Lost Family Members Research Articles

A qualitative analysis of factors impacting resilience among youth in post-conflict Liberia

BackgroundIn 2008, 5 years after the Liberian civil war ended, there were an estimated 340,000 orphans in Liberia, 18 % of the total child population of the country. Given that children make up half the population and that these children experienced significant trauma and loss both through direct exposure to the war and then to the Ebola epidemic, and indirectly as a result of the trauma experienced by their parents, the recovery of these children is essential to the recovery of the nation as a whole. The goal of this research was to identify factors contributing to resilience among youth in post-conflict Liberia. Resilience was defined as evidence of adaptive functioning and psychological health.MethodsSeventy-five young people (age 13–18) in the capital city of Monrovia, Liberia were recruited in 2012. Semi-structured interviews were conducted, and demographic data were collected. Interviews were then transcribed and coded thematically.ResultsForty-six of the participants were attending school, and 29 were not enrolled in school. Youth enrolled in school demonstrated greater adaptive functioning. This was particularly true for boys in any school setting and girls attending private school. Youth not attending school were more likely to have lost family members or become estranged from them, and many were also engaging in substance use. Emotion regulation, cognitive flexibility, agency, social intelligence and, in some cases, meaning-making were found in participants who showed resilient outcomes.ConclusionsCaregiver relationships mediate the development of psychological capacities that impact resilience. These findings suggest that youth who have lost a caregiver, many of whom are not attending school, are experiencing a significant ongoing burden in terms of their daily functioning and psychological health in the post-war period and should be the focus of further study and intervention targeting substance use and community reintegration.Trial registration Partners Healthcare IRB Protocol# 2012P000367.

Combinational losses of synucleins reveal their differential requirements for compensating age-dependent alterations in motor behavior and dopamine metabolism

Synucleins are involved in multiple steps of the neurotransmitter turnover, but the largely normal synaptic function in young adult animals completely lacking synucleins suggests their roles are dispensable for execution of these processes. Instead, they may be utilized for boosting the efficiency of certain molecular mechanisms in presynaptic terminals, with a deficiency of synuclein proteins sensitizing to or exacerbating synaptic malfunction caused by accumulation of mild alterations, which are commonly associated with aging. Although functional redundancy within the family has been reported, it is unclear whether the remaining synucleins can fully compensate for the deficiency of a lost family member or whether some functions are specific for a particular member. We assessed several structural and functional characteristics of the nigrostriatal system of mice lacking members of the synuclein family in every possible combination and demonstrated that stabilization of the striatal dopamine level depends on the presence of α-synuclein and cannot be compensated by other family members, whereas β-synuclein is required for efficient maintenance of animal's balance and coordination in old age.

The Transformation Process in Nurses Caring for Dying Patients.

Despite the recent increase in attention to end-of-life hospice care, little empirical evidence regarding the process of emotional or mental transformation in caregivers is available. This study explores the transformative process that occurs in nurses because of the spiritual suffering and conflict associated with after caring for dying patients. A phenomenological approach was used to investigate eight nurses (27-40 years old) working in the hospice ward of a medical center in Taipei. Data were collected through open-ended questions using semistructured interviews and were analyzed reflectively. A three-stage transformation in the emotional processes of participants was observed. In the first stage, the participants experienced acute emotional suffering because of facing the death of their patients, potentially exacerbated by their own memories of losing family members. In the second stage, the participants adopted coping strategies to improve self-care. These strategies included attempting to soothe patients, helping patients face or deal with unfulfilled business, and participating in funeral or memorial services. In the third stage, the participants learned to provide better care through emancipatory reflection and a reassertion of responsibilities toward the self, patients, and patient families. After the third stage, the initial emotional impact morphed into a medium for self-strengthening, and participants became more adept at detecting patient needs and at providing care to complete the transformational process fully. Emotional suffering was the primary factor that induced participants to transform their personal and professional selves. Adequate emotional self-management, dialogue with other nurses, and personal reflection are crucial actions that nurses may use to cultivate personal growth, implement ethical practice, interact with other nurses, and engage in personal reflection. Strategies such as caring for patients, implementing reflective nursing practices, focusing on patient needs, and utilizing past experiences enable nurses to develop a heightened sense of responsibility and awareness, thus empowering them to take better care of themselves and their patients.

Prevalence and Predictors of Somatic Symptoms among Child and Adolescents with Probable Posttraumatic Stress Disorder: A Cross-Sectional Study Conducted in 21 Primary and Secondary Schools after an Earthquake.

PurposeTo explore the prevalence rates and predictors of somatic symptoms among child and adolescent survivors with probable posttraumatic stress disorder (PTSD) after an earthquake.MethodsA total of 3053 students from 21 primary and secondary schools in Baoxing County were administered the Patient Health Questionnaire-13 (PHQ-13), a short version of PHQ-15 without the two items about sexuality and menstruation, the Children's Revised Impact of Event Scale (CRIES), and the self-made Earthquake-Related Experience Questionnaire 3 months after the Lushan earthquake.ResultsAmong child and adolescent survivors, the prevalence rates of all somatic symptoms were higher in the probable PTSD group compared with the controls. The most frequent somatic symptoms were trouble sleeping (83.2%), feeling tired or having low energy (74.4%), stomach pain (63.2%), dizziness (58.1%), and headache (57.7%) in the probable PTSD group. Older age, having lost family members, having witnessed someone get seriously injured, and having witnessed someone get buried were predictors for somatic symptoms among child and adolescent survivors with probable PTSD.ConclusionsSomatic symptoms among child and adolescent earthquake survivors with probable PTSD in schools were common, and predictors of these somatic symptoms were identified. These findings may help those providing psychological health programs to find the child and adolescent students with probable PTSD who are at high risk of somatic symptoms in schools after an earthquake in China.

‘Victim/volunteer’: heroes versus perpetrators and the weight of US service-members’ pasts in Iraq and Afghanistan

How might military service members figure as perpetrators of human rights violations? The question remains a taboo, painful and suppressed topic in United States’ face-to-face communities with strong veteran and active-duty presences. Our 2008–2014 ethnographic, team-based anthropological fieldwork focused on a mid-sized American city and its adjacent army base. We argue that the ambiguities and contradictions between soldiers-as-perpetrators and more common and public designations for soldiers and veterans – as heroes, protectors and volunteers, but also as victims of circumstance and injury – impede such exploration. War as a framework for legitimising lethal force complicates what constitutes perpetration, as do the implications of all-volunteer forces fighting protracted campaigns. The legacy of the Vietnam War brings key historicity to civilians’ efforts to not repeat the a priori victimisation of veterans as presumed perpetrators, alongside recognition that the signature, psychological and moral injuries of the post-9/11 wars also can render veterans as victims in the public's perspective. Finally, as counterpoint to the generalised avoidance of confronting rights violations, we draw on a journalist's account of a veteran who sought to face an Iraqi victim who lost family members directly; their mutual victimhood is sharply qualified by the civilian's innocence and the veteran's willing volunteerism.

Resilience and Healing Among Cambodian Survivors of the Khmer Rouge Regime

In this article the author presents a qualitative study about resilience and healing among Cambodian survivors of the communist Khmer Rouge regime. The database of the Documentation Center of Cambodia (DC-Cam) was used to analyze 30 stories of people who survived but lost family members during the Khmer Rouge regime. The participants acted as civil parties in the Cambodian tribunal involving a trial of “Duch,” the head of Tuol Sleng prison or (s21), where survivors’ relatives were interrogated, tortured, and killed. Participation in the DC-Cam investigations and in the trial were seen as healing, resiliency factors. Resilience is a person–environment concept that addresses how people and societies overcome/recover from adverse or traumatic events. Resilience was revealed here through people's narratives of critical events that occurred at the personal, interpersonal, sociocultural, and societal levels. Thus, the participants’ stories allow us to hear the “truth” of these experiences, how they have made meaning of them, and how they mustered their personal and environmental resources to deal with overwhelming demands (Gutheil & Congress, 2000). Findings suggest that participants attained closure and a sense of justice as a result of their interacting with DC-Cam staff and giving testimony to the tribunal.

Cross-sectional study of social support and psychological distress among displaced earthquake survivors in Japan.

This cross-sectional study aims to explore the relationship between different types and sources of social support and psychological distress by age and sex among survivors living in temporary housing 10 months after the Great East Japan Earthquake. Self-reported questionnaires/structured interviews administered from January to March 2012 recorded demographic characteristics, damage involving participants' families, social support, and psychological distress. Data on 296 participants aged 20 years or more from nine temporary housing complexes in Otsuchi were analyzed; K6 scores indicating psychological distress averaged 5.1 (standard deviation, 5.9; range, 0-24). Multiple logistic regression analyses indicated differences among types and sources of social support with regard to psychological distress by age and sex among disaster survivors. For men aged less than 65 years, social support by family was related to lower psychological distress. For women aged 65 years or more, emotional support from family, informational and instrumental support, and social companionship from friends in their own temporary housing complexes were related to less psychological distress. Differences in age and sex were related to different sources of social support in relation to psychological distress. It is necessary to pay more attention to those who lost family members in the disaster, especially men aged less than 65 years. It may also be necessary to support survivors in making friends when they relocate to temporary housing, especially women aged 65 years or more.

