Psychosocial Support 1

Running Head: Psychosocial Support

Psychosocial Support in Emergency Disaster Situations

Eliza Binns

Glen Allen High School

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Introduction

2017 wreaked havoc on all areas of the world by bringing about various natural disasters

of many different magnitudes. Due to these numerous catastrophes, there are presently thousands

of people that are attempting to restore their lives back to the order they knew before. This

recovery includes all levels of physical (rebuilding homes, clearing roadways, medical services,

etc.) as well as emotional rehabilitation (PTSD, grief, mourning the loss of loved ones, etc.).

While media coverage shows the primary support being offered during the emergency phase

immediately following the disaster, the public seems to forgo their interest in the recovery as

they see the situation be taken under control. The declining public attention to these catastrophes

often leaves the surrounding population completely unaware of the full measures that must be

taken to heal a suffering community. As the media coverage dies down, and is replaced by

seemingly more pressing issues, the public is left unaware of the long-term effects of the

disaster. These detrimental after-effects may be as trying as the disaster itself. The emotional

strain caused by anxiety due to a lack of food, economic ruin, PTSD, or even the grief from

losing a loved one, may leave individuals, and potentially entire communities, struggling to

rebuild themselves more so than that of their homes and infrastructure. The human mind is often

in need of just as much support through recovery as the material items damaged during these

times. However, it seems that many citizens witnessing the rehabilitation process are not aware if

this healing is taking place, much less if it is providing the support necessary to the suffering

individuals. Though often invisible to the public or left out of the media coverage, all aspects of

a disaster relief effort are pivotal to the complete healing of the communities, therefore

reinforcing the importance of the provision of more holistic recovery services, including that of

emotional support in the wake of these catastrophes.

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Disaster Definition

As the possibility of disaster occurrence increases in the present day due to shifting

demographics, aging infrastructure and climate change, it becomes vitally important that these

disasters are accurately labeled and defined in order to properly address them and the damage

they leave in their path. According to the International Federation of Red Cross and Red

Crescent Societies, a disaster is defined as a “sudden calamitous event that seriously disrupts the

functioning of a community or society and causes human, material, and economic or

environmental losses that exceed the community’s or society’s ability to cope using its own

resources.” In the case of natural disasters, this disruption is often a result of strong

winds/precipitation, high sea levels, or various other potentially dangerous and damaging

physical effects. These dramatic conditions are what separates an above average storm from a

life-threatening hurricane, or a rather large amount of rain from a flash flood. With the extreme

consequences of such catastrophes, there are currently thousands of populations all across the

world at risk of disaster due to their location, economic stability, and infrastructure capabilities

and are completely unaware to the potential danger they are in.

Populations become increasingly susceptible to the potential damage that may be caused

by these natural phenomena as their vulnerability increases as well. The International Federation

of Red Cross and Red Crescent Societies (IFRC) defines vulnerability as “the diminished

capacity of an individual or group to anticipate, cope with, resist, and recover from the impact of

a natural or man-made hazard.” Vulnerability is often associated with poverty due to the lack of

funds to provide stable infrastructure in the areas that they live and work, as well as the low

possibility of these communities having the resources necessary to recovery properly.

Additionally, richer countries often have a greater capacity to resist the impact of hazards.
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Higher income societies often have much more secure livelihoods and higher incomes which

increases resilience and enables people to recover quicker from a hazard (IFRC, Disaster and

crisis management). This capacity displayed by highly developed countries needs to be instilled

in all communities in order to limit the potential damages that may be caused to at risk

populations. Unfortunately, due to the world’s economic geography, many poor countries are

often located at the center of disaster-risk locations. As outlined in the IFRC’s World Disaster

Report in 2001, of approximately 3 billion people in the world affected by disasters from 1967 to

1991, 85% lived in Asia. And of those most detrimentally affected, the majority of them

inhabited rural and low-income communities, and therefore displayed high levels of vulnerability

and low capacity. For example, on September 29, 1971 a cyclone and tidal wave struck the rural

state of Orissa, India off the Bay of Bengal, killing as many as 10,000 (Sundar & Sezhiyan,

2007). In 1976, China was affected by the Great Tangshan Earthquake which reached a

magnitude of 7.5, and is thought to have one of the largest death tolls in recorded history,

reaching as high as 655,000 (Rafferty, 2011). Additionally, on April 30, 1991, Bangladesh

suffered from a cyclone killing an estimated 131,000 people and leaving a total of 9 million

without homes (Bangladesh cyclone 1991, 2018). By focusing on these groups of people that

may be the most vulnerable, disaster relief efforts can identify these communities and their needs

in order to better provide for the citizens in an adequate and appropriate way.

Disaster Management Efforts

The immediate effects following a disaster may often include the loss of life and damage

to property and infrastructure, as well as the possibility of leaving the survivors traumatized by

the experience and uncertain of the future, making them less able to provide for their own

welfare in the short term (IFRC, Disaster and crisis management). This can often leave large
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populations with extensive needs that must be addressed in order to assist the survivors in

rebuilding their lives and adjusting back to reality. Disaster management efforts must be

stretched to their full capacity in order to provide for all of these needs whether physical or

psychological.

For many types of disasters, the carnage that is left in their wake often results in civilians

being left without adequate food, shelter, water or any other necessities they require to sustain

life. Additionally, natural disasters such as earthquakes also have the possibility of increasing the

initial damage even more due to the resulting aftershocks, or the potential outbreak of epidemics.

In this unpredictable environment that is present in a community having recently been struck by

some form of natural catastrophe, the primary aims of disaster responses are rescuing victims

from immediate danger and the stabilization of the physical and emotional conditions of

survivors. Moreover, services such as restoration of essential services including water and power

are of the utmost priority in order for adequate care to be provided. Such effects include the

scarcity of food, the damage to hospitals and other emergency medical care facilities, as well as

the potential disruption to community self-help networks necessary for survivors to limit

vulnerability and increase their capacity to mitigate and recover from the disaster. In order for

relief efforts to undergo a smooth and efficient recovery period and to effectively mitigate the

disaster, all of these areas of potential further damage must be addressed. The International

Federation of Red Cross and Red Crescent Societies’ expectation for this immediate stage of

recovery is predicted to last for one to six months following the disaster which is contingent

upon the magnitude of the effects and the expanse of those affected. If not properly addressed

early on, extreme consequences of such a catastrophe may have various detrimental effects on

the population.
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Specific Relief Services

Once emotional and physical stability has been achieved, more specific actions can be

taken to work towards the complete restoration of the damaged community. These actions are

focused to primarily address the physical damage caused by the catastrophe in order to limit

levels of chaos and emotional trauma within the society. These services can be divided into three

sub-categories: food, shelter, and non-food items, all of which can be administered in the

community depending on the needs of the survivors and the situation at hand.

Food services are primarily delivered to populations that have suffered extreme damage

to food stocks or crops, or “where the effect is very localized, and when people are unable to

draw on their own savings or food reserves” (IFRC, Disaster and Crisis Management). These

services often accompany relief efforts dealing with catastrophes such as hurricanes, floods, or

various other disasters having a detrimental effect on the population’s food supply. The food for

these methods of support often comes from organizations such as the United States Department

of Agriculture. The food provided by the USDA comes from their programs including The

National School Lunch Program, The Emergency Food Assistance Program and The Food

Distribution Program on Indian Reserves. In the case of an emergency, “USDA can authorize

States to release these food stocks to disaster relief agencies to feed people at shelters and mass

feeding sites” (USDA 2017). More often than not, the food being provided by such organizations

must require little to no preparation due to the potential extensive damage of the surrounding

areas. This food is often in the form of canned juice, canned meat, and canned fruits and

vegetables (USDA 2017). Food-related services are offered in three different methods: short-

term assistance, deferred assistance, and long-term assistance. Short-term assistance is when the

need for food must be rapid, most commonly necessary following sudden disasters such as
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earthquakes and floods. These catastrophes may cause food stocks to be destroyed, normal food

supplies and marketing systems to be disrupted, and crops to be damaged or lost. In this case,

“short-term” may be as long as just a few days (most commonly the case with earthquakes), or

up until the next harvest when food stocks and crops can be restored. Deferred assistance may be

necessary in the event of floods, storms or localized droughts. This Food-Related Assistance

comes into action right before the next harvest in the case that the events may have damaged, but

not completely destroyed the crops and food stocks of the community. Finally, Long-Term

