Sunday, April 17, 2011


This school had had 40 children studying when the tsunami hit and all of them were killed. Many schools were near the beach so it was not unusual for all of the children in a building to be killed.


One evening in Sri Lanka, we drove around the area where the tsunami hit. There were collapsed buildings, dead trees and considerable debris on the beaches. One standing building had had 40 children studying inside. All were killed when the water swept through the window. Many schools were near the beach, so it was not unusual for all the students in a school to be killed.

Our team visited a refugee camp that held 125 families with 300 children. Fifteen members of this group died in the tsunami. In the camp, the parents reported that at first, the children had nightmares and would wake up and run, shouting, “The tsunami is coming!” Certain sounds, such as a flushing toilet, would cause some of them to jump up and run away.

The Danish, in cooperation with a local nongovernmental organization, sponsored this particular camp.

The 12-by-15-foot rooms were intended for full families. The walls were corrugated metal, and the roofs were covered with plaited straw for coolness. We were told it will be more than a year before regular housing is available.

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In our training program, we had 125 teachers crowded into a room that would have been uncomfortable for 30 because of the temperature. An additional 25 or 30 other participants waited outside because we had no room for them.

All wanted to learn methods to help their students cope with the twin traumas of personal risk and loss of friends and relatives.

We found out later that 20 faith healers were mixed in with the other participants. It seems that the locals preferred going to them with their symptoms rather than the few physicians in the area. We later met with these faith healers for a separate session.

The first morning, I had a feeling that our program was becoming a disaster in itself. We statrted two hours late. Our hotel was an hour’s drive from the classroom, and our host, whose car had been leading our van, hit one of the myriad of motorcyclists plying the narrow roads. He took the victim to the hospital.

Complicating the picture, our team--Arshad Husain, child psychiatrist and director of the International Center for Psychosocial Trauma at the University of Missouri-Columbia; Judith Milner, a child psychiatrist from Seattle; and I, a psychologist-- had taken 36 hours to get from Columbia to Sri Lanka’s capital, Colombo.

Colombo was a nine-hour drive across the mountains. We avoided the better coastal roads because rebels had put snipers in the area.

The road over the mountains was one lane, making passing difficult. The road was in disrepair, with bucking-bronco bumps that prevented sleep. This was probably the most difficult ride of any I have taken in my many trips into disaster areas. As a result, we were all a bit the worse for jet lag and a lack of sleep at the start of the program.

It became clear in the first hour of our presentation that many of the psychological concepts we were talking about, such as post-traumatic stress disorder, were completely new to our audience. Our interactive teaching methods also confused the participants, who were used to straight lecture. At the end of the first morning, the question in my mind was: “Can this program be saved?”

Things began to improve in the afternoon. We asked the participants to focus on their own symptoms after the tsunami and the symptoms of their students and helped them organize those symptoms into a system.

In our team’s debriefing that evening, we decided many of our participants were themselves having post-traumatic stress reactions. We decided to scrap our published program and focus on teaching them exercises they could use in the classroom to help their students.

The next day, with a larger classroom at a different site, we taught them four methods of relaxation to deal with tension, ways to use the students as support for one another and other basic methods of reducing stress. The teachers were cooperative and responsive.

Husain experienced several traumas of his own. He had flashbacks of the motorcyclist who smashed into the window on his side of the car, hurtling through the air. One morning in the dark, he fell into a stairwell that was not protected by a railing, giving him not only swollen places on his body but also extreme caution around stairs.

We had three other training programs to run, so our time in the area was short. The team believed that because of the intensity with which the participants had applied themselves, they had gained skills that will allow them to treat victims of post-traumatic stress disorder in the area.

In the area of Sri Lanka hardest hit by the tsunami 24 of the 125 participants in our training program were faith healers. This is a faith healers hospital with beds for four patients.

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