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Tsunami Disaster Relief

January 2005

Instructions for
Befrienders

Prof. Lakshman
Madurasinghe,MA.,MS(Psy)., PhD
Consultant Psychologist
PHILOSOPHY FOR
RELIEF WORK

1. We will work through the


network of other volunteers
2. We serve the communities
around without racial, religious
or other discrimination.
3. We use local helpers also in
providing relief.
4.We will have our devotions,
prayer and rest.
5. We minimize operational costs
and maximize the benefit to
those affected.
6.We will work ourselves out of
the job.

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SAFETY PRECAUTIONS
Your Physical Safety
1. Identify safe locations to run to in case of
emergency. Check with your team leader.
2. Know what to do in case of an alert
(tsunami, flood, storm, fire, earthslip, etc)
3. In case of a tsunami alert move inland
towards higher ground. If there is no time
to move inland to higher ground, upper
floors of high, multi-story, reinforced
concrete buildings could provide a safe
place to find refuge. Homes and small
buildings in coastal areas cannot
withstand tsunami impacts. Do not stay
in these structures if there is a warning.
Also stay away from rivers and streams
that lead to the ocean.
Your Health
1. Inoculate (or take protective medication)
against possible disease. Possible
diseases are: Hepatitis (A), Malaria,
Typhoid, Para-typhoid, Tetanus, Cholera.
(These are precautionary measures;
there are no reports of these diseases
yet). Volunteers are advised to
inoculate against typhoid and
tetanus (because in the event of injury
the tetanus toxoid vaccine is not readily

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available in the refugee areas).
2. Rarer possibilities which must however
be considered seriously are HIV
(which leads to AIDS) and HBV (hepatitis
B virus). HIV is transmitted by infected
human blood and body fluids such as
saliva, amniotic fluid etc. HBV can
survive in dried blood up to seven days.
3. Avoid directly handling potentially
infectious materials such as body fluids
(saliva, blood, etc.) To protect yourself it
is essential to wear protective equipment
such as masks, gloves, aprons etc. when
handling potentially infectious materials.
Avoid handling such material with broken
skin (open sores, cuts, abrasions, acne
any sort of damaged or broken skin such
as sunburn or blisters).
4. Hand washing is one of the most
important (and easiest) practices used to
prevent transmission of blood carried
pathogens. Wash hands or other exposed
skin thoroughly as soon as possible
following an exposure incident. Use
antibacterial soap. Don’t use harsh,
abrasive soaps.
5. Be careful of food and drink. Water
sources in disaster areas may be
contaminated. Drink only clean, boiled

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water and eat only hygienically cooked
food.
6. Protect yourself against mosquitoes
which could be malarial or filarial.
7. Get adequate sleep (minimum 6 hours)
and exercise (walking, jogging, dips, etc.
as possible in the context).

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LOOKING AFTER YOURSELF
Increase Your Stress Tolerance
• Exercise Regularly
• Eat Right
• Get enough sleep
• Take a break
• Make a concern list
• Prioritize values
• Evaluate relationship and
commitments
• Also do some things you enjoy-within
limits

Reporting and Group devotions


• Maintain your own journal
• Share non-confidential information at
the end of each day with your team
members as matters for devotion
and/or action.

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WHAT TO EXPECT

No one who sees a disaster is untouched by it.


There are two types of disaster trauma—
individual and community. Most people pull
together and function during and after a
disaster, but their effectiveness is diminished.
Disaster stress and grief reactions are normal
responses to an abnormal situation.

Many emotional reactions of disaster survivors


stem from the problems of living brought about
by the disaster.

What is a traumatic event?


A traumatic event is one in which we
experience a threat (actual or perceived) of
death or serious injury to self or others, with a
response of “intense fear, helplessness or
horror.” It is not the event itself, but the
meaning it has for the individual that makes it
traumatic.

What is the normal response to a


traumatic event?
Right after a traumatic event, normal people
experience a range of normal reactions,
including: anxiety, feeling “revved up;” fatigue;
irritability; hyper-vigilance; increased
emotionality; problems sleeping; exaggerated

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startle response, change in appetite; feeling
overwhelmed; impatience; withdrawing from
family and friends.

Psychic numbing includes a sense of being


emotionally numb after a trauma, experiencing
a sense of unreality, dissociative amnesia, in
which the traumatic event is pushed out of
awareness, “spacing out” and using
substances to “numb out.”

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STRESS INFORMATION
For someone who experienced the Tsunami
trauma, even though the event may be over,
he or she may now be experiencing or may
experience later, some strong emotional or
physical reactions. It is very common, in fact
quite normal, for people to experience
emotional aftershocks when they have passed
through a horrible event.

Sometimes the emotional aftershocks (or


stress reactions) appear immediately after the
traumatic event. Sometimes they may appear
a few hours or a few days later. And, in some
cases, weeks or months may pass before the
stress reactions appear.

The signs and symptoms of a stress reaction


may last a few days, a few weeks, a few
months, or longer, depending on the severity
of the traumatic event. The understanding and
the support of loved ones usually cause the
stress reactions to pass more quickly.
Occasionally, the traumatic event is so painful
that professional assistance may be necessary.
This does not imply craziness or weakness. It
simply indicates that the particular event was
just too powerful for the person to manage by
himself.

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KEY CONCEPTS FOR
BEFRIENDING

ESTABLISHING RAPPORT
• Offer caring eye contact, a calm presence,
and listen with your heart.
• Show genuine concern.
• Convey respect and be nonjudgmental.

ACTIVE LISTENING
Take in information through your ears, eyes,
and “extrasensory radar” to better understand
the survivor’s situation and needs. Some tips
for listening are:

Allow silence – Silence gives the survivor


time to reflect and become aware of
feelings. Silence can prompt the survivor to
elaborate. Simply “being with” the survivor
and their experience is supportive.