Assistance is “provided over a long period and combines both relief and self-reliance

development activities,” while progressively shifting away from relief in order for the

community to get back on its own feet (IFRC, Disaster and crisis management). This method of

assistance is “applied to emergencies due to successive crop failures and most situations

involving refugees or displaced people.” (IFRC, Disaster and crisis management). In order for

these methods of food support to act as a push back towards a life of normalcy and not cause the

communities to become dependent upon this relief, disaster management efforts must take into

account factors such as: “the initial health and nutritional condition of the people, the

possibilities for growing food or engaging in other income generating activities, government

policies, security station etc.” (IFRC, Disaster and Crisis Management). With all of this in mind,

relief efforts must also ensure that the food being provided is culturally and nutritionally

appropriate for the suffering community.

In addition to the possibility of crops and food stocks being destroyed, many citizens may

also find themselves homeless and without a safe place to live. This makes the provision of

shelter imperative during the initial stages of a relief effort in order for survivors to have access

to a secure and safe place to stay, “protection from the elements, and resistance to ill health and
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disease” (IFRC, Disaster and crisis management). The necessity of shelter is incredibly

important to avoid the increase of displaced persons which enhances an area’s vulnerability and

decreases their capacity. The primary goal of relief efforts when providing shelter to disaster

survivors is to establish temporary housing for individual families, keeping strangers within the

community separated ensuring personal safety and limiting the possibility of epidemic outbreaks

by decreasing the need for collective shelter within the community. In fact, the possibility of the

eruption of disease within communities recovering from natural disasters is all too common in

developing countries due to the displacement of people into overcrowded camps and cross-

contamination of water sources with fecal material and toxic chemicals. These poor living

conditions increase the risk for Cholera, Typhoid Fever, or even Dysentery in these tightly

condensed populations (CBS News, 2010). However, in some cases of extreme physical damage

to community infrastructure, individual shelter can prove to be both impossible and impractical,

making collective shelter in warehouses, halls or barracks, or in temporary planned or self-settled

camps the most practical method of shelter provision. Once citizens are determined to have

stable living conditions and a reliable food source, disaster relief efforts begin to focus their

resources towards rebuilding the community and its economy, as well as ensuring the health and

emotional stability of the survivors.

In order to do so, citizens are provided with non-food items that may consist of anything

from clothing, blankets, and bedding to stoves and kitchen sets, water containers, and hygiene

products. This support ensures that after people have lost everything due to the disaster, they are

still being provided with “basic and culturally appropriate goods and supplies to maintain their

health, privacy and dignity, to meet their personal hygiene needs, to prepare and eat food and to

achieve necessary levels of thermal comfort” (IFRC, Disaster and crisis management).
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Additionally, relief organizations work to assist these struggling communities to get back on

their feet by giving them the economic support necessary to ensure they will be able to fully

reach their independence in the future. Cash and voucher programs are available to survivors and

their families to complete this goal, as well as allowing them to “gain more control of their lives

and improving their survival chances” (IFRC, Disaster and crisis management). In addition to

supporting local businesses and markets to remain stable and functioning follow the disaster, the

International Federation of Red Cross and Red Crescent Societies describes these programs as

being relatively inexpensive to implement, more flexible for the beneficiaries by allowing them

to choose what they spend money on, as well as being incredibly supportive of the local

economy.

All of these methods of support are widely popularized by social media in the wake of a

natural disaster. Both those immediately affected, as well as those witnessing the relief efforts on

television are aware of their effectiveness and efficient physical reparations. These efforts

confirm the public’s confidence in the organizations manning these disaster efforts based upon

the physical evidence of the relief shown in the media. However, though many are aware of the

recovery taking place on the outside of these communities, they may also be oblivious to the

damage that needs repair on the inside. After enduring such trauma and damage through the

chaos caused by a natural disaster, survivors and their families may be struggling to recover

emotionally and psychologically.

