Quake relief workers suffering emotional trauma

Since he arrived in Pakistan-administered Kashmir seven days ago, Dr Junaid Agha, 24, has found it difficult to sleep. This is due in part to the cold, the cramped living conditions in his tent and the constant bustle as new patients are brought to the field hospital set up by young volunteer doctors on the outskirts of Bagh, about 150 km from the Pakistani capital, Islamabad. But something more sinister is troubling the Karachi hospital resident doctor. “It is the nightmares I have each night, within hours of going to sleep, that keep me awake,” Dr Agha explained. “I am too scared to doze off, and of course I am exhausted now.” Dr Agha’s terrifying dreams include images of bloodied children, wailing mothers, gashing head wounds that doctors have no means to treat and bodies lying unclaimed by roadsides. These are sights he has encountered daily since coming first to Muzaffarabad, the capital of Pakistan-administered Kashmir, and then to Bagh. Dr Junaid is not alone with his demons. Other volunteers, many ill-prepared for the human despair found everywhere in earthquake-ravaged areas, have suffered just as severely. Some, working in both the Kashmir area and in Mansehra, are reportedly “swallowing sedatives by the fistful” simply to keep going. Others, such as a 19-year-old student who returned to Lahore from Bagh a few days ago after helping at a medical camp in the area, is reported to have attempted suicide. “The state of many of the relief workers themselves is a concern,” said Dr Usman Razi, 56, a US-based trauma-care specialist who returned to his native Pakistan soon after the earthquake to work among victims. “Most have no training at all in disaster situations and were completely unprepared for the horrors they encountered here. They will need months of psychological counselling to recover.” He also describes instances in which young volunteers have virtually broken down, in a state of emotional collapse, and had to be rescued themselves by being taken out of affected areas. “The fact that some of these young volunteer doctors and medical students have worked almost non stop, in some cases for over a week, getting just four or five hours of sleep each night is an added concern,” Dr Razi said. The frustrations of working without X-ray machines and diagnostic equipment, where rain drenches both doctors and patients, and vital drugs, surgical stitching thread, cotton wool, bandages and even soap are in short supply, add to the stress of the medical workers. Many other non-medical volunteers are just as badly affected. Some have never witnessed human misery at such close quarters. “I cry all the time myself. Even my friends here laugh at me,” said 22-year-old volunteer Hammad Ahmed. “But I just cannot deal with the children who search for their mothers, or the fathers scrabbling at heaps of rubble to uncover dead children.” Thousands of Pakistanis, most of them young, have volunteered for work in quake-affected areas. Their efforts have been crucial in many areas, some having reached affected places within hours of hearing of the devastation. But most arrived completely unprepared for a human disaster that has shocked even experienced relief workers, including veterans of the tsunami in December 2004. “I have been in Gujrat, Indonesia and Ethiopia. I thought I had seen everything. But this is far worse. The scale is immense and the state of people truly awful,” said Dutch relief worker Peter Meyers. For many young volunteers, some mere teenagers, who have arrived from Karachi, Lahore, Islamabad, Peshawar and other cities to offer help, their experiences amid the devastation have left emotional wounds that could take months, possibly years, to heal.