A 2005 article, following the experiences with the tsunami, that has applications to reponses following the more recent cyclone disaster.

A tsunami and Sri Lanka: lessons from immediate responses

Abstract:  There are many lessons from just the immediate reactions of people in the aftermath of the destruction from the giant waves that hit Sri Lanka.  Reactions of victims fell, understandably, between extremes of resilience and helplessness. . There were strong calls for the services of professionals in the ‘mental health’ field, and steps were undertaken to mobilise them rapidly. Responses of those not directly harmed illustrated, at the two extremes, quite unusual levels of selflessness as well as of depravity.  All of these responses offer insights into how we live and how we react, and to an extent also into how we should.

Introduction

Most people are naturally moved to do something when they see a terrible disaster befall others.  But what they are naturally driven to do is influenced by many things.  If we had a better understanding of the different influences that govern our individual and collective responses we’d be better able to guide such responses towards greater benefit for those in dire trouble.

Methodology

I set out, two weeks after the giant waves generated by a tsunami hit over half the coastal belt of Sri Lanka, a few of the first hand and second-hand accounts from people I met during my own efforts to respond to the disaster.  The need for active steps on the part of all able people had subsided considerably by the end of two weeks and there was time to reflect on what we had recently heard, seen and been through.

The stories led to new thoughts, understanding and confusion.  These too I set out against each story.  A few of these, that illustrate what I feel are the more important things for us to think about further, are presented here.  And the accounts and reflections are as they were set out within the first two weeks of the disaster, uncontaminated by later experiences.  I make no attempt to link these unconnected observations with existing theory, preferring instead to present the events and ideas in a kind of structured essay.

Results

I set out a series of vignettes that came, unsolicited and unsought, to my notice – each followed by my own reactions to it.  My personal reaction to each is set out in italics.

1. Reactions of the ‘unaffected’

A baker, living a good three-hour drive from the nearest affected coast, set about baking as much bread as he could, soon after he understood what had happened.  He then collected a few volunteers and set off, in the general direction of the coast, in a truck laden with food for people he realised would have had none for quite some time.  Many families had bread that night because of this man.  He spent the whole of the next day ferrying clean water to those who were huddling displaced, with nothing but the clothes they were in – and some with none of their family around them either.

Acts of courage, in trying to help others at risk, were many.  Responding to someone in visible distress is almost a reflex, even when there is considerable personal risk.  People had willingly risked their lives, and some had died, trying to rescue others in the flood.  Cold-blooded risk taking, in going out looking for unseen people who may be in trouble, is quite another matter.  Efforts to locate strangers who may be injured or disabled, despite repeated alarms that another giant wave was on its way, were numerous.  The response of individual doctors who rushed spontaneously to attend to those in need of emergency aid, was exemplary.

A contrasting account is that of a group of young men, from just beyond the rim of destruction, who banded together to plunder jewellery, money, wristwatches and the like from the injured, the stricken and the bodies of the dead.  They threatened helpless survivors who did not co-operate.  Stories circulated of bodies being mutilated to facilitate the faster gathering of booty.

What makes one man plunder from a wrecked individual that another tries hard to soothe, deserves study.  We may for instance examine various biological influences that predispose or look to other individual propensities.  My own guess is that the man in the gang that pillaged would have behaved very differently if he were instead in the truck carrying provisions for succour.  The prevailing attitude in the small groups or circles to which people belong is probably a more powerful determinant of conduct than individual propensity.  It offers, also, greater potential for change.

We need therefore to look at the forces that make subsets of society feel that they don’t belong in, or to, the collective enterprise.  It is from among the cliques or gangs at the fringes that those who looted mostly came.  The immediate or cliché explanation for such behaviour is poverty and lack of education.  But nearly all persons that I asked here opined that such plunder would not have occurred, say, thirty years ago, at which time people were definitely poorer and had no more formal education than they do now.  The collective enterprise may more likely have fallen victim to free enterprise.

As responses became more organised, different helpers emerged.  The initial groups consisted of people who were readily moved and therefore moved spontaneously.  Towards the end of the first week, some of the more dispassionate and matter of fact types came more to the fore, mostly as part of the formal responses.  This provided more order and better reach to the less noticed needy and needs.

