MSF continues psychological services for earthquake and tsunami survivors

Two months after the massive earthquake and tsunami in the northeast of Japan, a team of Médecins Sans Frontières (MSF) Japanese psychologists are continuing to work with survivors as government-led recovery efforts expand across the region.

MSF has also designed, provided materials and managed the construction of a temporary housing shelter for 30 people in Baba-Nakayama, Minami-Sanriku, Miyagi prefecture.

Completed on May 4th, the temporary shelter will reduce the overcrowded conditions at the town’s main centre, thereby strengthening infection control and decreasing stress-related mental disorders among evacuees.

During the planning phase, many evacuees expressed a strong desire to be involved in the construction of the centre, which led to the facility being completed by a team of 25 locals well ahead of schedule. Workers at the site were provided with safety gear and supervised by MSF staff.

“There was a very positive atmosphere at the building site, with a lot of laughter and smiles among the workers, many of which have been living in tents, cars, or half-destroyed houses due to overcrowding at the evacuations centres,” said Yozo  KAWABE – the MSF logistician in charge of the project. “They were really happy to play a hands-on role in the construction activities and the whole process was very therapeutic psychologically because these survivors of the disaster could unite towards a common goal and regain a sense of self-reliance.”

Medical authorities have requested that MSF continues to provide the three doctors currently supporting local clinics in the area. However, as the local medical infrastructure stabilises, MSF is shifting the focus of its intervention towards providing psychological assistance to particularly vulnerable survivors of the disaster, including elderly evacuees, single parents and those with physical disabilities and chronic diseases.

The team of six national psychologists is also providing educational activities at one evacuation facility in Minami Sanriku to help survivors living in the centre identify those in need of psychological support and individual treatment. An open booth provides information on stress-coping mechanisms, recognising mental health issues and where to get further help, as well as specialized information tailored for parents and evacuees taking care of the elderly.

MSF also established a café at the Bayside Arena Clinic in Minami Sanriku as a space where evacuees can interact with MSF staff directly in a less formal and more social environment, providing increased opportunities to meet the population directly, build trust and identify vulnerable cases for further referral and therapeutic treatment.

“Most people lost everything in the disaster, including family, colleagues and friends, and the future is difficult to imagine,” said Ha Young LEE – a Korean psychologist that has worked with MSF in the aftermath of the Asian tsunami in Banda Aceh in 2005, as well as with North Korean refugees in Seoul. “Many of the evacuees are depressed and feel helpless and many are also going through a mourning process while coping with living in particularly challenging physical circumstances.”

As the initial shock of the disaster recedes, families are now having to address the process of moving forward and dealing with relocation and financial issues, which is placing further stress on their psychological state of mind.

“The need for psychological services is only going to increase in the months ahead as survivors begin to face the challenges of rebuilding their lives. They are already vulnerable and deeply emotionally traumatized, and stressful issues related to compensation and relocation are likely to trigger more serious mental health problems that need to be addressed,” Ha Young added.

Factbox: Tohoku activities and donations

• By May 8th, MSF medical teams had conducted a total of 2,075 consultations with patients in Minami Sanriku and Taro. In both places, the main issues addressed were hypertension followed by upper respiratory tract infections.

• Approximately 600 people have participated in counseling sessions organized by the MSF team of psychologists. The main problems being addressed relate to stress management, memory and concentration difficulties, concerns about possible dementia among elderly people, and sleeping disorders due to the crowded living conditions in the evacuation centres.

• MSF has supported the construction of a semi-permanent building outside an evacuation centre in Babanakayama near Minami Sanriku that will reduce overcrowding and provide accommodation for 30 people.

• MSF has distributed 4,030 blankets, 6,500 litres of water, one generator for a temporary shelter in Baba-Nakayama and 10,000 hygiene kits comprising soap, tooth brushes, toothpaste and towels to survivors of the disasters. Non-food item kit containing batteries, candles, matches and towels were distributed to 4,000 people.

• MSF has also donated two buses to local health services in Minami Sanriku to enable patients to travel between evacuation centres, their homes and medical facilities. In addition, MSF has donated a vehicle especially designed for wheelchair passengers.

• A social space has been set up outside a large evacuation centre in Minami Sanriku, staffed by MSF psychologists. The café space provides an area where people can get refreshments and talk in an informal setting with mental health staff, who can then identify particularly vulnerable cases requiring further support and offer one-to-one counselling. Approximately 320 customers have used the café facilities.

• In the longer term, MSF plans to support local authorities in the construction of two temporary medical clinics, one in Minami Sanriku and one in Taro.