Story Box

EMPLOYING A MINOR AS DOMESTIC HELP

2012-05-19T12:59:00.001+05:30

It is becoming pretty common to see young couple within our community here in Delhi and other major cities around India raising their children without the help of the traditional pattern of child-rearing –the grandparents. But in most instances, the young couples are bound to employ domestic help, especially the help of young girls.

It’s good to see our younger generation seeing household chores as worth a full-time job, but in doing so, there are certain rules and laws, as well as human rights involved that one must be fully aware of, so that we don’t destroy someone's life in the process.

It is rare to see cases of young children being sexually abused within our community, but financial exploitation like underpaying could be rampant thought it is conveniently swept under the carpet. In order to raise awareness, here are few points to note especially child labour and child abuse.

CHILD LABOUR

What is Child Labour?
Child Labour, in simple term, refers to work performed by children that HARMS them or EXPLOITS them in one or more ways (physically, mentally, morally, or by blocking access to basic rights like freedom, education, etc.).

Not all labour of children constitute child labour, and there is no universally accepted definition of ‘child labour’, however, if the work done by the child is considered to be harmful or exploitative, or that the child feels that he/she is being harmed or exploited, it is considered as child labour.

Who is a child?
Any child yet to attain the age of 14 years [Child Labour (Prevention & Regulation) Act].

However, depending on the kind of work being done by the child, the employer can also be prosecuted for harbouring child labour by employing anyone yet to attain the age of 18.

Punishment for Employing Child Labourer:
Penalty for violators: 3 months – 1 year of imprisonment and/or fine of Rs. 10,000 - Rs.20,000, Penalty for repeat violators: 6 months to 2 years of imprisonment.

A child working as a domestic help is also considered as child labour if the work done by the child in any ways comes to disrupts, hamper or block the child’s basic human rights. The child’s basic rights include the right to survival (food, nutrition, shelter); to develop to the fullest (cognitively, physically and developmentally); to be protected from harmful influences, abuse and exploitation; and to participate fully in family, cultural and social life.

Majority of child labourer are in need of care and protection, as such, the Juvenile Justice Act, which define a child as anyone yet to attain the age of 18 years, will be applied. Which means, if the domestic help you employed is younger than 18 years of age and the Child Welfare board think he/she is in need of care and protection, the Juvenile Justice Act will be applied. The Juvenile Justice Court is not a civil court, as such it is pro-child, trials are swifter and punishment are much harsher than under the Child Labour Act.

CHILD ABUSE

What is child abuse?
Child abuse is the INTENTIONAL injury or maltreatment of a child by any significant people in the child’s life which lead to temporary or permanent impairment of the child’s physical, mental or psycho-social development, or disability or death.

‘Significant people’ includes anyone of any age, any sex, related or unrelated to the child, including parents, legal and non-legal guardians, employers, etc.

Who is a child?
Anyone yet to attain the age of 18 years of age [Juvenile Justice (Child in Need of Care & Protection) Act].

What constitute child Abuse?
Abuses are of three major types – physical, emotional & sexual. But financial exploitation is also considered as a form of abuse nowadays.

Physical Abuse includes – any act of physical aggression including beating, trashing, slapping, punching, pinching, pulling by hair or clothes, pushing, throwing, biting, burning with hot object, branding, aggressive handling, arm twisting, etc.
Emotional Abuse includes – verbal and non-verbal; cursing, humiliating, degrading, frightening, threatening, belittling, name-calling, habitual blaming, constant hostility toward them, etc.
Sexual Abuse includes – touching and non-touching behaviours including kissing, fondling, touching private part, rubbing genitals on the child, forcing them to touch your private parts or forcing them to any kind of sexual activities, and inserting body parts and/or objects in into the private part, anus and mouth of the child or attempting to do that. The non-touching behaviour includes undressing, voyeurism, exposing them to pornography or exhibition of private parts to them.
Financial Exploitation includes – paying less, not paying or not paying in time, withholding payment for reason or no reason, etc.

Employing anyone below the age of 14, no matter what are the conditions and terms you agreed on, is a crime. In such case, if any other person like the parents of the child agreed to let the child be employed, the parents too could be prosecuted for human trafficking.

Abusing anyone, no matter what type of abuse it is, is a crime, and the crime become graver if the abused person is yet to attain the age of 18. The JJ Act also includes the parents/guardian as possible perpetrators, so it is applicable for the family as well i.e. if you abuse your own children, your children can charge you for abuse.

Concluding Remarks: We the north-eastern are often labelled as westernized, it is true to some extent. However, we still have this traditional tribal mind-set when it comes to laws and legal matter by solving it through traditional channel, or making traditional arrangement to help with domestic chores by providing basic education to the child while helping with the domestic chores, or taking children under guardianship.

It is good that if we are providing education to the less fortunate children of our relatives, and it is good if we could maintain consensus and avoid ugly legal wars by solving serious matter including murder using our traditional channel. But in many instance, societal sanction against certain behaviours is just not enough to deal with the magnitude of the crime and the crimes of the perpetrators. In cases like child sexual abuse, the abusers usually are serial abuser. And there is no denying that there certainly must be some such cases among us.

PS: In cases that come under the Juvenile Justice Act, the child can be made to undergo medical test to determine his/her age even if a proper birth certificate is provided.

Child Helpline : 1098

HEALTH CARE AS HUMAN RIGHTS

2012-04-19T23:02:00.001+05:30

THE HUMAN RIGHTS BASED APPROACH TO HEALTH CARE

Health is a fundamental human right indispensable for the exercise of other human rights. Every human being is entitled to the enjoyment of the highest attainable standard of health conducive to living a life in dignity.[1] - (International Covenant on Economic, Social and Cultural Rights, 2000)

The human right to health means that everyone has the right to the highest attainable standard of physical and mental health, which includes access to all medical services without any kind of discrimination. It means that hospitals, clinics, medicines, and doctors’ services must be accessible, available, acceptable, and of good and equal quality for everyone, on an equitable basis, where and when needed.

The design of a health care system must be guided by the following key human rights standards and principles:

Universal Access: Access to health care must be universal, guaranteed for all on an equitable basis. Health care must be affordable and comprehensive for everyone, and physically accessible where and when needed.
Availability: Adequate health care infrastructure (e.g. hospitals, community health facilities, trained health care professionals), goods (e.g. drugs, equipment), and services (e.g. primary care, mental health) must be available in all geographical areas and to all communities.
Acceptability and Dignity: Health care institutions and providers must respect dignity, provide culturally appropriate care, be responsive to needs based on gender, age, culture, language, and different ways of life and abilities. They must respect medical ethics and protect confidentiality.
Quality: All health care must be medically appropriate and of good quality, guided by quality standards and control mechanisms, and provided in a timely, safe, and patient-centred manner.

The human right to health also entails the following procedural principles, which apply to all human rights:

Non-Discrimination: Health care must be accessible and provided without discrimination (in intent or effect) based on health status, race, ethnicity, age, sex, sexuality, disability, language, religion, national origin, income, or social status.
Transparency: Health information must be easily accessible for everyone, enabling people to protect their health and claim quality health services. Institutions that organize, finance or deliver health care must operate in a transparent way.
Participation: Individuals and communities must be able to take an active role in decisions that affect their health, including in the organization and implementation of health care services.
Accountability: Private companies and public agencies must be held accountable for protecting the right to health care through enforceable standards, regulations, and independent compliance monitoring.

The Human Right to Health is protected by international laws and Indian laws as in:

Article 25.1 of the Universal Declaration of Human Rights affirms: ‘Everyone has the right to a standard of living adequate for the health of himself and of his family, including food, clothing, housing and medical care and necessary social services’.
Article 12 of the International Covenant on Economic, Social and Cultural Rights that affirm: Health is a fundamental human right indispensable for the exercise of other human rights. Every human being is entitled to the enjoyment of the highest attainable standard of health conducive to living a life in dignity.
Article 24 of the Convention on the Rights of the Child;
Article 5 of the Convention on the Elimination of All Forms of Racial Discrimination;
Articles 12 & 14 of the Convention on the Elimination of All Forms of Discrimination Against Women;
Article 25 of the Convention on the Rights of Persons with Disabilities;
Article 21 of the Indian Constitution that prescribe right to life and personal liberty -the Supreme Court has brought Article 21 to prescribes for the right to health, along with numerous other civil, political and economic rights, etc.
Various articles under the Directive Principle of State Policy and Health: Article 38 imposes liability on State to secure a social order for the promotion of welfare of the people, Article 39(e) related with workers to protect their health, Article 41 imposed duty on State to public assistance basically for those who are sick and disable and Article 42 makes provision to protect the health of infant and mother by maternity benefit. Besides, Article 47 considers it the primary duty of the state to improve public health, securing of justice, human condition of works, extension of sickness, old age, disablement and maternity benefits and also contemplated.

[1] General Comment No. 14 (2000) (1), Article 12 of the International Covenant on Economic, Social and Cultural Rights

tags: zo, zomi, zogam, lamka

HIV/AIDS Counselling: Disclosure Counselling

2012-02-07T11:56:00.000+05:30

DISCLOSURE COUNSELLING

This type of counselling assists clients to understand the need to share their HIV status with trusted loved ones for the purpose of support and care. In addition, it assists clients understand the importance of disclosure to reduce risks of re-infection by partner(s).

PLWHA may need support to disclose their status to loved ones and their loved ones may need support to cope with their feelings about the information. This is what makes Disclosure counselling a complicated process because the counsellor has to give support to the primary client but also to the significant others of the client and in some instances it is the counsellor that may have to disclose the HIV status of client to loved one.

Motivations for disclosure vary greatly, and debates about “degrees of disclosure” have been evoked. The “degrees of disclosure” refer to level of disclosure a client seeks, some want to disclose to loved ones while others may want to go public with their disclosure to help in reducing stigma in the community and to work as HIV/AIDS activists.

The Benefits of Disclosure Counselling

Helps the client ensure that an HIV negative partner does not become infected
Help ensure that positive partner can also access early care, treatment and support
It can also reduce the risk of an unborn baby contracting HIV from its mother.

Guidelines for disclosure counselling

Counsellor must respect a client’s decision not to disclose to partner when adamant and not put any pressure on client to disclose status out of coercion.
Counsellor must never disclose client’s status without consent.
The Counsellor must support client through the decision-making process with on-going counselling sessions.
If the client refuses or is taking time to disclose status then Counsellor must work and encourage the client to identify at least actions that would be adopted to reduce risk of infecting partner during this period.
The Counsellor must be ready to have series of counselling sessions with client before arriving at a final decision.

