Coping with crisis

How do earthquake survivors cope with the destruction of their homes: from the terror of the moment, when the building shakes and gives way, to the aftermath of picking through the debris of their lives? And what about those who have witnessed horrors, or endured brutality – how do they carry on, burdened with those memories?



In a word, resilience. Surviving a traumatic event does not mean psychological dysfunction will inevitably follow. According to Mike Wessels of the Columbia-based Global Technical Group on Psychosocial Well-being, it is a fiction that most people will need medical intervention to put their lives back together.



Reactions to - and symptoms of - stress vary. Some people have underlying conditions that may reduce their resilience, but generally, “When people who have been through a terrible ordeal feel safe, have shelter and access to food and water and have the basic means for survival, they can recover quite quickly,” says Alison Schafer, mental health and psychosocial support interest group coordinator for World Vision International.



"Trauma" itself might not be a helpful term; it suggests a medical approach, which neglects people’s broader psychosocial needs and the interventions required to meet them, according to the UN Inter-Agency Standing Committee (IASC) guidelines on Mental Health and Psychological Support in Emergency Settings. For many survivors the most troubling aspect of disaster is not the event itself, but coping with day-to-day life afterwards.



Rebuilding livelihoods, and thereby self-worth, is key. For parents, that means finding work to support their families; for children, the chance to get back to school and rediscover safety and routine. “The majority of the time people will heal within themselves once those other aspects of their lives are restored,” says Schafer.



A major stress factor is separation, so reuniting people is another important intervention. Religion can have a positive impact, and certainly the re-establishment of community and social networks, says Wessels.



A smaller group of the population, such as survivors of sexual violence, may need a mix of emotional and livelihood support delivered by community workers.



A smaller percentage still are those who display severe mental health problems - possibly as a result of the severity of their experience, the accumulation of loss and stress, or pre-existing mental conditions - and they will require specialized help.



As ever, it is the poor who are not only the hardest hit by disaster, but the least able to bounce back. The IASC guidelines stress that "in the early phase of an emergency, social supports are essential to protect and support mental health and psychosocial well-being". But they also recognize that affected groups have resources that can be tapped for support - from community leaders to traditional healers.



And yet "it is these very systems of support that tend to break down in the chaos of war”, notes the Machel Study 10-Year Strategic Review: Children and Conflict in a Changing World.



This in-depth looks at the challenges faced by communities in six countries as they struggle to rebuild their lives. 



Click here for In-depth: Coping with crisis



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