Taking care of Marabut's mental health
MANILA, Philippines – First, do away with politics.
It was the last thing Lourdes Ignacio wanted to deal with after Super Typhoon Yolanda (international name Haiyan) left much damage in the Visayas last November 2013.
STORIES ON MENTAL HEALTH AFTER YOLANDA:
- WHO: Mental health problems emerging in Yolanda-hit areas
- Yolanda a year after: Many still suffer grief, depression
- Post-Yolanda: Community support key to mental health
Like many members of aid groups, she along with her team from the World Association for Psychosocial Rehabilitation (WAPR) Philippines went south to see where and how they can help.
Knowing the shortage of psychiatrists in the country, they wanted to train health workers to detect severe mental health issues, but it had to be in a community of willing learners.
They traveled from Leyte to Samar, searching for the right place. There were affected areas with too much politics, areas where aid is already brimming, and areas where health workers couldn’t care less.
And then there was Marabut, in Samar, where the mayor expresses gratitude in grand gestures, and the municipal health officer is not only open to learning but has leadership to pass what was learned to barangay health workers.
"The chances of [the project’s] success is there,” Ignacio told Rappler. So off they went, to a 5th class municipality and a coastal community of 20,000 people and 24 barangays.
It was just as devastated as the next municipality, and everyone had stories to share – even the barangay captains themselves who lost their livelihood as coconut farmers.
At first, Ignacio’s team listened to the stories. But beyond listening, what they really wanted was to help strengthen community mental health services in Marabut.
"What happened? It's really just the entry of a psychosocial program to a devastated town where the essence of helplessness is really very strong,” she said.
Focusing on one place was perfect for the year-long project funded by CBM.
Care for caregivers
During WAPR's 5-day training for health workers last June, Marabut Mayor Percival Ortillo Jr sent as many health workers to participate, from the municipal health office down to the barangay health stations.
But even these health workers experienced the wrath of Yolanda, so the team from WAPR had to conduct psychosocial processing, which involves 3 things: allowing people to talk about their feelings and how they are coping, and allowing them to come up with a short-term plan.
COMMON MENTAL DISORDERS IN MARABUT (by age group):
- Children: mental retardation
- Adolescents: anxiety disorders
- Adults: schizophrenia
- Elderlies: depressive disorder
Today, the health workers are reaching out to all barangays of Marabut, capable of detecting early signs and symptoms of mental conditions in need of further support and medication. They are being followed-up monthly by WAPR.
To date, more than 50 patients in Marabut were found to be suffering from depression, anxiety and panic, chronic psychosis, epilepsy, and mental subnormality.
WAPR learned most of these patients already had mental health problems before Yolanda, but they never sought consultation and remained untreated.
"I am anticipating there will be more consultations this November, being the anniversary month. Naturally, unspeakable memories will resurface and may compromise a survivor’s functioning temporarily. This is expected and is normal,” Elizabeth Santos, also from WAPR Philippines, told Rappler.
The World Health Organization (WHO) estimated over 800,000 people in Yolanda-hit areas have suffered different mental health conditions over the past year, with 80,000 requiring further medication and support.
Health workers are not alone in promoting mental well-being in Marabut. Self-help groups exist wherein community leaders bring patients to consultations, thus removing the stigma that comes with mental disorders.
Other groups are also coming in to provide housing, scholarships, and livelihood to residents of Marabut.
“The mental health program is not just about listening to problems. We are not there to just handle the consultation of those with mental health problems, we are there to promote mental well-being through collaboration with other groups that could provide livelihood, education for children, and safety,” Ignacio explained.
Last October, Ignacio presented the success story of Marabut before health ministers during the 65th session of the WHO Regional Committee for the Western Pacific.
Coming from a disaster-prone country with “limited” mental health services, Ignacio emphasized on the need for a long-term perspective when it comes to mental health.
“We are developing a mental health service in the community by [training capacity building of community health workers] because the framework is [this]: mental health care in general health care is the way to go to address the mental health problems of the community,” Ignacio said. – Rappler.com
For Rappler's full coverage of the 1st anniversary of Super Typhoon Yolanda (Haiyan), go to this page.