psychological first aid

SRI LANKA: Boosting capacity in “psychological first aid”

NEGOMBO, 23 March 2008 (IRIN) – When school teacher M. Shihama was put in charge of a class of unruly slow learners earlier this year, her heart sank.

“At first, I was reluctant to take them on,” said the social science teacher at Al-Falah high school in Negombo in the western Gampaha District, fearing they were just troublemakers “But then I found that the children were actually miserable because they had been told they weren’t as good as the others.”

Using skills she learnt at a workshop on post-disaster mental health, Shihama coaxed her students, some of whom are still shaken after the 2004 tsunami, to make the most of their talents. She was pleased when colleagues soon began to see changes in the behaviour of her charges.

Shihama is one of almost 7,000 Sri Lankans, among them about 1,000 teachers, who have been trained in “psychological first aid, community and personal mental health and stress management” under a US$5 million post-tsunami psychosocial programme funded by the American Red Cross (ARC).

“They have been trained to be the first responders who can help survivors by contributing to their long-term resilience and their ability to cope with what’s going on,” said Kelly Bauer, the ARC’s information and reporting delegate for Sri Lanka and the Maldives.

Training for some 8,000

Working with its national counterpart, the Sri Lanka Red Cross Society (SLRCS), the ARC has about nine months to go before the three-year project winds up in five tsunami-affected districts, Matara, Galle, Kalutara, Colombo and Gampaha. Some 8,000 people will have been trained by them and an estimated 250,000 people have benefited, according to Bauer.

“After the tsunami, we had just a handful psychiatrists and psychologists who had to handle the large number of people that needed help in coming to terms with their ordeal,” observed Avindra Jayawardene of the Faculty of Medicine at the Ruhunu University in Galle. “So, any attempt to sensitise individuals in communities to pick up the psychological effects of a disaster can be a good thing.”

Practical benefits

But he pointed out: “They must be linked to a process of actually using what they know – or when the next disaster strikes, they won’t have had the practical experience of dealing with different scenarios and in adapting what they have learnt,” he said.

In the severely tsunami-battered southern districts of Galle and Matara, Nadeeja Abeydheera, the SLRCS’ psychosocial support officer for the south, has seen the training in post-disaster psychological support for community responders pay off during recurrent tsunami alerts in the past two years.

“There is a great sense of participation and involvement in the communities,” she said. “The people we have trained take the lead to evacuate others, take them to safe places, pass on information and keep the community together.”

Neutralizing the victim mentality

Justin Curry, the programme’s regional technical adviser, told IRIN it has great psychological benefits. “It is designed to neutralise the victim mentality.”

The ARC’s psychosocial programme does not deliver traditional psychiatric treatment for mental health problems, Curry told IRIN, but focuses on knitting together communities that have become unravelled after a disaster has struck and equipping them to face future calamities.

“The basic principle underlying the programme is that a disaster not only impacts on individuals, but also pulls communities and support systems apart,” he said.

“We are not so much concerned with the different types of activities that are held, but that people are brought back together by promoting a sense of collective problem solving for a common goal,” said Curry, adding that the ARC first implemented its psychosocial programme after earthquakes hit El Salvador and Gujarat State in western India in 2001.

Promoting feelings of security, unity

Support officers and community facilitators organise a variety of events, cultural shows and festivals to promote feelings of security and unity.

Murals are painted on school walls depicting the five steps of psychological first aid – meet basic needs, listen, accept survivors’ feelings, assist them to move on, and refer for treatment.

At a nursery for pre-schoolers in Negombo, youngsters recently had the unusual opportunity of exchanging their toy guns and swords for more innocuous playthings such as flutes and balls. “We funded this project at the request of the teachers who noticed that the children were unusually aggressive towards each other,” explained Thanaluxmy Robinson, the SLRCS’ psychosocial project coordinator in Gampaha.

“One of our initial challenges was working with a diversity of ethnic and religious groups in all the affected areas,” said Curry. “What affected one group did not necessarily affect another, so the projects had to be tailored for each community.”

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