Report 4: June 22, 2008, Sunday
The Cost of Care
Dr. Sing-Kiat Ting, a clinical psychologist who specializes in cross-cultural clinical care, and I just completed a week of full-time, intensive clinical training in Shanghai for 61 psychiatrists and psychologists from all over China (see photo). We have been meeting twice a year since 2006 with this same group of clinicians at the Shanghai Mental Health Center to provide training in psychotherapy.
This time (June 2008), the recent earthquake tragedy impacted both the attendance and focus of the clinical training sessions. About 15 of our regular training participants had been called to Chengdu to address the psychological needs of earthquake survivors. Altogether, the government has mobilized thousands of mental health and other professionals to serve 2-4 week rotating shifts in Chengdu.
In addition, because of the urgent psychological needs experienced among refugees of the earthquake, our training focused on disaster response and treatment for post-traumatic stress disorder. Almost all of our training participants had already treated survivors or expected to do so in the near future. Several participants who had been among the first mental health providers to serve in Chengdu shared their first-hand and very moving experiences with the class.
For example, a child psychologist named Dr. Wang recounted her experiences at a soccer stadium that served as shelter for many thousands of survivors. Her difficult task was to comfort and provide support for children who had lost their parents. The children she identified as most in need were those who were not playing with others and who avoided eye contact. She related how she would get down on their level, sit with them awhile, and just try to be supportive and caring – to see if there were any needs she could help meet. It was heartbreaking for us to hear how most of these children who had suffered such loss would just sit still, slumped over, with their heads down. They spoke in such low voices as if to indicate that they didn’t want or deserve any attention. While Dr. Wang said she did the best she could, the needs of the children weighed heavily on her. She told our class that the only way she got through it was to find a quiet place where she could be alone to recharge – away from the sadness and chaos of the stadium.
Another of our trainees, Dr. Liu, lives in Chengdu and was there during the earthquake. As director of a local mental health clinic, she immediately offered her services to the local authorities. During the turmoil following the earthquake, mental health services were not yet coordinated and it was sometimes difficult to provide services. But she said that her husband, who had a small factory north of the Chengdu epicenter, had an even more difficult task. Mobilized by the government to lead his company’s fleet of 60 transport trucks, he was asked to help move bodies from the earthquake area to burial sites or crematoriums. The images of what he and his employees saw became unbearable. Dr. Liu said her husband now has terrifying nightmares and cannot sleep through the night. As Dr. Liu spoke, she broke down in tears, and the class took time to comfort her.
The psychological needs from this disaster will be severe – not only for the refugees but also for those who work with them. Many survivors say they will never be the same, and they are right. But those who reach out to provide care and services can be traumatized, too. My heart goes out to all the mental health workers and others who are serving people in desperate need. My hope is that they will have time for rest and recovery along the way and, perhaps, an opportunity to debrief with colleagues before returning home.
|
