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| Sunday, 9 January 2005 |
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Features |  |
| News Business Features Editorial
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Compiled by CAROL ALOYSIUS Survivors of tsunami 2004 : How to recover from Natural Disaster Stress
Q: What is PTSD? A: It is a debilitating, anxiety disorder, that triggers memories following a traumatic, life threatening event - like the tsunami, war, accidents, rape that you were affected directly or have witnessed. Q: Does everybody involved in a traumatic event get PTSD? A: Not all survivors experience PTSD. Studies show that 8 per cent of males and 20 per cent of females develop PTSD, 30 per cent develop a chronic form of PTSD lasting a life time. Q: How does PTSD develop? A: Most people develop PTSD days or weeks following the exposure to the disaster. Q: Who are more prone to PTSD? A: Those with a previous history of depression; a previous history of sexual or childhood abuse; A family history of anxiety; early separation from parents; Drug abuse; alcoholism. Q: What are the stresses faced by the survivors? A: Fear of death, physical injury, loss of loved ones, property and communities. Q: What are the risks that will accompany the stresses? A: Depending on the duration of the traumatic event and the severity of the event, disaster stress may revive memories of prior trauma, and may increase psychological, social, economical, spiritual, and medical problems. Q: How will stress affect the survivors? A: Such stress will place the survivors at risk of Behavioral, Adjustment and Emotional problems. Q: What are the psychological problems experienced by people surviving a tsunami? How can one help them to readjust to normal life? And most importantly, how can negative psychological consequences be prevented? A: Psychological problems experienced by survivors can last for days and weeks: Emotional: Temporary feelings of fear, anger, guilt, shame. Hopelessness, helplessness, and emotional numbness, inability to show intimacy, love, and lack of interest. Cognitive: Lack of concentration, confusion memory loss, indecisiveness, disorientation, worry, self blame unwanted memories, and shortened attention span. Physical reactions: sleep disturbances, tension, fatigue, bodyaches and pains, racing heart beat, startling easily and lack of sex drive. Nausea, diarrhoea and change in appetite. Interpersonal relationships: Impairment of the person's ability to function in family and social life, occupational instability, marital problems, family discord and difficulties in parenting, friendships. Irritability, frustration, distrust, conflict, withdrawal, isolation, being judgmental, over dominating, feeling of rejected, abandoned, being distant. Q: What factors cause increasing readjustment problems? A: If any one has experienced the disaster directly or witnessed the following during or after the disaster: * Loss of loved ones, or friends * Witnessed gruesome death, had bodily injury, or seen dead or maimed bodies * Exposure to Extreme natural disaster or destruction, life threatening danger or physical harm (especially to children) * Loss of home, valued possessions, neighbourhood, or community * Loss of communication with or support from close relations * Extreme fatigue, hunger or sleep deprivation * Prolonged exposure to danger, loss, emotional/physical strain Q: How can one recover from disaster 'stress' and avoid negative psychological consequences? A: The following steps can help to reduce stress and post disaster readjustment Providing shelter, food, sanitation, privacy, sleep at least for a brief period, chance to sit quietly Start working on immediate family priorities in order to build up self esteem, and to develop a sense of hope. Establish communication with family, friends, counsellors and peers, so that you can relate "your story" at the same time be a listener to others, in order to release some stress. Learn to take each day at a time of disaster's wake. Learn to focus inwardly what is most important to you and your family, look and listen to learn from what you and others are experiencing and learn to forget what is not important. Q: Will all survivors of natural disaster manifest these symptoms? A: No. Most will experience mild stress reactions. Q: Can disaster experience result in a good reaction? A: Yes, at times it helps to strengthen relationships and growth. Q: Who will experience severe stress reactions? A: One in every three survivors. Guidelines for purifying water quality Listen for public announcements on the safety of the municipal water supply. contaminated, private water wells will need to be tested and disinfected after the waters recede. Questions about testing should be directed to your local health department. Water for Drinking, Cooking, and Personal Hygiene; Safe water for drinking, cooking, and personal hygiene includes bottled, boiled, or treated water. Your State or local health department can make specific recommendations for boiling or treating water in your area. Here are some general rules concerning water for drinking, cooking, and personal hygiene. Remember: Do not use contaminated water to wash dishes, brush your teeth, wash and prepare food, wash your hands, make ice, or make baby formula. If possible, use baby formula that does not need to have water added. You can use an alcohol-based hand sanitizer to wash your hands. If you use bottled water, be sure it