PARTNER NOTIFICATION IN DISCLOSURE

There are three ways in which partner notification can be carried out. They are:

Client Referral: This is a situation where the PLWHA chooses to inform the partner himself or herself. The advantage of this sort of disclosure is that Client is familiar with the partner and knows the best way to approach difficult issues with the partner and also knows what to do to calm or appease partner during such emotional crisis. The disadvantage is that the client lacks the counselling skills and experience which may help to alleviate the situation.
Counsellor referral: This is a situation whereby the Counsellor provides disclosure of client’s status to client’s partner with client’s consent.
Dual referral: In this situation the partner is informed by both client and counsellor after rehearsal has been done to see how best the disclosure can be carried out. The advantage of this sort of partner notification is that both client and counsellor can promptly react to any situation that arises from partner, the counsellor handling the situation with a professional touch while the client gives it a personal colouring.

Disclosure counselling, especially partner notification, is a controversial subject still highly debated in many countries and society, so it is wise to consider every aspect including the legal provision of the country.

REFERENCES

World Health Organization (1994); Source Book for HIV/AIDS Counselling Training,
Thomas, Prof. Gracious (2010), HIV/AIDS: Stigma, Discrimination and Prevention, IGNOU, New Delhi
World Health Organization (2004): Voluntary HIV Counselling and Testing, Manual for Training of Trainers, New Delhi, India
NACO (2011): Annual Report 2010 – 2011, National AIDS Control Organisation, Ministry of Health & Family Welfare, GOI
UNAIDS (2007); Counselling and HIV/AIDS, UNAIDS Technical Update, Best practice Collection

HIV/AIDS Counselling: Bereavement & Crisis Counselling

2012-02-06T11:54:00.000+05:30

BEREAVEMENT/GRIEF COUNSELLING

Bereavement is a term that can be used to describe any event that includes loss, so this could mean losing a job or the death of someone you know. Bereavement can also be termed as grief.

Bereavement in relation to HIV/AIDS could be grief over the loss of a dear one or grief upon learning one or a partner or a friend is HIV positive. Grief is multidimensional it can be experienced on all levels of the person, in the heart (feelings and emotions), the mind (thoughts), the spirit (meaning of life), the body (physical manifestations). It is a time of transition, beginning with period of diagnosis to death, shock of an anticipated loss, of trying to prepare for the inevitable.

When death follows a terminal illness (like AIDS) even though the family and friends know that the death is inevitable and have watched the person slip away during the illness, they are still left with a sense of loss. People grieve not only for the deceased, but also for the unfulfilled dreams and plans for the future that they hoped to share with them.

There is no right way of coping with a death; people respond to a loss in their own individual way. The way a person responds is partly dependent on their relationship with the deceased, but it also depends on their own personality and upbringing.

Goals of Bereavement Counselling

The main goal of bereavement counselling is to increase the reality of the loss to the mourners and help provide psychosocial and emotional support to them. Bereavement counselling also helps:

To help the person deal with spoken and unspoken feelings which he/she is experiencing about the loss of loved one or the HIV diagnosis
To help the person overcome difficulties of readjustment to everyday life after the loss or diagnosis
To encourage the person to say an appropriate goodbye and to feel comfortable reinvesting in life after the loss of the loved one without feelings of guilt
To help the person to be able to adjust to life after an HIV diagnosis.

CRISIS COUNSELLING

Crisis counselling is a short term intervention which focuses on dealing with the immediate situation. It involves helping clients to understand the crisis situation, express their feelings about it, and outlines an action plan and getting referrals. Crisis counselling in relation to HIV/AIDS is defined as a confidential dialogue between a PLWHA and a counsellor aimed at enabling the client to cope with the crisis which is being experienced. The crisis could be:

· Diagnosis of HIV infection
· Unexpected death in family
· Breakup of a relationship
· Death of another PLWHA
· Emergence of new symptom
· Treatment failure or anything that an individual perceives as a severe life event

The role of the counsellor in crisis counselling

One of the counsellors’ major roles during crisis counselling is to help the client define the problem and help restore a sense of control. Sometimes the crisis is so overwhelming for the client that he/she is unable to identify what the major problem of the crisis is, is it the HIV diagnosis itself or is it the need to disclose HIV status to a spouse that is causing the crisis and if both are regarded as a problem, which is the more serious of the two to the client. The counsellor must “Begin where the client is” and be reassuring and supportive as the client discusses the crisis. The counsellor must listen carefully and patiently because the client may sound incoherent initially but with adequate support will calm down and start communicating in a more coherent manner.

Counsellors should never offer false assurances to clients such as statements like “all will be well” because the counsellor really does not know if all will be well and cannot guarantee the client that his HIV diagnosis status will decline rapidly to AIDS or that if client was raped that the rapist is probably not HIV positive. This sort of false reassurance may temporarily help in calming the patient but on the long term I f the client does test HIV positive or declines rapidly from HIV to AIDS, the client will lose trust in the counsellor and feel that the counsellor lied to him/her.

The counsellor should help break the problem into smaller parts and help client prioritize different aspects of the problem. The counsellor should repeat certain information repeatedly to ensure that the client understands the situation and is not in denial. But the counsellor should not overstate the issue and annoy the client who is already emotionally overwrought. The counsellor should also help client set realistic goals for problems and identify which ones he can do something about and which one the client will just have to accept as a part of life.

HIV/AIDS Counselling: Preventing Mother-to-Child Transmission

2012-02-05T11:53:00.000+05:30

PREVENTING MOTHER-TO-CHILD TRANSMISSION (PMTCT)

This is another form of pre-test counselling. This is because for the pregnant woman who is getting tested she will be given pre-test counselling but because she is pregnant she will also be informed about the different options available for pregnant women who are HIV positive to avoid infecting their child with HIV.

Counsellor in antenatal clinics should provide information on Mother to Child Transmission (MTCT) to pregnant women. Counsellors must explain that HIV can be transmitted from mother to child during pregnancy, delivery, or breastfeeding. The benefits of early testing during pregnancy so as to enable better care for mother and child should also be emphasized.

Most HIV-positive children get the virus from their mothers. This type of transmission is called “vertical transmission”. There are three major ways for a pregnant positive woman to pass the virus to her child they are

During pregnancy: About 25 % of infections occur during this stage. During pregnancy, the virus can be passed to the child through the placenta, especially if it is damaged in any way.
During childbirth: About 60% of infections occur during this stage. During childbirth, the virus can be passed to the child through contact with the mother’s vaginal secretions and blood.
Through breastfeeding: About 15% of infections occur during this stage because of the presence of the virus in breast milk. The chances of a mother passing HIV to her baby are higher if she becomes pregnant at a time when there is a high level of HIV virus in her blood. This happens when she is in the window period or she is ill with AIDS.

Advantages of Testing during pregnancy

Knowledge of HIV status facilitates early referral for care.
Knowledge of HIV status allows appropriate treatment and follow-up of the child.
Knowledge of HIV status provides an opportunity to implement strategies to prevent transmission to the child.
Knowledge of HIV status enables women to take precautions to help prevent transmission to sexual partners.
For HIV-negative women, knowledge of HIV status can lead to appropriate HIV prevention measures and risk-reduction behaviour.

HIV/AIDS Counselling: Preventive Counselling

2012-02-04T11:52:00.000+05:30

PREVENTION COUNSELLING

Prevention counselling is similar to pre-test counselling as it provides an opportunity for the counsellor/client to negotiate and reinforce a plan to reduce or eliminate the risk of HIV transmission. Prevention counselling can also be given to relatives and significant others of an infected person so as to protect them from contacting the infection in the process of caring for the PLWHA. As seen above prevention counselling can be categorized into two:

Primary Preventive Counselling: This is the counselling given to an individual to avoid contracting an infection.
Secondary Preventive Counselling: This is the counselling given to an individual who is positive to help reduce the risk of re-infection. It is also given to the family, significant others and care givers of any infected person to enable them to be able to give proper care to the PLWHA as well as to protect themselves. It covers such issues as Universal Basic Precaution as well as Home Based Care.

Goals of Prevention Counselling

Preventive counselling facilitates an accurate perception of HIV risk for those who are unaware, uninformed or in denial. It should also:

Translate the client’s risk perception into a risk reduction plan that may be enhanced by knowledge of HIV infection status.
Helps clients initiate and sustain behaviour changes that reduce their risk of acquiring or transmitting HIV
Assess the clients readiness to adopt safer behaviours by identifying behaviour changes the client has already implemented and negotiate a realistic and incremental plan for reducing risk
Determine the client’s understanding of HIV transmission and the meaning of HIV antibody test results
Safe sex options can be discussed. A condom demonstration can be carried if client is willing to use condoms and is interested in knowing how to make proper and consistent use of a condom

HIV/AIDS Counselling: Post-Test Counselling

2012-02-03T11:51:00.000+05:30

POST TEST COUNSELLING

Post-test counselling helps the client understand and cope with the HIV test result. Here, the counsellor prepares the client for the result, gives the result and then provides the client with any further information required, if necessary referring the person to other services. The two usually discuss ways to reduce the risk of infection or transmission. HIV test results should always be given with counselling. The form of post-test counselling will depend on what the test result is.

The main goal is to help the client to understand and come to terms with his/her test results and to initiate adaptation to their sero-positive or sero-negative status. Post-test counselling helps the client to understand and cope with the HIV test result. Counselling for people who have recently received their results is similar to pre-test counselling, because both of them involve HIV risk assessment and the promotion of safer behaviours. The main difference is that in post-test counselling clients need to deal with the reality of their situation and not imagining it in the future. Clients also need to have a clear understanding of what their results mean and what options are available to them.

Giving results (positive) can be difficult and uncomfortable for the counsellor. Sometimes the counsellor fears they may not know what to say or do to an emotional client and fear that clients may harm themselves or others. Because of this counsellors may be tempted to make inaccurate suggestions and give inappropriate assurance so as to make the client feel better but this would be doing the client a disservice because the counsellor would be lying to the client and it is also unethical and unprofessional.

IMPORTANCE OF POST TEST COUNSELLING

Counselling after an HIV test is important for the following reasons:

For Positive test results: Post test counselling is given to convince the client about the reality and seriousness of the situation – it is often difficult for people to accept and believe that they are HIV positive based only on the results of a blood test, especially if they are feeling healthy and strong:

To ensure understanding of the test result.
To help client cope with the positive result, especially in the days and weeks to follow.
To make a plan for ongoing medical care and necessary referrals
To provide information about the dangers infecting others and getting re-infected with different strain of the virus.
To understand the need for careful planning and importance of medical attention for client who want to have children
To help the client with the issue of disclosure.

