A young resident of Tacloban in the Philippines walks through some of the damage and debris left by the Typhoon Yolanda, Dec. 21, 2013. Credit: UN Photo/Evan Schneider

By Jed Alegado and Angeli Guadalupe
MANILA, Sep 8 2015 (IPS)

Jun* is in chains, tied to a post in the small house that resembles a fragile nipa hut. His brother did this to prevent him from hurting their neighbours or other strangers he meets when he’s in a ballistic mood. Jun has been like this for three years now, but since Typhoon Haiyan hit the Philippines two years ago, his symptoms have worsened.

After the disaster, Jun lost his own house, his wife and his children. This psychological distress he went through triggered a relapse of his psychiatric illness. With no one else able to take care of him, Jun was taken by his brother to their family’s house.Climate change’s health impacts are inequitably distributed with the most vulnerable sectors like the elderly, children and pregnant women having the least capacity to adapt.

But since his brother is working and the other people in the house are their old, sickly and frail parents, no one can control Jun during his manic episodes. He has not been able to maintain his medications because his family can’t afford them and the free supply at the local health center doesn’t come consistently. For these reasons, the best option left for Jun’s brother is to put him in chains.

Impacts on mental health

A few more cases like Jun exist in Tacloban City and most likely, in other areas of the Philippines as well – both urban and rural. Typhoon Yolanda (also known as Typhoon Haiyan) struck the country on Nov. 8, 2013. It was a Category 5 super-typhoon with wind speeds ranging from 250 to 315 kph, killing at least 6,300 people and costing PhP 89 billion in damages.

Due to extreme loss and survivor guilt, at least one in 10 people here suffers from depression. But two years after the disaster, some survivors remain unaware of available mental health services. Others complain of the poor quality of services and scant supply of medications. Many survivors who are more affluent choose to consult psychiatrists in other cities to avoid the stigma.

As with most disasters, physical rehabilitation is prioritised. This is understandable and perfectly rational, but the mental health of the victims should not be forgotten.

According to the World Health Organization’s report on the Global Burden of Disease, mental disorders follow cardiovascular diseases as the top cause of morbidity and mortality in terms of disability-adjusted life years or the number of years lost due to ill-health, disability or early death.

Yet despite the staggering number of people affected, only an estimated 25 percent of them worldwide have access to mental health services. More than 40 percent of countries have no mental health policy and mental health comprises less than 1 percent of most countries’ total health expenditures.

Nowadays, climate change brings us more frequent and devastating natural disasters. In emergencies such as natural disasters, rates of mental disorders often double. Hence, attention to mental health should be doubled as well, especially in countries highly vulnerable to disasters such as the Philippines.

Being an archipelago and still a developing country, this is not surprising. According to the United Nations University Institute for Environment and Human Security’s World Risk Index Report 2014, out of the 15 countries with the highest disaster risk worldwide, eight are island states, including the Philippines.

Ensuring health impacts in the negotiation text

Health advocates are quick to respond to this alarming issue. Groups led by the International Federation of Medical Students (IFMS) are ensuring that the issue of health and its impacts to climate change are included in the climate negotiating text.

Beginning from the Conference of the Parties (COP 20) in Lima, Peru last year which continued in Geneva last February, the group has been advocating for health to be back at the center of negotiations and in effect ensuring that parties will forge a strong climate agreement in Paris on December.

Last week’s Bonn climate negotiations – one of the few remaining negotiation days before the actual COP in December – proved to be an exercise in futility as negotiators keep dodging on the issue of a loss and damage mechanism, which, according to health advocates, is crucial for helping people affected by the health-related impacts of climate change.

According to IFMS, “there is a growing involvement of member states to include health in the negotiating text. As a group, we want to ensure that health is included in all parts of the negotiating document – preamble, research, capacity building, adaptation and finance.”

Indeed, the impacts of climate change go beyond environment, food security, land rights and even indigenous peoples’ rights. More importantly, climate change has both direct and indirect effects on health. Climate change’s health impacts are inequitably distributed with the most vulnerable sectors like the elderly, children and pregnant women having the least capacity to adapt.

Parties to the UNFCCC must see this alarming issue towards forging a fair and binding climate deal in December which will limit keep global warming below 2 degrees C and ensure adaptation mechanisms to the most vulnerable nations.

In the future, it is foreseen that wars will be fought over water not oil. Disasters nowadays may give us a glimpse of the worst to come when the staggering impacts climate change worsen and affect us in ways beyond what we can handle.

