Emergencies and disasters are common and occur on a daily basis.

Although
most survivors will not experience any long-term negative mental health effects, some
will. First responders tend to have first contact with the survivors and, therefore, are in a
position to provide needed mental health assistance to survivors. Psychological first aid
(PFA) is an evidence-informed approach to providing support to survivors following a
serious crisis event, and it aims to reduce the initial distress of the traumatic event and
to promote adaptive functioning and coping. PFA has gained a great deal of attention
lately, likely due to the fact that it is easy to provide. This article discusses the potential
negative effects of emergencies and disasters on mental health, provides a description of
PFA and discusses its application, and provides an overview of the research base of PFA
and a discussion on the need for future research.
Response strategies refer primarily to the actions taken to deal with a disaster at
the time of the emergency, particularly the actions of emergency services such as fire,
ambulance, police and first responders in the disaster area. Response also involves
peoples own reactions and actions together with strategies to assist people at this time.
The most effective interventions in the immediate phase are practical assistance and
Psychological First Aid (PFA).
Those affected by a disaster need to be approached in a non-clinical way (unless
or until clinical needs are identified and accepted by the affected person, which will only
be the case for a minority of people). This means that health and mental health
professionals must be prepared to take on a different role from their normal practice. It
is important not to automatically carry clinical assumptions and behaviors into the

disaster. Even as health professionals, our first objective in the aftermath of disaster is
usually to ensure that immediate practical needs are met.

Psychological First Aid: Improving Mental Health in Emergencies

In disasters and crises throughout the world, people often struggle with how to
cope with what they experienced. For first-responders, there is a similar struggle: how to
reach out and support those who are suffering.
Psychological First Aid (PFA) was developed to teach first-responders and other
front-line workers how to foster safe, positive, and supportive environments for
survivors. Training in PFA gives people a better understanding of common reactions to
stressful events, as well as how to listen in a supportive, empathetic way. For parents,
there is guidance on how to help children cope, and more generally, when and how to
refer someone who is experiencing severe distress. PFA also includes self-care tips for
survivors and connects survivors to basic services where they can find psychosocial
support.
As a first responder to more than 65 emergencies, International Medical Corps
played a key role in developing and implementing the PFA approach. We helped develop
the Psychological First Aid Guide for Field Workers that was recently released by the
World Health Organization and implemented PFA in natural disaster and conflicts
around the world, including:
After a 7.0-earthquake devastated Port-au-Prince, Haiti and the surrounding
areas, International Medical Corps developed and distributed guidelines in PFA for

health care workers and relief volunteers who poured into Haiti to help. International
Medical Corps also trained more than 630 Haitian doctors and nurses in PFA, in
addition to other mental health topics.
When ethnic clashes rocked Kyrgyzstan in 2010, International Medical Corps
surveyed and interviewed 200 people and found the majority to be suffering from
psychological issues as a result of the conflict. In response, International Medical Corps
trained first responders and volunteers in PFA so that they could identify mental health
issues and provide appropriate emotional support and referrals.
After a 9.0-earthquake and subsequent tsunami hit Japan in 2011, International
Medical Corps trained 85 telephone and face-to-face counselors and 93 front-line
workers in PFA. In addition, International Medical Corps also provided training
materials and sessions specific to parents, teachers, or other caregivers to enable them
to support childrens emotional needs.
During Libyas civil conflict, International Medical Corps focused on training
health professionals and front-line workers in PFA in eastern and western Libya and in
the refugee camps on the Tunisian-Libya border. Just 120 days after the conflict started,
140 hospital staff were trained in PFA along with 21 teachers and 74 refugee camp staff.
These trainings continue today in hospitals, clinics, and other sites throughout Libya.
Given its past successes in improving the care that aid workers can provide to
those in crisis, International Medical Corps will continue to broaden the reach of PFA
through our global programs and bring this important skill set to emergency responders
worldwide.