It would be good if people who rush to help can be encouraged to take along at least one or two of the more dispassionate.  The less spontaneous may need a push to join, as they wouldn’t feel comfortable with pure action.  They’d prefer to stay back until things become clearer and then move, if at all.  But some of this type should be taken quickly to the front, simply to be there, observe and provide suggestions that don’t strike those who are busy in urgent action.

I add a response of my own.  I think it accurate to say that the past two weeks were lived more intensely than any other two weeks of the last year.  This is not a reference to just being physically busy but more to being engaged.  It comes as a surprise since I have always felt well connected to the world around me.  But the increased engagement is still a felt improvement of wellbeing.

I wonder whether a life of reasonable comfort and security has an enervating effect. Fervour in such circumstances may need to be generated through direct and indirect participation in collective religious and social rituals, sports and political contests and other commercially propelled distractions.  Engagement in one’s world is of a different kind, when it flows from effort even on behalf of previously unknown but real beings.

Those directly hit

A woman, immobile and visibly uncared-for, was found in a compound housing several persons who were rendered homeless.  The others appeared reasonably well looked after.   This woman was quite alone, and appeared not to have eaten anything for the two days since the sea swept in.  It transpired that she had lost all her family in the deluge.  None of the others displaced with her and in the same camp had felt moved enough even just to sit by her.  They too were undoubtedly all seriously shaken and may not have had their faculties functioning as normal.  Nearly everybody there may have been preoccupied with their own calamity and the struggle to compete for the trickle of provisions that reached their camp in the first days.

In another camp housing displaced people, a woman had taken the lead in getting all its members organised.  They shared equitably whatever reached the camp and there was in it a different atmosphere altogether.  The woman who took the lead succeeded in getting others to help each other and to deal with issues collectively.  She was recently married and had no children.  Her husband too had died in the cataclysm.

The difference between these two women has, I am sure, more to do with the kind of people they always were, than with the group to which they belonged – and of course the different scale of losses they suffered.  So the differences in response that we see here are probably not primarily due to the influence of the groups to which people belonged.  In the previous contrast, group membership appeared to be the most important determinant of the differences observed.  But individual variation cannot lightly be discounted.

Victims who were in camps that were disorganised had a hard time.  In the first few days they had to compete amongst themselves for the provisions that reached their camp.  The women felt highly insecure, especially at night.  In a few settings, groups of women chose to sleep in turn within a group that banded together for protection.  Order and protection were established remarkably fast in other camps.  While those ‘officially’ in charge of the camps were getting to grips with the many things that had to be initially sorted out, the displaced residents had quietly got their own group organised – attending to each other as best they could.

The difference in wellbeing for people in settings that were well organised, as opposed to those completely disorganised, was nearly always recognisable.  The benefit stems from such mundane matters as the equitable sharing of whatever is available for the whole group.  But it has also to do with collective self-efficacy.  In the settings that were fairly well organised from the start, the displaced community obviously played a major part in making it so.  Thus their higher level of wellbeing probably has much to do with a feeling of control. 

In all settings where those who were uprooted found themselves, there was initially no outside authority to give instructions or take change.  So the settings where people had taken charge of their own circumstances to the maximal extent possible were better organised in the early days.

People involved in providing immediate relief should make sure that the greatest feasible role is given to so-called victims, from the very first second.  Able members of the affected community must be allowed to participate to the fullest extent that they wish, alongside those who come in from outside.  This should be a partial safeguard against the few predatory elements that mingle with the helpers as well as forestall the tendency for the victims to lose power and control over the situation. It will undoubtedly contribute to faster community recovery.

Authorities handling the helping response, the media and the public in general tended all to divide relief needs into phases.  Physical needs such as medical assistance, food, water, sanitation and shelter were classified as immediate, psychological needs next and last the reconstruction of houses and livelihoods.  All service provision was geared according to this logical and sensible agenda.

