Conditions in the evacuation centers – the challenges for aid worker support

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As the Doctors of the World emotional and psychological care team helps in the relief effort, it is learning of the realities being faced by those in the evacuation centers.

In a medium-sized center (roughly 100 people), a local couple that the community would normally turn to has taken on a leadership role. Many of those in the center are elderly, and it is heartbreaking to watch those in their 80s go without the proper care they deserve. For the past four weeks they have refrained from going outside, which has only further weakened the strength of those among them who were already frail. Aid workers cannot help but be deeply affected by witnessing this. The wife along with the help of several other evacuees prepares 3 meals every day for over 100 people, while her husband spends the day helping with the reconstruction work in the town. They also make sure the toilets are being maintained and try to mediate any disputes that arise between fellow evacuees. All this despite that fact that they are evacuees, too.

It was initially possible for a limited number of evacuees to take on such a huge amount of responsibility in this way and give it their all due to the belief that it would only be for a short period of time until the government relief effort took over. While they may have been able to endure it for this long, we are now beginning to see the signs of psychological strain caused by such responsibility. Ideally under normal conditions teams would be established that would work in rotating shifts, but this is not viable in evacuation shelters with many elderly people because of the extra amount of care they need beyond immediate necessities like food, clothing and shelter. We frequently make mention in our update reports to the disaster relief headquarters of evacuation centers where a small number of very capable individuals are being overly relied upon. The center may seem to be functioning well, which means that other centers become prioritized instead, but this is only because a small number of people are working flat out.

Things that are currently needed to ease the burden on the evacuees include soup kitchens such as those currently being offered on a sporadic basis by volunteer groups (many say that a hot meal from time to time is greatly appreciated), distribution of relief goods (there is a mismatch between what evacuees want and what they are actually being given), people to help prepare meals on a consistent basis and food that can be eaten that doesn’t require any additional preparation. Voluntary leaders from among evacuees often feel a strong sense of responsibility toward those around them and neglect their own needs to care for the needs of others.

Local government staff in the area are not looking by indifferently. The majority of local public health officials were killed by the tsunami and the small number that remains is working night and day in the local community hall, which is serving as a makeshift disaster relief center. They are doing their utmost for the people of the local area, giving up any time off and working constantly – even though they are victims of the disaster too – receiving food in the evacuation centers and unable to have a bath. Employees of the Mental Health Welfare Center, which oversees mental health in Iwate Prefecture, have to deal with heavy work loads as they visit all the affected areas from Morioka to Ohtsuchi, collecting information, distributing medical supplies and coordinating health care teams.

In this way, all those on the ground have been working hard every day amid the psychological strain to rebuild. The facts that there is no real leader in charge and no where else to go can surely only add to the stress.

Volunteer Centers have been set up by the relevant bodies, but we are catching glimpses of exhaustion as volunteers try to respond to a variety of needs. There is an urgent need to address the disparity between evacuation centers and the mismatch of volunteers, as well as to make heard the voices of victims and the difficulties they are facing.

As part of the emotional and psychological care team we listen to the pain of the victims around us and are reminded daily of the importance of providing psychological support. We also play shogi with children, wash old people’s hair, help with collecting water and give massages. Meanwhile, something we often hear from medical and other support staff is ‘The people of Tohoku are tough.’ We cannot escape the fear that as these resilient people continue to be so resilient, the day will come when they will no longer be able to psychologically endure what they are going through.

Some day in the future when we will have finally achieved a full recovery and people have made a fresh start, we look forward to seeing them smile again. Which is all the more reason why, as we reaffirmed at this evening’s meeting, we will do all we can to make sure that the untiring efforts of the victims does not go in vain.

From the medical team