came from a safe source. If you do not know that the water came from a safe source, you should boil or treat it before you use it. Use only bottled, boiled, or treated water until your supply is tested and found safe. Boiling water, when practical, is the preferred way to kill harmful bacteria and parasites. Bringing water to a rolling boil for 1 minute will kill most organisms. When boiling water is not practical, you can treat water with chlorine tablets, iodine tablets, or unscented household chlorine bleach (5.25% sodium hypochlorine): If you use chlorine tablets or iodine tablets, follow the directions that come with the tablets. If you use household chlorine bleach, add 1/8 teaspoon (-0.75 ml) of bleach per gallon of water if the water is clear. For cloudy water, add 1/4 teaspoon (-1.50ml) of bleach per gallon. Mix the solution thoroughly and let it stand for about 30 minutes before using it. Note: Treating water with chlorine tablets, iodine tablets, or liquid bleach will not kill parasitic organisms. Use a bleach solution to rinse water containers before re-using them. Use water storage tanks and other types of containers with caution. For example, fire truck storage tanks and previously used cans or bottles may be contaminated with microbes or chemicals. Do not rely on untested devices for decontaminating water. Disinfecting Wells If you suspect that your well may be contaminated, contact your local or state health department or agriculture extension agent for specific advice. Here are some general instructions for disinfecting wells. To Disinfected Bored or Dug Wells To determine the exact amount to use, multiply the amount of disinfectant needed (according to the diameter of the well) by the depth of the well. For example, a well 5 feet in diameter requires 4 1/2 cups of bleach per foot of water. If the well is 30 feet deep multiply 4 1/2 by 30 to determine the total cups of bleach required (4 1/2 X = 135 cups). There are sixteen cups in each gallon of liquid bleach. And this total amount of disinfectant to about 10 gallons of water. Splash the mixture around the wall or lining of the well. Be certain the disinfectant solution contact all parts of the well. Seal the well top. Open all faucets and pump water until a strong odour of bleach is noticeable at each faucet. Then stop the pump and allow the solution to remain in the well overnight. The next day, operate the pump by turning on all faucets, continuing until the chlorine odour disappears. Adjust the flow of water faucets or fixtures that discharge to septic systems to a low flow to avoid overloading the disposal system. To Disinfect Drilled Wells Determine the amount of water in the well by multiplying the gallons per foot by the depth of the well in feet. For example, a well with a 6-inch diameter contains 1.5 gallons of water per foot. If the well is 120 feet deep, multiply 1.5 by 120 (1.5 X 120 = 180). For each 100 gallons of water in the well, use the amount of chlorine (liquid or granules) indicated above. Mix the total amount of liquid or granules with about 10 gallons of water. Pour the solution into the top of the well before the seal is installed. Connect a hose from a faucet on the discharge side of the pressure tank to the well casing top. Start the pump. Spray the water back into the well and wash the sides of the casing for at least 15 minutes. Open every faucet in the system and let the water run until the smell of chlorine can be detected. Then close all the faucets and seal the top of the well. Let stand for several hours, preferably overnight. After you have let the water stand, operate the pump by turning on all faucets continuing until all odour of chlorine disappears. Adjust the flow of water from faucets or fixtures that discharge into septic tanks systems to a low flow to avoid overloading the disposal system. (From the Center for Disease Control and Prevention) Food and personal hygiene Observing good food and personal hygiene can be life saving at a time when thousands of people are living in crowded refugee camps as a result of the recent sea invasion. The following guidelines from Your Child Your Family by Dr. H.A. Aponso et al could be useful to displaced persons. It has been said that cleanliness comes next to Godliness. It has to be specially observed in the storage and preparation of food at home. An adequate clean water supply is essential for washing hands and for washing all cookware, utensils and uncooked food, all of which should be kept covered, free from contamination by flies, cockroaches and rats. All vegetables and fruits should be washed with clean water. When preparing salads and sambols adequate precautions should be taken to clean the green leaves in salt water or in a mild solution of Condys. This would get rid of many harmful germs and pesticides and preservatives that may have been sprayed on the vegetables. Cooked food must be kept covered till meal-time and served on clean dishes or plates. Eating stale food should be avoided. Any unconsumed food, but not stale food, may be refrigerated. Contamination of food with infective organisms occurs during the raw state or after cooking, through settling of flies, contaminated hands, sneezing or coughing. Therefore, careful selection and washing of all fruits and vegetables eaten raw, and protection from flies, would help to prevent bowel infections. Contamination of food also occurs when vendors spray insecticides and various chemicals to pulses, vegetables and fruits, they