Yet, with the rapid turn of extreme weather events, what we are doing is not just for future generations. It is for us, who are living now on this planet. We are going to be the victims if we do not take responsibility as much as we can, as soon as we can.

*Name has been changed to protect his identity.

Edited by Kitty Stapp

Excerpt:

By Emina Ćerimović
NEW YORK, Jul 6 2015 (IPS)

Last week, I went to see the new flick “Love & Mercy,” about the life of Brian Wilson, a singer, songwriter, and the genius behind The Beach Boys. I hadn’t heard much about the film. In fact, I was expecting a summer movie about surfing and fun; The Beach Boys playing Kokomo, Good Vibrations, and Surfin’ U.S.A. on sunny California  beaches.

Emina Ćerimović. Photo Courtesy of HRW

I was wrong. Instead, lives of hundreds of people I’ve met unfolded on the screen.

Love & Mercy depicts Wilson in two narratives: in the first, he is portrayed at the height of his fame as the leader of The Beach Boys in the 1960s. The second features a middle-aged Wilson misdiagnosed with paranoid schizophrenia by Eugene Landy, Wilson’s therapist and legal guardian.

In the movie, Landy keeps Wilson heavily medicated as he controls every aspect of his life, including his finances, residence, family relationships and social interactions, and other basic life decisions. In one scene, Wilson talks about not speaking to his mother and daughters for years because Landy “doesn’t think it is a good idea.”

In another, Landy tells Wilson when and how much he should eat and whom he should date. Landy himself explains his influence:  “I’m the control. He is a little boy in a man’s body… It is my job, my duty to approve everyone Brian is spending time with.”Ivan and Tatjana told me that they did not consent to their confinement to an institution. They were, in fact, never asked about their preferences, wishes and wants.

Wilson did not argue against Landy taking charge for fear that Landy would have him committed to an institution. As Wilson explains in the movie: “I can’t do that [disobey Landy]. He is my legal guardian. He can do things to me… He can send me away… There’s no way out.”

As the movie unfolded, it wasn’t solely Wilson’s story that I saw on the screen. I was reminded of Tatjana and Ivan, whom I met in Croatia. They are among the 18,000 people with disabilities placed under guardianship there and denied their right to make decisions about their lives.

More than 90 percent live under full guardianship, under which the guardians – often nominated by the government – make all life decisions for them.

Tatjana was diagnosed with schizophrenia in her early 30s, deprived of her legal capacity and placed under guardianship. She is now 47 but can’t visit her daughter or her mother without the permission of her guardian – in her case, a social worker.

It is the same if she wants to move to another house, get married, sign an employment contract, make health care decisions, or even officially publish her poems. Tatjana lived for nine years in an institution against her will because her legal guardian placed her there.  

Ivan is 30 and was diagnosed with mild mental health problems. He was just 16 when he was placed indefinitely in Lopaca, a psychiatric hospital where 168 people, including 20 children, are confined. He still lives there.

Ivan and Tatjana told me that they did not consent to their confinement to an institution. They were, in fact, never asked about their preferences, wishes and wants. Both of them were stripped of their right to make decisions about their lives and appointed legal guardians.

Neither Tatjana nor Ivan was present during the court proceedings determining their legal capacity so they could  provide their input for this major decision about their life.  While guardians are supposed to only oversee decisions with legal consequences, such as signing contracts, in Croatia – just like what was depicted in Love & Mercy –guardians can monitor and control every move a person makes.

I saw firsthand that people with disabilities trapped in institutions in Croatia can experience a range of abuses including verbal abuse, forced treatment, involuntary confinement in hospitals, and limited freedom of movement.

At a pivotal point in the movie, Landy forbids Wilson and Melinda Ledbetter, his current wife, from seeing each other. That triggers Ledbetter, the true heroine of the movie, to intensify her efforts to free Wilson from Landy’s control. She learns that Wilson’s will would have awarded the vast majority of his wealth to Landy. The good news: Wilson’s family files a lawsuit successfully challenging the guardianship.

Sadly, there are no heroines to free Tatjana or Ivan of their guardians. There is a chance of a happy ending though. Croatia, unlike the U.S., has ratified the U.N. Disability Rights Treaty, which requires governments to move away from guardianship and instead provide a system of assistance and support for decision-making that respects the autonomy, will, and preferences of the person with the disability. Croatian laws, however, don’t reflect this.

Key policymakers in the Croatian government should see “Love & Mercy.” Maybe then they will abolish Croatia’s guardianship regime and provide a wide range of support measures. Who knew that The Beach Boys’ influence could go so far beyond their music?

Edited by Kitty Stapp

Excerpt: