Providing mental support in times of disaster

Mental health is health, but it is usually treated as a byword of physical ailments. The disparity gets wider when climate-related disasters like Tropical Storm Ana strike. The storm affected one million people across southern Malawi in January 2022.
In the worst-hit district of Chikwawa, mentions of severe floods caused by the rainstorm evoke memories of the 46 people confirmed dead, 275 injured, and 18 people reported missing.
However, the trail of destruction left unseen scars in the minds of survivors.
Health Surveillance Assistant Sydney Lapika faced the survivors' mental agony, giving them psychosocial first aid at Nchalo camp and its ravaged villages.
He recalls: "The storm struck amid the COVID-19 pandemic, which has disrupted the livelihoods. Many people had lost jobs, loved ones, and businesses to the pandemic and its disruptive preventive measures.
"Then came the heavy rains that fell for three days non-stop, causing floods that left the affected with maddening losses. Thousands who fled their falling homes struggled with the shock of putting up in congested camps with limited access to water, sanitation, and privacy. Many needed mental support to cope with the misfortune and the new normal." 
In April, Lapika was trained in mental health and psychosocial support (MHPSS), including psychological first aid (PFA), skilled health workers, police officers, child protection officers, and community victim support unit members. UNICEF provided the training under the Umoyo Wathu UN Joint programme, through the District Social Welfare Office (DSWO) with funding from Foreign Commonwealth and Development Office. 
The HSA says the capacity-building opportunity helped the team work together to lessen the burdens and burning issues disturbing the affected population's mental well-being.
"Tropical Storm Ana caused untold misery as some survivors lost everything to floods: Their homes, food, sanitation facilities, livestock. We learned to work as a team and help the whole person physically and psychologically," says Lapika. 
The psychosocial first aid sessions helped traumatised survivors release their pent-up fears.

"While providing psychosocial support, we got to understand the devastated survivors' losses, fears and hidden stories, including gender-based violence which surges during emergencies such as COVID-19, Tropical Storm Ana, and Tropical Storm Gombe," says Lapika.
The privacy required for psychosocial pep talk helped the change agents collect information about sexual violence and challenges seldom discussed in public.
"Psychosocial first aid prepared the survivors to understand that not all was lost and return home with the hope to start rebuilding. Others freely confided in us what they were going through, including GBV," explains Lapika.
The social protection team was trained to refer GBV cases to relevant authorities for action.
For instance, if child protection officers, camp leaders, and community victim support members encounter allegations of sexual abuse, they swiftly report to the police. The law enforcers quickly engaged health workers for checkups to ascertain the alleged sexual attacks and give the survivors necessary assistance, including pills that avert an unwanted pregnancy and HIV infection.
If the tests confirmed a sexual attack, the police were expected to take the matter to court, where the health workers would tender the findings as part of the evidence.  
"Psychosocial support gives counsellors access to people's minds and stories that would remain untold if no one gave them an ear or paid attention to what they and how they behave," says Lapika. 

The duty-bearers trained in mental health and psychosocial support became the eyes and ears of the district's social protection system to benefit the vulnerable. 
 "If we neglect the mental needs of people in despair, we can lose lives, and some can commit suicide, while others can develop mental disorders. Many lose interest to eat and interact with friends," Lapika states.
Child protection officer Lysan Mangasanja says there was no time to waste in the mental health response.
 "When we get a report that a child had been affected, we rush to the place and inform relevant duty-bearers to take it up urgently," he says.
The insights from the psychosocial first aid helped create a safe school environment for teachers and learners hit hard by COVID-19 and the cyclones.

In many schools, teaching and learning stopped for over a week following Cyclone Ana.
Peter Magwira, the Assistant Centre Manager at Nchalo Teachers Development Centre, recalls the lamentations of learners and teachers gutted by the emergency.
"Cyclone Ana left me overwhelmed as teachers and learners had lost their homes, possessions, and school materials to the floods. I remember that school came to a stop. Where learning continued, attendance was low. However, it was no secret that their minds were not on school work but the problems haunting their hearts and families," says Magwira.
The mental health tips proved vital in restoring the hope and confidence of those who needed them most. 
Magwira hopped from school to school, assisting learners and teachers in the path of destruction.
"When I got to school, I interacted with teachers and looked at attendance. If the children were fewer than the enrollment, I asked the teachers to explain the disparity before reaching out to the children as individuals or in groups.
The burning issue?
"From their concerns about disruption of schools, there is a need to construct more evacuation centres so that survivors do not occupy schools when floods occur. The children also want urgent replacement of the books, uniforms and other educational basics destroyed by floods."
UNICEF donated books, pens, recreational facilities, and school-in-a-box accessories to various schools and children's corners in Chikwawa and other affected districts.