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The aftermath and enormous devastation of the tsunami has focused global attention on Southeast Asia. Media descriptions of the tsunami made headlines with descriptions of a wall of water reaching 8 to 12 meters high as it approached land.

As one of the ISTSS representatives to the United Nations, I attended a number of meetings focusing on the tsunami relief efforts. One of the most informative meetings was the Jan. 13 presentation by Jan Egeland, Under Secretary General and Emergency Relief Coordinator for the UN Office for the Coordination of Humanitarian Affairs.

Under Secretary General Egeland reported that the tsunami crisis affected 12 countries with more than 150,000 casualties, half of which were children, and has resulted in more than 24,000 missing persons and 1 million displaced people. To complicate matters, the devastated areas also include three conflict zones consisting of Aceh, Sri Lanka and Somalia.

The international community response has been extraordinary, involving 12 governments, 100 local governments, more than 150 NGOs and partner organizations with 5,000 international staff in Banda Aceh alone. This has resulted in severe strain on airports, roads and support services.

Leading the coordination of the tsunami relief efforts on the ground is the role of the UN’s Office for the Coordination of Humanitarian Affairs (OCHA). The role of OCHA includes focusing on logistics, identifying and alleviating bottlenecks (i.e., with bilateral military assets), targeting funds and mobilizing sustained international support through the reconstruction phase. In essence, OCHA’s role is to coordinate resources to reach those most in need. Daily coordination meetings of 60 OCHA staff take place in 12 locations. In addition, a joint Disaster Management Center has been established by the Indonesian government and OCHA.

The unprecedented global response to the tsunami has resulted in more than $5 billion pledged from more than 60 donor nations, in addition to billions in private donations. The United States also has increased its pledge to $950 million for tsunami relief. Public tracking of donations and partnerships are also coordinated by the UN with Price Waterhouse providing pro bono services to track the pledges.

While relatively small portions of the donations have been allocated toward mental health services, some of the countries within the European Union have progressive disaster and crisis response initiatives designed to follow up both nationally and abroad with regard to their citizens who may be victims of disasters. Remarkably, Finland has donated 4 million Euros of which 1 million was specifically designated for mental health crisis response services.

The goal of the coordination of pledges by the UN is to avoid a drop-off between that of commitments and actual contributions, which fund relief efforts. This coordination also includes persuading donors to pledge new funds to avoid taking funds from Africa and the other “forgotten emergencies.”

Considerable concern has been expressed with regard to the realization of pledges, as often much is promised and only a small percentage materializes. This concern was emphasized by Ambassador Goonetilleke, Acting Permanent Representative of the Mission of Sri Lanka to the UN, in another meeting focusing on the response, relief and recovery of Southeast Asia.

providing immediate shelter and food, potable water, sanitation and medical facilities. Long-term goals focus on rebuilding housing and communities, re-establishing fishing and tourism industries, and developing an early warning system to prevent future disasters.

The mental health response to the tsunami is being developed by WHO, UNICEF and the International Red Cross and Red Crescent Societies, international organizations working in the various affected countries. In addition, UNICEF is also dispatching “schools-in-a-box” to affected areas, each package consisting of teaching materials and equipment for 80 students. It was recommended by WHO that the mental health response be initiated in the third or fourth week, as lifesaving activities need to take precedence in the first few weeks.

As is the case with all large-scale disasters, tsunami efforts should be focused on short-term and long-term needs assessment. Ongoing mental health intervention should be coordinated through local established mental health organizations, which are sensitive to cultural norms and integrated into community psychosocial support. In addition, ongoing mental health support is needed for emergency and relief workers and others such as journalists, who may be affected as a result of their work, to prevent the development of posttraumatic stress disorder. Psychosocial group support is especially important in the Asian culture, in which community and family group support is the main source of coping as opposed to the focus on individual intervention prevalent in Western societies.

The recovery of Southeast Asia from this enormous disaster is expected to take more than a decade. The continued support of the international community provides an opportunity to highlight the generosity and helpfulness of people who come to the aid of others living in distant parts of the world.

Resources

International Federation of Red Cross and Red Crescent Societies, www.ifrc.org

The United Nations Children's Fund, UNICEF, www.unicef.org

United Nations Development Programme, www.undp.org/bcpr

United Nations Office for the Coordination of Humanitarian Affairs, http://ochaonline.un.org

USAID, www.usaid.gov

World Health Organization, www.who.int

Elizabeth Carll, PhD, is an ISTSS Representative to the United Nations. Yael Danieli, PhD, and Joyce Braak, MD, also are UN representatives.