Interventions for survivors of the tsunami disaster: Report from Sri Lanka

Fernando, Gaithri A.

doi:10.1002/jts.20042

Cited by 17 publications

(13 citation statements)

References 9 publications

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“…In the Palestinian refugee camps a significant relationship between household density and poorer health was found, but neither headache nor stomach ache were investigated [12,13]. The tendency for this population to somatise their psychological distress combined with the high household density could suggest that the association between objective crowding and reported physical symptoms in this study operated via the influence of subjective crowding on mental distress found by Ruback and Pandey and Fuller, Edwards et al [10,11,31,32]. …”

Section: Discussionmentioning

confidence: 80%

Sri Lankan tsunami refugees: a cross sectional study of the relationships between housing conditions and self-reported health

Turner

Pathirana²,

Daley

et al. 2009

BMC Int Health Hum Rights

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BackgroundOn the 26th December 2004 the Asian tsunami devastated the Sri Lankan coastline. More than two years later, over 14,500 families were still living in transitional shelters. This study compares the health of the internally displaced people (IDP), living in transitional camps with those in permanent housing projects provided by government and non-government organisations in Sri Lanka.MethodsThis study was conducted in seven transitional camps and five permanent housing projects in the south west of Sri Lanka. Using an interviewer-led questionnaire, data on the IDPs' self-reported health and housing conditions were collected from 154 participants from transitional camps and 147 participants from permanent housing projects. Simple tabulation with non-parametric tests and logistic regression were used to identify and analyse relationships between housing conditions and the reported prevalence of specific symptoms.ResultsAnalysis showed that living conditions were significantly worse in transitional camps than in permanent housing projects for all factors investigated, except 'having a leaking roof'. Transitional camp participants scored significantly lower on self-perceived overall health scores than those living in housing projects. After controlling for gender, age and marital status, living in a transitional camp compared to a housing project was found to be a significant risk factor for the following symptoms; coughs OR: 3.53 (CI: 2.11–5.89), stomach ache 4.82 (2.19–10.82), headache 5.20 (3.09–8.76), general aches and pains 6.44 (3.67–11.33) and feeling generally unwell 2.28 (2.51–7.29). Within transitional camp data, the only condition shown to be a significant risk factor for any symptom was household population density, which increased the risk of stomach aches 1.40 (1.09–1.79) and headaches 1.33 (1.01–1.77).ConclusionInternally displaced people living in transitional camps are a vulnerable population and specific interventions need to be targeted at this population to address the health inequalities that they report to be experiencing. Further studies need to be conducted to establish which aspects of their housing environment predispose them to poorer health.

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Section: Discussionmentioning

confidence: 80%

Sri Lankan tsunami refugees: a cross sectional study of the relationships between housing conditions and self-reported health

Turner

Pathirana²,

Daley

et al. 2009

BMC Int Health Hum Rights

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“…Significant minority ethnic groups include Tamils and Moors, commonly referred to as Muslims (Department of Census and Statistics, Sri Lanka, 2001). Sri Lankans tend to be collectivistic and traditional in orientation (Durvasula & Mylvaganam, 1994; Fernando, 2005, 2008). However, the long‐drawn‐out armed conflict that began in the 1980s and the tsunami of 2004 appear to have disrupted the social bonds that tie children to parents and families to each other.…”

mentioning

confidence: 99%

Growing Pains: The Impact of Disaster‐Related and Daily Stressors on the Psychological and Psychosocial Functioning of Youth in Sri Lanka

Fernando¹,

Miller²,

Berger³

2010

Child Development

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155

138

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Daily stressors may mediate the relation between exposure to disaster-related stressors and psychological and psychosocial distress among youth in disaster-affected countries. A sample of 427 Sri Lankan Sinhalese, Tamil, and Muslim youth (mean age = 14.5) completed a survey with measures of exposure to disaster-related stressors and daily stressors, psychological distress (posttraumatic stress, depression, and anxiety), and psychosocial distress. The results indicated that daily stressors significantly mediated relations between war- and tsunami-related stressors and psychological and psychosocial distress. Some daily stressors not directly related to disaster also predicted functioning. These results point to the need for policies and interventions that focus on reducing proximal daily stressors that are salient to Sri Lankan youth exposed to disasters.

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“…The British and American exports could not imagine that the Sri Lankans had evolved a culture better able to interpret and give meaning to terrible events because of their intimate familiarity with poverty, hardship, and war. The tsunami was just another event, quite different from the perceptions of the British and Americans (Fernando 2005). While the Euro-Americans turned to medications, the Sri Lankans turned to spirituality -Buddhism for the Sinhalese, Hinduism for the Tamils, Islam for the Moors, and Christianity for the rest (Fernando and Berger 2017).…”

Section: Psychiatry's Lack Of Cross-cultural Awarenessmentioning

confidence: 98%

Critique of Psychiatry in Rural and Remote Communities

Mehl‐Madrona

McFarlane

Mulrenin

2020

Handbook of Rural, Remote, and Very Remote Mental Health

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We criticize the collapse of psychiatry in most settings to a purely biomedical model in which strict rationalist standards are applied to thoughts and behavior leading to diagnosis and treatment with medication. The effect of this on local cultures has been to undermine acceptance of unusual behavior by community members and participation of extrafamilial agents in the recovery process of people with emotional suffering. The arrival of a biomedical model has resulted in greater stigmatization and less compassionate treatment of people with what biomedicine calls mental illness. We criticize the chief response of psychiatry being to diagnose and medicate with relative insensitivity to the social determinants of health and the specific circumstances of peoples' lives that make them suffer. A profit-driven mental health system which exists in the United States complicates this further by its preference for short visits and medication as more profitable than longer visits and psychotherapy. Even in countries with universal coverage, however, the impetus exists to see more people in shorter time since this reduces short-term costs though arguably increasing longer-term costs. We describe the modern history of the critical psychiatry movement which has arisen in parallel with psychiatry's increasing emphasis on mental illness arising from defective brains and its almost exclusive reliance on medication as the primary treatment model. We trace this movement from R.D. Laing and Joseph Berke, through Loren Mosher, and to Marius Romme and the Hearing Voices Movement, which is now Intervoice. We discuss Fernando's analysis of biomedical psychiatry's coming to Sri Lanka after their devastating tsunami and how its model of trauma undermined centuries-old ways of coping and conceptualizing loss that were grounded in the spiritualities of the region. We review Julie McGruder's description of American psychiatry's coming to Zanzibar and how it undermined the quality of life for those suffering from what psychiatry called schizophrenia. We conclude with a call to psychiatry to return to a more balanced biopsychosocial-spiritual model and to balance biomedical treatment with social and spiritual approaches, relying upon local community experts to be collaborative partners in a participatory democratic manner to determine what defines mental health and illness and how it should be addressed.

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Interventions for survivors of the tsunami disaster: Report from Sri Lanka

Cited by 17 publications

References 9 publications

Sri Lankan tsunami refugees: a cross sectional study of the relationships between housing conditions and self-reported health

Sri Lankan tsunami refugees: a cross sectional study of the relationships between housing conditions and self-reported health

Growing Pains: The Impact of Disaster‐Related and Daily Stressors on the Psychological and Psychosocial Functioning of Youth in Sri Lanka

Critique of Psychiatry in Rural and Remote Communities

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