Excerpts from the Unpublished Chronicle of a Debriefer
By: THELMA SINGSON – BARRERA, RN
Psychosocial Care Specialist
“The Philippines is the 4th most accident prone country in the world next to China, India and Iran. Over a period of ten years. From 1992-2001, more than 5 million Filipinos were killed or injured as a result of disasters and man-made calamities.
The Philippines is a natural laboratory for floods, typhoons, earthquakes, volcanic eruptions, landslides and other types of disasters simply because: it is geographically located along the typhoon belt area of the globe (Philippine average of 22 typhoons a year),
on the Pacific Ring of Fire (home to 452 volcanoes or 75% of the world’s active and dormant volcanoes), and where 90% of the world’s earthquakes and 80% of the world’s largest earthquakes occur. The Philippines (unfortunately) owns over 352 volcanoes of which 22 are active and 27 are potentially active.”
True enough, on September 26, 2009, Typhoon Ketsana (known in the Phillippines as “Ondoy”) made landfall, and according to the Philippine Atmospheric Geophysical Astronomical Services Administration (PAGASA), Ketsana dropped 455 mm (17.9 in) of rain on Metro Manila in a span of 24 hours on Saturday – the most in 42 years. A month’s worth of rainfall in a single day washed away homes and flooded large areas, stranding thousands on rooftops in the city and elsewhere.
Personally, I’m lucky my house (in San Pedro, Laguna) is quite safe from typhoons and floods, but I have always been much affected as well, as a service provider. I was monitoring the effects of the typhoon through my cell phones as a number of my friends and some of our hospital staff were trapped in flood waters and asking for my help. My brother and his family in Pasay were also frantic and overly anxious and fearful because the flood waters kept on rising with only a few steps reaching the second floor of our ancestral house. They have not eaten regular meals but only water and biscuits. Nobody expected that fast rise in flood water and the endless rainfall. At that time, there was a party in the house celebrating the 15th birthday of my youngest daughter. As they were all merry-making, I refused to eat my meals while I continue to monitor those who were asking for my help, because they know I have friends at the National Disaster Coordinating Center (with my long disaster experience as a debriefer/psychosocial care provider). I feel helpless not being able to help and seek help for them. I was equally fearful when they don’t answer my text messages anymore, and I kept on praying they will all survive, despite the needed help not really reaching them. It was either the people who are supposed to help that time were also victims and trapped in the floods as well, or there was no safe means for them to come to the rescue of the victims asking for help.
On the first working day (Ondoy hit the country on Saturday) I was already anticipating teams will be deployed to provide PSYCHOSOCIAL INTERVENTION to survivors. I initially formed 5 teams out of the pool of Psychosocial care Provider/ specialists we have in the hospital (National Center for Mental Health). I also learned that a number of them were also victims : their houses still flooded and they were also trapped on their rooftops with their precious belongings all submerged in water.
Our office (Office of the Medical Center Chief) received the order of deployment, with the Medical Center Chief, Dr. Bernardino Vicente, as the Chairman of the Psychosocial Committee for the Task Force Ondoy. Being the point person on Psychosocial under Dr. Vicente, I was ordered to form teams. Realizing that our workforce will not be able to cover the big population affected, Dr. Vicente decided we call all those agencies and organizations from government, private, academe, faith-based and others who are known to provide psychosocial intervention. A networking meeting was immediately called for. A situationer was given to the group by Dr. Ron Law of the DOH – HEMS (Health Emergency Management Staff) . Mapping of resources followed, with merely identifying who does what and where.
A crush course on PSYCHOSOCIAL PROCESSING (PSP) AND PSYCHOLOGICAL FIRST AID, including the IASC Guidelines on Mental Health & Psychosocial Support (MHPSS) during Emergencies and Disasters, were imparted to the willing volunteers, even to those who are already experienced so we can all level off with what specific psychosocial intervention will be needed.
Sites were identified, prioritizing on the number of affected population and those which were already accessible at that time.
Four teams were deployed daily in 2 – 3 sites. MHPSS rapid assessment was done to the identified sites and proper coordination to local officials was in place. Even the other health needs were identified and responded too by the teams.
