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Friday, March 9, 2012

Mental health must match post-3/11 recovery


By DAVINDER KUMAR

SENDAI — Over the past year, the tsunami-ravaged coastline of Japan's northeast has undergone a cleanup never seen before in history for its sheer scale and speed.

From Ishinomaki to Onagawa, Shichigahama to Kesennuma, the landscape has been drastically altered as the nation presses on with the world's costliest disaster recovery to date.

Town after town affected by the tsunami has been razed to the ground. Houses, schools and busy markets have disappeared. Almost everything that was damaged has been flattened and cleared. The horizon now shows towers of scrapped cars, recovered metal and millions of tons of cleared debris. Some colossal industrial units will take longer to dismantle.

The great fortresses of Japan's economic power, they stand like grim mausoleums, annihilated by the brute force of tsunami waves that tore through their steel ramparts as if they were made of paper.

Much like their nation, Japan's tsunami survivors have also put on a brave front to their immense loss and suffering. As the world watched the news of March 11, 2011, with disbelief, the survivors were making an orderly queue to receive emergency relief. There was shock and great tragedy, but no public display of emotion.

One year later, the tsunami survivors are still mourning their dead. Many are waiting to hear about their missing relatives. Thousands are still in temporary accommodations unsure when they will return to their homes. Despite all this, the survivors rarely speak out and, least of all, complain about their circumstances. To be seen needing help is a dent in one's self-respect and seeking it is akin to a betrayal of those who need it more.

Even with such overarching altruism and valiant attempts to live up to the embodied values of stoicism, tsunami survivors, especially children, need help.

For thousands of tsunami-affected people, life has not moved on since 3/11 as they try to come to terms with their loss. Earthquake, tsunami and the fear of nuclear radiation has put a significant part of the population under stress.

Japan's decision to spend ¥13 trillion ($167 billion) over five years for recovery is a robust response. The urgency to return to business is evident, and core priorities have been set around economic revival and economic benefits.

Missing, however, from the discussion is the pressing human needs of survivors.

Regardless of a nation's advancement and resources, disasters affect everyone. The emotional impact of tsunami on survivors cannot be addressed by rapid reconstruction and physical recovery alone.

Mental health professionals readily furnish data to show how — years after the 1995 Kobe earthquake, which killed more than 6,000 people — the number of psychological cases continued to rise.

The 2011 tsunami dwarfs the Kobe disaster in its casualties, magnitude and geographical spread. The experts fear that if the emotional needs of affected people are not addressed immediately, there could be long-term ramifications for the general psychological well-being of those at risk, especially children.

Child rights organization Plan Japan's experience of reaching thousands of tsunami survivors in the past year confirms this assessment. The organization has come across disturbing stories of children playing tsunami games or being scared to flush toilets as it reminds them of tsunami waves.

Psychologists working with Plan have reported cases of grown-up children showing anxiety, wetting beds and adults going through depression and some even developing alcohol and gambling addictions.

Plan, which runs its entire programs in developing countries, launched emergency aid in Japan as an exception. It focused on the emotional well-being of tsunami- affected children and their caregivers such as parents and teachers in Miyagi Prefecture, which suffered the most casualties and the worst damage.

The perceived social duty to be resilient and the tendency in Japan to confuse psycho-social care with mental illness means that those in real need may never seek help. Plan Japan staff had to adapt and evolve ways to reach very private people. Tea parties were used as an excuse to bring people together so that they can talk and share their feelings. Psycho-social care had to be rebranded as child support.

Emotional support or psycho-social care is often neglected in disaster response, yet it is among the most basic needs of disaster survivors. It is vital for affected people to be able to relate to and deal with their circumstances. Simple things such as group activities, games or getting people to talk to each other can play a significant role in the healing process.

Best still, expressing emotions and sharing feelings can prevent high-risk people from advancing to stages where they require specialized mental health care involving psychiatrists and clinical psychologists.

The events of 3/11, however, have exposed a worrying neglect of emotional well-being in Japanese society, a sentiment echoed by mental health experts who fear that things could get worse.

For prided stoicism and economic realities, the pressure is intense on Japan and its tsunami survivors to resume business as normal.

As the world's third largest economy races for rapid rebuilding and reconstruction, it must not lose sight of survivors' emotional well-being. It is a challenge and a humanitarian need that must be met. For Japan's recovery to be successful, it must be matched in mind.

Davinder Kumar is an award-winning development journalist and global press officer for child rights and community development organization Plan International. He is also a Chevening Human Rights Scholar. This article is based on his recent visit to tsunami-affected areas in Japan.


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