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Inter Press Service (IPS)
Wednesday, 6 April, 2005
By Richel Dursin
JAKARTA: Over a 100 days have
passed since the Dec. 26 tsunami killer waves struck,
wiping out over 290,000 lives. Though bodies have been
cleared away and the homeless have found other places
to live, the mental health of women tsunami survivors
in the worst hit Indonesian province of Aceh remains
precarious.
According to Indonesian psychologists working in Aceh,
humanitarian organisations continue to ignore the
psychosocial needs of this vulnerable group.
''Acehnese women are being left out,'' Livia
Iskandar-Dharmawan, public co-ordinator of Trauma
Recovery and Psychosocial Intervention Foundation,
told IPS.
''While there are many aid agencies focussing on
Acehnese children, very few organisations are giving
emphasis to the plight of women in the province,''
Dharmawan said.
Psychologist Suryo Dharmono agreed.
''Until now, there are no clear psychosocial
programmes for the rehabilitation of women tsunami
survivors in Aceh,'' she said in an interview. ''Women
tsunami survivors in Aceh are confined to doing
domestic chores only and have no outlet to release
their stress.''
Azrul Azwar, director general of community health of
the Ministry of Health, acknowledged that Acehnese
women are being ''forgotten'' as the emphasis is on
children, who suffered the most number of deaths in
the disaster.
Azwar named the United Nations Population Fund (UNFPA)
as one of the very few organisations that are
assisting women tsunami survivors in Aceh.
But Amanda Melville, United Nations Children's Fund
(UNICEF) child protection officer in Aceh, said many
organisations are focussing on children because they
are more prone to trauma than adults.
''Besides, it is easier to set up play activities for
children than for adults,'' Melville said, adding ''it
is difficult and complicated to work with grown-ups''.
Psychologists pointed out that trauma counselling,
recreational support and income- generating activities
for the recovery of women tsunami survivors in Aceh
are not being implemented in the province.
The only ''healing'' activity for women tsunami
survivors in Muslim-dominated Aceh, according to
psychologists, is praying, reading the Quran, and
reciting Islamic prayers.
''Women tsunami survivors in Aceh should be given
appropriate attention as well,'' said Stephanus
Indradjaya, national programme officer of World Health
Organisation- Indonesia.
''We have to minimise their stress and build their
self-esteem,'' Indradjaya said, adding that one way to
reduce their stress and develop their self-esteem is
to provide them with a livelihood.
Psychologists lamented that women tsunami survivors in
Aceh have become all the more stressed out, as their
role had been limited to providing care to their
husbands, children and orphans.
About 80 percent of the Dec. 26 tsunami casualties in
Aceh were women and a number of those who survived now
have psychological problems, which range from anxiety
to depression.
Sondang Sidabutar, Aceh co-ordinator of the Trauma
Recovery and Psychosocial Intervention Foundation,
pointed out that in one village in Aceh there were
around 200 women before the tsunami. After the
tsunami, only 15 women survived.
''The women in Aceh are overworked, as they have to
cook, do the laundry and serve other people,''
Sidabutar said, adding that the situation makes them
more susceptible to the development of mental
disorders.
Health workers said limited access to basic services
also contributes to the trauma suffered by the tsunami
survivors.
According to the government, around two million
Acehnese survivors are expected to be in need of
psychosocial support and up to 400,000 Acehnese may
have trauma-related stress disorder requiring skilled
mental intervention.
Currently, there are 400,376 internally displaced
people in Aceh, 250,000 of whom are living with host
families. The remaining are in temporary tents or
public buildings such as offices, schools, mosques and
barracks.
''Tsunami survivors in Aceh who are suffering from
trauma-related stress disorder most of the time don't
know what to do and where to go,'' said psychologist
Dharmono. He said he often receives text messages on
his mobile phone from Acehnese asking about simple
coping mechanisms for trauma and where they should go
for psychosocial support.
The Ministry of Health reported that many mental
health personnel in Aceh perished in the killer waves
and those who survived are also suffering from trauma,
which in turn affects their performance.
Other competing programmes such as those in
reproductive health, nutrition, child health and
communicable diseases also overwhelm health care
providers in tsunami-ravaged Aceh.
Among different levels of government, co-ordination is
still weak and not all decision- makers put
psychosocial support and mental health as a priority.
Health workers lamented that Indonesian authorities
and the international community are giving much
emphasis on reconstructing infrastructure rather than
the mental health of the tsunami survivors.
''Psychosocial and mental health provision should
complement humanitarian work, starting in the first
days and weeks of the relief effort, and should
continue and be translated into substantial
interventions through the rehabilitation and
reconstruction phases,'' said Pandu Setiawan, the
Ministry of Health's director for community mental
health.
In Indonesia, there are about 7,000 psychologists. Of
this, only 200 are clinical psychologists and between
eight to 10 are assisting tsunami survivors in Aceh.
''The number of psychologists in Aceh is definitely
not enough,'' said Indradjaya of WHO.
Addressing the shortage of psychologists, the Ministry
of Health deployed mental health professionals to
train community leaders in Aceh, including teachers
and religious leaders on how to provide psychological
first-aid and psychosocial support. So far, around 320
people have been trained in the capital Banda Aceh and
Lhokseumauwe town, but the government still thinks
that they are not yet competent in providing trauma
counselling.
To help tsunami survivors recover from trauma-related
stress disorder, the United Nations Educational,
Scientific and Cultural Organisation urged health
workers to include a cultural component in their
psychosocial programme.
''Any psychosocial programme for tsunami survivors not
only in Aceh but also in other areas should have a
cultural aspect based on the traditions of the
affected people,'' said Himalchuli Gurung, a UNESCO
programme specialist. (END/2005) |