For negative test results

First, because of the “window period”, a negative result may not mean absence of infection, and the client might wish to consider returning for a repeat test after 3-6 months.
Second, counsellors need to discuss HIV prevention, providing support to help the client adopt and sustain any new safer practices.

For indeterminate test results

To explain the need for re-testing and the reasons that the result could have been indeterminate
To help the client develop a plan for protecting him/herself from HIV

Clients may experience a range of emotions upon learning their test results. Many of these emotions will be very strong and should be acknowledged by the counsellor. A client who is very emotional, either in a positive or negative way may be too distracted to hear information that is given to them. Therefore, it is important to help the client to explore his/her emotions and “vent” them. Once a client has released his/her feelings, s/he will be more receptive to receiving other information regarding prevention, treatment and referrals.

Reactions to results from clients can vary from happiness (negative result) to anger despair, depression, grief, anxiety, suicidal ideations, shock and denial (positive or indeterminate result). What determines people’s reactions to their result varies. One of the most important is how well-prepared the person was for the news during the pre test counselling at which the counsellor should have properly prepared the client for the result and also have studied the client and be able to determine the pre-test psychological condition of the client which would help in anticipating how the client would react to the result.

IMPORTANT POINTS FOR POST TEST COUNSELLING

Post test counselling must begin the session by asking how the client has been feeling since having the test and what has been going through his/her mind since taking the test. They should also give the test result in a neutral tone of voice which shows no emotions to reflect what the result is. State the result clearly and simply.

It is important to begin the post-test session by asking how the client has been feeling since having the test and what has been going through his/her mind since taking the test.
Ask the client if they have any questions but by this time most clients are anxious to receive their result and might not be ready to ask any questions.
Give the test result in a neutral tone of voice which shows no emotions to reflect what the result is. State the result clearly and simply.
Make sure that the client has understood the test result and that the client is emotionally and psychologically ready for more information to be provided
Assess the clients understanding of the test result. Ask the client to explain what the test result means to him/her and check for any misperceptions or misinformation.
Assess emotional understanding by asking the client how he or she is feeling at that moment, and allow the client to express the emotions

Once the client is emotionally able to cope start to help the client to plan what the next steps will be. This is called behavioural integration. Behavioural integration requires that the client make an immediate plan (ask ‘what are you planning to do when you leave here today?’) as well as plans for partner notification (disclosing HIV status to partner), modifying the risk-reduction plan or other behavioural changes depending on their test result and the clients Situation.

HIV/AIDS Counselling: Pre-Test Counselling

2012-02-02T11:49:00.000+05:30

1. PRE-TEST COUNSELLING

HIV counselling is often given in connection with a voluntary HIV test. Such counselling helps to prepare the client for the HIV test, explains the implications of knowing that one is or is not infected with HIV, and facilitates discussion about ways to cope with knowing one’s HIV status. It also involves a discussion of sexuality, relationships, possible sex- and drug-related risk behaviours, and how to prevent infection. It helps correct myths and misinformation around the subject of AIDS. Whenever resources permit, pre-test counselling should be made available to those who desire it.

People who do not want or do not have access to pre-test counselling should not be prevented from taking a voluntary HIV test, however. In contrast, informed consent is always required before an HIV test where the individual’s name will be linked to the result. To allay anxieties while awaiting the test result, some individuals may seek support not only from their own families or a knowledgeable community worker.

Pre-test counselling simply refers to counselling given to an individual prior to taking an HIV test. It is given to prepare the person for the HIV test and the implications of taking the test. Pre test counselling has certain core objectives which are:

To explain the test and clarify its meaning;
To also explain the limitations of test results and to caution the client about potential misuse of results.
To help the client to think about possible reactions to the test result and who should be told. If the test result is positive, who could be informed and who could provide emotional support
To help the client understand why the test is required and to make a decision about the test.
To review the client’s risk of infection which is also called risk assessment. HIV/AIDS risk assessment requires discussion of personal sexual lifestyle of the client, with far-reaching implications.
Correct myths and misinformation about HIV
Review the test procedure, including issues related to false positive and false negative and also “window period”
Explain and obtain informed consent Discuss potential implications (personal, medical, social, psychological and legal) of a negative or positive result; discuss and demonstrate condom use

1.1 IMPORTANT POINTS FOR PRE TEST COUNSELLING

Pre-test Counselling is usually the first point of contact of the client with counsellor/health facility that is providing the testing service so it is important to establish a good rapport. If you prepare your client well during the pre-test session, you may encounter fewer difficulties during the post test.

Identify yourself and clarify your role as a counsellor.
Emphasize confidentiality of everything that will be discussed.
Ask if relevant why he/her opted to come for counselling and/or testing or clarify why he was referred for counselling.
Obtain relevant medical history (past and present) e.g. serious illness in the past, blood transfusion; cough and diarrhoea, STD's etc;
Ask about personal habits such as smoking, drinking, drugs etc. This helps with assessing risk behaviour
Ask about sexual history. Does the individual have a steady partner, wife/husband, boy/girlfriend, other partners outside relationship, etc;
Assess client's knowledge on HIV/AIDS. This enables the counsellor the opportunity to correct misconceptions /misunderstandings; Also to cover such issues as modes of transmission, prevention etc.
Assess the client’s understanding of getting tested for HIV and what the test entails
Explain what the result will mean if positive or negative including the window period and explore the personal implications of having the test, and what a positive or negative result will mean to him/her and their family and/or significant others;
Educate the individual on safer sex practices and healthy lifestyle practices.
Discuss with the client what will be required in the area of behaviour change to reduce the risk of contracting HIV irrespective of whether the result will be positive or negative;
Help identify how the client will protect their sexual partner/s
Explore clients support mechanisms. Who they will tell or talk to about their results? Where they will get support? Explore areas of strength e.g. faith and/or other support systems (supportive husband/wife, relatives, or work-mates);
Explain the procedure for the HIV test and what it entails
Provide an opportunity for the client to ask questions
If the client decides to test, obtain informed consent. Explain the informed consent form and allow the client time to read a leaflet on HIV testing where feasible

1.2 RISK ASSESSMENT

Risk assessment refers to conducting a review of clients’ risk of HIV infection. It is important to remember that this is a very sensitive subject and the client is expected to share information that he/she may never have shared with any other person. To assess the client’s personal risk, the counsellor should continue to explore with him/her the following areas:

Current and past client’s sexual behaviour
Current and past sexual behaviour of the client’s sexual partner(s)
Current and past drug usage pattern of both the client and clients partner
Has client’s ever had a blood transfusion done?
Client’s exposure to non-sterile invasive procedures

Based on the information gathered from the risk assessment, the counsellor can help the client identify any behaviour that leaves the client open to risk of acquiring or transmitting HIV. The essence of exploring risk with the client is not only to show the client that he/she is open to risk of infection but also to help the person examine ways in which he/she can reduce the chances of getting infected. This means helping the client to develop a risk reduction plan.

1.3 EXPLAINING HIV TESTING AND THE MEANING OF TEST RESULTS

Clients considering testing for HIV must be provided with appropriate information they need to make an informed decision and this should include the method for testing used in the organization. This is very important because some people have a fear of needles and need a lot of psychological preparation before taking an injection so the counsellor may have to prepare the individual as well answer questions the client will have about the testing procedure.

It is important that the counsellors be sufficiently knowledgeable about HIV testing procedures as clients will often have concerns about the accuracy of the test and have specific questions about the laboratory procedures used and the counsellor has to be able to show familiarity with the testing procedure so as to convince the client. The client should also be assured of the confidentiality of the whole testing procedure.

The counsellor should also take time and ensure that the client understands the meaning of a negative or positive HIV result. The counsellor should never assume that the client understands the meaning of the negative/positive test result because the meaning of negative/positive in the English language may confuse some clients.

1.4 CONSENT FOR HIV TESTING

Counsellors should always ensure that a client’s consent is given and depending on the organization maybe in written format. It is the client’s right to have or refuses to have an HIV test carried out and they should not be coerced.

It is the counsellors duty is to ensure that client understands the meaning and possible implications of HIV testing and to ensure that the client does not feel pressured to make a decision but rather that the client makes the decision to test at their own pace.

Finally it is important to reassure the client that the test result will be held in the confidence, to reinforce reasons why the client may benefit from knowing his/her HIV sero-status, and provide an appointment to return for test results.

HIV/AIDS Counselling: Definition, Goals & Types

2012-02-01T11:47:00.000+05:30

HIV/AIDS COUNSELLING: DEFINITIONS

Counselling has been defined as a process of helping a person/people learn how to solve certain interpersonal, emotional and decisional problems. Counselling, in relation to HIV and AIDS is a confidential dialogue between a person and a care provider aimed at enabling the person cope with stress and make informed personal decisions relating to HIV and AIDS (World Health Organisation-WHO 1994).

Counselling poses an essential part of HIV antibody testing. HIV/AIDS Counselling is universally performed in two distinct phases - before (pre-test) and after testing (post-test) - regardless of the client’s HIV status. Counselling prior to the test, known as Pre-test Counselling, will help the client understand the test results and its implications. Post-test Counselling is undertaken irrespective of the test result to help the client to integrate and understand the meaning of the test result at all levels - rationally, emotionally, behaviourally, and medically (Jose & Jyothiram, 2008).

MAJOR GOALS OF HIV/AIDS COUNSELLING
The major goals of HIV/AIDS counselling are as follow:

a) Preventive: Providing counselling service and information to help prevent and mitigate the continued spread of HIV by providing information about risk behaviours that leave people vulnerable to contracting HIV infection as well as helping individuals to develop the required skills for behaviour change.

b) Supportive: Providing counselling services to help support people that are infected or affected by HIV. The support includes emotional, social and psychological help given to people who are infected by HIV and those that are affected by the virus.

c) Rehabilitative: Ensuring that clients have access to all the health services available by providing adequate referrals for treatment, care and support services.

TYPES OF HIV COUNSELLING

There are several types of counselling in relation to HIV Counselling. The essence of the different types is to provide for the different stages of the HIV infection that the infected person and the relations will go through. The types include:

a) Pre-test counselling
b) Post-test counselling
c) Prevention counselling
d) Bereavement counselling
e) Crisis counselling
f) Disclosure Counselling

The Various type of HIV/AIDS Counselling are explained in the next posts….

HIV/AIDS: STIGMA

2011-10-01T22:42:00.000+05:30

1. MAJOR CHALLENGES: STIGMA AND HIV/AIDS

“Stigma in terms of HIV/AIDS is any form of behaviour towards a person living with HIV/AIDS that leaves the individual feeling unwanted or dejected. It can occur in different settings – healthcare setting, home, office, church or community. HIV/AIDS-related stigma is a real or perceived negative response to a person or persons by individuals, communities or society. It is characterized by rejection, denial, discrediting, disregarding, underrating and social distance. It frequently leads to discrimination and violation of human rights.” [1]

The Joint United Nations Programme on HIV/AIDS has defined HIV/AIDS-related discrimination as follows “Any measure entailing any arbitrary distinction among persons depending on their confirmed or suspected HIV serostatus or state of health”.