A provider of immediate survival needs noticed an elderly man, attending to something in the rubble of what was just the previous day his house.  The visitor found that the man, using an improvised screwdriver, was trying to unscrew a remaining hinge off a frame, from which the torrent had wrenched off the door.  He and his wife were collecting the few hinges and nails left, he said, ‘Because we may be able to use these again when we rebuild’.

Various psychological explanations can be provided of this couple’s response – by the very next morning.  The simplest is that they had decided simply to get on with it.  When large numbers are affected, people in different phases of physical and psychological adjustment are crammed anonymously sometimes, together.  Some allowances need to be made for the huge variation between individuals.  One person is ready to move on immediately, while most are still dazed.  Another individual is immobile for weeks, way behind the rest.

The woman who lost all her family and does not move herself to get any food needs psychological help in the acute phase itself.  The help needed is simple and natural – one of the community just to sit beside her, maybe hold or hug her. Where survivors of the ravaged community take part in the immediate relief there will be a few who would have it in them to reach out to this woman.  Some effort should be spent in deliberately creating space for the survivors to be part of the psychological helping resources too.  They would not only be a strong source of natural support to their fellows – to the bereaved, for example – but also a source of improved sense of collective self-efficacy and, eventually, control.  In the ideal world, every feasible means will be used to hand over leadership and control of the relief effort to the people in need of it.

Delivery of needs

The speed with which the provision of essentials occurred was phenomenal.  The return to partly damaged houses, even where nearly all possessions had been washed away, also happened quite fast. It would have been even faster if not for the fear that persisted for more than a week or so, that another wave may still hit.

One possible reason, proffered unkindly, was that politicians were not able to take complete charge at the beginning. The public, media, popular personalities and professionals, together with responsible government officials, appeared to have a large say.  The whole move to help was led by ‘people’.  This seems to have been a phenomenon in the global response too.  Governments, especially in the privileged countries, were left standing while the public moved.  Is this an indication of the beginning of a new era with the communication revolution?

Psychological support and reactions

The anticipated need for professional help to provide psychological support for victims was alluded to from the very first day, and perhaps the first hour, in all the national and international media broadcasts.  Some agencies began, within the first twenty-four hours, to call for volunteers to counsel victims.  A state agency reported within three days or four that it was already mobilising extensive counselling services.  The general theme was that these persons should quickly reach the traumatised to lend a professional ear, and help them relate their stories over and over again, so as to ease their suffering.

Words such as ‘trauma counselling’ and ‘post traumatic stress disorder’, and indeed ‘PTSD’ became very much part of public discourse.

People do relate their traumatic stories over and over again when they grieve.  But they do this more naturally with people to whom they feel close – than with strangers, however empathic. In a cataclysm, the natural others who’d normally reach out to those bereaved, or otherwise grieving, may be unavailable.  The demand for professionals to get into the scene, almost as a matter of urgency, may have arisen from recognition of this unusual circumstance.  The magnitude of the horrors visible in the images shown may also have contributed to the feeling that professionals were needed to handle the aftermath.

My impression is that it reflects also a latter-day social shift – towards regarding the provision of human comfort as a matter best done by professionals. 

Reports were heard that researchers and their students from abroad wished to come to Sri Lanka to study the psychological impacts.  Most local professionals – including me, I recognised – responded initially with cynicism.  Theirs was seen as an attempt somehow to use the unimaginable human suffering going on in Sri Lanka.  And it prompted me to start writing this piece, which began as a letter of protest against such unethical scientific curiosity.  It has evolved into an essay closer, I recognise, to what the letter was initially protesting against.

No progress in helping will ever be made if we deem it unethical to study what happens to people in trouble and how they overcome extreme adversity.  The potential benefit to future sufferers can render the academic interest ethically justified. But somehow the sense of people wanting to visit hurriedly to study what happens to the survivors was off-putting.  Perhaps a good basis on which to decide what should be off limits is taste, not ethics.  Just to peep at victims of a disaster shows a lack of refinement, however rigorously scientific or ethically acceptable the peering.  The driving force has to be concern and compassion, not curiosity.  Society, not ethics committees, must judge whether the desire to help potential future victims is too abstract a concern to render pure scientific curiosity decent.