PHILIPPINES: PSYCHOLOGICAL FIRST AID TRAINING FOR TEACHERS

EI and the Federation of Free Workers-Trade Federation VIII (FFW), one of its
national affiliates in the Philippines, conducted a training session on psychological first
aid on 4 April, at the Central Philippines University, as part of the EI post-Hayan
(Yolanda) rehabilitation programme.
Thirty seven participants from four EI affiliates - the Alliance of Concerned
Teachers (ACT), the Samahang Manggagawang Philipino-National Alliance of Teachers
and Office Workers (SMP-NATOW), the Teachers Organisation of the Philippine Public
Sector (TOPPS) and the FFW took part in the training. All came from areas affected by
the typhoon in western visayas (districts).
Next step counselling
The FFW opted to conduct psychological first aid training rather than
psychological trauma counselling, because the latter had to be conducted at an early
stage after the tragic incident and takes a longer period to process in the minds and
behaviours of the victims. Psychological trauma counselling helps to raise peoples
awareness, so they are prepared if incidents or unfortunate calamities strike again in
their regions.
The Trade Federation VIIIs President, Jomel General, welcomed participants.
Then Amalia Campos, FFW National Vice-President for the affected visayas, presented
background information on the EI and FFW joint action in the Philippines.

Empowering participants through experience sharing

During four different workgroups, participants were asked to outline the burdens
they have been carrying since Yolanda struck, how they manage stress, and how they
care for others in the community.
They shared their reactions, explained how they were coping with and managing
stress; articulated concerns and strategies to deal with family and peers; identified
possible

actions

to

address

typhoon

Yolanda

survivors

common

concerns;

acknowledged each others strength as survivors; and were able to better understand
what psychological first aid is and how to apply it when needed.
Speakers highlighted the hope they have in a prompt, satisfactory, and
sustainable recovery in the affected national areas.
EI: Important initiative for teachers' health
This post-Yolanda psychological first aid initiative is very important, said EI
General Secretary Fred van Leeuwen. We commend our colleagues for getting involved
in it. This is going to allow them to recover, feel better, and therefore provide better
quality education to their students.

WHO, DOH ADDRESS MENTAL HEALTH OF YOLANDA VICTIMS IN THE

PHILIPPINES
As the Philippines continues to recover more than a month after Typhoon
Yolanda, the Department of Health (DOH) and World Health Organization (WHO)
address the possible psychological effects the traumatic event caused the survivors by
training field workers in disaster areas. The typhoon will have long-lasting effects. We
must be prepared to give support to families and communities for the long-term, and we
need more trained field workers to do it, said WHO Representative Dr. Julie Hall.
With the participation of government professionals, universities, and community
agencies, WHO and DOH have organized training for field workers involved in relief
operations in areas hit by Yolanda. In addition, copies of Psychological first aid: Guide
for field workers manual are distributed to bureaus working with the health, education,
social welfare, and security departments. The psychological first aid authored by WHO,
War Trauma Foundation, and World Vision International involves humane, supportive
and practical help to fellow human beings suffering serious crisis events.

The guide,

endorsed by many international agencies, also provides a framework for supporting the
victims in ways that respect their dignity, culture, and abilities. DOHs disaster mental
health specialist Dr. Ronald Law cited the importance of the guide to the victims of
Yolanda. Ive been sent to previous disasters before but you could see that this is really
something bigger. Psychological first aid is something that we are really trying to
disseminate to all health workers. It is a practical and powerful tool, said Law.

As

people are more likely to suffer from a range of mental problems during and after

emergencies, providing psychosocial support to the victims became one of WHOs top
priorities. - See more at

DISASTER RELIEF AND REHABILITATION

Fr. Amado L. Picardal, CSsR, STD
The role of affected BECs
FOR the last three years, three typhoons have devastated parts of Mindanao and
the Visayas. Typhoon Yolanda was the latest and most destructive. Thousands have lost
their lives and many more lost their houses and means of livelihood. Among those
affected were Basic Ecclesial Communities (BECs). Relief operations continue and the
work of rehabilitation is just starting. The response coming various parts of the country
and from all over the world has been overwhelming. There were dioceses, parishes and
BECs in Luzon and in Mindanao that also sent aid. The spirit of generosity and
bayanihan is very evident.
The question is what is the role of the victims and survivors? What is the role of
the affected communitiesespecially BECs?
The members of affected communities are not just helpless victims or passive
recipients of aid. They can actively participate in the immediate relief efforts and longterm rehabilitation. This is not easy or even possible where BECs are weak or nonexistent. Where there are BECs that are highly developed and remain intact during
disasters, they are able to help in the initial damage assessment and in the orderly

