CHENNAI: In Kurungudi village, merely six-and-a-half hours away from Chennai by road, 51-year-old Sundari ties a flower garland. “I have lived in this village for 35 years. Committing suicide by consuming pesticide is very common in our village. My husband and son committed suicide this way,” she said.
But it is not hard to imagine the circumstances that drove Sundari’s husband and son to end their lives — debt, poor crop yield, uncertain rains, exploitation by middlemen in the sale of crop or substance abuse would have left an emotional and mental toll that they felt they could not bear. In Tamil Nadu, 23 people out of one lakh are similarly driven to commit suicide, mostly due to family problems, says a 2015 NCRB report.
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But in December 2004, the state had witnessed a natural disaster that irrevocably impacted the people’s ethos. The 2004 tsunami left 1,567 families bereaving the death of their relative. The coastal village of Devanapattinam in Cuddalore have small houses holding smaller families. Around 290 lives were lost due to the tsunami in Cuddalore, and the people, whose primary occupation is fishing, have been affected financially, physically, and mentally.
A cross-sectional 2007 study conducted in a village in Cuddalore that suffered severe loss of property, and the loss of 61 lives showed that the prevalence of post-traumatic stress disorder was 12.7 per cent. It further stated that the most common psychiatric disorder was post-traumatic stress disorder, followed by alcohol abuse in males and anxiety disorder in females.
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Another study published in the Journal of the Indian Academy of Applied Psychology in 2008 states, “In addition to promoting feelings of safety, interventions aimed toward populations affected by the December 2004 tsunami need to focus on income-generating activities. Also, there is a need to target initiatives toward women and those individuals injured during the tsunami, given that these groups are more likely to experience post-traumatic stress disorder.”
“Right after the tsunami hit, people were more concerned about their physical health. It was only after two of three weeks did the mental health aspects come to the forefront,” said Dr Lakshmi Vijayakumar, consulting psychiatrist and consultant to the WHO for suicide and prevention. “The people who were vulnerable to PTSD fall into three types — the first are those with existing psychological problems that the tsunami triggered, the second are those who suffered multiple and severe loss both physically, financially and emotionally, and the third are those who naturally were not very resilient and had difficulty coping with stress.”
The Sneha Foundation worked closely with the people in Cuddalore. Dr Vijayakumar said that the fishermen, who worshiped the sea as their goddess and their friend, were unable to cope with the idea that she had rejected them so harshly. Children too, suffered in the same way, and it took a long time to reconnect with nature.
Lack of psychiatrists
The Government of India-provided data this year says that there are less than 4,000 psychiatrists in the country. The National Mental Health Survey also reveals that there are only three psychiatrists, one clinical psychologist, and less than one psychiatric social worker for every 10 lakh people in Tamil Nadu.
Unique ways of coping up
A 2007 study reveals that tsunami survivors found unique ways to cope with and accept the disaster based on cultural factors. “Survivors valued their unique individual, social and spiritual coping strategies more than formal mental health services. The results of this study suggested that interventions after a disaster should be grounded in ethnocultural beliefs and practices, and should be aimed at strengthening prevailing community coping strategies,” said the study.
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The prevalence rate of PTSD among households affected by the 2004 tsunami in Cuddalore. Source: Prevalence of Post Traumatic Stress Disorder in Coastal Fishing Village in Tamil Nadu, India, After the December 2004 Tsunami, published in 2007
What is PTSD?
According to Lakshmi Vijayakumar, many suffered from acute stress disorder after the tsunami. The best treatment for people suffering from this disorder was to listen to their problems and rely on their natural resilience. However, if this disorder persists after two or three weeks, it is categorised as Post Traumatic Stress Disorder.