Go to these links to see Dr Raj Persaud's work around the world in psychiatry where he collaborates with Mental Health Workers all over the world. The item below is from the Action Aid Website at this link
http://www.actionaid.org.uk/101155/raj_persaud_sees_cyclone_sidr_aftermath.html This item below is from the Action Aid website.
Raj Persaud sees Cyclone Sidr aftermath
15 February 2008
In the wake of Cyclone Sidr which struck Bangladesh on Thursday 15 November, ActionAid took Consultant Psychiatrist Dr Raj Persaud out to the stricken areas to see the devastation caused and meet some of those people worst affected.
Dr Persaud also met mental health professionals who are working on the ground with ActionAid to assess and deal with the psychological needs of those traumatised by the devastation and loss of their loved ones.
One of the most severely affected villages was Padma, on the Bay of Bengal, a 15-hour drive from Dhaka. Trees were uprooted, fishing boats and buildings destroyed and livestock washed away. Sixty villagers died there, and the bodies of another fourteen have never been found.
Children's drama therapy
Rusho, one of the therapists, said: "There are a number of children here who are very traumatised. Some cannot remain standing, some have become uneasy, some have become restless and some have become stiff. There are some children who cannot hold a pen properly now.
"The image of waves and pain of losing family members have disturbed them psychologically."
It is with thanks to the tireless efforts of Rusho and his colleague, Reza that they have taught the children to laugh and play again.
Mental Health in Bangladesh
Across Bangladesh, there are only 100 psychiatrists to look after a population of 140 million. Between 50 and 60 of those are based in Dhaka which leaves around 40 for the rest of the country.
Providing psychological care to alleviate some of the trauma associated with major disasters is vital in ensuring the long-term recovery of those most affected.
Dealing with psychological issues from the outset helps those caught up in disasters to recover more quickly and contributes to long term stability at a community level.
Go this link to watch videos of Raj observing Action Aid's work in Bangladesh
The item below is from The Daily Star Newspaper
The Healing of Minds
It's important to put into perspective the colossal impact that Cyclone Sidr had on our people. Thousands of people lost their lives during this natural disaster. Those who managed to survive lost their homes and their families. The process of rebuilding all that has been destroyed is a long and tedious one, if it does happen at all.
In addition to these more obvious effects, the victims of Sidr are also suffering from another side effect of the natural disaster that ruined their lives -- that of mental trauma, which is an aspect of medical and health care that most developing countries do not believe that they have the luxury to explore. The psychological trauma that victims of such disasters go through can sometimes scar them for life and prevent them from picking up the pieces and carrying on.
We are a culture that shies away from any form of mental illness. Perhaps it is because like most other people, we fear the unknown. However, one of the main reasons cultures such as ours do not prioritise either the state of a single individual's or a collective nation's mental health is because we feel that there are 'bigger things to worry about.' In a nation where the majority of the population is starving and below poverty level, how relevant is people's mental wellbeing?
Dr. Raj Persaud, Consultant Psychiatrist at the Bethlem Royal and Maudsley Hospitals and Gresham Professor for Public Understanding of Psychiatry in the UK, believes that mental health is extremely relevant. He gives two different examples of how poor mental health affects a person's behavioural patterns, which can in turn affect a person's every day life. “If a fisherman, for example, after the cyclone, were to develop a phobia of water,” he says, “he would in turn lose his livelihood. Also if one were to lose their child or family, the chances that they will not go for aid are higher. I also noticed that mothers who lost their sons were so devastated that they could not properly care for their daughters who are very much alive and need that care. It is imperative to work on people with these different mental traumas and try to bring them to a level where they can perform their daily functions.
“Another very interesting thing is that apparently, when the alarm sounded that the cyclone was coming people did not go to the shelters. Their whole attitude is that similar alarms have come before and nothing happened. It's these behaviour patterns that are linked with the study of mental health.”
According to a research survey coordinated by the National Health Institute in Bangladesh, 16% of the population in Bangladesh suffers from some kind of mental disorder. The percentage went up to an alarming 80% after Cyclone Sidr. Dr. Persaud, also a programme presenter of the BBC Radio series, Travels of the Mind, recently visited the affected areas of South Bangladesh (Bagherghat), to oversee a 'psychosocial programme' administered by ActionAid, which in addition to providing health care, shelter and food like other organisations, is going the extra distance by also studying the effects that Sidr had on the mental state of the people in those areas.
According to ActionAid's press release about the programme entitled 'Mind care should find a priority for cyclone survivors' -- ActionAid programme to address psychosocial needs of the survivors is expected to boost confidence and resilience, "In the cyclone-hit areas, ActionAid team members came across children who complained about repeated nightmares." The programme will not only work with the victims of Sidr but also provide training for the community volunteers and relief workers, such as skill building and orientation for teachers. In addition they will work hands on with the community and involve them in various street plays and skits which will not only positively influence children but also provide them with an outlet.
“Addressing the mental health and psychosocial needs of the survivors is crucial in any mass calamity,” says Dr. Unnikrishnan PV, Emergencies & Conflicts Advisor, ActionAid International, from Dhaka. “Our experience of working in similar disaster situations shows that an early intervention that is rooted in the community can heal the shock and trauma as well as fasten recovery.”
Dr. Persaud also worked in a similar programme organised by ActionAid in Chennai after the Tsunami, in which he studied the psyche of the population -- were they more psychologically resilient to disaster, or were they, as a result of all these disasters, more vulnerable and fragile. While comparing his experiences in both places he says, “Bangladesh and Chennai were very similar but I find that Bangladesh faces worse problems, especially considering that India's economic growth is stronger. Also Bangladesh is subjected to recurring natural disasters and there is political instability which affects the mental health of the people as a whole. At the time of crises, the people, or a nation need an authority which provides them with hope and optimism. What I think has happened in Bangladesh is that the people do not believe in the system, and have lost faith.”
Dr. Persaud also felt that in addition to the mistrust and disappointment felt by the people towards authoritative figures, there are also various cultural obstacles such as the 'set-in-stone' gender roles, which are so rigidly followed that a man or a woman can and will be punished and ostracised from the community if they break out of it. “There is a massive intolerance among the people about people who are not following their roles as men and woman,” he says.
However, despite the obstacles that he encountered on the way, Dr. Persaud still felt that the programme was helpful to the people in the affected areas, especially because he was working with such dedicated staff. “I found that there was incredible community solidarity among the people of Bangladesh,” he says. “I was also very impressed with the extremely skilled therapists we had at the programme, they went about their job with such commitment and enthusiasm.”
Dr. Persaud and ActionAid collectively worked together for the past few months to come up with a cognitive programme before he came to Bangladesh on January 24 to study the programme's implementation. Although the idea is certainly different and unique, the concept of healing the mental health of natural disaster victims leads us to new questions. Is mental health in Bangladesh a 'neglected ailment?” After all, for these victims, once they get their lives back on track, they will still be left with the pain of losing a loved one, the emptiness of starting everything over again. Perhaps keeping mentally healthy might not solve the basic problems, such as where their next meal will come from, or how they will manage to keep shelter, or even what they will do if this disaster reoccurs. But it is important to also prioritise their mental health as well as their physical needs, so that they can remain strong enough to survive the many trials and tribulation that they have to suffer through every day of their lives.
Dr Raj Persaud FRCPsych