The Aesthetics and Ethics of Faith: A Dialogue between Liberationist and Pragmatic Thought by Christopher D. Tirres

Reviewed by: The Aesthetics and Ethics of Faith: A Dialogue between Liberationist and Pragmatic Thought by Christopher D. Tirres Tad Bratkowski (bio) Christopher D. Tirres, The Aesthetics and Ethics of Faith: A Dialogue between Liberationist and Pragmatic Thought. Oxford, UK: Oxford University Press, 2014. 223 + xi pp. ISBN 978-0-19-935253-1. $63.78 (hbk.) From the title and subtitle of Christopher D. Tirres’s book, we already ascertain that the work addresses four discrete philosophic disciplines or traditions: American pragmatism, Latin American liberation, aesthetics, and ethics. And at first glance, each of the four does not evoke an immediate connection to the other three, but Tirres is capable of putting them into a genuine conversation. Tirres’s book is organized into eight chapters, with the first and eighth serving respectively as a succinct introduction and conclusion. I will analyze these eight chapters as three separate yet interrelated projects. In the introduction, entitled “American Faith in a New Key,” we find a concise statement of his wide-ranging project of connecting liberation theology to pragmatism and aesthetics to ethics. He states: “The challenge . . . becomes how best to reconnect a vision of faith practice that takes seriously cultural identity and popular aesthetics, on the one hand, with a vision of faith practice that is tied to the idea of concrete change and civic activism, on the other” (7). In his second chapter, Tirres gives a detailed, practical description of this aesthetics of faith in action. He recalls his experiences as an observer of the Good Friday services at the San Fernando Cathedral in San Antonio, Texas. The most elaborate of these liturgies is the via crucis, in which actors recreate Jesus Christ’s trial and crucifixion through San Antonio’s streets with thousands of onlookers. Yet Tirres pays just as much attention to a smaller service on Good Friday evening. In the Pésame, an actress portraying the Mother Mary grieves for her son and, in turn, consoles parishioners who lost family members in the past year. Through these liturgies “the aesthetics of ritual blend into ethical concerns” and they serve to “reference the resurrection less as a supernatural event and more as a recurring, everyday reality” (38). I will return to his practical account of ritual later to evaluate this project’s success. In chapters 3 through 5, Tirres undertakes his bridge-building project between Latin American/American Latino theologies and classical American pragmatism. Chapter 3 centers on the thought of several Latino theologians, such as Alejandro García-Rivera, María Pilar Aquino, Ada María Isasi-Díaz, and Roberto [End Page 119] Goizueta. Tirres ties these thinkers into the aesthetics of faith by noting that U.S. Latino theology takes an “aesthetic turn” in which these thinkers abandon “a ‘detached’ view of aesthetics or religion” in order to “root [their] work in particular histories, stories, artistic forms, and ways of life within the Latino/a context” (55–56). This chapter ends with an introduction to key concepts in pragmatism, such as habit, problematic situation, and instrumentalism. The focus of chapter 4 is Tirres’s fusing of pragmatic aesthetic experience with Latino theology’s religious experience. Dewey’s empiricism is nonreductive, consisting of qualitative moments in experience’s stream rather than atomistic sense data. Hence, Tirres notes that experience includes intermittent moments of aesthetic “undergoing” and moral faith as ethical “doing” (91–92). At the same time, “pragmatism offers a theory of religious faith that is not beholden to institutional forms of religion” (96). However, Tirres suggests that James’s and Dewey’s accounts of faith fail to disclose the social dimensions of religion, and on this issue, the Latino experience can help to strengthen pragmatism (98). This project continues in chapter 5, where Tirres turns his attention to the Latina ecofeminism of Ivone Gebara. Tirres once again builds mutually beneficial bridges. Pragmatic epistemology’s focus on inquiry complements Gebara’s contextualism and holism. At the same time, her unique insights can aid in projects pragmatists find favorable, such as deconstructing rigid doctrine, critiquing dichotomies, and finding creative solutions to practical problems (128). Whereas the project of chapters 3 through 5 is building new pathways between pragmatism...

