Saturday, December 4, 2010

Prevention is Better than Cure

A disaster not only brings suffering or injuries at the time it strikes  but afterward, too, in the form of psychological effects and infectious disease. The mental and emotional effects of natural disasters may not be apparent at first. This is because the first reaction is to take care of the physical damage while on the other hand, the agents of infectious disease find favorable conditions after a catastrophe and can easily spread if nothing is done to prevent them.


Typically, in a state of emergency, people need to be rescued and their physical safety is of first concern. Efforts are focused on cleaning up, rebuilding and providing shelter, etc. Because there are so many things that need to be taken care of, many people have to put their emotions on the back burner while they deal with the physical damage..
Mental health phases after disaster
There are two main things needed to be done on the victims:

1. Prompt treatment
Every single psychiatry symptoms finding should be considered as important signal as a psychopathology condition. Can be like people who appear to keep on being silent or hysterical cry or shouts.

2. Regular evaluation
Evaluation of the mental status of disaster- affected people should be done routinely. The procedures can be started right after the triage is done and continue thoroughly.

I've discussed about the clinical emergency response on physically and psychologically in my previous post. Welcome to read it back :)

Meanwhile, the prevention measurements should also being intervened towards the staff in charge for the psychological managements. They may be are already trained to do the job, nonetheless, they are also human with limitation of strength. Hence, it's recommended that these workers are placed in disaster affected area in less than 2 weeks. They have to avoid from experiencing psychiatric morbidity protecting them from any flaws on their emotion, energy, and even activities so they can be a truly good support group for the victims.


Lots of people are in close proximity during a time that challenges the ability practice normal hygiene, with strained bathroom facilities and diaper changes occurring in close quarters. Worst when they can't get clean water sources. It can also due to problems finding fresh clothes and laundry facilities and disposing of trash. It's not uncommon for people in the refugee camp to suffer diarrhea, nausea and respiratory illnesses, including colds.

The general safeguards which can be done and yes; can be explained to the refugees for them to really practice may include:
  • Water must be boiled or treated with iodine or chlorine before using it to clean, cook with or drink.
  • Fully cook food.
  • Wounds need to be cleaned as soon as possible and care should be taken to avoid new ones. Make sure they know who and where that they can get a treatment from.
  • Hygiene is one of the best infectious disease preventions. The victims notwithstanding, may not be able to care on this by themselves. There are so many of them and they have their own problems to deal with.. It's mostly (yes, not 100%) our responsible. Staff or volunteers to the the sanitary procedures are very important.
Here is the example of good management which support the prevention of infectious disease in the refugee camp on the Merapi eruption victims :)

Click to enlarge
That describes the condition of Posko SD Gambiranom, Manukan, Condongcatur, Depok (it's actually a school. Read the whole story for full details). One of the best statement to be highlighted is, 

"Secara umum, di posko ini, pengungsi dan relawan bekerjasama agar kondisi pengungsian tetap bersih dan rapi."

Translated: "In general, in this post, refugees and volunteers working for the refugee condition is kept clean and tidy."
Crystal clear, right?
The responsible for these preventions measurement goes to everyone involving in the circumstances :)

  • "Disaster Management in Mental health", lecture by dr. Bambang Hastha Yoga, Sp. KJ
  • "Disaster Surveillance", Guest lecture: Dinkes Propinsi DIY

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