One year after a violent tremor killed more than 26,000 people and destroyed 85% of the city of Bam, in south-eastern Iran, thousands of residents still suffer from the trauma caused by the devastating earthquake of 26 December 2003. Some 75 thousand people were left homeless and practically every family in the city of almost 120,000 has lost a parent, a child, a sibling or a friend.
The psychological disorders caused by the quake are characterized by sleep disorders, inability to carry out normal social functions, explosive behaviour, domestic violence and a dramatic increase in drug addiction. They are being tackled by an innovative programme of psychological support implemented by the Iranian Red Crescent Society (IRCS). The Bam relief operation is the first one in the history of the Red Cross and Red Crescent Movement where extensive psychological support has been deployed immediately following a large scale disaster.
"Twelve months later, signs of the devastation are still evident, not just in the collapsed buildings but in peoples' minds," says Mohammed Mukhier, head of delegation for the International Federation of Red Cross and Red Crescent Societies in Iran. Integrating psychological support into the relief effort right from the beginning of a sudden-onset disaster is a model that could be used more widely, Mukhier explains. "Our experience in Iran can be used in response to future disasters elsewhere, and we should take care to provide that support both to the victims and to rescue workers."
More than 20,000 people have already been interviewed by Red Crescent psychological support teams. They visited almost 4,000 families in their tents soon after the disaster in order to assess the need for assistance. Out of 9,300 people who were identified as needing psychological support, more than 5,600 people have gone through individual or group counselling.
Psychological support programmes also include group therapy, painting, sewing, computer classes, and play therapy for the children. The programmes are supported by the Red Cross Societies of Iceland, Denmark and Italy and are largely funded by ECHO, the European Union's humanitarian office. "The aim of the group activities is to get people to talk about their experiences and not to keep them tucked away in an isolated corner of their minds," says Ms. Aghdas Coffee, who is in charge of implementing the IRCS psychological support programmes in Bam.
Even today, new cases are being registered. One Red Crescent counselling centre in Bam received 129 new patients diagnosed with Post Traumatic Stress Disorder during the month of September 2004. The problems are compounded by an increase in drug addiction following the earthquake. Bam is on the drug smuggling route through Iran from Afghanistan and Pakistan.
The tremor, measuring 6.5 on the Richter scale and centred directly underneath the 3,000-year-old city, turned all 131 schools and all hospitals and clinics in Bam into a heap of bricks and dust. The Iranian Red Crescent - supported by the International Federation and Red Cross and Red Cross Societies from around the world - is currently operating Bam's emergency hospital - originally a field hospital brought to Bam within 72 hours of the earthquake by the Red Cross Societies of Finland and Norway.
When the permanent hospital is rebuilt, this temporary structure will be packed up as an emergency response unit for use in future disasters, not just in Iran but potentially in neighbouring countries as well. The International Federation and the IRCS have mobilized international resources to support the construction of ten schools, an urban health centre - scheduled for completion in the second half of 2005 - and a road rescue station.
The International Federation is also helping the Iranian Red Crescent strengthen its disaster preparedness programmes, both in Bam and in Iran as a whole. The IRCS is embarking on an ambitious training programme for its disaster relief officers and is replenishing its disaster stocks. However, as Mohammed Mukhier, underlines, helping Bam's traumatized population heal its deep psychological scars remains a priority in the coming months.
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