The Need for Psychosocial Support

Following a natural disaster, survivors may have witnessed all sorts of damage and

catastrophes fall upon their communities. These experiences have the potential to traumatize

survivors due to their trying and demanding effects. As people struggle to accept the loss of their
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homes, belonging, or even loved ones, they are also required to come to terms with the new life

they are being forced into. This departure from a life of normalcy to a life of hardships and

trauma has the potential to increase the prevalence of mental illnesses in the community. In order

to improve and maintain the mental well-being of the survivors following the overwhelming toll

that is taken on them by these catastrophes, relief organizations place an increased focus on

psychosocial support, which the International Federation of Red Cross and Red Crescent

Societies defines as referring “to the close relationship between the individual and the collective

aspects of any social entity.” This support “helps individuals and communities to heal the

psychological wounds and rebuild social structures after an emergency or critical event” (IFRC,

Disaster and crisis management). In addition, the provision of this support has many benefits to

the recipient such as the prevention of distress and suffering from potentially developing into

something more severe, helping people “cope better and become reconciled to everyday life,”

and helping the “beneficiaries to resume their normal lives” (IFRC, Disaster and crisis

management). In fact, the absence of such support has proven to have detrimental effects on

survivors’ mental states, further damaging their current and future lives.

These effects can often be so overpowering that those suffering from them begin to

display their internal emotional hurting in physical and behavioral ways. As these symptoms

become visible to those around them, survivors may find themselves having trouble establishing

personal connections with their loved ones in the midst of their suffering. The psychological

trauma that one endures in the events of a natural disasters has the potential to evolve into greater

and more extensive emotional damage in the form of PTSD, anxiety, depression and various

other behavioral disruptions. Signs of Post Disaster Stress can be seen as anything from daily

abnormalities such as difficulty sleeping, low threshold for frustration, limited attention span and
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reluctance to leave home, or even more physical signs such as colds or flu-like symptoms,

headaches/stomach problems, disorientation or confusion and especially fear of crowds,

strangers, or being alone (FEMA, Coping with disaster). In the event of someone struggling to

recover from losing family members, their homes, their jobs, and any financial and emotional

stability they may have previously had, the presence of any of these symptoms makes it

increasingly difficult to work their way back to a life of normalcy. Not only will these symptoms

affect survivors’ personal lives due to the emotional scarring that has been left behind, but it also

has the potential to affect their professional work lives as they are unable to think of anything

other than the exact moment their lives changed for the worse. As these survivors are struggling

to think straight and keep track of all of the chaos that has entered their lives in the recent past,

they are also doing their best to work their way back to the life they had before the sky broke, the

earth cracked, or the wall of water fell upon them. However, despite how hard they try to ignore

pain, the voice in the back of their head, or the traumatizing memories, sometimes it is

impossible to move forward without the help of others. It is because of this that psychosocial

support is so important to disaster survivors and their recovery. This support not only “plays a

major role in enhancing the well-being and life-quality of people with mental health problems”

but it also gives them the strength they need to accept these recent events and do whatever it

takes to move past them.

However, as beneficial as this support is, many of the most vulnerable developing nations

lack the access to it, making them even more susceptible to potential emotional damage.

Following the 7.0 magnitude Haitian earthquake that took place in 2010, the World Health

Organization discovered a severe lack of psychological resources and nearly “non-existent

mental health care systems with only ten psychiatrists nationwide” (Tiberi, 2016). This nation’s
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high levels of poverty and economic instability, as well as its dangerous location directly in the

hurricane corridor made Haiti extremely dangerous to such catastrophes. The incapacity to

mitigate this disaster and cope with the effects, both psychological and physical, made the

victims of this earthquake extremely susceptible to various forms of PTSD and mental illnesses

in the future. Olivia Tiberi performed a study where she researched the psychosocial effects of

this disaster among the Haitian civilians in her 2016 article Mental Health in Haiti: Beyond

Disaster Relief, in order to determine the true extent of the absence of psychological support in

disaster victims. She found that 56% of the individuals she interviewed displayed signs of

anxiety and 28.2% could be medically diagnosed with Major Depressive Disorder following the

disaster (Tiberi, 2016). Of those individuals, approximately 76%-85% with “severe disorders

[failed] to receive treatment” (Tiberi, 2016). In a country that was already at risk to such

disasters due to their high levels of vulnerability, the damaging mental effects that many are

struggling to cope with in the years following the 2010 earthquake makes them even more

susceptible to future catastrophes and other hardships the population may experience.

