Contents & Abstracts
Editorial : From
Fire to Foot and Mouth Disease: Safeguarding the well-being of children, communities
by Douglas Paton
The 2001 Foot and Mouth Disease (FMD) crisis represents one of the greatest social upheavals in the United Kingdom since the Second World War, as well as one of the worlds largest ever epidemics of the virus. In order to deal with an epidemic of this magnitude, The Department of Environment Farming & Rural Affairs (DEFRA) needed to second and reassign staff (many from other government organisations such as the Environment Agency) to work on the front line of the crisis, often in dangerous and highly stressful environments. These workers typically received little training to prepare them for their roles, and what limited preparation they did receive often contrasted strongly with practical experiences, they thus found themselves working in unpredictable and chaotic situations. Based on a longitudinal ethnographic study of the health and social consequences of the 2001 FMD epidemic, our research indicates that repeated exposure to distress and suffering led some of these front-line workers to experience what we term post traumatic experience. The study raises a number of issues relevant to the evolving concept of occupational health in increasingly fractured and ambiguous domains of work and particularly in disaster and post-disaster situations.
We all had to go, us 'dirty' people, to a training day up in Carlisle, where we'd be get told what our duties were it was a complete and utter waste of time it wasnt like that at all, I was off work with depression afterwards, I still havent really fitted back into workDEFRA Field Officer, interview, April 2002
We develop a model of sequential responses of disaster survivors as they experience natural disaster stages. The disaster response model is based on the confluence of psychological processes with temporal environmental states that are markers of disaster periods. The study analyzes journalistic narratives taken from informants experiencing natural disasters in two culturally diverse communities. Recorded short-term vivid memory traces of survivors are assumed to accurately project their interpretations of events and experiences, reflected in their narratives. Whilst survivors share many similarities in their profiles of natural disaster response, some cultural differences in response are observed between communities, such as religiosity.
This paper presents a case study of a 9-year-old girl who sustained 38% burn injuries on the face, back, hands, palms and shoulder and diagnosed with stress disorders three and half months after a school fire tragedy. The key objectives were to: identify harmful psychological reactions and associated behaviour in the child which could have long-term psychiatric implications; administer different play therapy activities to facilitate the ventilation of negative thoughts and emotions; apply and find out the suitability and appropriateness of a 10-days home-based psychosocial intervention program for children who encountered such traumatic life events; discuss the problems with the parents and to provide Psycho-education to them for a speedy recovery process of the child. The child was selected randomly for the pilot testing of the program. Trained disaster psychosocial care professionals applied different play therapy methods to facilitate the ventilation of thoughts and emotions in the child. The home-based intervention spanned for a period of 10 days. The comparison between the pre and post intervention psychological symptoms and behaviour were analysed on Impact of Event Scale (Horowitz, Wilner, & Alvarez, 1979) validated by Dyregrov and Yule (1995) and Beck Anxiety Inventory (BAI). A significant reduction in psychosomatic symptoms, especially stress and anxiety symptoms was noted at post-intervention/treatment assessment. The mean scores on the IEC and BAI were also minimal. Psycho-education to the parents on the nature and course of stress disorder proved useful in the entire duration of intervention. Parents, neighbours and relatives corroborated the behavioural change in the child observed by the team. Reduced anxiety, apprehension, shyness also validated the intervention. The findings basically highlighted the significance of providing right kind of mental health care services/interventions to alleviate stress and other reactions associated with such traumatic life events encountered by children.
The practice of psychological in Indian context has been initiated two decades before and a systematic intervention of psychological support in the form of disaster mental health, trauma counseling, crisis intervention and psychosocial care is very new. After tsunami International Non Governmental Organisations (INGOs) provided few days' training package on psychosocial aspects for field staff of NGOs and they made the conditions of victim's emotionally worse due to lack of professionalism. Since the relief phase is over, many INGOs have withdrawn their focus on psychosocial care. But for long term rehabilitation there is a definite need of psychosocial care for the victims. The Environment, Livelihood, Infrastructure and Institution re-building - ELII Approach suggested in this article is a theoretical model that is more appropriate in planning the community rebuilding process.
November 7, 2007