By IPS Correspondents
JAKARTA, Apr 6 2005 (IPS)

Over a 100 days have passed since the Dec. 26 tsunami killer waves struck, wiping out over 290,000 lives. Though bodies have been cleared away and the homeless have found other places to live, the mental health of women tsunami survivors in the worst hit Indonesian province of Aceh remains precarious.

According to Indonesian psychologists working in Aceh, humanitarian organisations continue to ignore the psychosocial needs of this vulnerable group.

”Acehnese women are being left out,” Livia Iskandar-Dharmawan, public co-ordinator of Trauma Recovery and Psychosocial Intervention Foundation, told IPS.

”While there are many aid agencies focussing on Acehnese children, very few organisations are giving emphasis to the plight of women in the province,” Dharmawan said.

Psychologist Suryo Dharmono agreed.

”Until now, there are no clear psychosocial programmes for the rehabilitation of women tsunami survivors in Aceh,” she said in an interview. ”Women tsunami survivors in Aceh are confined to doing domestic chores only and have no outlet to release their stress.”

Azwar named the United Nations Population Fund (UNFPA) as one of the very few organisations that are assisting women tsunami survivors in Aceh.

But Amanda Melville, United Nations Children’s Fund (UNICEF) child protection officer in Aceh, said many organisations are focussing on children because they are more prone to trauma than adults.

”Besides, it is easier to set up play activities for children than for adults,” Melville said, adding ”it is difficult and complicated to work with grown-ups”.

Psychologists pointed out that trauma counselling, recreational support and income- generating activities for the recovery of women tsunami survivors in Aceh are not being implemented in the province.

The only ”healing” activity for women tsunami survivors in Muslim-dominated Aceh, according to psychologists, is praying, reading the Quran, and reciting Islamic prayers.

”Women tsunami survivors in Aceh should be given appropriate attention as well,” said Stephanus Indradjaya, national programme officer of World Health Organisation- Indonesia.

”We have to minimise their stress and build their self-esteem,” Indradjaya said, adding that one way to reduce their stress and develop their self-esteem is to provide them with a livelihood.

Psychologists lamented that women tsunami survivors in Aceh have become all the more stressed out, as their role had been limited to providing care to their husbands, children and orphans.

About 80 percent of the Dec. 26 tsunami casualties in Aceh were women and a number of those who survived now have psychological problems, which range from anxiety to depression.

Sondang Sidabutar, Aceh co-ordinator of the Trauma Recovery and Psychosocial Intervention Foundation, pointed out that in one village in Aceh there were around 200 women before the tsunami. After the tsunami, only 15 women survived.

”The women in Aceh are overworked, as they have to cook, do the laundry and serve other people,” Sidabutar said, adding that the situation makes them more susceptible to the development of mental disorders.

Health workers said limited access to basic services also contributes to the trauma suffered by the tsunami survivors.

According to the government, around two million Acehnese survivors are expected to be in need of psychosocial support and up to 400,000 Acehnese may have trauma-related stress disorder requiring skilled mental intervention.

Currently, there are 400,376 internally displaced people in Aceh, 250,000 of whom are living with host families. The remaining are in temporary tents or public buildings such as offices, schools, mosques and barracks.

”Tsunami survivors in Aceh who are suffering from trauma-related stress disorder most of the time don’t know what to do and where to go,” said psychologist Dharmono. He said he often receives text messages on his mobile phone from Acehnese asking about simple coping mechanisms for trauma and where they should go for psychosocial support.

The Ministry of Health reported that many mental health personnel in Aceh perished in the killer waves and those who survived are also suffering from trauma, which in turn affects their performance.

Other competing programmes such as those in reproductive health, nutrition, child health and communicable diseases also overwhelm health care providers in tsunami-ravaged Aceh.

Among different levels of government, co-ordination is still weak and not all decision- makers put psychosocial support and mental health as a priority. Health workers lamented that Indonesian authorities and the international community are giving much emphasis on reconstructing infrastructure rather than the mental health of the tsunami survivors.

”Psychosocial and mental health provision should complement humanitarian work, starting in the first days and weeks of the relief effort, and should continue and be translated into substantial interventions through the rehabilitation and reconstruction phases,” said Pandu Setiawan, the Ministry of Health’s director for community mental health.

In Indonesia, there are about 7,000 psychologists. Of this, only 200 are clinical psychologists and between eight to 10 are assisting tsunami survivors in Aceh.

”The number of psychologists in Aceh is definitely not enough,” said Indradjaya of WHO.

Addressing the shortage of psychologists, the Ministry of Health deployed mental health professionals to train community leaders in Aceh, including teachers and religious leaders on how to provide psychological first-aid and psychosocial support. So far, around 320 people have been trained in the capital Banda Aceh and Lhokseumauwe town, but the government still thinks that they are not yet competent in providing trauma counselling.

To help tsunami survivors recover from trauma-related stress disorder, the United Nations Educational, Scientific and Cultural Organisation urged health workers to include a cultural component in their psychosocial programme.

”Any psychosocial programme for tsunami survivors not only in Aceh but also in other areas should have a cultural aspect based on the traditions of the affected people,” said Himalchuli Gurung, a UNESCO programme specialist.

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