Addressing Psychosocial Needs in the Aftermath of the Tsunami

Abstract

MSF discusses its response to tackling mental health problems in Aceh, Indonesia, and explores some of the main concerns in responding effectively to mental health problems in an emergency setting.

The expression of depression among Javanese patients with major depressive disorder: A concept mapping study

“…Prior to preparing the Indonesian translation, an English version was edited to a Flesch-Kincaid reading level of Grade 6. Psychiatric terms were avoided because psychiatric disorders may be culturally associated with shame ( de Jong, Prosser, & Ford, 2005). Written words were restricted to no more than two syllables and verified by bilingual therapists at the SHP.…”

“…The prominence of religion in the lived experiences of the people participating in the study was suggested by Statements 68, 72, 83 and 86, all of which make reference to Allah/God and/or religion. The Muslim religion is central to Indonesian culture and traditions, in part intermingled with more traditional old Javanese beliefs in superstition and magic (de Jong et al, 2005). Religious influences denote the meaning individuals associate with their situation.…”

“…For example, in a study following the tsunami in 2004, de Jong et al (2005, p. 487) found that several individuals "understood the tsunami as punishment or warning from Allah for being 'immoral.'" In Indonesia people with a depressed mood or other psychological concerns may seek assistance from a spiritual healer and not utilize mental health services (de Jong et al, 2005;W. Agus, personal communication, October 2, 2005;B.…”

Six Months in Aceh

“…In Aceh, people traditionally consult local religious leaders, village leaders and dukuns, and rely on family support to deal with mental health problems. Some have questioned the validity, and highlighted the difficulties, of applying Western approaches in the context of significant cultural differences 9 , 10 . Potential barriers include competitiveness between traditional and Western services, the privileged nature of local spiritual knowledge and the perceived threat of competing cultural orientations.…”

Development of a Screening Instrument for Post-Traumatic Symptoms

“…Sri Lanka, a nation already in distress from periodic civil wars, experienced a devastating disaster on 26 December 2004, when an underground earthquake in the Indian Ocean measuring 9.2 on the Richter scale produced an immense tsunami (de Jong, 2005). This tsunami struck Sri Lanka and 13 other countries in and around the Indian Ocean.…”