HIV/AIDS is not the only disease that is affected by stigma other conditions like epilepsy, cancer, tuberculosis, syphilis and psychiatric illnesses are stigmatizing diseases, what differentiates HIV from them is that people living with HIV are stigmatized for a multi-dimensional number of reasons which go beyond the physical illness itself. Some of the reasons are:

HIV is associated with a number of behaviours that are regarded as deviant by society, i.e. homosexuality, drug use, promiscuity etc.
People are afraid of getting infected with the virus
HIV has no cure and finally
Religious or moral beliefs lead some people to conclude that having HIV/AIDS is the result of a moral fault that deserves punishment and that God is punishing people that is why some people are HIV positive.

Causes of Stigma in HIV/AIDS

The cause of stigma and discrimination can be reduced to the following points:

Fear: Fear is a powerful feeling. When people are afraid of something they run away from it and as they run away from it the less correct and accurate information they will get about the object of their fear. This leads to the fear increasing and a vicious cycle is continued.
Ignorance: Ignorance is the harbinger of fear, and the source of misinformation.
Intolerance: This occurs when people are unwilling to cooperate and compromise. Intolerance is breed by people’s inability to accept diversity and difference
Denial: Is a phenomenon whereby instead of people facing the reality of a situation they would rather avoid the situation.
Misinformation: This one of the biggest causes of stigma. When people are ignorant of certain information they will make up stories or embellish the stories to suit their own thoughts and values about the situation.

Forms of Stigma

There are 2 major forms of stigma.

Felt Stigma: Self Stigma -This refers to the stigma that a PLWHA develops towards him/herself as a result of all the negative misconception that the individual has about a positive HIV result. Self Stigma can be manifested in the following ways: loss of interest, withdrawal, dejection, loss of self-esteem, guilt, isolation, etc.
Enacted Stigma: This refers to the stigma that a PLWHA faced from his environment because of his status as HIV positive. The various form of enacted stigma are:

Family Stigma: This refers to stigma within the family and friends. Manifestations of stigma in family include: rejection of infected person by family members and friends, family refuse to share food, room or talk with infected person, etc.
Community Stigma: This refers to stigma within the community and community member refuses to interact with PLWHAs
Religious Stigma: This refers to stigma within religious Organizations, such as churches and mosques. Religious stigma are manifested in the same way as does mentioned in the area of community stigma but it is unique because the PLWHA will be labelled a sinner and is can be regarded as deserving the HIV punishment for his/her sins.
Media related Stigma: This refers to stigma that is perpetrated by the mass media. This includes referring to PLWHAs as “victims” or “promiscuous people”, or disclosing the status of a PLWHA without consent.
Office/Work Place Stigma: This refers to stigma that occurs within an Office or work place.

Consequences of Stigma and Discrimination

Stigma and discrimination affects the individual but it also affects the society at large when it continues and is not remedied. Below are some of the consequences of Stigma and discrimination:

It Limits peoples access to healthcare because people fear stigmatization that may occur if they go to HIV clinics and others people get to find out.
It increases HIV prevalence and incidence in the country because people are afraid to disclose their HIV status for fear of stigma caused by lack of disclosure.
When PLWHA are discriminated against economically (unjustly sacked) the loss is that of the whole family which is affected by the loss in income
Because of the fear of disclosing their HIV status, PLWHA are not able to access the social support available to them in the society
There is increase in psychological and emotional disturbances amongst PLWHA which takes a toll on the society as a whole
The PLWHA may Loss self esteem and confidence and this may leave the person unable to face challenges ahead of him/her.

Strategies to Address Stigma and Discrimination

The issue of stigma and discrimination can only be resolved with a concerted effort from all levels. As shown stigma and discrimination can occur anywhere and can be perpetrated by anybody even loved ones. All stakeholders in the fight against HIV have to be involved in addressing the issue of stigma and discrimination and how to combat it. Some strategies which have worked in other countries and can be adopted appropriately can be found below:

Planning and formulating of comprehensive HIV prevention and care activities that will involve all necessary stakeholders.
Advocacy/sensitization of communities about HIV/AIDS to demystify it
Inclusion of HIV/AIDS into various curricula across the country to ensure that all young people are aware and knowledgeable about HIV/AIDS.
The Government should ensure that policies aimed at reducing stigma and protecting the rights of PLWHA are adopted and implemented.
HIV Counselling and Testing should be promoted and encouraged with emphasis on the benefits of knowing ones status.
Improving access to HIV treatment, care and support by increasing the number of HIV treatment centres across the country
Giving the virus a human face through PLWHA activist who will speak out about living with the virus
Promoting the establishment of autonomous self-help groups/support groups that will act as support system and advocates for PLWHA in the country

[1] Definition of HIV-AIDS related stigma produced from Stigma-AIDS 2001, discussions and Regional Consultation on Stigma and HIV/AIDS in East and Southern Africa, 2001

tags: zo, zomi, zogam, lamka

I'm Indian* but...

2011-08-11T19:07:00.000+05:30

*condition apply

So the Honourable Chief Minister of Mizoram, Mr. Lal Thanhawla wanted all Mizos to accept their Indian nationality, or lose their ration card...humph thank God I got no ration card!!! (Sinlung News)

But, you know, dear Chief Minister, that sucks because even after living almost a decade in the National capital of India, I'm still not accepted as an Indian. And as a matter of fact, I really don't care it either. I'm tired of being an unaccepted and unacknowledged Indian national. By the way I've long given up complaining, whining and explaining the geography of India that almost 90% of Indian are guaranteed not to know, and in trying to cope with the plain and unabashed racism and discrimination I have faced because of that ignorance. My blog is a tastemant to that fact.

Anyway, what option do we really have? We want it or not, we are Indian, and we are the new untouchable Indian who have faced all sorts of discrimination in our so called country, which made us, people like me, a disgruntled lot. May be you didn't know how it feels to be a part of a group that doesn't want you. Perhaps you may blame us for us not willing to be called Indian. Perhaps it's time that we arrange some sort of agreement as to what we should be called. May be, a different kind of Indian, perhaps yellow Indian? But no matter what, no one, none who should, will acknowledge our claim.

Anyway, tell me, dear Chief Minister, how can a peacock be a crow when its feather are glittering like gems or is it the other way round - that the crow is as black as a coal. What difference does it make, a crow will never be a peacock, nor a peacock become a crow. It simply doesn't add up.

Perhaps you can teach the Indian govt. what and how, you and your family did to make your young wife feel comfortable and at-home just after you got married, and she entered your family home for the first time. It's too many decades late now to be treated as a new bride, but may be, just may be, it still can make some difference, if India, for once, treated us as it's own.

After so many years, if some sections of the Mizos, and other tribal communities in the north-east doesn't feel at home in India, and are not comfortable with the 'Indian' tag, it's hardly their fault. After all, their claim of being a free and sovereign people before being seceded into India is not a hoax or myth, and you know as well as me, that....is for a fact!!!

So, dear Chief Minister, what say you????

tags: zo, zomi, zogam, lamka

An Overview of Churachandpur District Census Data 2011

2011-05-24T19:04:00.001+05:30

Churachandpur belongs to us, isn't it? Anyway that's where we live, and that's the one place that concerns us mostly. Here is a quick overview of census 2011 for Churachandpur district and a bit of an analysis.

Population Density and Decadal Growth

Here is no big change, smaller district are gaining population which is a rather good sign in the sense that urban migration is not as rampant as supposed to be.

Literacy Rates and Literacy Gap between Male and Female

Here is a reason to celebrate (even though it’s not good enough). The literacy gap between Male and Female continued to be the lowest in our district. Even though we lag behind Imphal West in term of overall literacy rate, it seems our women have better access to education. (But this is also dependant on many factors, like the numbers of illiterate ageing population, statistical outliers, etc). By the way, the national/country gap is 16.68% which means two districts in our state is worst than the country percentage.

Sex Ratio

The country sex ratio is 940, Churachandpur’s is 944. We are a little better off than the country in our discrimination towards the girl child. Overall, in the state we ranked no. 5 which is an improvement from the last census where we ranked no. 7. (I always though we as a Christian will be more welcoming to a girl child than the Hindus in the plain area). But no doubt, our preference and the importance we attached to a male child is undeniable.

But there seems to be a little improvement among the present 0 – 6 years even thought they will not make much of a statistical difference in the next census.

The above table is based only among children belonging to age 6 and below (who are not included in literacy counts). If this is the trend for the future, than the sex ratio of Manipur is done for, however, the comfort is that, the above children will only contribute to the existing rate, and they will not be counted as separate, apart from that, we have a good nine years to correct the wrongs.

Huihui let’s make room for the girls. We are Christian, we are Zomi, we are proud of our women and their achievement, and we love bragging about how independent our women are. But we are not as good as we thought we are and apparently, we don’t love our women enough!

Why I Don't Support Anna Hazare

2011-04-30T00:18:00.000+05:30

My friend often asked me if I have been to the Ramlila Ground to support Anna. Sometime I told them I can't manage the time, and some time I just told them I choose not to be there.

The truth is, I love Anna Hazare, and admire his courage. I hate corruption as much as he does, and as much as you. I want the Lokpal Bill, and I want the Prime Minister's Office to come under it, and I want it to be implemented immediately....so basically I agreed with Mr. Hazare in every sphere....

But Anna lost the supporter in me when he said 'my Lokpal, or no lokpal'! That's it...that is the major reason why I am not out on the street supporting the man I so admired - Anna Hazare!

Besides, his authoritarian views on justice including his support for capital punishment and his alleged support for forced vasectomies as a method of family planning horrified me.

I'm a child of democracy, and I'm a child of freedom! As much as I believe in my freedom, I also believe in the freedom of other. I have seen war, I have seen anarchy taking over democracy, and I don't like either of it.

I believe the constitution is supreme, that my fundamental rights are fundamental, and that democracy is too precious to be used as a play thing.

I 'hate' people who undermine democracy and freedom, I 'despise' them as much as corruption. Anna Hazare just made to my list...

I don't support someone who 'ransomed' a democratically elected government, a government who have the country's mandate! I personally went to vote for this Government, and it hurts me to see that my Vote and fundamental right is being ransomed by a group of people....

No matter what their cause and reasons are, no matter my disappointment with the present government....I don't like being ransomed and hijacked! No matter what the end is, the mean is most important to me!

