Tuesday, January 25, 2011

Lessons from the Floods

The last year has seen unprecedented flooding around the planet. Last July, the world watched in horror as Pakistan disappeared under a tide of brown water.  And in just the last couple of months we have seen devastation in Australia, Brazil, South Africa and Sri Lanka. These floods have killed thousands, destroyed millions of homes, wiped out livelihoods and vital food crops, and disrupted transport networks, power supplies, and industries. Untold millions are at risk of psychological trauma as they face their losses and try to rebuild their lives. Many are grieving the death of loved-ones, and the loss of their precious homes, possessions, livelihoods and communities. Many more are facing horrific memories of scenes they witnessed as people and animals were swept away, or buried in mudslides.

When we are faced with a life-threatening situation, our bodies prepare for ‘flight or fight’. Non-essential functions, such as digestion, shut down and energy is diverted to the major muscles. When we take action, this energy is discharged. If we are unable to act for some reason, the energy may remain trapped in the body. If left unprocessed and unhealed, trauma results, with long-term consequences for the affected individuals and their families, friends and communities.

The experience may resurface in debilitating flashbacks and nightmares; result in unreasonable fears and phobias; lead to depression and anxiety disorders; encourage alcoholism and other addictions; produce inappropriate outbursts of anger and aggression; or lead to physical disorders such as muscular tensions and suppression of the immune system. Behaviours flowing from trauma can devastate relationships and family life, affecting the lives of grandchildren as well as children.

This leaves us with several questions. What can the victims do to process and heal these experiences before they become trapped as trauma?  What can the community and government do to help them?  How can those who do suffer trauma be helped to heal? What lessons can we learn from the Australian floods about handling such crises in the future?

In Australia, when people left their homes ahead of the flood they often went to refuges where they were looked after. This forced inactivity was stressful, leading to anxiety, frustration, and occasional anger. Their state of mind often improved when they were able to return to their wrecked homes because at least they could do something to start the cleanup. By contrast, in poorer and less well organized nations, those who flee the floods often end up as refugees, struggling for very survival, but helpless to do anything but wait.

With a few notable exceptions, the floods in Australia were mostly slow-moving and predicted accurately so that the residents of many towns were able to build temporary levees and otherwise protect their properties. Communities pulled together in this task, individuals often working round the clock to protect the homes and businesses of strangers. The resulting sense of support and caring helped many to face what was to come with less distress, even when the defences were overtopped.

In a similar way, an army of volunteers turned out to help clean up once the flood peak passed. Many home-owners were emotionally overwhelmed by this generosity - a feeling which sometimes helped them release their pent-up grief and loss. Similarly, many volunteers said they couldn’t just stand by and watch events on TV, but had to do something to help. This suggests that perhaps they, too, were releasing pent-up emotional energy and preventing potential trauma that might have arisen due to empathy with the victims.

This reaffirmation of the Aussie spirit of ‘mateship’ was truly heart-warming, and will do much to heal individuals and communities. It will also strengthen the sense of belonging, with far-reaching benefits for community life in the good times as well as the bad times ahead.

Australia, as a wealthy country, is also well-placed to provide counselling support to those affected - something that is often overlooked in the rush to provide food, water, shelter and other physical needs. This was recognised by the Australian campaigning organisation GetUp! which focused its fundraising appeal on providing trauma counselling for victims. It is not yet clear what psychological support the government will provide, but it is to be hoped that this will be a substantial component of its recovery strategy.

In Queensland, psychologists have warned teachers in the affected areas to watch out for children suffering mental distress. Dr Jane Shakespeare-Finch was quoted as saying  "Some will be scared, some will be feeling anxious, some will be feeling a little bit unsure about what's happening next. … With children in particular in the long-term, trauma can manifest itself in the body. So, for example, there might be unexplained headaches or stomach aches or aching legs or a sense of being dizzy. … Things that look like they are physical but they are actually the body remembering trauma. … A sense of safety is vital for children now that the disaster is over. Knowing what will happen next is a really important thing. … What happened for a lot of children in this flood is that it took away their view of the world being a predictable place, and we need to re-establish that idea of predictability and safety.”

Despite these positive outcomes, the floods will leave many people with a legacy of trauma. The stoic spirit of the Aussie battler, who gets on with cleaning up and rebuilding, who turns his or her back on the past, is admirable in many ways, but can result in traumatic memories being buried. Such memories may include the dangers survived, the loss of family or friends, horrendous scenes of devastation, the loss of treasured possessions and family mementos, and a home which will never be the same again. In some cases, people may even lose their sense of identity which was closely attached to their homes and possessions, or businesses. These people need on-going understanding and support from family, friends and community if they are to come through, just as war veterans do when they return from the trauma of combat.

As climate change continues, we will see more catastrophic floods and more potential for trauma to wreak havoc in the lives of individuals, families and communities. Hope for the future in vulnerable areas lies in minimizing the risks, particularly to people, and providing essential support. Some elements of a flood strategy include:

•    Improved flood forecasting and effective warning systems
•    Development of survival strategies, including identification of and publicity about safe refuges
•    Provision of well trained and equipped emergency services, based in local communities where appropriate
•    Training of military personnel in disaster relief work
•    Strengthening the bonds in local communities during the good times, so that they will pull together in adversity
•    Encouraging people to express emotions such as loss, grief and fear. Rather than stoic endurance, they should be encouraged to allow their tears to flow and their bodies to shake as they release potentially traumatic experiences
•    Increasing the number of people trained to identify trauma and facilitate its healing. These need not be psychologists, but can be ordinary, trusted members of local communities such as teachers and health workers.

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