Wayanad survivors struggle, support system ramps up

Volunteers helping at site. Pic/Courtesy District Information Office

The external injury scars may heal, but the mental scars will remain for a long time. Those who survived are finding it difficult to come to terms with the tragedy, a challenge Kerala will need to address. They require counsellors and psychologists to help them overcome grief and loss, says Annie Raja, who is stationed in Wayanad and meeting survivors at camps.

Although the state is providing sanitary pads for menstrual hygiene at camps and public toilets, there are also concerns about communicable diseases, and steps are being taken to address them. City-based psychiatrists admit that the immediate need for survivors will be long-term counselling and psychiatric support, and returning to routine will be an uphill task.

Survivors in shock

"Most of the survivors are struggling to overcome the tragedy, and some do not even have the support of their loved ones to mourn. Many vacated their houses on the fateful night without having time to collect extra clothes or valuables. Some rushed to relatives' homes to avoid flooding and heavy rains, but landslides even washed away otherwise safe houses," survivors told Annie Raja, who contested the Lok Sabha election from Wayanad on a CPI ticket.

Annie Raja met survivors of the Wayanad landslides

"The roaring sounds of the landslide and devastation still echo in the ears of many who are being counselled at the camp. Sanitary pads, face masks, and bio-waste are being collected regularly by the district administration to maintain hygiene and prevent communicable diseases. Many volunteers from Tamil Nadu and other districts of Kerala have come forward to help, but trained counsellors will be needed for long-term support. Their injury scars may heal, but the mental scars will remain for a long time," said Annie.

Multiple levels of intervention

Ramon Magsaysay Award winner psychiatrist Dr Bharat Vatwani, said, "There are various facets to this tragic loss...the loss of loved ones, the loss of a supportive almost-family neighbour community, the loss of material wealth, home, hearth & belongings, the loss of an identity and the possible loss of faith in the Gods above with 'Why me/us' being the dominant recurring intrusive thought. This will need intervention at multiple levels, regional-language speaking psychologists for counselling, psychiatrists for appropriate supportive medication, social welfare organisations for the necessary long-term shelter-roofs, economic and financial support from the government and well-meaning citizens of society, spiritual support from the religious organisations of their cultural setting etc etc."

"Most importantly, the loss has wiped out years of association, be it at an emotional or material and physical level. As such, the support too has to be a planned long-haul... beyond the knee-jerk reactions so prevalent in the modern social-media dominant times of ours," he said.

Grief is the response to any loss

"Grief is the response to any loss. Grief reactions are normal responses to abnormal situations. Its intensity is proportional to the severity, duration, and intensity of exposure to the disaster. The grief process occurs through various stages and is often experienced in waves or cycles with periods of intense and painful emotions," said Dr Suresh Bada Math, head of Forensic Psychiatry and Legal Aid Clinic at NIMHANS, Bangalore.

Most of the survivors are struggling to overcome the tragedy, said Annie Raja

"Disasters are an inevitable part of life. Preparing for ‘when' a disaster strikes, rather than ‘if,' requires a shift from relief-centred post-disaster management to a holistic, integrated, and preventive approach based on disaster prevention, preparedness, and mitigation," said Dr Suresh.

"It involves responding to the emotional and psychosocial needs of disaster-affected people. Community-based group interventions should start as early as possible, targeting all high-risk populations in the affected area. The management approach should be conservative in medication and innovative in psychosocial support. There is a need to de-medicalise the survivors' disaster response and involve local community workers. Rehabilitation efforts should be culturally appropriate and aimed at empowering the community to cope with future disasters," Dr Suresh added.

Mental health care is a right

"Mental health care is a right and must be provided to all victims of the Wayanad disaster. With homes gone, survivors need to be rehabilitated elsewhere. This trauma is profound, and counsellors need to be part of the relief effort from Day 1. Survivors are in the immediate post-impact phase of the disaster, experiencing shock, numbness, agitation, and sadness. Mental health first aid should be provided in relief camps, allowing survivors to share their experiences. Repeated recounting of their trauma should be met with patient listening from frontline workers. The state should deploy mental health professionals and develop a long-term recovery plan to prevent late-onset PTSD and depression," said Dr Harish Shetty, a senior psychiatrist with extensive experience in disaster mental health care.

Annie Raja said survivors' injury scars may heal, but the mental scars will remain for a long time

"Mental health relief will help them become reasonably mindful to receive relief, and compensation and use it rationally. If this is not done survivors end up spending the money on meaningless rituals and quacks. Religious organisations will flood this area and they need to be monitored strictly and not be allowed to use the vulnerable affected for the sake of conversions. Politicking causes a lot of harm and destroys the mental health of the populace. Politicians should not swarm in great numbers. Every survivor should be screened for deep distress and thoughts of self-harm, which has to be prevented," said Dr Shetty

Other side

121 counselling experts provide mental support

A team of 121 psychiatric experts has been deployed by the Kerala health department to provide mental support to those in relief camps. The team, divided into smaller units across camps and relatives' homes, includes clinical psychologists, psychiatric social workers, and counsellors, each unit headed by a psychiatrist. Their primary goal is to address mental distress and provide support, with special attention given to pregnant women, children, and senior citizens. The health department has developed a comprehensive plan to address long-term mental health needs, explained a senior district information officer coordinating rescue and relief work.

Special focus is also placed on individuals with pre-existing mental health issues and those on medication. Efforts are made to ensure the continuity of medication. Another group in focus is those who are having alcoholic/narcotic withdrawal symptoms, the officer said. The death toll has surpassed 205 (including 84 females, 93 males, and 28 children), with around 250 people still missing.

Rahul Gandhi, who was Wayanad MP, visited the landslide hit district and met the survivors

Arrangements for garbage and bio-waste disposal

Detailed arrangements for waste management have been made in relief camps. Each woman and adolescent girl is provided with a zip cover for menstrual needs, which is also used in toilets. Aakri, a private agency, is responsible for collecting and disposing of toilet waste. Both bio-toilets and normal toilets are available, with Harithakarma Sena cleaning each toilet every two hours.

"Two waste bins (for biodegradable and non-biodegradable waste) are placed in each camp. The collected waste is handed over to Clean Kerala Company and Green Worms for safe disposal. On the third day of the landslide, Harithakarma Sena volunteers cleaned Chooralmala town, collecting 90 per cent of the accumulated waste. The waste has been moved to the MRF (Materials Recovery Facility) of the Kalpetta Municipality," the officer concluded.