Healing wounded psyches

More than relief and reconstruction of the destroyed structures, attention needs to be focussed on the children of Bhuj who have been traumatised by loss and what they have seen, says ANITA LAZARUS.

WHEN one loses a parent, one loses the past, when one loses a partner, one loses the present, but when one loses a child, one loses the future. In the Kutch earthquake, not only did many communities lose their future, but where children survived, they were severely traumatised and suffered from Post Trauma Stress Syndrome. Survivors limp through life with damaged psyches. The effect of trauma being widespread among the children, it could result in a whole generation with a damaged psyche.

A woman who was eight and a half months pregnant on the day of the quake walked slowly out of the house of falling mud, thatch, bricks and sticks. Her son was born later, in the open with a plastic sheeting for privacy and protection.

A sensitive programme to detect signs of trauma would be required to help him as he grows; keeping in mind that a child can hear the sound of the quake and destruction as early as 20 weeks in the womb. He would have also shared the mother's emotions of fear, panic and grief.

Those who were under one-year-old at the time of the quake, have not the language to express the shock, insecurity and distress they experience. Shambu is 10-months-old is afraid of loud sounds. He clings on to his grandmother's things after she died when a wall collapsed. Eleven-month-old Kewal was buried when his house collapsed. Saved by two fallen crossbeams, he now clings to his mother.

Children of two and above, who have some language, often do not have the vocabulary, so they use substitutes to express how they feel. A four-year-old boy was thrown clear when the 300-bed Bhuj General Hospital was destroyed but his mother died. The wound on his forehead and his constant whine as he clings to his cousin is apparent evidence of distress. He requires help from a deeply caring, personalised programme in years to come.

Older children may have the vocabulary but lack understanding of their situation. Six-year-old Aarti can express herself, but her eyes indicate incomprehension of the loss of her mother and subsequent abandonment by her father. Ten-year-old Naran's cry for help came through the deliberate destruction of the kites meant for the children's play. This was his way of handling the trauma of a collapsed house that overlaid the earlier trauma of losing his father.

Perhaps teenagers need the most help as they observe the sudden wrenching away of a promising future, owing to the loss of loved ones. To whom can they express their frustration of potential? Who will share their burden of grief and loss when they are already struggling with adolescence?

With schools closed, bands of unsure, curious children followed relief teams around the villages ready to participate in any interesting activity. A game or suggestion of a group activity drew them in droves. Our team's "Pied Piper Kit" consisted of kites, balls, whistles, marbles, balloons and simple games and action songs. Just bouncing a ball in an open ground drew curious children. This would gradually develop into a brisk game of satoli (seven tiles). Kites were another favourite with boys.

The hottest favourites were sketch pens and paper. The children drew their experience of the earthquake, complete with a fallen roof and national flag, a reflection of the Republic Day celebrations that were in progress when the quake struck. These pictures become the focal point of discussions. The description of what happened validated their experience as a first step in mentally coping with their trauma. It also established the beginnings of a new trust-based relationship at a time of great insecurity.

This was just the beginning of the process that will pipe out their insecurity and loss and draw them towards normalcy. The work of inner reconstruction has begun. At the village-community level, the communities and extended families express a desire to look after their own orphans, rather than offer them for adoption. Remaining in a familiar environment is a positive step in the right direction. In addition, the existing local non governmental organisation in Kutch, Abhiyan, is working to co- ordinate the restoration of mental health with international and national NGOs, as well as with the the National Institute of Mental Health and Neuro Sciences (NIMHANS) and Tata School of Social Work teams. Though the process has begun, much still remains to be done.

Relief is comparatively easy, while the reconstruction of buildings, societies and psyches requires patience and perseverance. Though tedious work, it carries its own reward; the privilege of participating in the healing of the psyche of a society.

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