PHOTOGRAPH FOR TIME BY PHILIP BLENKINSOP / AGENCE VU

TOGETHER TO THE WATER: As part of therapy to help overcome their fear of the water, Thai fisherfolk from Koh Nok village wade into the ocean for the first time since the tsunami

Healing Hands
	For many survivors, the tragedy of Dec. 26 hasn't faded easily. But with the right help, they're learning how to move on
	By Andrew Marshall

Posted Monday, March 28, 2005; 20:00 HKT
Jane Lopacka asks her audience to imagine walking with her toward the sea. Easy? Not for the fisherfolk of Koh Nok village, which was devastated by the tsunami that killed more than 5,000 people in southern Thailand. One woman in the packed community hall sobs uncontrollably; others visibly tremble. Yet Lopacka, a British trauma therapist, is soon asking them to imagine walking into the sea until it is as high as their ankles, then their knees, then their necks. Finally, at the end of the 40-minute session, comes the bombshell. "O.K.," says Lopacka, "who's coming with me to the water?"

Half the class freezes. But the rest follow Lopacka and her Thai colleague Dr. Sutatip Bhamarapravati, co-designer of this trauma-therapy program called Making Waves, to a nearby inlet. There, fully clothed and holding hands, the villagers wade into the sea for the first time since Dec. 26. "My legs were shaking so much that I thought I would fall over," says Suthinan Sertrong, a 30-year-old fisherwoman.

Making Waves is one of the programs created to confront the shock and grief caused by December's earthquake and tsunami. Trauma counselors face an enormous task throughout the region. The World Health Organization estimates that some 500,000 people in Aceh alone face mental-health problems. The first six months is crucial for preventing post-disaster trauma from evolving into something much longer lasting. Sudden, shocking loss is especially difficult for survivors, say experts, as are children's deaths, mass mortality, and catastrophes from which loved ones' bodies are never recovered—all factors tragically common in countries struck by the tsunami. In Sri Lanka's refugee camps, says Upul Wasantha, a Sri Lankan social worker partnering with the U.K.-based NGO BasicNeeds Sri Lanka, mental health is becoming the prime concern: "The longer these people stay in these camps, the more likely it is that their problems will get more serious."

Disaster survivors commonly experience nightmares, insomnia, heart palpitations, stomachaches, fatigue, confusion, guilt and despair. "With most people, these symptoms die down in about six weeks," says Susie Morrison, a trauma expert with International Medical Corps (IMC). "But with others, they don't, and this can begin to affect their whole lives." About 5% of survivors, experts say, might experience terrifying flashbacks, severe depression or suicidal thoughts. Yet, in many cases, therapy is not a priority. Of more immediate importance to their emotional well-being are physical concerns: health, a home, a job.

That's why the men of the northern Acehnese village of Pante Gurah are hard at work. The tsunami flattened every house in the village, and swept in hundreds of dead bodies, along with fishing boats weighing more than 20 tons. Local fishermen—including those who lost wives and children—have propped the boats up with jacks and, with a simple chain-and-pulley system, are dragging them along rollers made from palm trees back toward the water. The aid agency International Rescue Committee (IRC) provides the equipment, pays each man a daily wage, and is designing a loan system to help owners fit new engines and make their vessels seaworthy. "The activity helps the men forget their troubles," says Basri A. Gani from the IRC. It also gives them a future. "One boat can provide work for 20 to 30 men."

Job prospects in Aceh's provincial capital Banda Aceh are bleaker. Scrap collecting and corpse retrieval are the main work in the once thriving district of Lam Jame, now a dust-choked wasteland of rubble and twisted metal. Amid this desolation, a mobile clinic from Médecins Sans Frontières (MSF) is dispensing first aid, tetanus shots, and protective boots and gloves free of charge. Afterward, an MSF mental-health team sitting nearby offers the clinic's visitors a drink and a chance to talk. MSF psychologist Donatella Paioro says this is an effective way of reaching traumatized people, particularly men: "Men are more difficult to approach in any culture, but this way they come and talk to us. They tell us about the family members they've lost. They tell us how hard it is." Unlike Thais and Sri Lankans, who live far from the Dec. 26 epicenter, Acehnese must still endure powerful aftershocks that reactivate terrible memories and spark fears of another disaster.

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