And, I still consider democracy and freedom as my fundamental right. I wouldn't let anyone tell me otherwise.

Thank You!

tags: zo, zomi, zogam, lamka

The Last Song

2011-03-30T19:16:00.004+05:30

I still must have run about butt-naked for all that I care, but that was a long time ago. It was the time when my grandmother was still alive and told me tales of the wondrous days of her youth. I can swear she did sing me a few songs when she'd find it hard to describe but for the life of me, I didn't remember a single word of the songs or what it was all about. But that was not the last time I heard those songs.

Now almost 20 years later, I’m scouring the internet for one of those songs (don't you wanna frown at the irony here -learning/looking for our traditional song in the internet!) for reason which I should have foreseen and which people have every right to expect of me.

See my sister who studies in Norway called me about her peculiar problem. "I have the perfect dresses (traditional) but what am I suppose to do about the traditional song or dance" she moaned. For all that I care she can sing one of those Lengtong Pauno's, but it did bug me that I myself didn't know a single line of those song, which people identified with me as my traditional song.

I remember, as a kid, our yearly sojourn to either one or the other of our aunts' village during the harvest festival. my parents would hardly approve of us going for the simple reason that there were free flow of alcohol but not wanting to offend any of the aunts, they would sent us packing without them hardly ever accompanying us. As the youngest in my family, I do feel lonesome, but anticipating for the festival in itself was a treat!

I remember, seeing men and women, young and mostly old, sitting around the hearth, or dancing along in circle in the big porch or court-yard, and throwing those songs at each other in anticipation of a reply. The reply did come every time and the song and dance would continue - the beat of the drums and the shrill but melodious voices mesmerizing the quaintly dead night in to a full bright morning.

Then I remember listening to, as a kid, the Smokies and the Eagles, the McKameys, etc, and while growing up came the Back-street Boys, MLTR, the Gaither Homecoming Friends, Avril Lavigne, Leeland, Sugarland, et al. They have entertained me and mesmerized me like any songs is suppose to do... And if I needed to express myself, I got a diary and a blog to express myself! I don’t need to twist and reverse words and sing it in monotone to express anything!

See I never needed the song! Am I still who I am since I didn't know and can't sing any of those so called 'traditional' song? A man without a leg is still a man, right? But then why do I write all this stuff about a stupid song if I don’t so much as care about it? Or is it really that stupid? And don’t I care?

But the truth is, I do care and it bugs me that I don't know any of those songs and can't sing even a single line. It is like a little stain in your favourite white shirt that people hardly notice but spoiled the cloth for you! Every time you looked at the cloth, you see the big (actually tiny-little) stain!

So for the sake of me, I downloaded those songs and practiced a few of them. I have never got the chance to sing or show-off. And when I do sing it, will it be the last song? I have this idea of force feeding my children (when I have them) with these songs. But how long will the song survives -especially when it is faced against the like of Lady Gaga and Justin Bieber?

The honest truth is, those traditional songs are dying... we can accept that fact or make plans to revive them by singing them in our daily life, in our churches, and re-packaging them in a different avatar! But then, that's not case now.

Another truth is, we had more advance and stylist way to express our feelings and emotions, we no longer need to sing each other a song... we just make a simple phone call. Those songs were supposed to be expressed and came from the heart only and are very special - just like my diary.

The final truth is - the last song had been sung and we don't know when! Another song will not be sung again simply because we don't know how to!

Psychosocial Impact of Disaster on Vulnerable Groups and Social Work Intervention With Survivors of Disaster

2011-03-04T22:33:00.000+05:30

(This is part of my assignment on types of disaster and psycho-social impact of disaster, references are given at the end)

Psychosocial Impact of Disaster on Vulnerable Groups

-Children

-Women

-Elderly

-Differently Able

Social Work Intervention with Survivors of Disaster

Conclusion

References

1. PSYCHOSOCIAL IMPACT OF DISASTER ON VULNERABLE GROUPS

Disasters do not affect everyone in the same way. At an individual level, some may experience a disaster with few or no psychological consequences, while others will go through the same disaster and be emotionally devastated. Beyond individual variation, certain categories of people are especially vulnerable or vulnerable in specific ways.

1.1 CHILDREN

Two myths are potential barriers to recognizing children’s responses to disaster and must be rejected: (1) that children are innately resilient and will recover rapidly, even from severe trauma; and (2) that children, especially young children, are not affected by disaster unless they are disturbed by their parents’ responses. Both of these beliefs are false. A wealth of evidence indicates that children experience the effects of disaster doubly.

Most children respond sensibly and appropriately to disaster, especially if they experience the protection, support, and stability of their parents and other trusted adults. However, like adults, they may respond to disaster with a wide range of symptoms. Their responses are generally similar to those of adults, although they may appear in more direct, less disguised form.

Among younger children, anxiety symptoms may appear in generalized form as fears (separation, strangers, animals, or sleep disturbances. They may withdraw socially or may lose previously acquired developmental skills (e.g., toilet training). Among the older ones, anxiety symptoms may appear in sleep disturbances, irritability, or aggressive behavior and angry outbursts may appear. Other changes in behaviour includes mood swing, obvious anxiety and fearfulness, withdrawal, loss of interest in activities, etc.

As children approach adolescence, their responses become increasingly like adult responses. Greater levels of aggressive behaviors, defiance of parents, delinquency, substance abuse, and risk-taking behaviors may be evident. School performance may decline. Wishes for revenge may be expressed. Adolescents are especially unlikely to seek out counselling.

1.2 WOMEN

Women’s roles and experiences create special vulnerability in the face of disaster. In poorer countries, women are more likely to die in disasters than men are. In richer countries, as well, women often show higher rates of post disaster psychological distress – depression, PTSD, and anxiety (Enrenreich, 2001). Several aspects of women’s experience of disaster may contribute to these results:

· Women are often assigned the role of family caregivers. As such, they must stay with and assist other family members. This may affect their willingness to leave their homes when a disaster (such as a storm) threatens.

· Women may be more isolated and home-bound due to their traditional roles. As a result, they may have less access to information (both before a disaster and after).

· In the aftermath of disaster, women may face another threat: violence. This threat may take several forms like physical or emotional abuse from their spouse and sexual exploitation by other.

· Women may also be exposed to rape and other forms of violence in shelters or refugee camps. In war situations, women and girls are extremely vulnerable.

· Health care facilities in shelters and refugee camps often do not attend to women’s needs with regard to reproductive health, and providing for relief of other sources of strain on women, such as responsibilities for childcare, often get a low priority.

· In the aftermath of disaster, women who have been widowed by the disaster may find it harder to remarry than men. Lacking skills that are saleable in the paid job market, they may be left destitute.

The experience of women in disaster, it should be emphasized, can create opportunities for women, as well. Women may have better social networks and hence, more social support than men. They may emerge as the leaders of grass-roots level organizations. They may be able to use disaster aid to develop skills and acquire tools and take on non-traditional roles.

1.3 THE ELDERLY

Reports on the responses of the elderly to disaster are inconsistent. In some disasters, they seem no more vulnerable than younger people. In others, they appear more vulnerable. Despite the inconsistency in formal research studies, there are reasons to believe that that the elderly are at increased risk for adverse emotional effects in the wake of disaster. They may live alone and lack help and other resources. Depression and other forms of distress among the elderly are readily overlooked, in part because they may not take on exactly the same symptom pattern as among younger people. For instance, disorientation, memory loss, and distractibility may be signs of depression in the elderly.

The elderly are also more vulnerable to being victimized. In the context of increased stress on the family and community, meeting their special needs may take on a lowered priority. One particular issue that may appear is feelings that they have lost their entire life (loss of children, homes, memorabilia) and that, due to their age, there is not enough time left in their life to rebuild and recreate.

1.4 THE DIFFERENTLY ABLED

Although people who are physically challenged and mentally ill or challenged have distinct needs from one another, all three groups are at especially high risk in disasters. For those in each group, the normal patterns of care or assistance that they receive and their own normal adaptations to produce acceptable levels of functioning are disrupted by disasters. For instance, supplies of medication, assistive devices such as wheelchairs, familiar caretakers, and previously effective programs of treatment may become unavailable. This has both direct effects and increases anxiety and stress. Stress, in turn, may exacerbate pre-existing mental illness. There may also be special needs with regard to housing or food.

Those who were mentally ill or developmentally delayed may also have fewer or less adaptable coping resources available and less ability to mobilize help for themselves. The ongoing problems of the disabled may seem to the other victims of the disaster to be of only minor importance in comparison to their own acute and unaccustomed suffering. Their disabilities may even seem like an obstacle to dealing with the disaster itself. The disabled are especially vulnerable to marginalization, isolation, and to “secondary victimization.” They are at greater risk of post-disaster malnutrition, infectious disease (e.g., in a shelter situation), and of the effects of lack of adequate health care.

2. SOCIAL WORK INTERVENTION

Social Work practice can adopt various approaches in intervention with survivors of disaster. At the micro level, we can undertake psycho-social support of victims and do curative work, at the mezzo level, we can undertake preventive measures like community mobilization and capacity building, and at the macro level, we can intervene in better disaster mitigation and management programmes.

At the micro level, psycho-social support in the context of disasters refers to comprehensive interventions aimed to address a wide range of psychosocial problems arising in the aftermath of a disaster. These interventions help individuals, families and groups to restore social cohesion and infrastructure along with maintaining their independence and dignity. Psychosocial support helps in reducing the level of actual and perceived stress that may prevent adverse psychological and social consequences among disaster affected people

The role of a social worker in providing psycho-social support to survivors varies from one disaster phase to another. It is thus important to understand their phase specific roles in the aftermath of a disaster.

A. Immediate phase: At the aftermath of the disaster, the first major role is to reduce the distress of the people by helping them overcome their trauma and come to terms with their losses (material or life). The second major role is to increase relief and the third major role is to establish linkages with resources.

B. Later phase: After the immediate phase of disaster is over, the next major role is the assessment of needs to ensure a holistic intervention. Interventions at this stage should focus on making people own the process and become equal partners in the entire rebuilding process right from planning to implementation. They should help survivors to ensure that the options are viable, sustainable and owned by the people. Regular monitoring should form an integral part of the needs assessment because it could bring out new issues that need to be addressed and lead to innovative intervention packages for better recovery and rebuilding. And, the final role is in referring a person to a specialist if the worker is not able to help the survivors to deal with their problems.

In order to make a holistic and beneficial intervention, the Social worker must adhere to some basic principles, values and understanding including;

- No one who experiences or witnesses the event is untouched by it

- Safety and material security underlie emotional stability

- Disaster stress and grief reactions are normal responses to an abnormal situation.