Psychological aid in crisis and emergency situations: Psychological follow-up by emergency-related professionals

IntroductionThe development of contemporary society, the mass media, and new technologies improves living standards on the one hand and, on the other, enhances the risk of large-scale catastrophes, accidents, and natural disasters (Yanitsky, 2004). From year to year the number of people who survive natural disasters and human-caused accidents and catastrophes is growing, as is the number of professionals involved in disaster-relief operations, such as rescuers, medical professionals, and psychologists. The 1990s saw the intensive development of new work for psychologists: rendering psychological aid to people affected by emergencies. During that time, because of a shift in the political system and the democratization of society, these issues gained a public dimension.The Center for Emergency Psychological Aid of EMERCOM of Russia became one of the first subdivisions within the law-enforcement (security) agencies whose task was to provide psychological aid to the injured (Vorobjev, 2001). Subsequently, it sparked the promotion of a unique work stream within the psychological service of law-enforcement agencies consisting of psychological follow-up in rescue and emergency-response operations; this work involved the implementation of a set of measures aimed at stabilizing the sociopsychological environment in the emergency area, providing emergency psychological aid to the injured, and preventing negative sociopsychological implications for the sufferers and the professionals from EMERCOM of Russia (Shoygu, 2012a).As early as the First World War the necessity for developing special forms of emergency short-term assistance was articulated. At that time the primary objective of psychiatrists operating in the front-line hospitals was the recovery and reactivation of the officers and men (Fedunina, 2006).Objectives and scope of emergency psychological aidAt a later time, when extreme conditions no longer applied to normal life and when emergency-related experiences ceased to be an unavoidable component of human development, people who were affected by extreme factors without being specifically trained professionals were identified as the injured (sufferers); in many cases they were in need of medical and psychological aid (Dmitrieva, 2003). By systematizing and analyzing the experiences of psychologists working in extreme circumstances a classification of victims was devised (Shoygu, 2007):* directly affected people, isolated in emergency beds* people affected in a material or physical sense as well as people who lost family members and relatives or lacked information about them* witnesses: people residing in close vicinity to a place of tragedy* speculators* participants in disaster-relief operations.Through the use of continual and numerous observations, the psychogenic responses and disorders arising in extreme circumstances can be split into two groups: those with and those without psychotic symptoms (Alexandrovsky, Lobastov, & Spivak, 1991). According to the observations of professional psychiatrists, psychotic symptoms are rare (Reshetnikov, Baranov, Mukhin, & Chermyanin, 1989). Longitudinal studies of the delayed psychogenic implications of catastrophic events led to the conclusion that a maximum degree of immediate aid is necessary (Shoygu, 2012a).Coincidently, according to the estimations of professionals, only dining the 20th century, did such diverse events as earthquakes, floods, volcanic eruptions, hurricanes, tsunami, tornados, fires, avalanches, mudflows, and epidemics deprive over tens of millions of people of life (Vorobyev, 2000). This situation led to the emergence of an independent area in psychological practice -- emergency psychological aid -- the focus of which is a human being who finds himself/herself in extraordinary, extreme circumstances. This practice can be defined as short-term aid to human beings following a severe, negative, stressful impact (distress). …

Inaccuracy and Testimonial Literature: The Case of Loung Ung's First They Killed My Father: A Daughter of Cambodia Remembers

In his 2001 review essay of three survivor accounts of the Cambodian genocide (1975-79), Sody Lay criticizes Loung Ung’s First They Killed My Father: A Daughter of Cambodia Remembers (2000) for historical and cultural inaccuracies, calling Ung’s testimonial text “a sensationalization and over-dramatization of the Killing Fields experience” (“Cambodian” 173). Lay not only accuses Ung of consciously manipulating her story for “the sake of making a buck,” but he also questions her status as a Cambodian: “Given Ung’s lack of memory and her apparent disdain for everything Khmer, it is not only ironic but misrepresentative for her book to be subtitled ‘a daughter of Cambodia remembers’” (181). The Khmer Institute Web site, which Lay co-founded and for which he serves as Executive Director, has published scathing reviews of Ung’s book with similar accusations regarding historical inaccuracies and cultural inauthenticity. One group of reviewers examines a section in First They Killed My Father in which the Ung family takes a trip in the early 1970s to Angkor Wat, pointing out that such a trip was impossible because the area was a battle zone at that time. The reviewers then note that Ung miscalculates Cambodia’s Angkorian period (from approximately the ninth to the fifteenth centuries) when she wrote that “Angkor Wat was built by powerful Khmer kings as monuments of self-glorification in the ninth century and completed three hundred years later” (Ung 67), reducing this seven-hundred-year period to half of its length. The reviewers conclude: “A true ‘daughter of Cambodia’ would not be so careless as to provide such blatantly incorrect information about these [Angkor Wat] temples, as they are an integral part of Khmer heritage and pride” (Hor, Lay, and Quinn). However, such harsh criticism does not take into account the impact on survivors such as Ung of losing family members, being separated from their homeland, and struggling with a new language and culture in an attempt to build a new home thousands of miles away from Cambodia, in a place with unfamiliar customs and rituals. Furthermore, not every Cambodian American has had identical experiences. In attempting to make sense of this controversy, we must explore how to take Lay’s charges into account while still valuing Ung’s memoir. This essay begins with a discussion of the Lay-Ung controversy in the context of the Cambodian diasporic community, paying close attention to the politics of representation and our need for multiple and diverse representations. Teri Shaffer Yamada’s work on Cambodian American autobiography informs the discussion of Ung’s First They Killed

