors
Consecutive floods in Kerala not only washed away lives and livelihoods, it also left psychological scars.
Sainaba, 37, was brought to one of the many relief camps for those affected by the floods and landslides that devastated Kerala in August. But she was unable to come to terms with what had happened. “There was grief and a sense of guilt that she had not been able to save her child. She couldn’t accept his death,” says Hareesh Krishnan, nodal officer of Wayanad’s District Mental Health Programme.
It’s when the waters recede and the rubble is cleared that the real picture of the damage wrought by a natural disaster like a flood emerges. Less tangible than the loss of possessions, and hence often overlooked, is how these large-scale natural disasters affect the mental health of survivors.
“The human impact of emergencies is often tragic — families are torn apart, lives are lost, properties are damaged and critical social and health services break down. Timely mental health support is essential for individuals and communities, and serves as a springboard to recovery,” says Hank Bekedam, World Health Organisation’s India representative WHO’s epidemiological projections show that 20-40% of a population affected by natural disaster suffers from mild psychological distress while between a third and half of them could suffer from moderate to severe psychological distress.
“Loss of property, life or livelihood, all of these cause distress. In a natural disaster, everything happens in a few hours or seconds, so the coping capacity of the person is lost,” explains K Sekar, head of the department of psychiatric social work at the National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru. Psycho-social first-aid becomes critical. “The priority is to ensure reactions are not converted to symptoms. The longer it takes for it to get identified, the problem can become chronic and difficult to contain,” he says.
A Year Apart
In the wake of the historic floods of 2018, the state government had conducted counselling sessions at rehabilitation camps. “But we decided to continue with the sessions after the suicide deaths of two survivors who had returned home — a man whose house was destroyed and a student who lost his certificates,” says state Health Minister KK Shailaja, who has earned accolades for her handling of the Nipah virus outbreak. Building on this experience, the social welfare and health departments swung into action immediately this August to help heal any mental trauma. Over 50,000 people have been given psycho-social help, according to the government.
In relief camps, group sessions by counsellors spread awareness about the impact on mental health and helped legitimise the fact that people might want to seek help for how they were feeling. For children, there were play therapy sessions where they were encouraged to express themselves through art. A helpline was also set up. Importantly, people knew who to reach out to for counselling.
The camp sessions were followed by home visits by ASHA (accredited social health activist) workers trained to identify symptoms. They referred those who needed help to counsellors. After last year’s floods, counsellors had been appointed on a one-year contract at family health centres in all flood-affected areas. “The idea is to empower the local people to eventually form a support group of their own,” says Amal Abraham, a doctor based in Idukki, a district severely affected in the 2018 floods.
A result of these interventions is the normalisation of counselling in a state where 14% of the adult population was found to have suffered a psychic disorder at least once, according to a 2017 state mental health survey report. “When we first came here, people avoided us. It took a lot of time to gain their trust,” says Mintu Prasanth, 28, a mental health counsellor at Chittirapuram family health centre in Idukki. “Now, people approach us to discuss their problems.”
Back in Meppadi, Sainaba is on the road to recovery and, as a first step, has accepted her child’s death. “We told her we would be there for her if anything were to happen again,” says Rineesh VV, a programme coordinator with Hrudayaram Counselling Centre. The focus now is to get the entire panchayat declared free of the impact of mental trauma.