Mennonite Central Committee

Trauma Counseling in the Andaman Islands

February 16 , 2005
by Carolyn Holderread Heggen

In the introduction to his book, “General Knowledge: Andaman and Nicobar Islands,” Baban Phaley says, “Here nature has created some of the most exquisite scenario making it look heavenly, vivid, varied and (pervaded) by a rare and enduring beauty.” Its “magnetic charisma” leaves one “speechless at its splendidness.” Indeed, as we neared the end of our two-hour flight from Kolkata (Calcutta) and began the descent into the Andaman capital of Port Blair, the sparkling clear turquoise waters and lush green jungles made it easy to imagine I was headed for an exotic tropical vacation. As our plane continued to drop, the sight of reddish brown rice paddies; temples, shrines, bridges and buildings askew and crumbled; boats smashed and deposited far from the water’s edge quickly jolted me back to reality.

At the request of West Bengal Volunteer Health Association, a longtime partner of Mennonite Central Committee in India, I had in fact come to train community workers, teachers and medical people who wanted to learn how to respond to the overwhelming psychological trauma left in the wake of the recent disaster.

 

Camps for survivors

Soon after the tsunami hit, tens of thousands of people were brought to Fort Blair by Indian Navy ships and helicopters from the 37 other small, inhabited islands that make up the Andaman and Nicobar archipelago in the Bay of Bengal. In a part of the world that suffers more than its equitable share of natural disasters and has too much experience dealing with calamities of Biblical proportions, the Indian government, local people and just-arrived displaced people quickly and efficiently set up “camps” in school yards, in army camps, on public lands and open fields. As people were rescued from the outlying islands and brought to Port Blair, shiploads were settled together in one camp. When the camps could hold no more, another camp was set up. There are currently 18 different camps at Port Blair. The smallest has around 300 residents while several “house” over 1,000 in makeshift tents of plastic. Because subsequent recovery trips found additional survivors, family members have ended up in different camps and post-tsunami confusion make it difficult to get families reunited. Because of this, many survivors who saw their loved ones washed out to sea still cling to the fantasy that perhaps they have now washed ashore, been rescued and are safely awaiting them in another camp. For the time being there seems to be sufficient food and water for drinking in the camps but bathing is a rare luxury.

 

The injured

Many survivors arrived with serious physical injuries. Corrugated sheets of tin in the churning waters caused serious and often fatal cuts and amputations. Many were thrown against concrete retaining walls and buildings and suffered severe head injuries, abrasions and broken limbs. The most critically wounded were taken from the rescue ships directly to the government hospital. I visited ward after ward of severely wounded tsunami survivors. The hospital staff has ingeniously rigged up make shift traction devices for shattered limbs and broken backs. It was heart-breaking to see young people who have had arms, legs, hands and feet amputated. Some have lost all family members, their home, their means of livelihood as well. I can’t imagine the extent of their physical and emotional pain. It is no surprise that many express frustration that they too did not die.

 

Providing medical care and mosquito nets

MCC provided immediate funds to ship medical supplies from the Indian mainland. At each camp an indigenous health worker was identified or appointed and a small “clinic” set up where people come for basic health needs. A volunteer local doctor secured by West Bengal Volunteer Health Association visits each camp daily to attend to more serious medical needs. There are the expected diarrhea, upper respiratory and conjunctivitis outbreaks. Several children with chicken pox have been treated but so far a widespread outbreak has been prevented.

Because of the pools of trapped and brackish water and the destruction of many latrines at Port Blair, there is an infestation of mosquitoes and large flies. At camps people begged us for nets because they were unable to sleep at night or protect their young babies, the old and the sick during the day. We were able to place a call to Kolkata and thousands of brightly colored nets were put on the next ship. As we distributed the nets, people graciously thanked us.

