Suggestions to help take care of the emotional health of Singaporean relief workers going to tsunami-hit areas

Thursday, 30 December 2004 @ 03:39 PM SGT

Contributed by: Gatekeeper

This is an article from:
Ronnie Koh
The Network for Strategic Missions
+65 9 336-2324

Dear friends: Here are some suggestions forwarded by Dr Kelly O'Donnell to help take care of the emotional health of Singaporean relief workers going to tsunami-hit areas. Dr O'Donnell is a member care/mental health consultant associated with Member Care Associates-Geneva. Please disseminate to churches and organizations that are sending relief teams. Thank you.

1. Distinguish between a few types of helpers, and how you want to support them. I am assuming most would be in the first category. There are lots of
overlap between the two categories of course.
(a.) those providing relief work for victims/bereaved--caring for physical needs
(b.) those providing psycho-social support for victims/bereaved--like debriefing, counselling
(c.) another category of often overlooked are people to assist (in order to also prevent secondary trauma), is to help support those that are coordinating the services from afar or especially those on site.

2. Type of screening/orientation done for church-related people wanting to fly to help

Are potential relief workers personally stability?
Do they have any past experience in crisis-related areas?
Are they physically hardy?
Do they have any serious medical or emotional condition?
Do they have vaccinations for water-borne disease and other physical hazards?
Any problems to getting their physical needs met on location such as clean water, reliable food, shelter, clothing to wear?
Do they need to sign legal-related forms/disclaimers?
Will they be given overall orientation to the specific setting, crisis work, normal stress
reactions in oneself and in the victims, etc.?

Preparation in advance is critical and will help things run more smoothly right through to the follow-up. CIB--or Critical Incident Briefing is
important. Some helpful summaries are on various web sites such as Mobile Member Care Team
www.mmct.org

3. Cooperate and coordinate as much as possible , in advance and on-going, with international relief agencies; so make sure the church group is connecting with a group that is well organised/experienced and/or with local contacts on site.

4. Perhaps there could be one centralized body that could be asked to take on the role of being a central information point and debriefing organiser if they want to;
Someone needs to be a communication coordinator to send regular updates to those at the churches that send out teams. Essentially, a crisis
coordination group (three to five people from different agencies) could form to help coordinate or at least help track with the teams being sent
out, and to monitor the adjustment of the teams/people when they return.

5. To pro-actively prevent unnecessary struggles/anxiety, etc. daily "defusings" on site are usually done, where workers come together as a group and have a chance to rest in a quiet place, briefly share together, listen to updates etc. In addition, a small group support structure and buddy system can provide encouragement and a way to catch anyone who may be struggling and/or succumbing to stress.

6. If a trained mental health professional or someone with experience in recognizing worker-stress could go, that would be helpful.

7. I like the idea of going through group debriefing upon return to Singapore; make it mandatory as a condition for going to help; and organizing folks in Singapore that can help provide this debriefing; within a few days of returning.

8. Remember, the issue is not developing Post Traumatic Stress Disorder so much as it is being aware of normal responses to stress and being aware of a variety of anxiety-related symptoms that can result.

9. Meeting together a month or so after folks return to further process the whole experience and to support positive adjustment (and to catch anyone struggling) is extremely beneficial. Subsequent meetings may be helpful as well and can be discussed at the one month meeting. So maybe meet again a month after debriefing.

10. Wondering if anyone from Singapore is planning to provide psych-social support, in addition to the physical help, to victims.

11. Operational debriefs/review are also helpful too, in addition to the more "emotional" debriefs discussed above.

Ronnie Koh
The Network for Strategic Missions
+65 9 336-2324

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Here is additional info from Dr. Doug Dickens, a trainer for NOVA (National Organization for Victims Assistance) and who was initially trained by the Critical Incident Stress Foundation. He is also a member of an American Red Cross disaster team.

(1) I have just checked the www.mmct.org/resources.htm site and think it has good, concise articles which you can print quickly. You might also check www.emedicine.com/emerg/topic826.htm (especially sections 5-8) for a quick overview of helpful information.

(2) Utilize these two resources and incorporate appropriate faith issues into discussions.

(3) I believe that it is important that every person on every team meet daily (team by team) to "defuse"; or discuss what they have done and experienced EACH DAY, and to pray for each other, for victims, and for other helpers. Of course, the pre-departure meetings to prepare them (as though we really can!!) and the return trip debriefing... perhaps monthly for several months.

(4) One of the things I believe you will see with your teams is what is referred to as a "trauma membrane." Those persons who have shared in these common experiences may find themselves more willing to share with each other­and after a while not so willing to talk meaningfully with others who have not been a part of their experience. That may be ok, as long as some exclusive "club" of Good Samaritans does not occur driving a wedge between those who could go and help and those who could not. (I think you get the drift of that conversation).

(5) Of course, for many of us who, thousands of miles away have been exposed via television to constant images of the tragedy... we (and especially our younger children) become "vicitimized" without being aware of it. Children of your team members should certainly be talked to in a way that they know that their parents will be safe and return home safely... younger pre-adolescents especially don't have the abilities yet to process cognitively what they are experiencing via media on other levels.

Ronnie Koh
The Network for Strategic Missions

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