Cynicism was voiced in various quarters also about the motivation of locals who moved rapidly to help.  Some of it was based on the charge that this or that act of helping was carefully publicised for maximal popularity.  Several of those who prominently helped were cast as people trying to improve their public image, or even self-image.  Others were portrayed as being more interested in an ulterior motive such as securing political mileage, religious conversion, incidental sexual gratification, or later financial benefits.

There are no means by which to demonstrate that an action is driven by just the pure and unalloyed impulse for selfless service – if indeed such proof was demanded.  Our other agendas always intrude even when our primary interest is only to help. We must ensure that our extraneous objectives neither overshadow nor intrude to a degree that affronts the general sense of good taste or decency.  If we know that they do not, we should have the courage to act despite the possible warped characterisations of cynics.

Blaming

The government was blamed for not letting people know in time of the impending disaster.  Equipment capable of detecting the approaching swell was said to have been available but not put in operation due to incompetence.  Pinning blame on the government did not gain momentum, given that other countries including India, the regional technological superpower, hadn’t been able to warn its citizens.

Many stories did the rounds about tsunami warning centres in Hawaii, and possibly other places, not alerting the Indian Ocean countries at risk.  The BBC, it was reported, had quoted the centre in Hawaii as having said that they did not know whom to contact in the countries in peril.  Resentment was further aroused by stories that the American military base in the Indian Ocean island of Diego Garcia suffered no casualties or serious damage because they took timely precautions – but didn’t choose to raise the alarm with others at risk.  Later versions added that there were also British troops there, who too were saved by knowing well in time about the approaching tsunami.

It is customary to blame governments.  The trend is next to blame the USA, after which seems now to come the United Kingdom!  I suspect that for the many who are not equipped enough with the requisite theological refinements to circumvent it, the desire to blame a human agency stems mostly from the need for a distraction, to avoid a crisis of faith.

Other fauna

Newspapers reported that no animals, birds or reptiles had died, other than a few of the domesticated species.  This was surprising since an area hit hard was a wildlife sanctuary.  The animals in the wild, even lumbering elephants, appeared to have got to safety early enough.

Blame for humans here seems fair.  We appear to have overpowered, through our domestication, the natural instincts of animals caught up in our progress.

Repeated broadcasts were made over the media that the reconstruction had begun within a week.  It was reported, also within about a week, that the authorities had decided that no new construction was to be allowed within 100 metres of the shore.  Later broadcasts claimed that the no-construction rule applied up to 200 metres and then 300.  Those who had previously been living within the specified zone would be provided alternative land in safer places, less near the sea, on which houses would be built for them.

Human fauna in positions of power over others should be prevented from making decisions with scant regard for the helpless.  Few of those whose life had been washed away in its entirety would be in a mood to resist decisions being taken on their behalf, and presumably for their own safety or welfare.  Victims who possessed only abstract legal rights over the piece of land they had lived on, apart from the clothes they were wearing, were now hastily being denied permission to rebuild their houses on land they previously occupied.  The motivation for this decision could at best be attributed to benevolent, though blindly insensitive, paternalism. At worst, it could reflect avarice of the worst kind, given the commercial potential that beach property holds for later development into lucrative tourist services.

CONCLUSIONS

Wellbeing in the immediate aftermath of cataclysmic events is improved by re-establishing structure as soon as possible.  In the unstructured, the less fine elements of human nature find more scope to manifest.  And the greater the say that those directly affected have in establishing order and structure, the better the visible short-term result.  Victims of disaster would probably do well to see how they might collectively gain as much control over their circumstances as possible, as soon as possible.

In cataclysmic events, the classical descriptions of phases – through which people’s responses to severe trauma are recognised to move – are not particularly helpful in understanding what happens to the affected population.  Individuals adjust at incredibly different speeds.  And the struggle for personal survival, loss of all physical rootedness, the absence of the close circle with whom pain can be shared and being cheek by jowl with others similarly or worse affected, modify greatly the reactions seen in ‘normal grief’.

Mental health professions must examine whether they have oversold themselves.  The public now looks, instinctively, for a professional response where it previously did not.  And, I believe, often where it should not.