October 13, 2019

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Bangladesh is the eighth worst affected country in the world in terms of natural disasters. Between 2008 and 2017, approximately 37 million people were affected.

In emergency situations like these, mental health conditions take a toll on affected populations, diminishing levels of wellbeing. It may take an infinite amount of time for these groups to heal as they find it difficult to cope and recover.

As physical scars resulting from disasters such as a flood can visibly outweigh the impacts of psychological trauma in affected communities, it becomes easy for emergency responders to turn a blind eye to the underlying need for psychosocial assistance. Hence, international guidelines recommend that psychosocial and mental health support remains a major priority during an emergency response.

In July 2019, the boundaries of wellbeing were pushed when parts of northern and southern Bangladesh became home to one of the worst floods in recent history. As of 25 July, 6,867 villages were flooded, in 163 sub-districts, affecting 7.6 million people. An estimated 114 people died, mostly as a result of being struck by lightning, drowning or bitten by snakes. Approximately 600,000 houses were damaged and over 300,000 people displaced.

Humanitarian actors from various national and international agencies, including BRAC responded by extending support in the form of life-saving cash, shelter and WASH services.

Yet these communities now face the threat of being excluded from receiving critical psychosocial support, due to their denial and obliviousness of their mental trauma. Adding to this complexity, phase-wise emergency response operations from organisations such as BRAC continue to be shaped by funding constraints, time barriers, limited resources and inaccessibility to remote locations, deprioritising the need to deliver long-term psychosocial assistance to survivors.

Following a disaster needs assessment, organisations like BRAC could prioritise life-saving psychosocial support interventions, strengthening preparedness and readiness to respond. Repackaging humanitarian services centred on identifying psychosocial trauma and securing sustained wellbeing within vulnerable groups can then be better facilitated.

During a response, long periods of observation inside a survivor’s home or neighbourhood would widen the scope for response staff to elicit emotional accounts from these groups and help them cope with the shock.

Trained crisis responders or local community members can impart psychological first aid, the provision of basic psychological care in the short-term aftermath of a traumatic event. The basic principles of this form of aid include: allowing freedom of expression of participants, being a responsible listener and not handing out advice, showing acceptance of a survivors’ often erratic feelings such as fear and anxiety, fostering confidence and empathy, not being judgemental, showing that responders are here to provide support, and lastly making information readily available.

Outreach aims to provide emotional support during acute emergency periods. The technique is adopted to assist survivors in expressing and understanding disaster-induced stress, difficulty in sleeping, thinking clearly, and grief reactions aiding individuals to return to a balanced state.

Assisting survivors with personal losses such as burying a loved one, attending to the wounded, assisting frail or disabled members, and rebuilding homes is a large part of enhancing a community’s coping mechanism.

Beyond these activities, linking communities to essential services such as medicare, education, training and income generation support, results in strengthening resilience and rebuilding social capital.

Initiatives like these should be culturally appropriate, gender sensitive and inclusive where the needs of vulnerable groups in particular women, children, marginalised populations, the elderly and persons with disabilities are paramount.

Simultaneously, the capacity of frontline staff to deliver psychosocial support in emergencies must constantly be monitored so that their wellbeing is perpetually retained. Ways in which this could be achieved is through regular rewards, granting adequate periods of leave, a pay rise, promotion including psychosocial counselling while dealing with highly intense emergency situations.

To address gaps relating to available resources and the significant need for psychosocial services, WHO is scaling up psychosocial and mental health care by training health workers to learn how to recognise the symptoms and to provide first-line support for common mental health conditions.

The dire and widespread mental health consequences of natural disasters in Bangladesh have yet to receive due attention. At present, the detection of mental health issues in emergencies, their treatment and reporting is generally low. This trend calls for a robust and inclusive mental health policy framework to counter these loopholes.

Mental health and psychosocial support in emergencies is crucial to the social and economic recovery of individuals, societies, and nations. By addressing such needs, emergencies can proactively function as catalysts for stakeholders to produce workable national mental health services and strengthen the resilience of affected populations to unequivocally overcome the effects of disasters.

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