Even as a trained psychosocial nurse, Akemi Nitta is at a loss to try to capture in words the overwhelming impact of the emotions she faced, supporting grieving survivors as they identified the bodies of loved ones in the Japanese Red Cross Society's hospital in Ishinomaki.
"I don't know what words I can use to describe those people's situation best,” she said. “Whatever words we have used to talk about previous disasters, these descriptions seem totally inadequate to describe this situation.”
For more than a week, Nitta worked as part of an eight-member team of dedicated psychosocial workers in the hospital following the disaster. One of their primary responsibilities was looking after the families, whose loved ones were deceased.
"It's not a matter of accepting or not accepting this person's death; people don't have a choice,” Nitta said. “They just have to face the situation.”
Amid the despair and numbness, there were shades of hope and comfort. In one family, a son brought the body of his 70-year-old mother to the hospital, not knowing whether his brothers were alive or dead. The next day, they appeared at the hospital, having heard that their mother was there.
"She brought us here to meet up again," one of the siblings said.
With nowhere else to lay bodies but in the car park of the hospital, some families want to take their loved ones back to a resting place at home. For many, however, nothing was left of their home after the tsunami.
The Japanese Red Cross Society is also offering counseling and emotional support to survivors who have lost their homes and traditional way of life. The Japanese Red Cross has 2,400 nurses nationwide trained to give psychosocial support following major emergencies.
Many of the sources of comfort that help people come to terms with the death of a loved one are simply impossible to find in the aftermath of a tsunami, such as looking at a picture of a loved one or hearing their last words.
"The hurt of the people in this situation is so great, they can't feel anything,” she said. “So when things return to normality a bit, the emotions will burst out. People will feel anger, sadness and frustration that they can't take anywhere. At that stage, there should be somebody or some system there to receive those emotions."
In such a situation, it’s all too easy for even trained psychosocial workers to feel inadequate.
“I could only do my best, that’s all I can say,” said Nitta, speaking of her difficult occupation. “I was beside the families, and I felt affection for them and I cried.”
Clearly, the emotional wellbeing of Japanese Red Cross Society's own personnel is itself an issue requiring careful attention. After the employees and volunteers finish shifts, their own emotional state is evaluated and support is offered, if needed.
Experts say that it's important to recruit local people to carry out psychosocial support in order for them to be able to relate to survivors in their familiar dialect. There's also a need to ensure that the techniques are adapted for special needs. A high proportion of the survivor population is elderly, for example.What is psychosocial support? Psychosocial support is an integral part of the Red Cross international emergency response. Doctors, nurses and counselors help disaster survivors prevent distress and suffering from developing into something more severe, cope better, adapt to changes in circumstance, and resume their normal lives. It helps individuals and communities heal the psychological wounds and rebuild support structures after an emergency or another traumatic event, which can help transform people into active survivors rather than passive victims. Read more...
"It's important to introduce community activities such as exercises, as well as their normal habits, such as chatting and drinking tea. Older people also need health advice because that is their worry. But they also need some peaceful time too," said Dr. Jeyathesan Kulasingam, a Red Cross delegate with experience in health and psychosocial support programs following the 2008 Sichuan earthquake in China, where the welfare of the elderly was also a major concern.
Psychosocial support will be a vital part of the humanitarian response as the Japanese Red Cross Society continues to meet the needs of the hundreds of thousands of survivors of this disaster. This type of aid will be needed beyond the immediate aftermath; counseling will be critical for months and even years.