- Disaster results in two types of trauma i.e. individual and collective

- Interventions must be appropriate to the phase of disaster

- Interactions should be matched to the disaster phase

- Interventions must take people’s culture into account

- Direct interventions have an underlying logic

- Family and Social Support systems are crucial for recovery

- Recognize that there is a specially vulnerable group in the society

The basic techniques adopted by social worker in providing psycho-social care to survivors of disaster are (Sanapathy, 2009):

a) Ventilation: ventilation is a process to help the disaster survivors in expressing their thoughts, feelings and emotions related to the disaster and the resulting living conditions. Beside survivors of disaster who are undergoing traumatic-stress disorder and PTSDs have urgent need to ventilate, so they should be allowed to do so as it is shown to be therapeutic to them.

b) Empathy: Looking at the event from the other person’s perspective and trying to realise the trauma of the other person by keeping himself/herself in that situation

c). Active Listening: Active listening is an important skill to facilitate ventilation and develop empathy, which in turn facilitate the whole process of providing emotional support.

d). Social support: In a disaster situation all the support systems get disrupted, hence the need to rebuild and restore. The rate at which the survivors will get over with the trauma of the events will highly depends on the kind of social support he or she gets, and also social support in any form is known to be therapeutic.

e). Externalization of Interests: Engaging survivors in small but productive activity/work would help them in imbibing a positive thinking and feelings. This technique is very crucial from the participatory community disaster management approach. This also helps the survivors in providing a channel to ventilate/express some of their repressed emotions and feelings. In addition this technique has a positive impact on their self-esteem and self-concept. Once they are engaged, their minds will be meaningfully occupied and the physical movement will also add to the increased level of feeling better and energized.

f). The Value of Relaxation: Introducing relaxation activities for children (for instance some games, songs, dancing, painting, colouring and other things) and adults involving physical movement has proved to be very beneficial in helping survivors recover from their trauma and pain. These activities will help to channelise their energy and control some stress producing hormone.

g). Turning towards Religion and Spirituality: Religious belief or belief in a higher power greater than man is an integral part of human beings’ existence and this gives great relief and support during critical periods of their lives. Similarly, spiritualism can also help in rebuilding shattered life gradually. Therefore, it is important to reinforce the religious practices and spirituality in the person we are working with because it has tremendous power to heal the pain and suffering.

Psychosocial and emotional care services deal with human emotions, thoughts and behaviours in situations when people are highly distressed due to their exposure to disaster consequences. It is important to understand that, providing this type of care services is not a charity or pity rather it is an essential aspect of the human rights of the survivors to live with dignity in disaster situations.

3. CONCLUSION

India is a theatre of Disasters. Natural disasters are quite frequent in different parts of the country, be it earthquake, Tsunami, cyclone, flood, drought or land-slides. Further the human made disasters like industrial, chemical, fire, nuclear, riots, refugees, internally displaced persons and prolonged conflicts and other complex situations retard country’s overall development. These disasters are quite devastating and life threatening for the affected people.

Disasters have impacts on individuals, families and communities. These are not distinct, separable effects. The devastating effects of disaster on the individuals making up a family or a community play a major role in creating the family and community effects. Even more important, social support systems play an extremely important role in protecting individuals from the impact of the disaster and from the impact of stress in general. Social disruption both reduces and interferes with the healing effects of the family and the community and is itself an enormous source of stress on the individuals who make up the family or community. Disruption of the family or community may be more psychologically devastating, both in the short run and especially in the long run, than the disaster itself.

However, disaster tends to dehumanize the majority population, evident in the manner of their treatment of survivors. This is most evident amongst the marginalized section of the society. For example, in every disaster in India, the medium of meeting the emotional needs of women usually is to arrange for their marriage. Secondly, community participation in post-disaster rebuilding seems a goal unattained. The government always took over a parental role of doling out compensation and the community are pre-occupied with chasing after the compensation. Thirdly, India does not have a framework for rehabilitation with a long-term perspective. In most disasters, there is a massive upsurge of goodwill and material support at the acute phase, but once the acute phase is over, they are totally ignored.

India is a vast country and undeniably disaster prone, however, it must challenge why each and every disaster is allowed to cause the same amount/level of damages with every new disaster, again and again.

The most basic issue in psychosocial intervention following disasters is to transform those affected from being victims to survivors. What differentiates a victim from a survivor is that the former feels himself subject to a situation over which he has no control over his environment or himself, whereas a survivor has regained a sense of control and is able to meet the demands of whatever difficulty confronts him. A victim is passive and dependent upon others; a survivor is not – he is able to take an active role in efforts to help his community and himself recover from the disaster (Ladrido-Ignacio & Perlas, 1995).

4. REFERENCES

1. British Psychological Society (1990): Psychological Aspects of Disaster; British Psychological Society, Leicester

2. Cedar Rapids Counselling & Psychotherapy Group (2008): Phases of Disaster; Back to Business: Health Recovery – Stress Management, Cedar Rapid (AI)

3. Centre for Research on the Epidemiology of Disasters (CRED): Technical Reference, Chapter 4. Disaster: Types and Impact, "Safer Homes, Stronger Communities: A Handbook for Reconstructing after Natural Disasters" published by the World Bank in January 2010.

4. Ehrenreich, John H, (2001): Coping with Disaster: A Guidebook to Psychosocial Intervention (Revised Edition), Centre for Psychology and Society, State University of New York (also available at http://www.mhwwb.org)

5. Ladrido-Ignacio, L, & Perlas, AP, (1995): From victims to survivors: Psychosocial intervention in disaster management in the Philippines. International Journal of Mental Health, 24, pp. 3-51.

6. Roa, MVS Srinivasa (2006): Chapter 5: Psycho-Social Consequences of Disaster in Disaster Management, Oxford Press, New Delhi

7. Satapathy, Sujata (2009): Psychosocial Care in Disaster Management: A Training of Trainers Module; National Institute of Disaster Management, Ministry of Home Affair, GOI, New Delhi

8. WHO (1992): Psychosocial Consequences of Disabilities: Prevention and Management”. WHO/MNH, PSF/91.3, Rev. 1

INTERNET

1. David Baldwin’s Trauma Pages, http://www.trauma-pages.com

2. Disaster Management, http://www.en.wikepedia/disastermanagement

3. Disaster Mental Health Institute, http://www.ncptsd.org

4. International Society for Traumatic Stress Studies (ISTSS). http://www.istss.org

5. National Centre for PTSD, http://www.dartmouth.ed/dms/ptsd

tags: zo, zomi, zogam, lamka

PSYCHO-SOCIAL IMPACT OF DISASTER

2011-03-03T22:29:00.000+05:30

(This is part of my assignment on types of disaster and psycho-social impact of disaster, references are given at the end)

1. Impact of Disaster

2. Social Impact of Disaster

3. Psychological Impact of Disaster

4. Psychosocial Impact of Disaster

1. IMPACT OF DISASTER
Disaster impacts comprise physical, health, economic, social and psychological impact. This paper focuses on the psycho-social aspect, so before we go into the details, let’s take a look at the other kind of impact (i.e. physical, health and economic aspect) that a disaster can have.

The physical impacts of disasters include casualties (deaths and injuries) and property damage which leave the survivor homeless, and both vary substantially across hazard agents. The physical impacts of a disaster are usually the most obvious, easily measured, and first reported by the news media.
Health Impacts of disaster lies in the number of injuries which occur from the event itself, and which followed later on in the form of different virus and diseases. In the short-term, the major health concern is on the injured, and the disturbances of supply of basic amenities like clean drinking water, food, medicines, medical treatment, etc. to prevent an outbreak of diseases. In the long-run, the major health concerns include provision of health facilities, exposure to the environment due to lack of proper shelter and clothing, and an outbreak of malnutrition and famine due to the disaster.
Economic Impacts of disaster will include loss of property and economic establishments like shops, farms etc., damaged social infrastructure, loss to trade and business, and disturbance to livelihood activities.

1.1 COMMUNITY OR SOCIAL IMPACT OF DISASTER
Disasters directly affect their individual victims. But beyond that disasters create tears in the tissue of social life. Sometimes this is direct and total, as when disaster forced people to leave their land and migrate elsewhere. In other cases, the rapid influx of helpers, the presence of government officials, press, and other outsiders (including mere curiosity seekers), and the flood of poor people from outside the disaster area into a disaster area seeking their own share of the food and other supplies relief agencies are providing to disaster victims, combine to further disrupt the community.
Even when the formal structure of a community is maintained, the disaster can disrupt the bonds holding people together, in families, communities, work groups, and whole societies. When those bonds are destroyed, the individuals comprising the affected groups lose friends, neighbours, a community, a social identity. These collective effects of disaster may ultimately be as devastating as the individual effects. The consequences of disaster for families, neighborhoods, communities, and societies are many:

Change in Family Dynamics: Disaster-produced deaths or disabilities, family separations, and dependency on aid givers and intervention by outsiders that may upset or challenge traditional child rearing practices, traditional patterns of male-female relationships, traditional line of authority and hierarchy, or in simple term, may force people out of traditional roles or into new ones.
Increase in Family/Community Violence: In the wake of disaster, marital conflict and distress rises; increases in marital conflict, parent-child conflicts, intra-family violence (child abuse, spouse abuse) are reported to be rampant.
Change in Community Dynamics: Disasters may physically destroy important community institutions, such as schools and institutions, and traditional patterns of authority are disrupted along with customary social controls on individual behaviour. Disasters can also disrupt the ability of communities to carry out customary or traditional livelihood activities central to people’s individual, community, and social identity, ranging from work and recreational activities to accustomed rituals.
Change in Societal Role Dynamics: Disasters place a strain on traditional community social roles, patterns of social status, and leadership. In the wake of disaster, new leaders may emerge in a community, due to the role of these people in responding to the disaster.
Increase in Anti-social Elements: Several studies have shown an increase in the rates of community violence, looting, riots, agitation, aggression, drug and alcohol abuse, and rate of legal convictions in the wake of disaster.
Change in Community Source of Livelihood: Disasters disrupt the ability of communities to carry out customary or traditional livelihood activities. Some of these disruptions are temporary, but others are hard to reverse. This may be limited to personal possessions or may lead to permanent loss of tools, animals, and land.
Change in Productive patterns: Disaster may lead, directly or indirectly, to permanent changes in productive patterns, especially patterns of land ownership and use. Shifts from subsistence agriculture to wage labor, land looting, migration and uprooting and resettlement play a role.
Change in Community Cohesion: Schisms may appear in a community, as cohesion is lost. One danger is that of scape-goating, either of individuals or using traditional divisions in the community (e.g., along religious or ethnic lines).