Labelle: Funk, Feminism, and the Politics of Flight and Fight

For now he knew what Shalimar knew: if you surrendered to the air, you could ride it.Toni Morrison, Song of SolomonFlyyyyyy!Patti LaBelle, Somewhere over the RainbowPart I: Flight-Breath, Movement, ElsewheresLabelle, the powerful funk/rock/soul group that performed and recorded from 1971 to 1977, had the power to shake up the room. Make the walls thump with their voices. Liftfolks up till they soar. On a 1975 appearance on Soul Train, at the height of the group's popularity, the audience watches transfixed, forgetting to pose. Listening, they move together, individuality somehow melded into one more coordinated body. The bass thumps in their chests and carries them out and onto the dance floor, and we, too, feel the beat deeply. It carries even thirty-five years later. These are not some demure girl group. These are some kind of funky jungle birds, soaring, flying over the audience with their voices, giving them chills.Within moments of constraint, often linked to the material world of sexism, poverty, and loneliness, we find a consistent sonics of flight and transcendence in 1970s R&B/ funk/rock trio Labelle's music and performances. We hear the sonics of flight in Labelle's voices: Patti's long-held, soaring opening notes, the use of Sarah and Nona's background voices to circle, support, and uplift, the driving use of repetition and improvisation in the songs' endings-all aspects of virtuosity, an African-derived aspect of the jazz aesthetic. In Labelle's distinctly Afrofuturistic and feminist work, the black female body itself becomes a technology for flight. As Mark Dery defines it in his influential essay Black to the Future: Afro-Futurism 1.0 (Dery, 1995), Afrofuturism is the self-conscious appropriation of technology in black popular culture in order to think out problems of imaginative freedom in the past, present, and future. We might think of this technology in familiar terms-images of space travel, computer enhancement of voice like vocoders-or in less obvious ways-the African drum, the phonograph, the microphone. Labelle's use of voice, as well as rocking funky dance, combined with incisive lyrics bring to Afrofuturism a black-feminist informed critique of race, sexuality, and gender. The technologies of their highly theatrical performances, including elaborate stage shows and costumes-and not the least, the microphone-make heightened use of the black body, bringing to the fore its survival and flourishing. At the same time that Labelle makes outrageous and amazing use of technologies, they could not do so without the body itself-the body's movements, its sensuality, the body's breath as it lifts others and sends them into flight. We see in Labelle's vocal and dance performances the ability to transcend the merely human toward the spiritual. Labelle uses these powerful tools to move across the constraints of genre, and to push past racialized codes of gender, drawing from the styles and histories of the past, and envisioning a freed-up future for its audiences.In many ways, Labelle's ability to capture these moments of flight come from the hard work and insight from a career of struggle and deep immersion in the business of making music. Interviews with the group reveal a foundational sense of neighborhood and family for each of the women, but also experiences of struggle and risk: childhood poverty and violence for Hendryx, losing family members to cancer and diabetes for Labelle, and for all three, navigating the often financially and emotionally exploitative aspects of the music business, handling racial segregation on the road, and the sometimes sexism of the chitlin' circuit.Patti LaBelle, born Patricia Louise Holte on May 24, 1944, began singing at age fourteen, at the Beulah Baptist Church, where she soon began garnering solos. She formed the Ordettes, her first group, in 1958, where she was joined by her future Labelle partners, Sarah Dash and Nona Hendryx, in 1959. …

Dancing Embodied Memory: The Choreography of Place in the Peruvian Andes

Dancing Embodied Memory: The Choreography of Place in the Peruvian Andes

Prolonged grief disorder three decades post loss in survivors of the Khmer Rouge regime in Cambodia

During the Khmer Rouge (KR) regime from 1975 to 1979 millions of Cambodians were confronted with the death or murder of family members. The long-term psychological consequences of these traumatic losses have not yet been investigated. The purpose of this study was to determine the rate and potential predictors of prolonged grief disorder (PGD) in survivors of the KR regime. The Inventory of Complicated Grief-Revised (ICG-R) was administered in a sample of N=775 Cambodians in face-to-face interviews who had lost at least one family member during the KR regime. Symptoms of PTSD were assessed with the PTSD Checklist-Civilian Version and symptoms of depression and anxiety with the Hopkins Symptom Checklist-25. The prevalence of PGD in the sample was 14.3%. PGD was moderately associated with symptoms of depression, anxiety and PTSD. The loss of a spouse, a child, or a parent was associated with higher symptom severity of PGD than was the loss of a sibling or distant relatives. PGD was predicted by the relationship to the deceased and symptoms of depression and PTSD. Limitations of the study include the non-random sampling recruitment. The ICG-R has not been validated for use in Cambodia. The vast majority of Cambodians lost family members during the KR regime. Even three decades later, PGD was prevalent in a substantial proportion of the present sample and related to other psychiatric disorders. The results underline the importance of examining PGD in studies of war-related psychological impairment.

