Raquel Eidelman Cohen MD,
Earthquakes are disasters that cannot be predicted and whose
effect can be considered catastrophic depending on the severity and
duration. The earthquake that occurred
in the Ica Region of Peru on
Knowledge in the field of assistance to survivors has been enriched by the collaborative work of numerous professionals worldwide who have published and presented their findings, leading to a better understanding of survivors’ behavior, crisis reactions, stressor effects on the individual and stress responses, coping and adaptation to painful changes in their lives.
Individuals who have experienced a traumatic event oftentimes suffer psychological stress related to the incident. In most instances, these are normal reactions to abnormal situations. Individuals who experience these feeling may believe they are unable to regain control of their lives or that they may develop pathological manifestations due to the trauma. However, professionals who work in the field of mental health assistance in natural disasters now understand that for the most part, this behavior is an expression of both substantial stress plus an effort to return to normal function, although a small number of individuals will develop both somatic or psychological disorders due to variables of genetic origin, previous traumatic experiences, pre-morbid chronic conditions, or severe environmental lack of resources. Intervention techniques are constantly refined to help in the recovery of function of traumatized individuals.
Techniques available to help individuals after a disaster are defined as active interactions whose aims are to promote, complement and reinforce healthy functions and adaptive behavior of the survivors. Although expressions of empathy are helpful, care must be exercised not to reinforce or reward the “victim” role. Care should be taken not to interfere with psychological defenses, which the survivor needs during the initial period post-disaster. Establishing a relationship may be difficult in the initial period because the survivor often has distorted thinking due to high anxiety and cognitive blurring. They may be defensive, guarded and overwhelmed. Once a relationship is established, the worker can offer options in solving problems and can help the survivor by suggesting different methods to find the most feasible way of living day by day.
The worker needs to be aware that the survivor will face different experiences as the community is reorganizing and as individuals continue to return to function. This process is based on the passage of time after the impact of the event. Each period of time, generally referred to as “Impact”, “Post disaster phase”, and “Reconstruction”, has its own unique characteristics of adaptation behavior. Each phase will stimulate varying emotions and attitudes, presenting a challenge to the worker who needs to ascertain what this changed behavior means. What this increasing knowledge of behavior change in relation to the overall timeline indicates is that intervention techniques must be "in sync" with the stage of crisis resolution after the disaster impact.
earthquake surprised, frightened, and stunned Peruvians on
A TRAINING PROGRAM (Aug.20 -
was able to follow the course of post-disaster activities through the TV
(Peruvian governmental document translated and summarized)
The Directory of Mental Health of MINSA calls on the mental health professionals responsible for working with the affected population of the earthquake which occurred on the 15th of August to a workshop to reinforce the plans of intervention for the provinces of Canete, Chincha, Pisco, and Ica. The workshop will be based on the experience and the activities of mental health professionals in natural disasters, will be led by experts and national/international agencies, and will strengthen the practices and knowledge of the assisting teams.
Based on the planning function, MINSA will be strengthening the local and regional health units in association with the mental health hospitals, organizing the work by operational zones. Within the first phase of work we have the following objectives:
1. Complete the evaluation of needs and resources that will include field visits to the disaster zone.
2. Train planning staff and decision-makers to complete and adjust the working plan
3. Train mental health disaster team leaders, the staff of mental health hospitals, and members of the government administration. The curriculum will include methods of working with different groups, children, adolescents, and adults in addition self-help methods for the trainees.
4. Develop monitoring and support systems for the mental health teams in the disaster zone.
The work will be supported with the
technical and financial capacity of the Panamerican
Health Organization and the faculty of the Univ. Calletano
Heredia through their Program of Trauma - Global
Health Research Initiative - Teasdale-Corti Team
Grants Program and supported by the Douglas Mental Health University Institute
Experts invited to participate are: Dr.
Carlos Martin Berestain from
*Delineate methodology and procedures necessary to help the survivors, respecting their culture, to recover its functional capacities.
*To increase the knowledge of the bio-psico-sociocultural processes that give support to the interventions in the resolution of crisis responses
*Identify the techniques of intervention for adults, children, and older adults.
*Present the methods of self- help to the professionals that work in disasters.
Methodology - Lectures (PowerPoint
*Prioritize the important problems for survivors
*Interactive and participatory activities during the sessions.
*Orientation towards active role play
*Emphasis in the here and now.
*Emphasis in the practices and opportune solutions.
OF THE DAILY
*Presentation of content.-trauma ,crisis, physiologic and psychology c defenses
*Practices - vignettes, modeling of roles, use of video-therapeutic intervention
*Presentation of cases and examples-based on actual cultural and earthquake experiences
*Discussion - question and answer periods—multidisciplinary perspective
Members of the teams will be asked to read the materials that were provided to them before the session so as to be prepared to discuss and to ask questions they have. Emphasis was focused on participation and interaction between the participants and presenter.
After participating in several large symposiums composed of administrators, agency personnel, and professionals interested in the program for disasters, I began to meet with the staff from each city’s mental health team. We worked intensively for two days developing the details of the two day training that would be offered to each team. We wrote the scenarios for role-playing, the sequence of the PowerPoint presentations, time, and content.
It was anticipated that each team would receive copies of the curriculum, CD’s of training materials, and a bibliographic list of articles. We repeated these activities every two days, fine-tuning our approach as we determined what worked best, and balancing the time versus the number of attendees. The average number of trainees was between 50 and 70 multidisciplinary mental health professionals, including educators, administrators and police officers.
the first day of training, as the “students” (who were also a mix of “damificados” assigned to assist survivors and
the training in