The social impact of disaster can progress at a very slow pace and develop over a long period of time and can be difficult to assess when they occur. Despite the difficulty in measuring these social impacts, it is nonetheless important to monitor them, and even to predict them if possible, because they cause significant problems for the long-term functioning of specific types of households and individual member of an affected community.

1.2 PSYCHOLOGICAL IMPACT OF DISASTER
Living in a disaster area can be highly stressful. Staying in damaged buildings, relocating to shelters, dealing with the death or injuries of loved ones, as well as the prolonged time and energy involved in recovering from the affects of the disaster can result in feelings of anxiety and depression. Disaster is known to cause a wide range of negative psychological responses in the victims including:

- psychophysiological effects such as fatigue, gastrointestinal upset, and tics;
- cognitive effects such as confusion, impaired concentration, attention deficits;
- emotional effects such as anxiety, depression, and grief;
- behavioural effects such as changes in sleep and appetite, substance usages;

Although the precise figures vary from situation to situation, up to 90% or even more of victims can be expected to exhibit at least some untoward psychological effects in the hours immediately following a disaster. In most instances, symptoms gradually subside over the weeks following. By twelve weeks after the disaster, however, 20% to 50% or even more may still show significant signs of distress. The number showing symptoms generally continues to drop, but delayed responses and responses to the later consequences of disaster continue to appear. While most victims of disasters are usually relatively free of distress by a year or two after the event, a quarter or more of the victims may still show significant symptoms while others, who had previously been free of symptoms, may first show distress a year or two after the disaster. Anniversaries of the disaster may be especially difficult times for many survivors, with temporary but unexpected reappearance of symptoms which they had thought were safely in the past (Ehrenreich, 2001).
The extraordinary prevalence of such strong physiological, cognitive, and emotional responses to disasters indicates that these are normal responses to an extreme situation, not a sign of ‘mental illness’ or of ‘moral weakness’. Nevertheless, the symptoms experienced by many victims in the days and weeks following a disaster are a source of significant distress and may interfere with their ability to reconstruct their lives. If not addressed and resolved relatively quickly, such reactions can become ongoing sources of distress and dysfunction, with devastating effects for the individual, their family, and their society.

1.3 PSYCHOSOCIAL CONSEQUENCES OF DISASTER
To what extend the disaster will be affect the victims will depend on the context of the individual’s social support system. Secure, supportive relationships are essential for the victims’ processing of the events and the eventual recovery. Those who have no close and supportive social environment are more vulnerable whereas those who are in a supportive environment can more easily cope with the situation.
Psycho-social coping with disasters depends upon the ability of the victims to adjust psychologically, the capacity of community structures to adapt to crisis, and the help available to the victims. The most common psycho-social consequences of disasters are:
(a) Cauldron of Emotions
A cauldron of emotional reactions can come to the boil after a disaster. Beginning with numbness, traversing elation, and relief for having survived, the victims will eventually ride up an ‘anxiety escalator’. Common post-disaster reactions include flashbacks, nightmares, involuntary triggering of memories, panic attacks, etc, often culminating in a proactive ‘avoidance response. Normally, this psycho-social impact of disaster settles down within the first weeks, however, if they remain protracted and intense, they represent a post-traumatic stress disorder .
(b) Disaster Syndrome
The disaster syndrome, as currently known and understood in the social sciences disaster literature, is the human condition characterized by ‘stunned psychological incapacitation’, ‘shock’, and ‘immobility, inability to act rationally, and inability to take care of oneself or others’ in the aftermath of a disaster. This “psychological shock” following disaster impact affects ‘only a small proportion of people’ and when it occurs, the condition is usually ‘short lived, say the sources. In major disaster with high casualty rate, disaster syndrome is often seen in about 25% to 75% of the victims in the first week, but significantly dropped within 10 weeks.
(c) Grief Reactions
Grief is a multi-dimensional syndrome, it can be for love ones, home, treasured possessions, livelihood, or community. The severity of the morbidity is greater when it is associated with personal loss. The emotional reactions of grief include sadness, distress, and anger as well as longing and yearning. Grief reactions usually tape off in 4-6 weeks and recurrences are induced by anniversaries. Psychological morbidity among the bereaved is aggravated by a weak social support systems, particularly in the case of women who have lost children. Intense grief reactions, in fact, can become chronic and lead to severe depression.
These psychological and practical obstacles to a ‘normal’ grief reaction or response to the death of a loved one may contribute to a feeling of lack of closure or permit magical fantasies that the deceased person has not, in fact, died. Any of several abnormal bereavement syndromes may appear[1].

· Inhibited Grief: The bereaved exhibits a pattern characterized by psychic numbing, over-control and containment of emotions, little display of affect. They may be seen as “coping well,” yet this pattern is associated with later depression and anxiety.
· Distorted Grief: The bereaved shows intense anger and hostility which dominate over their sadness and guilt. This anger may be directed at anyone the bereaved associates with the deceased’s death (e.g., relief workers).
· Chronic Grief: The feelings of sadness and loss do not dissipate. Frequent crying, pre-occupation with the loss are unremitting.
· Depression: The bereaved lapses into depression, with prolonged grief, despair, and a sense that life is not worth continuing. Sleep and appetite disturbances may appear. The bereaved may have active fantasies of being reunited with the deceased and suicidal ideation or attempts may occur.
· Excessive Guilt: The bereaved may show excessive self-recrimination and guilty pre-occupations, which eclipse their sadness. Self destructive, yet not overtly suicidal behaviors, such as frequent accidents or excessive drinking may occur.

(d) Post-Traumatic Stress Disorder (PTSD)
Battle fatigue like feeling typically numb at first but later, depression, excessive irritability, recurrent nightmares, flashbacks to the traumatic scene, over reaction to sudden noises, feeling of guilt because significant others are dead while the individual is still surviving are some sign that the survivor is under Post-Traumatic Stress Disorder. The characteristic symptoms of Post Traumatic Stress Disorder include:

· Persistent re-experiencing of the traumatic event: Recurrent and intrusive recollections of the events of the disaster; recurrent distressing dreams in which the disaster is replayed; intense psychological distress or physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event; or experiences in which the victim acts or feels as if the event is actually re-occurring.
· Persistent avoidance of stimuli associated with the trauma and continued numbing of general responsiveness: Efforts to avoid thoughts or feelings or conversations about the disaster; efforts to avoid activities, places, or people that remind the victim of the trauma; inability to recall important parts of the disaster experience; markedly diminished interest or participation in significant activities; feelings of detachment or estrangement from others; restricted range of affect; or a sense of a foreshortened future, without expectations of a normal life span or life.
· Persistent symptoms of increased arousal: Difficulty falling or staying asleep; irritability or outbursts of anger; difficulty concentrating; hyper-vigilance; exaggerated startle response.

This general cluster of symptoms has been reported in every part of the world. In less industrialized parts of the world and among people coming from these areas, the avoidance and numbing symptoms have been reported to be less common and dissociative and trance-like states, in which components of the event are relived and the person behaves as though experiencing the events at that moment, may be more common.

(e) Post-Traumatic Syndrome (Post-Traumatic Depression)
Psychological effects of the disaster may persist for many months; from acute phase if they move onto chronic phase, they tend to suffer from posttraumatic syndrome. Though the symptoms of posttraumatic syndrome generally appear soon after the trauma, in some cases there is an “incubation period”. Some of the important symptoms are: difficulty in falling or staying sleep, Irritability or outbursts of anger, difficulty in concentration, hyper vigilance, exaggerated startle response almost similar to panic attack, etc.
Post Traumatic Depression: Protracted depression is one of the most common findings in studies of acutely or chronically traumatized people. It often occurs in combination with Post Traumatic Stress Disorder. Trauma can produce or exacerbate already existing depression.
Common symptoms of depression include sadness, slowness of movement, insomnia (or hypersomnia), fatigue or loss of energy, diminished appetite (or excessive appetite), difficulties with concentration, apathy and feelings of helplessness, anhedonia (markedly diminished interest or pleasure in life activities), social withdrawal, guilty ruminations, feelings of hopelessness, abandonment, and irrevocable life change, preoccupations with loss, and irritability. In some cases, the person may deny being sad or may complain, instead, of feeling “blah” or having “no feelings.” Some individuals report somatic complaints, including widespread aches and pains, rather than sadness. Suicidal ideation or attempts may appear. With children, somatic complaints, irritability, social withdrawal are particularly common.
In some cultures, depression may be experienced largely in somatic terms, rather than in the form of sadness or guilt. Complaints of “nerves”, headaches, generalized chronic pain, weakness, tiredness, “imbalance,” problems of the “heart,” feelings of “heat,” or concerns about being hexed or bewitched may appear.

[1] Note: Different cultures vary widely with respect to the ‘expected’ reaction in situation of grief. [For further information on this, please refer to John H Enrenreich’s Coping with Disaster. Also available at http://www.mhwwb.org]

CATEGORIES OF VICTIMS & PHASES OF DISASTER

2011-03-02T22:21:00.000+05:30

(This is part of my assignment on "types of disaster and psycho-social impact of disaster", references are given at the end)

1. Categories of Victims of Disaster

2. Phases of Disaster

1. CATEGORIES OF VICTIMS OF DISASTER

Almost everyone in the population is affected by a disaster. No one is untouched by it. Those who suffer damage are called victims. The victims may die or live. Those who manage to live are called survivors. These survivors can be classified as follow (CRED, 2010):

VICTMS	DEFINITIONS & EXAMPLES
Primary Survivor	One who is exposed to the disaster first-hand and then survives. They are called ‘survivor victims’. Intervention is primarily for them since they are the most highly impacted amongst the victims. *Survival guilt* (“why don’t I die with my family?”) is very high among primary survivor.
Secondary Survivor	One who grieves the loss of primary victims, Eg. A mother who lost her child, or a man who lost his friend. *Self-blame* (“I should have done this”) is common among secondary survivor.
Third Level Survivor	The rescue and relief personnel who are exposed to the devastation and sufferings of people are also highly affected by the disaster. They undergo almost the same mental trauma as the other victims.
Fourth Level Survivor	Reporters, government personnel, traders, etc.
Fifth Level Survivor	People who read about or see the event in media reports.

2. PHASES OF DISASTER

Disasters are not totally discrete events. Their possibility of occurrence, time, place and severity of the strike can be reasonably and in some cases accurately predicted by technological and scientific advances. It has been established that there is a definite pattern in their occurrences and hence we can to some extent reduce the psychosocial impact of damage though we cannot reduce the extent of damage itself.