Assessment of the posttraumatic symptoms among survivors for three years following Wenchuan Earthquake

To investigate the incidence of posttraumatic stress disorder (PTSD) and its influencing factors for three years following the "5.12" Wenchuan Earthquake. A systematic sampling of 870 subjects who came from Beichuan (605 persons) and Jiangyou (265 persons) areas were investigated by adopting subscale of PTSD Checklist-Civilian Version (PCL-C) and Social Demographic Questionnaire. The incidence rate of PTSD was 8.5% (74/870), the incidence rates of PTSD for the area of Beichuan and Jiangyou were 11.2% (68/605) and 2.3% (6/265) respectively. Subjects from Beichuan had higher PTSD incidence rate compared to Jiangyou (P < 0.05). The prevalence of PTSD for female and male were 11.8% (55/465) and 4.7% (19/405) respectively, female had higher prevalence of PTSD compared to male (P < 0.05). The incidence rates of PTSD for victims who suffered from major property lost and those who lost less were 13.3% (62/466) and 3.0% (12/404) respectively, victims suffered major property lost had higher incidence rate of PTSD(P < 0.05). The incidence rates of PTSD for victims who lost family members and those did not were 13.4% (45/336) and 5.4% (29/534) respectively, victims who lost family members had higher incidence rates of PTSD (P < 0.05). The posttraumatic symptoms for survivors who suffered from PTSD mainly focused on the symptoms of reexpericement and over vigilance, the prevalence rate was 100% (74/74). Exaggerated startle response, intense psychological distress and physiological reactivity were higher than others in total 17 symptoms, accounting for 96% (71/74), 94% (70/74) and 90% (67/74). The logistic regression showed that being female, victims who suffered from major property lost, lost family member in this earthquake were the risk factors of PTSD, and the values of OR (95%CI) were 2.746 (1.580 - 4.772), 3.616 (1.871 - 6.988) and 1.805(1.057 - 3.084), respectively. Posttraumatic symptoms were still common among survivors three years after "5.12" Wenchuan Earthquake. Survivors in Beichuan (heavy hit area), female victims, victims who suffered from major property lost, victims who lost family member need more social and economic support.

