A Decade of Disasters: Lessons from the Indian Experience

Abstract

Over the past decade, India and the United States of America have experienced a number of traumatic mass disasters that have tested their resources in responding to the needs of individuals in distress, survivors, and communities. India experienced sectarian riots in the state of Gujarat in 2002; a massive and unprecedented tsunami on December 26, 2004, which killed some 10,000 persons along the Tamil Nadu coast from Nagaputanim to Chennai; and, more recently, a series of earthquakes in Kashmir. The United States has been traumatized by terrorist attacks on the World Trade Center and Pentagon (the second and third attacks on the World Trade Center) on September 11, 2001, and a series of massive storm events, most notably Hurricane Katrina on August 28, 2005. Disasters, both natural and man-made, defy prediction but can be anticipated. India has learned from past disasters that there are necessary responses, both in terms of the physical needs of shelter, food, and immediate medical attention, as well as the emotional needs of both the shortand long-term psychosocial rehabilitation. India has trained teams standing at the ready and working in the present disaster-affected areas, which could ensure immediate support in the event of a subsequent disaster, whenever it might occur. By contrast, the U.S. seems to be surprised, even in denial, that it could be vulnerable to such events. There are lessons to be learned from the Indian experience of preparedness to mass disasters. On the night of December 2, 1986, forty tons of cyanate gas escaped from the Union Carbide chemical plant in Bhopal. The disaster, which caught India completely by surprise, left 2,000 dead and some 200,000 people suffering long-term consequences. At the time of the disaster, there were no psychiatrists in Bhopal, the mental health aspects of the disaster were poorly understood, and, fearful of litigation and compensation, many administrators and health workers took complaints to be factitious. Teams of psychiatrists, psychologists, and psychiatric social workers were dispatched to Bhopal to treat survivors and to train general medical officers. They documented confusional states, reactive psychoses, anxietydepression, and grief-reactions as immediate consequences. Long-term consequences included various disabilities, uncertainties about the future, broken social units, and problems related to rehabilitation. A paradigm shift toward the community-based psychosocial support model happened after Orrisha Super-Cyclone in the year 1999, which left more than 10,000 people dead and a million people with broken homes and hearts. In this disaster, community level workers, middle-aged people from the community, were trained on basic psychosocial aspects and were supported by social workers. Medical professionals were trained on disaster mental health to provide support to those with higher mental health needs where pharmacological intervention was required. Similar models were put in place after the Gujarat earthquake in 2001 and the Gujarat riots in 2002, the South Asia tsunami in 2004, and the Kashmir earthquake in 2005. All of these experiences have shown that the community-based approach to providing psychosocial care is the most beneficial and practical means of ensuring support for everyone.