distribution of aid. This was the case in Cagayan de Oro after Typhoon Sendong and in
Davao Oriental after Typhoon Pablo.
This was also the case in some BECs in Samar in the aftermath of Typhoon
Yolanda. Some BECs in San Antonio, Basey worked hand in hand with the barangay
officials and relief teams in damage assessment, data gathering and relief operations.
Besides assisting in relief efforts, these BECs also respond to the psychologicalspiritual needs of their members. What the survivors need are not just food, shelter and
clothing. Besides psychological first-aid or stress debriefing, they also need spiritual
solace and inner healing at a time of shock and grief when their faith is shaken.
Masses are celebrated and bible-reflections are held in the affected areas and in
evacuation centers, which are very helpful. These are opportunities for them to share
their stories and strengthen each others faith.
The BECs have an important role in the recovery and rehabilitation of the
affected areas. The reconstruction of houses and chapels are opportunities to build up
and strengthen communities. BECs can grow in these new communities. A good
example of this is the new housing project in Iligan that emerged after typhoon Sendong
and in Davao Oriental and Compostela Valley after Typhoon Pablo.
In the rehabilitation phase, the BECs can actively participate in the consultation,
planning and implementation of housing and livelihood projects. They can also monitor
how aid from government, private entities and foreign nations are being spent. This can
be a deterrent to corruption.

The role of BECs is best summed up in report of the Daughters of Charity

Assessment team in San Antonio, Samar:
A strong sense of mutual support and concern pervades. The structures of the
Basic Ecclesial Communities in terms of zones and clusters have gone a long way in
making more tolerable an already intolerable situation. This confirms that in moments
of extreme need and disaster, the bond of relationship and the structures of governance
in the BECs provide a solid ground not only for faith but also for mutual support, relief
and rehabilitation.
With the climate change, it is realistic to expect more disasters like typhoons
Sendong, Pablo and Yolanda in the future. There is a need to come up with protocols on
how to prepare communitiesincluding BECsto effectively respond to these disasters.
This will also require that BECs be developed and strengthened.
The initiative and support of the bishop, parish priests, diocesan social action
center, BEC practitioners and leaders is vital in mobilizing BECs to actively participate
in disaster relief and rehabilitation.

PRIEST STRESSES CALAMITY VICTIMS NEED FOR PSYCHOLOGICAL

COUNSELING

MANILA, Jan. 30, 2014Food and shelter are not the only necessities that
victims of recent calamities must acquire. The need for psychological counseling is also
an integral component in helping traumatized victims rebuild their lives, a Catholic
priest said.
Fr. Carlos Ronquillo, Director of the Saint Alphonsus Theological and Mission
Institute in the Philippines, noted that aside from providing relief efforts, it is also
important to facilitate psychosocial intervention among victims of natural calamities.
Letting people tell their story should be an integral component in responding to
disaster situations like typhoon (Yolanda), Ronquillo said in his interview with the
Vatican radio, referring to Super Typhoon Yolanda which struck Central Visayas last
November.
The death toll from Super Typhoon Yolanda rose to 6,201 as of January 29, with
28,626 injured and 1,785 still missing, according to the National Disaster Risk
Reduction and Management Council.
What the church has been used to is the temporal approachwhich is
understandable because people are desperate, people are in need, and the immediate
needs to be attended would definitely be food (and shelter since) most of them have lost
homes, Ronquillo said.

But we have failed to recognize that in this situation; (the people) did not only
lose their homes. They lost many of their family members and that is more traumatic
than losing (in) poverty, he said.
And precisely for that reasonpsychological intervention should bean integral
component (of disaster response) from hereon. Without any psychological
intervention, our response as church would still be deficient, he added.
Lasting impact
Ronquillo, who participated in various relief efforts, noted that individuals who
suffered from the devastation brought by different calamities yearn to share their story
to others who are willing to listen and sympathize with their situation.
It is precisely an affirmation on our part that when we organize this mission of
religious people, Catholic men and women from the southern Philippines, we believe
that (psychological intervention) should be an integral component of any effort that
should be done by the church in responding to disaster situations, he said.
The priest noted that the psychological component of relief efforts could bear
lasting impact to the lives of people, especially during the point when they are left on
their own to rebuild their lives.
The moment (these people) are left on their own, the effect of (these disasters)
would be horrible, Ronquillo said, noting the trauma brought by natural calamities to