Building Blocks and Stumbling Blocks: Peacebuilding in Aceh, 2005–2009

Building Blocks and Stumbling Blocks: Peacebuilding in Aceh, 2005–2009 Craig Thorburn1 (bio) Introduction The August 2005 Helsinki Memorandum of Understanding (MoU) between the Government of Indonesia and the Free Aceh Movement (Gerakan Aceh Merdeka, GAM) formally brought an end to nearly thirty years of violent conflict in Aceh. Since then, Aceh has been largely peaceful, and major strides have been achieved in laying the groundwork for lasting peace and social and economic recovery and development in the province. The twenty-nine year rebellion and counterinsurgency wrought terrible deprivation and suffering for the majority of the province’s population, causing nearly 30,000 deaths. The conflict damaged and destroyed infrastructure and productive assets, disrupted economic activity, and bred rampant corruption and extortion. Despite the province’s abundant natural wealth, the poverty level in Aceh remained among the highest in Indonesia.2 In the period following the demise of President Suharto’s New Order government in 1998, numerous attempts were made to negotiate an end to the conflict, but none [End Page 83] lasted more than a few months.3 It was not until after the catastrophic Indian Ocean tsunami of December 2004 that the government of Indonesia and GAM were able to negotiate a lasting peace. GAM leaders in Aceh and abroad all lost family members in the tsunami, contributing to their resolve to prevent further loss of life in the province. Indonesia’s political leaders, as well, were moved to overcome their differences with GAM for the greater good of helping the Acehnese people to rebuild their lives and livelihoods. The presence of large numbers of international aid organizations and workers involved in the tsunami recovery effort opened the province to international scrutiny, helping to push both sides to the negotiating table. In an opinion piece published in the New York Times the day after the signing of the accords, President Susilo Bambang Yudhoyono said, Peace in Aceh was a priority that I publicly set for myself during last year’s presidential campaign and after my government took office in October. But the real political opportunity came knocking only after the tsunami last December.4 Government negotiators were authorized to bring important new offers to the table, including a significant realignment of the economic relationship between Aceh and the Indonesian central government; amnesty for GAM fighters; release of political prisoners and detainees; and permission for Aceh-based political parties to contest elections.5 In return, GAM negotiators agreed to drop their demand for Acehnese independence, accepting instead provisions that mandated significantly increased self-government for the province.6 Mediator Martti Ahtisaari’s insistence on the principle that “nothing is agreed until everything is agreed” distinguished this negotiation from previous attempts, and surely contributed to its lasting success.7 The historic accord was signed by Indonesian Justice Minister Hamid Awaluddin and GAM Chairman Malik Mahmood in Helsinki on August 15, 2005, ushering in a new era of peace in Aceh. In spite of the long duration and high level of violence and destruction of the Aceh conflict (and unlike post-conflict situations in many other parts of the world), institutions and capacities needed to lay the foundations for sustainable peace and development were largely in place at the time the accord was signed. In Aceh itself, although a significant proportion of the population experienced some form of victimization during the conflict, there were not major population dislocations, and village and other local institutions still functioned. Provincial and district government structures were intact, though operating at sub-optimal levels. As in conflict zones worldwide, Aceh’s government was characterized by high levels of corruption and poor service delivery. Nonetheless, structures were in place at the time of the signing that provided a viable starting point for rebuilding effective local government in Aceh. [End Page 84] Indonesia is a successful democracy, with a robust economy. The national government was able immediately to mobilize political and fiscal resources to support the peacebuilding process. Numerous international donors already had a presence in Aceh, supporting the massive tsunami recovery effort there. Some of these agencies initiated new peacebuilding programs, and a small portion of excess tsunami recovery funds was redirected to assist conflict-affected...

Disaster’s Scope Impeded Psychiatrists’ Best-Laid Plans

Back to table of contents Previous article Next article Clinical & Research NewsFull AccessDisaster’s Scope Impeded Psychiatrists’ Best-Laid PlansAaron LevinAaron LevinSearch for more papers by this authorPublished Online:6 Jan 2012https://doi.org/10.1176/pn.47.1.psychnews_47_1_15-aAbstractThe Great Eastern Japan Earthquake on March 11, 2011, along with the ensuing tsunami and the subsequent explosions at three nuclear power reactors at Fukushima, left much physical and human damage in their wake, reported Japanese psychiatrists at the annual meeting of the International Society for Traumatic Stress Studies in Baltimore last November.More than 15,000 people died, nearly 6,000 were injured, and 3,700 remain missing.Jun Shigemura, M.D.The disaster workers who responded to the scene, and who continued working in the area for many months afterward, were among the hardest-hit groups, said Jun Shigemura, M.D., Ph.D., of the National Defense Medical College in Tokorozawa, Japan.“Disaster workers were not only exposed to traumatic events but had heavy workloads and bore high expectations from the rest of Japanese society,” said Shigemura, listing a number of affected groups: police, military forces, firefighters, coast-guard personnel, nuclear-plant employees, civilian government officials, construction workers, and-medical and dental professionals.Many recovered bodies were held pending identification in temporary morgues. Shigemura described meetings with mortuary workers responsible for 500 unidentified bodies in a single warehouse. He sought to destigmatize the workers’ acute responses to the tragedy and to handling the resulting bodies, and he helped supervisors understand the stresses borne by these workers.Nuclear-plant workers were under particular stress, he said. They worked six days on and three days off and often slept in the plants wearing their protective clothing. Many had already come close to death, having survived the tsunami, the explosion, and the release of radiation. Some had lost coworkers, family members, and homes and were additionally burdened by public criticism and guilt for being among the perpetrators of the nuclear part of the disaster.Radiation Complicated ResponseNational health authorities will need to allocate additional resources to counteract this increased stress and higher prevalence of mental health disorders among the disaster responders, said Shigemura.The radiological dimension of the disaster added to the complexity of the response, said Yoshiharu Kim, M.D., Ph.D., of the National Center for Neurology and Psychiatry in Tokyo.“Anxiety about radiation can develop independently of actual pollution,” he said. “So the scientific idea of ‘safety’ is different from the psychological sense of ‘security.’ ”As a result, it is important for health authorities to integrate psychosocial support with provision of information about radiation well beyond the known geographic limits of increased radioactivity, he pointed out.Lessons Learned From Prior DisasterAs bad as the disaster was, the mental health response might have been worse had it not been for the lessons learned from a previous massive earthquake that struck the city of Kobe in January 1995, said Hiroshi Kato, M.D., Ph.D., of the Hyogo Institute for Traumatic Stress in Kobe.Workers in protective suits and masks wait to enter the emergency operation center at the crippled Fukushima Dai-ichi nuclear power station in Okuma, Japan, last November.Credit: AP Photo/David Guttenfelder, Pool“Before the Kobe quake, the suffering of survivors was overlooked because people were habituated to disasters and bore them with silence, avoidance, and patience,” said Kato. “ ‘Gaman’—endurance—is a very important attitude in Japan.”The nation was better prepared to offer mental health support for survivors after the March earthquake, but was handicapped by the sheer scope of the damage, said Kato. “Many survivors lost family members, and people couldn’t put their lives back together because the loss of infrastructure destroyed their livelihoods as well.”The mental health response system developed after Kobe depended on public-health nurses providing outreach, since they were already close to local people and thus were able to reduce the stigma some people felt about seeing higher-level mental health professionals. After the 2011 disaster, however, regional health centers were evacuated or severely damaged, said Kato. In addition, many health workers were among the disaster’s victims. Thus, increasing the mental health workforce on such short notice was difficult. Long-term funding was allocated for more mental health workers, but there were not enough professionals available for the short term. ISSUES NewArchived