also add formalin to fish to improve the keeping quality. Green leaves are often sprayed insecticides. Such food items should be well washed to remove these toxic substances. Green leaves and vegetables are best grown at home. Milk should be boiled, unless it has been previously boiled and packed in clean containers. Beef and pork, unless properly cooked, may cause parasitic diseases. There is a risk of salmonella infections of the bowel, if eggs are consumed undercooked or raw for the same reason, cracked eggs should not be consumed. Cooked food such as rolls, cutlets and pastries served in eating houses, should be stored in glass cupboards, free from flies and handled with tongs, this is a legal requirement. Salads, sambols, cold meats and fruit drinks are best avoided when eating out. Cooked food kept under refrigeration must be properly thawed and heated, if not sufficiently heated organisms tend to multiply at room temperature. Partly heated food is a good medium for bacterial growth. Artificial sweeteners and colouring matter are best avoided in food items. Food Hygiene The following rules, adapted from WHO guidelines should be practised at all times, and not only during epidemics caused by food and water-borne diseases: Raw foods, especially eggs, milk (unpasteurised) poultry, meat, fish, should for cooked for at least 5 minutes at a temperature of 158 degrees F (70 degrees C) or above. Germs can enter and rapidly multiply in cooked food, therefore, keep food well covered, and consume without much delay - the longer the wait, the greater the risk. Store cooked food in closed containers, if you have to store food for more than 5-6 hours, do so in a refrigerator at a temperature of 50 degrees F (10 degrees C) or below, please note that if you put in a large amount of warm food into the refrigerator, or if you keep opening its door very often, it will take a long time for the temperature to reach 50 degrees F. During that time, germs can multiply rapidly in the food. Stored food should be heated to 158 degrees F before serving. Cooked food can get contaminated by even slight contact with raw food, this can happen even with indirect contact. e.g. do not cut a raw chicken and use the same chopping board to cut the cooked one. Wash hands thoroughly before you start preparing food, and also after each interruption, especially if you have to change the baby's nappy or use the toilet, after handling raw foods, wash again before getting on to prepare other foods, if you have an infection of the hands or fingers, dress it properly (Handyplast is a convenient dressing) before handling food. Every article - e.g. food or clothes you wear - should be regarded as a potential source of infection, keep clothes clean. Safe water (boiled previously) is as important in the preparation of foods such as salads and sambols as it is for drinking purposes, note this carefully especially in the preparation of infant foods, and in using water for ice cubes. Personal hygiene Use a handkerchief or tissue to blow the nose, do not use a part of your clothes for this purpose. Cover the mouth when coughing, sneezing, or yawning. Wash your hands after using the toilet, preferably using soap. Bathe regularly and wear clean clothes. Wash hands before eating or handling food. Trim the nails Do not eat anything fallen on the ground without washing it first. Pass urine or stools only in a latrine (exception - babies) Do not spit except into a container that can either be disposed or hygienically maintained. Doctors warn: Beware of eye disease This is a viral infection of the conjunctiva, which often occurs in epidemics. The disease is highly contagious. It spreads quickly in schools, school hostels, prisons, refugee camps, out patient departments of hospitals and vehicles used in mass transport. The initial symptom is a gritty feeling under the upper lid of one eye, followed later by a watery discharge. The lids tend to paste together after sleep. The affected eye gets quite red and the lids too may be swollen. A small gland in front of the ear may become enlarged and painful. The disease spreads to the other eye in 50 per cent of patients. The affected persons harbour the virus in the eyes, nose and throat. The spread of the virus is by direct contact, use of common towels, pillows, washbasins, and also via sneeze or a cough. Following sore eyes, which may last about seven days, some patients may develop white spots on the cornea; some may develop a dry eye. In case of any doubt it is best to consult a doctor. Treatment and prevention There is no specific drug that kills the virus, which causes this infection. However, fearing a bacterial super-infection, antibiotic eye drops are used. Warm fomentation of the eyes are also helpful. Patients with sore eyes should stay at home, avoid contact with family as much as possible; they should avoid the use of towels and such other articles used by others, and wash the face in warm water as often as possible. With regard to prevention, avoid travelling in a sealed air-conditioned bus or where such a patient may be travelling; also avoid any close contact with them. |
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| Produced by Lake House |
The personal tragedies experienced by thousands of people, young and
old, in the wake of the tsunami, has left permanent scars both physical
and mental on them. DR. RANI GOONEWARDENE discusses with CAROL ALOYSIUS
about dealing with Post Traumatic Stress Disorders (PTSD).