the mentality of people. When the rain starts falling, many of them become afraid. They
do not know how to manage their fear.
He stressed the importance of psychological counseling to individuals who are in
the process of rising up from the shambles brought by disasters.
Just come to think of it, a big number of children and adults having gone
through the traumatic experience of saving themselves from the surges and seeing their
relatives dying or disappearing. How do you locate that experience and where would
they get the resources to be able to handle that? Ronquillo asked.
Definitely, not the relief and food response. Theres got to be a certain story
telling. Theres got to be a certain accompaniment, which would enable them to face up
to the shadows that they have experienced through that disaster, he said.
Theres got to be something that we could offer (these people) beyond the
traditional response that we give them, he added.
Untapped resource
Ronquillo noted that psychological counseling can be included in different church
relief efforts through religious individuals who have gained expertise on psychological
counseling due to the long years they have rendered in the ministry.
What is concrete reality among the religious is that they have this resource
within themreligious formation from different congregations and orders often
[include] psychological processing, he said.

He urged religious members of the church to refine, repackage, and bring this
resource in the service of those who are most in need.
What is important is how you harness this resource thats there, untapped, from
our many religious priests, sisters, and brothers, Ronquillo said, noting that true
healing could only be achieved once they are able to break walls and help victims share
their stories. (Jennifer Orillaza)

HELPING YOLANDA SURVIVORS FIND WELLNESS, WHOLENESS,

GROWTH AND HEALING
Dr. Bautista speaks to UP Tacloban students at the orientation program for cross
enrollees held at the Palma Hall Annex, UP Diliman. Dr. Bautista speaks to UP Tacloban
students at the orientation program for cross enrollees held at the Palma Hall Annex,
UP Diliman.
Disasters impact strongly on the whole being of the individuals, groups and
families affected. This means that disasters not only harm the physical health and
economic stability of victims. It also affects their mental, spiritual, social and emotional
well-being. The good news is that the majority of survivors can pull themselves together
and deal with the aftermath, especially if they are provided psychosocial support.
Psychosocial Support in the field of disaster mental health (referred to as MHPSS
as representing mental health and psychosocial support or MHPSS) are strategies and
programs that seek to help individuals, families and communities (i) rebound from
crisis; (ii)

moderate their stress reactions to disaster; (iii) resist forces towards

hopelessness and destabilization, and (iv) develop strengths and competencies not only
to survive, but also to grow in the face of disaster.
In the aftermath of Typhoon Yolanda, the UP Diliman Department of Psychology
(UPDDP) marshalled its resources and competencies to reach out to individuals, groups,
and families affected by the typhoon.
A few weeks after the disaster, students from UP Visayas Tacloban College
(UPVTC) started to cross enrol at the UP Diliman Campus. The UPDDP had its share of
majors from UPVTC enrolling in both psychology and non-psychology subjects. There
were also UPVTC students who took psychology courses as electives.
As an expression of the Departments wish to welcome and lend support to its
students from UP Tacloban, the Department hosted a welcome gathering for both their
psychology majors and non-psych cross enrollees from UP Tacloban. In the welcome
gathering, the UP Tacloban students made friends with UP Diliman students and
faculty, were oriented on Diliman campus life, and had the opportunity to share their
needs and concerns as new students in the campus who are also recovering from a
disaster experience. Some of these students continue to meet with the teachers and
students they had met in the welcome gathering for updates and affirmation of
friendship bonds.
The Department also partnered with the Department of Computer Sciences and
the Department of Biology in reaching out to students affected by Typhoon Yolanda.
Volunteer faculty, graduate students and alumni of the UPDDP provided individual
and/or group psychosocial processing to affected students from these departments.