I, being the over-all in charge of the deployment was in a quandary of how to put all things in order. It was a big problem for me to get people from different sections, as they have to be spared from their usual ward / hospital work. Most of the team members deployed came from the Nursing Service, as they are the only ones who have basic training on MHPSS as part of their In-service training.
The most challenging part of my work is the formation of the teams and giving them DAILY orientation early in the morning before deployment and post-mission technical debriefing as they return from the sites in the afternoon or early evening. My long years of disaster work (20 years), though was a big help, but this one made coordination more difficult. The task was personally overwhelming for me because it took much of my time and energy, especially on the first 2 weeks of the month-long deployment. Getting as much people to be deployed and being in the office early in the morning (coming to & from my residence in Laguna) for the pre-departure briefing and staying late in the office for the post-mission debriefing of the teams; and collation/ submission of reports. I felt then, I was no longer getting enough sleep. That even in my sleeping hours, my mind was still “pre-occupied” with what else to do and how to do it better. And believe it or not, the stress took its toll on my teeth. I had this disturbing toothache, but my dentist can’t see anything wrong. I even had a dental Xray to be sure there was no underlying problem, still it was negative. It was only when my dentist asked if I am stressed that I realized I had a different and unusual stress reaction, my teeth were affected.
But my being the over-all coordinator did not limit me to staying in the command post. Several times I joined the teams. In Barangay Bagong Silangan in Quezon City, where most of the casualties were registered, around 67, the sight was horrible! In a covered court, all survivors were mixed with the dead. Coffins line up in one end of the court and on the other end are warm bodies. On the sides are surviving pets: dogs, goats, pigs. It was horrific to see lines of coffins belonging to just one family, 3 young children and a father, all dead! Seeing this and sensing that people are still in a confused stage, the team provided psychological first aid: consoling, defusing and facilitated a very important ritual among Catholics: a requiem mass before the mass burial. It was noted that the parish priest was also very busy and probably confused as well as to what else to do to be able to help, hence, our team facilitated the conduct of the last rites.
This was also the first time in my many years in psychosocial work that upon arriving on the site, wearing our psychosocial shirts, the people gave us a warm welcome telling us they appreciate our presence because they need us most now on top of their other basic needs. Two (2) teams were deployed daily in that area for one month and provided psychosocial intervention to health workers, barangay leaders and the students of a high school in the barangay. Play, arts, puppetry were used during the psychosocial processing. The team which consisted mostly of nurses and nursing attendants, provided as well, health teachings to prevent the outbreak of diseases; and also treatment of minor wounds and skin infections, and were able to assess & refer promptly those who need further treatment in hospitals.
Another site which we continuously provided psychosocial intervention was Muntinlupa City where several barangays were still in flood water for more than a month. An unforgettable experience was riding on an airbed or a small banca just so we can reach the evacuation area. And still we have to walk on shallow flooded waters with or without or boots on. This was our daily means of transport so we can access our clients.
What is unique about our “Ondoy Experience” was that this was the first time a Networking meeting was called for by the National Center for Mental Health and DOH-HEMS for all agencies providing psychosocial intervention in an effort to organize, harmonize and maximize all available resources to be able to reach out to and serve as much number of clients/ survivors as possible. Although there were limitations and some problems encountered in using volunteers to augment the workforce of government: like, these volunteers only prefer limited areas, population and time (weekends only) in the provision of intervention. Many did not submit reports of the services they provided hence it was not included in the comprehensive MHPSS response report. This was despite agreement that the National Center for Mental Health will be the central repository of all records and reports and will also be the one to collate these reports to be submitted to HEMS/ NDCC.
It will take years for the survivors to forget the Ondoy nightmare. It has claimed hundreds of lives, destroyed million peso-cost of properties, shattered the dreams of the victims and their families, but..proper and timely mental health and psychosocial support (MHPSS) will help them to resolve the trauma and move on with life.
I have nothing but hopes and prayers that there will be no more Ondoy in our lifetime.
© 2011, Filipino Nurses. All rights reserved. DISCLAIMER: The accuracy of all articles contained in this website are the responsibility of their respective authors. All articles are for informational purposes only and are NOT intended to replace the advice of a doctor. The owner of this site disclaims any liability for the decisions you make based on these information. If you have any health-related questions, please consult your physician. If you feel ill, please seek medical attention immediately.