How inclusive development works for disaster risk reduction

By Malini Shankar
Digital Discourse Foundation

When I was researching for my picture E Book – Preparing for the Day After (https://play.google.com/store/books/details?id=EbzkBQAAQBAJ) an NGO activist in Nagapattinam in Tamilnadu, India (which was battered by the Asian Tsunami and claimed 6065 souls in a fifteen minutes) told me that she was a bit perplexed and challenged how to prepare for Disaster Risk Reduction for differently abled and more importantly – for people with mental health issues. It remains a question begging for an answer from the authorities and Disaster Risk Reduction specialists.

The concept of Disaster Risk Reduction entails that the impact of a calamity in a given human landscape is reduced by making the populace in calamity prone areas resilient.

I am myself a physically challenged person. Although I have largely recovered from a childhood head injury induced-paralysis, there are things I cannot do easily… like run down a flight of stairs if the building is on fire, or run to safety if a bomb explodes behind me on the street. I often muse … that in case I have to face a landslide or a flood or a tsunami, there is no way I can run to safety. I have to just give myself up to Father Fate! But atleast as a journalist I can articulate this for a wider audience and make it count in the corridors of power.

If there is either a diabetic amputee or a person with neurological disease like say spasticism on a wheelchair stuck on say the 22nd floor of an urban concrete jungle during a fire tragedy how can caregivers escort him / her to safety? Hence inclusive DRR calls for infrastructure ramps and big service elevators to accommodate stretchers and wheelchairs. Ramps have to be a part of the fire exit in every multi storeyed building. Compromise on this reflects on transparent governance or – more to the point – lack thereof.

Things become a little more complicated when you think of the hearing impaired villager in a tsunamigenic coast off India or Indonesia. If an early warning is ‘sounded’ on the public address system … it will be beyond the grasp of the hearing impaired persons and given that hearing impaired persons usually suffer from speech impairment too, he or she cannot even ask what hit them and why is everyone running. It is likely, that usually hearing impaired persons suffer from speech impairment, their talk may be affected leaving them incomprehensible to the lay person on the street. The answer to this lies in lip synced bulletins and mock drills being broadcast. Lip synced early warning messages need to be complemented by multilingual text scrolls on broadcast media for inclusive disaster risk reduction strategies. Lip synced mock drills in every village in every district in every country or state makes hearing impaired people resilient to inevitable natural calamities and man-made disasters.

Next think of the mental health patient. Many people living with invisible mental health issues in the Orient live with it undiagnosed. Thus a person suffering from acute Bipolar disorder may not even know that s(h)e is suffering from it. Thus the question of educating the bipolar patient on natural and man-made calamities or early warning and standard operating procedure will be almost an insurmountable task.

Caregivers for people suffering from mental health issues thus need to be trained in early warning and standard operating procedures for safe evacuation of people suffering from mental health issues.

Statutory compliance for caregivers of people suffering from mental health issues needs a relook. Travel concessions and tax regimen need to be factored in for caregivers. Cabin crews in the aviation industry need to be trained in dealing with passengers with mental health issues – for subsidising caregivers’ travel will obviously be financially unviable.

During emergencies or calamities caregivers are best equipped to gauge the panic reaction of people suffering from mental health issues. Dr. K. Sekhar, registrar at India’s National Institute of Mental Health and Neuro Sciences (http://www.nimhans.ac.in/) in Bangalore, spoke exclusively to Digital Discourse “It is well established that anyone and everyone who witnesses or experiences disaster do undergo panic, numbness, freezing, withdrawn reactions. These reactions are common for an uncommon situation. Yet, it needs to be realised that the first responders are always within the family, community and the society. It becomes important that they need to respond to themselves first as well be informed, taught and trained with simple information and practical skills to take care their family members who might have mental health issues. These persons may not be able to understand or react to the gravity of the impending issue during or immediate impact of human made or natural disasters. Such simple information and practices would go a long way in empowering the individual, family and the community at large.” “Humanitarian crises have a major impact on mental health, worsening pre-existing conditions and creating new ones” says a policy brief from CBM International.

Including the needs of children in disaster risk reduction not just builds resilience in future generations but protects the needs of one of the most vulnerable sections of society.

Mock drills Dos and Don’ts need to address the comprehension and receivability of instructions for children of all diverse backgrounds. In 2009 a local Tsunami followed an earthquake near Tonga but all the adults, expecting a tsunami ran to higher grounds because they had the training; all the mortalities were of children because the children had not been included in training and mock drills. I cite from an article I wrote for the Inter Press News Service (www.ipsnews.net/) - http://www.ipsnews.net/news.asp?idnews=50530 back in 2010.

Aloysius Laukai of New Dawn FM, Bougainville, Papua New Guinea said Community Radio can help a great deal in Disaster prone areas like Papua New Guinea. Referring to the utility of Community Radio in Disaster Risk Reduction he said “In January 2010 there was an earthquake followed by a Tsunami but the children perished in the Tsunami, no adult died… because adults knew that when the Sea withdraws it portends the arrival of a Tsunami and all the adults fled to higher ground. All the unfortunate casualties were children”.

Tsunami shelters on hills near Banda Aceh in Sumatra, Indonesia. While they are located on higher ground, these fragile pillared shelters ae not really resilient to seismic forces or conform to construction code. © Dr. Sampurnananda Mahapatra

Inclusion of the needs of people living with mental health issues for disaster preparedness gives high scores for the development quotient. © Pamela Machado Creative Commons.

There are studies available today that prescribe standard operating procedure for inclusive preparedness. Some sample studies maybe found on http://www.mhinnovation.net/sites/default/files/downloads/innovation/reports/CBM_PolicyBrief_Final.pdf and http://www.cbm.org/Hurricane-Matthew-One-year-later-531985.php

There is also increasing awareness on the need for mental health care in humanitarian crises. Think of the agony and stress faced by displaced people in the civil war in Syria, fratricide in Afghanistan, the ‘war on terror’ in the Middle East, the Rohingya crisis, war in Yemen, the refugees who walked across Europe in 2015 … the people living under constant threat of war I the demilitarised zones between North and South Korea and you can imagine the impact of trauma on fragile human emotions and their mental health.

Mental Health issues are rooted in manifold disasters:

  • People persecuted will suffer from a sense of haunting for the rest of their lives. – A significant mental health issue.

  • Refugees and migrants lack of sense of stability and acceptance… a significant mental health issue.

  • People who have survived war or terrorist attacks with permanent handicap will pay a very significant emotional price triggering mental health issues.

  • The survivors of the Asian Tsunami found themselves so dumbstruck that many had lost their voices for months on end. Human relationships amongst the survivors became even more fragile than the fragile human life spans … in the aftermath of the Mega Earthquake that triggered the Asian Tsunami.

  • With the reign of terror of the Islamic State coming to an end, those foreign fighters who have survived but are distraught to go back to their homelands will need counselling to reintegrate into a peaceful society.

The need for mental health care, especially in humanitarian crises cannot be overemphasised. For, bottling up emotions is a recipe for more disasters in the future.