 

Signs of hope

A woman at one of the camps told us she knew how to sew and asked if it would be possible to find a sewing machine for her to use. She said if she had a machine and some fabric she could sew clothes for people in the camp. We found out that three other women and a man know how to sew and asked them if they would be willing to not only sew clothes for the camp occupants but also teach some of the young people to sew. They were excited at the possibility and by evening we had purchased four simple sewing machines and bolts of brightly colored fabric. On each subsequent visit I saw the machines in use as groups of young people sat on the ground watching intently as the fabrics were cut, the machines threaded and the garments sewn.

One of our team members did a survey of the ages and grade level of all children in the camps. She ordered reading and math books, writing notebooks and pencils from Kolkata and then found people in each camp willing to conduct classes for the children. Residents of the camps seem excited to be doing something productive with their time and are happy to be involved in the re-establishment of normal community activities. This shift from passive victimhood to active, meaningful participation seems critical to psychological healing. One of the happiest images I have from camp life is of a group of men and women of various ages sitting on the ground, peeling potatoes and chatting together.

 

Psychological trauma

While camps are now able, though quite challenged, to meet basic physical needs, the psychological needs are immense. Most camp residents have a personal story of profound loss and nightmarish images trapped in their minds. Many children fight sleep and don’t want to close their eyes because when they do they see haunting “pictures.” This is a part of the world where women are the most disempowered and a widow is considered a worthless burden on society. The many tsunami widows not only struggle with deep personal loss and grief but wonder how they will ever be able to support their children and survive the coming years. My first conversation in a camp was with a 23-year-old pregnant woman who sat crying, surrounded by her three frightened children. Her husband was washed out to sea and she never found his body. She has no other surviving family. While she wants to think he may have grabbed onto a floating palm tree and will be waiting for them when they return to their island, she knows it is unlikely and looks dazed and haunted as she says over and over, “What will become of me and my children?”

Now that basic physical necessities have been secured, teachers, medical people and community workers are beginning to ask how the deep psychological wounds might be addressed. They have asked for basic training in crisis counseling with particular interest in how to address the needs of children. It was in this training role that I was asked to come to India.

In the Andaman Islands I did separate training workshops with teachers at the elementary, middle school and secondary levels. We focused particularly on ways of using art, stories, play and drama to help students externalize and resolve the internal terror they have experienced.

At the government hospital I met with nurses and the medical staff to conduct a workshop on healing responses to emotionally devastated patients. Sitting on the front row of the large lecture hall was a young nurse who frequently wiped tears from her eyes as I spoke. She later shared with me her personal story of tsunami terror and shared how hard it is to help her patients and be compassionate with them when her own heart is so full of sadness. She had been living on the island of Little Andaman, working at a small medical clinic. Almost every building, including her clinic and home, was destroyed. Her two children and husband survived but the children are “frightened of everything” and have not been able to sleep. The ongoing earth tremors continue to traumatize them and they don’t want to leave her side but she must work to earn some money if they are going to rebuild their home and life. Her greatest sadness and concern is for her husband. Because of a head injury his memory is now impaired. “His thinking isn’t right now,” she says. She too voiced the lament I was to hear over and over: “What am I to do?”

Relief workers, emergency response teams and community workers have been working 14 to 16 hour long days for over a month now in hot, muggy, mosquito-infested tense situations. They are capable and committed, but exhausted. I was happy to have a chance to hold workshops with them on compassion fatigue and self-care. They responded enthusiastically and emotionally to the invitation to set limits for themselves and to suggestions for ways they can help each other monitor and manage their workload and stress. One soft-spoken, gentle participant said the workshop helped him understand why, for the first time in his life, he has been feeling anger for no understandable reason. “Now I understand these strange feelings I’m having. I’m burning out.” This is a key group for the rebuilding of tsunami-affected communities. Support for them will be vital in the months ahead.

My heart is full already of images of destruction and stories of despair. But in the Andaman Islands I also saw enough expressions of human compassion, courage and generosity to renew my belief in the resilience of the human spirit and energize me for the work ahead.