Last year's earthquake in Gujarat, which occurred a year ago last Saturday, resulted in widespread but neglected mental health problems, a conference of non-governmental organisations and mental health specialists meeting in Ahmedabad, India, concluded last week.
The massive earthquake killed between 14 000 and 20 000 people, damaged over 1.2 million houses, and affected almost 8000 villages in Gujarat, west India. More than 3000 health facilities were destroyed, including a 281 bed district hospital, a 16 bed mental hospital at Bhuj, and 239 health centres.
Doctors, health workers, and representatives of non-governmental organisations who attended the workshop—organised by Oxfam India, Actionaid, and experts from the National Institute of Mental Health and Neurosciences—thought that mental health problems arising from the earthquake, though neglected, were rampant.
“Such problems could roughly be affecting some 30% of the affected general population,” Rangaswamy Srinivasa Murthy, professor of psychiatry at the National Institute and editor in chief of the WHO's World Health Report 2001, told the BMJ.
“From the studies reported in this workshop, it seems to be higher in the disabled persons and as high as 70-80% in the resettlement colonies,” he added.
A study by Oxfam India in Anjar, 30 miles east of the quake's epicentre in Bhuj, indicated that 100% of school students and 75% of teachers reported a psychological problem. Symptoms of anxiety, depression, sleeplessness, avoidance of total contact with the outside world, and suicidal tendencies are some of the manifestations of psychological problems, said Professor Murthy.
The key factor affecting disaster response, he added, remains a lack of government policy. Although official statistics state that 17 000 people were operated on and some 167 000 were treated at various makeshift facilities, non-governmental organisations allege that lack of postoperative care has serious effects, with many people developing gangrene and then requiring amputation.
“With each passing day, the disability load is increasing and adding to psychosocial stress,” said Dr P V Unnikrishnan, coordinator for emergencies, Oxfam India. Unsafe blood transfusions and instances of surgeons using a single instrument on scores of patients without disinfecting are likely to cause another HIV disaster, he warned.
The Latur earthquake in Maharashtra in 1993 witnessed a similar scenario and now ranks second to Mumbai in HIV infection.
Figure.
PA/EPA
Dazed and confused: a survivor sits in an Ahmedabad hospital