In moments of silence, pray silently, and if


appropriate, touch the person gently on the
hand or shoulder. Show that you care. Let
God’s love flow through you.

Attend nonverbally – Eye contact, head

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nodding, caring facial expressions, and
occasional “uh-huhs” let the survivor know
that the worker is in tune with them.

Paraphrase – When the worker repeats


portions of what the survivor has said,
understanding, interest, and empathy are
conveyed. Paraphrasing also checks for
accuracy, clarifies misunderstandings, and
lets the survivor know that he or she is
being heard. Good leadings are: “So you
are saying that … ” or “I have heard you
say that . . . ”

Reflect feelings – The worker may notice


that the survivor’s tone of voice or
nonverbal gestures suggests anger,
sadness, or fear. Possible responses are,
“You sound angry, scared etc., does that fit
you?” This helps the survivor identify and
articulate his or her emotions.

Allow expression of emotions –


Expressing intense emotions through tears
or angry venting is an important part of
healing; it often helps the survivor work
through feelings so that he or she can
better engage in constructive problem-
solving. Workers should stay relaxed,
breathe, and let the survivor know that it is

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OK to feel.

SOME DO’S AND DON’T’S

Do say:
These are normal reactions to a disaster.
It is understandable that you feel this way.
You are not going crazy.
It wasn’t your fault, you did the best you
could.
Things may never be the same, but they
will get better, and you will feel better.

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Don’t say:
It could have been worse.
You can always get another pet/car/house.
It’s best if you just stay busy.
I know just how you feel.
You need to get on with your life.
As a result of receiving comments such as
these, the survivor may feel discounted, not
understood, or more alone. It is best when
workers allow survivors their own experiences,
feelings, and perspectives.

WORDS OF CAUTION

• Don’t become over involved and do too


much for the survivor. This is usually not in
the best interest of the survivor.
• Survivors should be empowered to solve
their own problems; they then feel more
capable, competent, and able to tackle the
next challenge.
• Workers should clearly understand the
scope of their role in the disaster relief
effort and recognize that empowering
survivors is different from doing for them.

CONFIDENTIALITY

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A helping person is in a privileged position.
Helping a survivor in need infers a sharing of
problems, concerns, and anxieties—sometimes
with intimate details. This special sharing
cannot be done without a sense of trust, built
upon mutual respect, and the explicit
understanding that all discussions are
confidential and private. No case should be
discussed elsewhere without the consent of the
person being helped (except in an extreme
emergency when it is judged that the person
will harm himself or others). It is only by
maintaining the trust and respect of the
survivor that the privilege of helping can
continue to be exercised.

CULTURAL, RELIGIOUS AND ETHNIC


GROUPS

• Be culturally sensitive with regard to dress


and behaviour.
• Cultural groups have considerable variation
regarding views of loss, death, home, the
family, spiritual practices, grieving,
celebrating, mental health, and helping.
• Learn about the cultural norms, traditions,
local history, and community politics from
leaders and others belonging to the groups
you are serving.

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• Be respectful, well informed, and do not
promise what you can’t deliver.
• Be specially sensitive to differing religious
beliefs. Do not disparage other
religions. Do not hand out tracts or
religious literature.

HUMAN SERVICE AND DISASTER RELIEF


WORKERS

• As a disaster relief worker you will


experience considerable demands to meet
the needs of the survivors and the
community.
• You will witness human tragedy, fatalities,
and serious physical injuries.
• Be aware that over time, you may show the
physical and psychological effects of work
overload and exposure to human suffering.
• You may experience physical stress
symptoms or become increasingly irritable,
depressed, over involved or unproductive,
and/or show cognitive effects like difficulty
concentrating or making decisions.
• If you experience these symptoms it is time
to take a break.

Helping victims

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THINGS TO TRY:
WITHIN THE FIRST 24 - 48 HOURS
• Periods of appropriate physical exercise,
alternated with relaxation will alleviate some of
their physical reactions.
• Help them to structure their time; keep them
busy.
• Tell them: “You’re normal and having normal
reactions; don’t label yourself crazy”.
• Encourage them to talk to people; talk is the
most healing medicine.
• Warn them about numbing the pain with
overuse of drugs or alcohol, they don’t need to
complicate this situation with a substance abuse
problem.
• Encourage them to reach out; people do care.
• Encourage them to maintain as normal a
schedule as possible.
• Encourage them to spend time with others.
• Help your co-workers as much as possible by
sharing feelings and checking out how they are
doing.
• Encourage those who can write to keep a
journal; write their way through those sleepless
hours.
• Do things that feel good to you.
• Remind them that those around them are also

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under stress.
• Advise them not to make any big life changes.
• Encourage them to make as many daily
decisions as possible that will give them a feeling
of control over their lives.
• Get plenty of rest.
• Advise them not to fight reoccurring thoughts,
dreams or flashbacks - they are normal and will
decrease over time and become less painful.
• Advise them to eat well-balanced and regular
meals (even if they don’t feel like it).
FOR FAMILY MEMBERS & FRIENDS OF
SURVIVORS
• Listen carefully. private time.
• Spend time with the • Don’t take his anger
traumatized person. or other feelings
• Offer your assistance personally.
and a listening ear if • Don’t tell him that he
(s)he has not asked is “lucky it wasn’t
for help. worse;” a
• Reassure him that he traumatized person is
is safe. not consoled by those
statements. Instead,
• Help him with tell him that you are
everyday tasks like sorry such an event
cleaning, cooking, has occurred and you
caring for the family, want to understand
minding children. and assist him.
• Give him some

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