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Shaken to the core

By Ammu Joseph

The residents of Sastur in Maharashtra, where 1,400 people were killed in the Latur quake a decade ago, continue to suffer alarming levels of psychological distress. A recent study emphasises the need to integrate psycho-social care into post-disaster reconstruction initiatives

The residents of Sastur village in Maharashtra's Osmanabad district have clearly not recovered from the major earthquake that rocked Latur and Osmanabad, in the state's Marathwada region, a decade ago.

Although they now live in earthquake-resistant concrete houses in the relocated village, most of them are still fearful and prefer to sleep outdoors or in makeshift tin sheds. The fact that the area continues to experience tremors every few months – most recently during the Ganesh Chaturti festivities in the first week of September – has obviously not helped to rebuild their confidence.

Sastur's residents are evidently ill at ease in their “new, improved” village, which is almost ten times larger than the original, the ruins of which are located two kilometres away. The fact that they had no role in planning or building what appears to be a caricature of a modern village has probably contributed to their sense of alienation.

The urban-style, quadrangular shopping centre meant to accommodate the over 200 shops that existed in the old village provides a vivid example of reconstruction that pays little heed to local needs and lifestyles. Built over the objections of the gram panchayat, which had reportedly recommended clusters of shops to serve different neighbourhoods, it currently boasts only about a dozen functioning establishments, while the rest predictably operate out of houses or improvised spaces in various parts of the village, which now has a population of approximately 9,000.

The adults of Sastur seem to accept tension and stress as an inescapable part of their lives. According to them, the dramatic increase in the consumption of alcohol, especially among men, was only to be expected in view of the trauma they went through when their village was flattened and 1,400 of its citizens killed by the earthquake that hit the area on a rainy night in September 1993. They point out that they have had no access to mental health services of any kind since then.

The widely reported disintegration of traditional family bonds and social relationships has clearly not helped the situation. As many people stated repeatedly, “Feelings are different now… Family ties are not the same… Our village has become like an urban colony.”

A recent study by the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, and Swayam Shikshan Prayog (SSP), Mumbai, confirms that the psychological scars left by the disaster have not yet healed. A survey conducted in the first phase of the study, covering over 6,000 individuals in more than 760 villages, found psychological distress persisting among one-third of the earthquake-affected population. Levels of distress were expectedly highest among those living in the most severely affected areas, like Sastur.

This is not surprising since, despite the fact that the importance of addressing psycho-social issues had been highlighted by mental health professionals and institutions early in the crisis, no systematic and sustained effort has so far been made to tackle these long-term needs of survivors.

To make matters worse, among the 3 Rs of Relief, Reconstruction and Rehabilitation, the last was obviously given the least priority, especially in the most badly affected areas. According to government records, the Maharashtra Emergency Earthquake Rehabilitation Programme (MEERP), with a total budget of Rs 1,300 crore, spent only 1% of it on economic empowerment, 4% on social rehabilitation and 0.7% on community rehabilitation.

According to the survey report, titled A Decade After the Earthquake: Psychosocial Distress Among Survivors, and released during a recent two-day event in Latur to mark the tenth anniversary of the disaster, “It is important to recognise that psycho-social need is an essential aspect of overall rehabilitation and reconstruction efforts. Rebuilding ‘broken' lives is a continuous need in a community.”

The need for a proper assessment of the psycho-social fallout of the Marathwada earthquake emerged from a November 2001 gathering of women leaders of self-help groups functioning in the area. The women said they and others in their communities had experienced a range of psycho-social problems both during and after the rehabilitation phase. It was clear that the ongoing needs of the earthquake-affected population had not been addressed in a systematic or sustained manner.

Coming from villages categorised as “less affected” by the disaster, these women had been successfully involved in post-earthquake reconstruction work, thanks to SSP, which was entrusted by the state government with the task of ensuring community participation and monitoring in the repair and strengthening component of the MEERP. They had subsequently gone on to form SHGs that helped them to not only address their livelihood needs, but also contribute to the development of their village communities. SHGs spread over nearly 900 villages in the area are now linked together by an umbrella organisation, the Sakhi Federation.

NIMHANS, SSP and the Sakhi Federation hope to build on the former's positive experience with enlisting and training community level workers to provide psycho-social care after two major disasters (the 1999 cyclone in Orissa and the 2001 earthquake in Gujarat). They plan to develop a cadre of grassroots health volunteers to address the mental health care needs of earthquake survivors in Maharashtra, particularly women.

The process has already begun. The survey was conducted by members of the Federation who were given basic training in essential facilitation techniques -- such as active, empathetic listening -- and in simple data collection methods. According to these “barefoot” field investigators, people reported feelings of relief as they spoke about their experiences to someone actively engaged in listening to them.

While late is obviously better than never, the NIMHANS/SSP report emphasises the need for psycho-social care to be integrated into post-disaster reconstruction initiatives, from the very beginning, as an essential part of the relief and rehabilitation process. It also clarifies that official initiatives are critical since only the government has the capacity to reach all the affected people, as well as the resources to effect the necessary changes in the system.

One of the crucial lessons to be learnt from Latur is the need for a holistic disaster preparedness and response policy that pays attention to the importance of healing minds, and not only repairing bodies and buildings.

(Ammu Joseph is a Bangalore-based writer and journalist. She focuses on issues related to women and the media.)

InfoChange News & Features, November 2003