Heterogeneous Effects of International Migration and Remittances on Crop Income: Evidence from the Kyrgyz Republic

This paper uses a unique representative household budget survey from the Asian Development Bank to analyze the impact of international migration and remittances on crop income of rural farmers in the Kyrgyz Republic. Unlike other studies we allow the impact of remittances to be different for farmers with different land size and test whether reduced labor availability is more relevant for permanent than for seasonal migrants. We find that losing family members has a significant negative effect on crop income, but only for permanent migrants. Remittances partially compensate for this, but their positive impact decreases with farm size.

Heterogeneous Effects of International Migration and Remittances on Crop Income: Evidence from the Kyrgyz Republic

This paper uses a unique representative household budget survey from the Asian Development Bank to analyze the impact of international migration and remittances on crop income of rural farmers in the Kyrgyz Republic. Unlike other studies we allow the impact of remittances to be different for farmers with different land size and test whether reduced labor availability is more relevant for permanent than for seasonal migrants. We find that losing family members has strong negative effect on crop income, but only for permanent migrants. Remittances partially compensate for this, but their positive impact decreases with the farm size.

Mental health and quality of life survey among child survivors of the 2008 Sichuan earthquake

To characterize child survivors' mental health and quality of life after a massive earthquake. A population-based survey of 596 children aged between 8 and 16 years was conducted in the severely affected areas of the earthquake, using a multi-stage systematic sampling design. The point prevalence rates of posttraumatic stress disorder (PTSD) and depression among the child survivors aged between 8 and 16 years 15 months after the earthquake were 12.4 and 13.9%, respectively. Health-related quality of life (HRQoL) was found to be strongly and negatively associated with PTSD and depression. Children who had lost family members were most likely to develop PTSD (OR = 6.6; P < 0.001) as well as depression (OR = 4.1; P < 0.001). Children who reported no utilization of mental health services were four times more likely to suffer from PTSD than those who did not (P = 0.002). More than one in five child survivors were identified as having PTSD or depression; HRQoL of these identified children were deeply compromised. Utilization of mental health services may significantly reduce the risk of developing PTSD symptoms.

Are the elderly more vulnerable to psychological impact of natural disaster? A population-based survey of adult survivors of the 2008 Sichuan earthquake

BackgroundThe association between ages and psychological impact of natural disasters has not been well characterized. A population-based study was conducted 15 months after the 2008 Sichuan earthquake to assess whether elderly survivors were more likely to develop posttraumatic stress disorder (PTSD) and general psychiatric morbidity.MethodsA population-based survey of 327 survivors (152 elders, 175 younger adults) was conducted in severely affected areas by the earthquake, using a multi-stage systematic sampling design.ResultsCompared with the younger adult survivors, the elderly were more likely to have symptoms of PTSD (22.5% vs. 8.0%, p = 0.001) and general psychiatric morbidity (42.0% vs. 25.4%, p = 0.003). Risk factors, such as being elderly, having been in serious danger, having lost family members, and having felt guilt concerning one's death or injury were significantly associated with developing PTSD; being elderly, having family members or friends seriously injured, and having felt guilt concerning one's death or injury were significantly associated with developing general psychiatric morbidity. Utilization of mental health services is strongly associated with the decreased risk for developing both of the symptoms.ConclusionCompared with the younger adults, the elderly survivors were more likely to develop PTSD and general psychiatric morbidity. More mental health services should be distributed to the elderly and groups at particular risk, to ensure their smooth mental health reconstruction after the earthquake.