DISASTER IN SOUTH ASIA SAARC REGION

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DISASTER IN SOUTH ASIA (SAARC REGION)

• Roy Abraham Kallivayalil MD, DPM
• Gen. Secretary, Indian Psychiatric Society
• Secretary General, SAARC Psych. Federation
• Associate Professor of Psychiatry
• Medical College, Kottayam, Kerala, India.

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The mental health consequences of disasters have
been the subject of a rapidly growing research
literature in the last few decades. Moreover they
have aroused an increasing public interest, due
to the dramatic impact and wide media coverage of
many recent disastrous events- Disaster
Mental Health (WPA 2005)
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SAARC REGION

• 7 Countries
• India
• Pakistan
• Bangladesh
• Sri Lanka
• Nepal
• Bhutan
• Maldives

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TSUNAMI DISASTER IN SAARC REGION

• Brought havoc in the region
• Thousands died
• Several thousands injured
• Thousands of homes washed away

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APPROXIMATE LIVES LOST IN SAARC REGION

• Sri Lanka 30,000
• India 20,000
• Maldives 1,000
• Bangladesh - 3

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PROBLEM FACING THE REGION

• Huge number of bereaved families, who lost
  father, mother, son, daughter, sibling or the
  entire family.
• All belonging lost for some
• No place to live
• No worthwhile occupation
• Limited means of livelihood

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SOCIAL CONSEQUENCES SAARC REGION

• Poor social support
• Families have broken up
• The social fabric is lost
• Schools, markets, fishing, agriculture, places of
  worship destroyed.

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Emotional Consequences seen commonly in the region

• Acute grief region
• Acute psychotic episodes
• Hysterical conversion
• Depressive disorders
• Recurrence of psychosis
• Suicidal ideation and DSH
• PTSD

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Existing Scenario In India

• Mental health policy formulated in 1982.
• Substance abuse policy absent.
• National Mental Health Programme 1982.
• Essential list of drugs Yes
• Mental Health Legislation MHA 1987.
• 0.83 of Health Budget on Mental Health.
• Disability benefits Yes
• NGOs involved in advocacy, promotion, prevention,
  treatment and rehabilitation.

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Scenario India (WHO Atlas 2001)

• Beds (per 10,000) 0.25
• Beds in Mental Hospitals 0.2
• Beds in General Hospitals 0.05
• Beds (Others) 0.01
• Psychiatrists (per 100,000) 0.04
• Neurosurgeons 0.06
• Psychiatric nurse 0.04
• Neurologists 0.05
• Psychologists 0.02
• Social workers 0.02

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Scenario In Srilanka

• Mental Health Policy is being developed
• Substance abuse policy is present
• National Mental Health Programme1966
• Essential list of drugs 1985
• MHL Mental Disease Ordinance (1960)
• 1.6 of health budget on Mental health
• No disability benefits for mentally ill
• NGOs are involved

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SCENARIO SRILANKA (WHO Atlas 2001)

• Beds (per 10,000) 1.8
• Beds in Mental Hospitals 1.4
• Beds in General Hospitals 0.3
• Beds (Others) 0
• Psychiatrists (per 100,000) 0.2
• Neurosurgeons 0.03
• Psychiatric nurse 1.8
• Neurologists 0.06
• Psychologists 0.02
• Social workers 0.07

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SCENARIO IN MALDIVES

• Mental Health Policy absent
• Substance abuse policy 1977
• NMHP Absent
• Essential list of drugs Yes
• No Mental Health Legislation
• Disability benefits - Yes
• NGOs are not involved

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SCENARIO MALDIVES (WHO Atlas 2001)

• Beds (per 10,000) -
• Beds in Mental Hospitals -
• Beds in General Hospitals -
• Beds (Others) -
• Psychiatrists (per 100,000) 0.36
• Neurosurgeons 0.36
• Psychiatric nurse 0
• Neurologists 0
• Psychologists 1.2
• Social workers 0

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What has been done in Sri Lanka?

• Relief measures
• Mental health workers involved
• Multi disciplinary approach
• NGOs involved
• Support from WPA/WHO/other countries
• Many other important measurers

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What has been done in India?

• Union and State Government involved in combined
  relief efforts.
• Psychiatrists and mental health workers are part
  of the team.
• Indian Psychiatric Society in the fore-front.
• NGOs involved
• Media support

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Role of Indian Psychiatric Society

• Formed a special task force for Tsunami Disaster
  relief on 29-12-2004.
• Chairman Dr. S. Nambi
• Co-Chairmen from all the five zones
• Convenor Dr. P. Joseph Varghese
• Co-convenor Dr. Varghese P. Punnoose
• Members Presidents and Secretaries of affected
  states.

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The IPS Task Force

• Mobilized country wide efforts
• Co-ordinated the relief measurers
• Encouraged participation by all
• All the zones and the states participated
• Co-ordinated by IPS President and Gen. Secretary.

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IPS Technical Advisory Committee

• Members who had valuable experience in disasters
• Dr. Mohan K. Issac (NIMHANS)
• Dr. N.G. Desai (IHBAS, Delhi)
• Dr. K. Shekhar (NIMHANS, Bangalore)
• Dr. R.H. Bakre (Gandhi Nagar, Gujrat)
• Dr. Mohan Agashe (Pune)

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Contributions to PMs Fund

• IPS Members mobilized contributions to the Prime
  Ministers National Relief Fund (PMNRF).
• Kept in touch with PMO.

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Role of SAARC Psychiatric Federation

• Mobilized support for relief measurers in the
  region.
• Provided technical expertise
• Encouraged members to work in other countries.
• Enlisted regional cooperation and participation.

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The South-Asia Region - Looking Ahead

• Dearth of trained psychiatrist and mental health
  professionals.
• Time consuming rehabilitation measurers
• The notorious red-tape
• Media interest is waning
• Paucity of resources.

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Plan for the Future

• Involvement of all stake holders
• Mobilizing National and International expertise
• Equitable distribution of resources within each
  country.
• Rehabilitation holds the key
• Mental health needs higher priority

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A Disaster is an empirical falsification of
human action, the proof of the incorrectness of
human beings conceptions on nature and
culture- Juan J. Lopez - Ibor
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Thank You