Through such activities, the students were able to enhance their effectiveness in dealing
with lifes challenges.
Headed by the UPDDP Wellness Committee, these groups began to offer life
coaching and psychotherapy sessions. Affected students and families are now
discovering that seeking psychosocial support is not a sign of weakness or of psychiatric
illness, but a creative and responsible way of helping oneself move forward after a most
trying experience.
In response to the request of UP Diliman faculty, the UPDDP collaborated with
the Office of the Director of Instruction to conduct a workshop for UP Diliman faculty
members on addressing the psychosocial needs of students.
One of the venues where the Department began to reach out was Facebook. They
created posts to let people know that they were providing psychological support to
students and employees who have relatives living in provinces ravaged by the storm.
Aside from this, the Department also offered an intensive three-day training
workshopBringing Hope to Disaster Survivors: A Course on Application of
Psychosocial Support in Disaster Situations. The workshop was attended by 30
graduate students and faculty. UNILAB expressed its solidarity with the Departments
efforts at capacity building by providing free meals and snacks while the Philippine
Pediatric Society gave the group free use of their seminar room and facilities.
After the workshop, some of the attendees began sharing what they learned with
other colleagues so more people could help disaster victims more effectively.

More recently, relief workers from Barangay Amorsolo have asked the
Department to assist them in providing care not just to the victims they were helping,
but to their own staff as well. Once more, the UPDDP Wellness Committee is mobilizing
its volunteer psychologists to provide community-based care for barangay workers who
are feeling the strain of journeying with individuals and families who have survived
Yolanda but continue to deal with the ravages that the disaster experience brings. The
Departments volunteer psychologists will also be meeting with the affected families
living in the UP campus to engage them in kumustahan, a process expected to clarify
the families psychosocial needs and the ways that they wish to be helped by friendpsychologists from the UP community. The meeting is expected to help create
opportunities that will make it easier for affected individuals and communities to access
psychosocial support being provided by the Department.
Seeing the need to provide an environment conducive to helping relationship not
only for those affected by the Yolanda typhoon but also for those seeking growth and
healing from the Departments volunteer and professional psychologists, the College of
Social Sciences and Philosophy (CSSP) has designated rooms within the Palma Hall
building for psychological support and psychotherapy. These rooms will serve as places
where wellness and wholeness activities will be offered for CSSP and UP campus
constituents.
Even before Yolanda, the UPDDP, together with other UP units, already saw the
possibility that disasters can hit a UP college or even a whole UP community such as
what happened in UP Tacloban. In the spirit inspired by the framework of DRRM
(Disaster Risk Reduction and Management), the UP system through UP Padayon has

instituted a system-wide disaster preparedness program.

The program includes a

workshop on Disaster Preparedness that will be brought to different campuses of the

University of the Philippines. The workshop was first conducted in UP Diliman in
October 2013. The second run took place in UP Baguio, on the second week of January
this year. The Department is pleased that the UP System sees the importance of
including a section on MHPSS in the workshops curriculum. Indeed responsible
preparation for disasters and true healing from the ravages of disasters necessarily
require a component on learning the knowledge and skills of providing mental health
and psychosocial support (MHPSS).
There is a saying that To whom much is given, much is also expected. The
faculty and students of the Department of Psychology feel that they are recipients of
much blessing because of their training and competencies in helping disaster survivors.
And so it is their desire to be able to use their skills to really help people find wellness,
wholeness, growth and healing.

References:
Bautista, V. (2014, June 16). Psychosocial Aspects of Healing. Retrieved February 7,
2015, from http://www.up.edu.ph/psychosocial-aspects-of-healing/
Education International - Philippines: Psychological first aid training for teachers.
(n.d.). Retrieved February 7, 2015, from http://www.eiie.org/en/news/news_details/3019
Orillaza, J. (2014, January 30). Priest stresses calamity victims' need for psychological
counseling. Retrieved February 7, 2015, from
http://www.cbcpnews.com/cbcpnews/?p=29960
Picardal, A. (n.d.). Disaster relief and rehabilitation. Retrieved February 7, 2015, from
http://www.cbcpnews.com/cbcpnews/?p=27632
Psychological First Aid: Improving Mental Health in Emergencies. (n.d.). Retrieved
February 7, 2015, from http://internationalmedicalcorps.org/page.aspx?
pid=2135
WHO, DOH address mental health of Yolanda victims in the Philippines. (2013,
December 17). Retrieved February 7, 2015, from http://ffemagazine.com/whodoh-address-mental-health-of-yolanda-victims-in-the-philippines/