Such emotional trauma can be also seen in the wake of the 7.8 magnitude earthquake that

hit Nepal in 2015. The Journal of Nepal Health Research Council published a 2018 article titled

Anxiety, Depression, and Post-Traumatic Stress Disorder After Earthquake which outlines the

“prevalence and comorbidity of commonly occurring psychological symptoms in people exposed

to [the] Nepal mega earthquake in 2015 a year after the event” (Thapa, 2018). This natural

disaster killed 8,669 people and injured 16,808 while leaving thousands of people homeless due

to the damage of 288,793 buildings, accurately deserving the title of a “mega earthquake”

(Thapa, 2018). The conduction of this research consisted of the interview and study of 198

individuals’ psychological well-being. The results wielded unbelievable results of emotional and
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mental trauma in those affected by this natural disaster. Borderline anxiety symptoms were found

in 52.5% of the individuals and significant anxiety was seen in 20%. Additionally, borderline

depressive symptoms were determined to exist in 20% of participants while significant

depressive symptoms were found in 8%. As if these issues in and of themselves were not

detrimental enough, 7.6% of participants displayed traits of both anxiety and depressive

disorders determining there to be extremely high levels of PTSD in survivors (Thapa, 2018). The

long term effects that this specific natural disaster has had on its survivors proves how

imperative it is that natural disaster victims get the adequate emotional support necessary to

avoid a lifetime plagued by mental illnesses.

Though one’s emotional and psychological wounds may not be as visible to those around

them as the physical destruction that is evident following these disasters, the recovery from such

emotional trauma takes far longer to overcome than material losses, as seen by the Nepalese

psychosocial illnesses even a year after the “mega earthquake” struck. In fact, areas with high

levels of vulnerability may witness the erosion of “protective support systems that are normally

available” making the emotional mitigation of these catastrophes even more difficult for relief

teams (IFRC Psychosocial Support Program, 2016). However, if adequate emotional support is

provided in a timely manner, these areas of high vulnerability may be able to avoid this

emotional ruin all together while “foster[ing] and rebuild[ing] social trust, social empathy,

nonviolent communication, and peaceful resolution of tension and a culture of non-violence”

(IFRC Psychosocial Program, 2016). By addressing one’s emotional state quickly following the

disaster, relief organizations can eliminate the possibility of PTSD from occurring in these

individuals. Additionally, it removes the possibility of these emotional wounds being left to heal

themselves and therefore just beginning to fester and grow worse over time. With proper
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psychosocial support being offered in the early days following a disaster, survivors can be given

the treatment they need to prevent the evolution of their memories into a state of trauma.

Conclusion

Natural disasters and emergency situations often fill a community with turmoil, chaos,

and the fear of the unknown due to the confusion of the population’s current state. These events

bring about incredibly trying situations that test an individual’s physical and emotional strength

and stability. Whether it is emergency-induced problems (grief, non-pathological distress, or

depression and anxiety disorder), or humanitarian aid-related problems (anxiety due to

information about the relief effort, i.e. food distribution, shelter locations etc.), survivors of a

natural disaster are suddenly overcome with life-consuming worries that have the ability to alter

their future. As these worries and the terrifying memories of the disaster continue to dwell within

the individual and the community, it often brings about emotional and psychological distress

within those who are suffering. This distress has the ability to completely dominate one’s life,

making it harder to make it through each and every day. Though these psychological effects are

so powerful over those struggling, many people are unaware of the true lengths that it goes to

and the trauma it causes. As the media excitement begins to die down from these disasters a few

weeks or months afterwards when people begin to see the physical reparations in action, the

emotional wounds within the survivors do not go away even as homes are rebuilt and power is

restored. As shown by the long-term effects of these wounds, it is imperative that the public does

not forego their interest in these relief efforts or their passion for helping these communities to

recover. Just being able to withstand such damaging events shows incredible strength within the

survivors; it is time that the public and surrounding populations do their best to use the resources

they have to provide these struggling communities with whatever additional strength and
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stability they may be lacking. Rebuilding infrastructure and healing broken bones is not enough

to adequately heal a broken community following the disastrous effects of such a natural

catastrophe. These citizens need long-term care and support in order to holistically heal from

their trauma and to better prepare them for the future in case disaster decides to strike again.
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