There are a number of disaster phases that have been identified by mental health professionals (CRACC, 2008). Each of these phases is associated with emotional and behavioural elements, although there is often overlap.

(i) Pre-disaster Warning: The length of this phase depends on the event. For flooding, there are usually several days of warning that give people time to prepare, but for tsunami the warning might be short, while earthquake may not come with a warning.

(ii) Impact/Inventory (within hours): People may be temporarily stunned or confused as the disaster strikes, but they quickly recover and focus on protecting themselves and those close to them. Emotions include fear, helplessness, loss, dislocation, and feeling responsible ("I should have done more"). The inventory phase immediately follows the event as people start forming a preliminary picture of individual and community conditions. Emotions are wide-ranging as the extent of the impact is realized.

(iii) Heroic (up to 1 – 2 weeks): Throughout these first phases and afterward, people are responding to demands for heroic action to save the lives and property of others. Altruism is prominent. And people are willing to put forth major energy to help others survive and recover.

(iv) Honeymoon (1 – 24 weeks): This phase generally extends from one week to six months after the disaster. For those most directly affected, there is a strong sense of having shared with others a dangerous, catastrophic situation. For the community, there is a sense of cohesion and working together to recover. Relief efforts are in full swing, and hopes of a quick recovery run high. The emotions associated with this phase range from gratitude and hope to grief and continued disbelief.

(v) Disillusionment (2 months – 2 years): This phase can last from two months up to two years. The realities of recovery set in, and people experience feelings of disappointment, frustration, anger, resentment and bitterness if setbacks occur and promises of assistance are not fulfilled or are seen as too little, too late. Outside relief agencies and volunteers leave and some local community groups may weaken. Those most directly affected realize they have much to do themselves and their lives may never be the same. The ‘shared community’ feeling may gradually be lost as people concentrate on rebuilding their own lives and solving individual problems. Emotions are likely to include self-doubt, loss, grief, and isolation.

(vi) Coming to terms/Reconstruction (2 -5 and Lifetime): This phase generally lasts for several years after the disaster. Survivors focus on rebuilding their homes, businesses, farms and lives. The appearance of construction and new buildings, and development of new programs and plans bolster residents' belief and pride in community and in their own individual abilities to rebuild. But this process can be marked by ups and downs as anniversary and other events trigger emotional reactions, and if signs of progress are delayed.

It is important to understand the various phases of disaster because adopting the most appropriate approach right after the onset of disaster can make a big difference in the long-term, especially in the sphere of dealing and coping with the psycho-social impact.

TYPES OF DISASTER

2011-03-01T22:19:00.000+05:30

(This is part of my assignment on types of disaster and psycho-social impact of disaster, references are given at the end)

1. Introduction

2. Concept of Disaster

3. Types of Disaster

1. INTRODUCTION

Disaster is a phenomenon that causes huge damage to life, property and destroys the economic, social and cultural life of people. It is a tragic event with great loss stemming from events such as earthquakes, floods, catastrophic accidents, fires, riots or explosions.

Every disaster results in deaths and injuries, damages and destructions, which are always visible. What are not always visible are the mental agony, trauma and stress of the survivors who have suffered losses of their near and dear or sustained damages of their assets and property.

Often such invisible impacts of disasters escape the notices of decision makers as well as rescuers till the affected people crowd the hospitals or suicide rates go up. Often such distress has continued for long after the initial outpouring of goodwill and charity of the general public and attention of media had died down, and even after the physical damages have been restored and reconstructed. Early recognition and proper intervention could have prevented many such prolonged agonies.

Today, there has been recognition of the need and importance of psychosocial intervention in the aftermath of a disaster. This has encouraged innovative research and practices that contributed to the knowledge base in disaster management more than ever before.

This paper will attempt to explain the concept of disaster and explain in details the various types of disasters. Then it will analyse the psycho-social impact of disaster on the individual, family and the community, and conclude with what kind of social work intervention can be undertaken.

2. CONCEPT OF DISASTER

- Disaster is “any occurrence that causes damage, ecological disruption, loss of human life, deterioration of health and health services, on a scale sufficient to warrant an extraordinary response from outside the affected community or area” (WHO, 1992)

- Disaster means a catastrophe, mishap, calamity or grave occurrence in any area arising from natural or manmade causes, or by accident or negligence which results in substantial loss of life or human suffering or damage to, and destruction of property or damage to/degradation of environment and is of such a nature of magnitude as to be beyond the coping capacity of the community of the affected area (DM Act 2005, GOI).

Disaster is a serious disruption of the functioning of a society, causing widespread human, material, or environmental losses which exceed the ability of the affected society to cope using only its own resources.

Thus, by definition itself, there cannot be a perfect ideal system that prevents damage, because then it would not be a disaster. It has to suffocate our ability and capacity to recover. Only then it can be called as disaster.

In contemporary academia, disasters are seen as the consequence of inappropriately managed risk. These risks are the product of a combination of both hazard/s and vulnerability. Hazards that strike in areas with low vulnerability are not considered a disaster, as is the case in uninhabited regions. For instance, a mud-slide in the jungle of the Amazon may not be a disaster, but a mud-slide in the poverty-stricken slum clusters of Mumbai definitely is a disaster.

Hazard refers to any phenomenon, substance or situation that has the potential to cause disruption or damage to infrastructure and services, people, property and environment. Capacity is the resources and skills people possess, and can be develop, mobilize and access that will allow them to have more control over shaping their own future and coping with disaster risks. Vulnerability is a concept that describes factors or constraints of an economic, social, psychological, physical and geographic nature, which reduce the ability of a community to prepare for and cope with the impact of hazards. Risk is the probability that negative consequences may arise when hazards interact with vulnerable areas, people, property and environment.

The damages caused by disasters are immeasurable and varies with the geographical locations, climate and the degree of vulnerability. Those related to weather and the earth’s geology like tsunami, earthquake, hurricane, cyclone, flood, etc. are the most widely recognized. However recent events like Fukishima Nuclear Leak in Japan (2011) and the Godhra Communal riot in Gujarat (2002), etc., point out that the sources and kind of damages are more complicated.

3. TYPES OF DISASTER

It is important to understand various kinds of disasters because depending upon the actual nature of disaster, the immediate reaction needs to be different. Understanding of each kind of disaster might also help in identifying the onset of a disastrous event, so that appropriate actions can be undertaken at all stages which could have a major impact on the final outcome in terms of amount of final loss.

Disasters are classified in various ways. Based on the time it takes to strike, disasters may occur suddenly (sudden disaster) like earth-quake and tsunami, or they may develop over a period of time (a slow onset) like climate change, famines caused by years of drought. However, disasters are commonly categorized by their origin –natural disaster and man-made disaster. Based on the scale of devastation and damage it caused, natural and man-made disasters are further classified into major/minor natural disaster and major/minor man-made disaster.

3.1 Natural Disaster

Natural disasters are primarily natural events. It is possible that certain human activities could maybe aid in some of these events, but, by and large, these are mostly natural events. A natural disaster is a consequence when a natural calamity affects humans and/or their built environment.

Among various natural hazards, earthquakes, landslides, floods and cyclones are the major disasters adversely affecting very large areas and population in the Indian sub-continent. These natural disasters are of (i) geophysical origin such as earthquakes, volcanic eruptions, land-slides and (ii) climatic origin such as drought, flood, cyclone, locust, forest fire, etc.

Natural Disasters can be broken into different categories based on its origin and cause as given in the table below.

CATEGORIES	DEFINITIONS & EXAMPLES
Geophysical Disasters	Those events originating from solid earth, e.g. earth-quake, volcano, landslide, etc.
Hydrological Disasters	Those events caused by deviations in the normal water cycle and/or overflow of body of water caused by wind set-up. Eg. flood, storm, coastal flood, etc.
Meteorological Disaster	Those events caused by short-lived/small to meso-scale atmospheric process (in the spectrum from minutes to days). Eg. tropical cyclone, hurricane, storm, tornado, etc
Climatological Disaster	Those events caused by long-lived/meso- to macro-scale processes (in the spectrum from intra-seasonal to multi-decadal climate variability). Eg. heat wave, cold wave, drought, etc.
Biological Disaster	Those disaster caused by the exposure of living organisms to germs and toxic substances, Eg. epidemic, plague, diseases, insect infestation, etc.

Source: CRED (2010)

For some type of natural disaster, it is possible to predict disaster to some extent, however it is not possible to control nature and to stop the development of natural phenomena but efforts could be made to avoid disasters and alleviate their effects on human lives, infrastructure and property through disaster management.

3.2 Man-made Disaster

Anthropogenic hazards or man-made disaster can come to fruition in the form of a man-made disaster. In this case, "anthropogenic" means threats having an element of human intent, negligence, or error; or involving a failure of a man-made system. This is opposed to natural disasters resulting from natural hazards.

Man-made disasters cover a wide range of events created largely due to accidents, negligence or sometimes even by human design, which result in huge loss of lives and property every year all over the world. These include road, rail, river, marine and aviation accidents, oil spill, building and bridge collapse, bomb blast, industrial and chemical accidents etc. These also include the threats of nuclear, biological and chemical disasters.

Man-made disaster can be divided into different categories viz. sociological disaster, technological disaster, transportation disaster and hazardous or CBRNs disaster.

CATEGORIES	DEFINITIONS & EXAMPLES
Sociological Disaster	It includes those disasters like war, civil disorder, communal riots, crimes, arson and terrorism
Technological Disaster	It includes those disasters like industrial accidents, fire, structural collapse, etc.
Transportation Disaster	It includes those disasters related to accident of train, aeroplane, ship, etc.
Hazardous or CBRNs Disaster	It includes those disasters related to chemical, biological, radiological and nuclear (CNRN) accidents

Source: CRED (2010)

The extent of damage caused by man-made disasters varies greatly and while this is the case, it is important to state that others have notably high costs when compared to others. This is especially true when it comes down to responding and recovering. Additionally, there are different factors which influence the costs such as location. For instance, if this were to occur in densely populated but wealthy countries, the end result might prove to be huge. However, if the same were to occur in densely populated but poor countries, the after effect costs might prove to be lower and this is in part closely tied to insurance.

One Hundred Years of...?

2010-05-18T21:23:00.003+05:30

One hundred years of Christianity
One hundred years of Civilization
One hundred years of Modernity
One hundred years of Celebration

celebrating Christ in our life, each day and everyday
celebrating the love, peace and harmony it brought to us

The last line is a bit awkward, but there is no denying that we, the Zomi, have come a long way within just a century...

from jungle dweller to urban crawler
from head hunter to money hunter

There are hundreds of parameters to measure the speed of our transformation...and i guess, if we could measure in term of "kph", it must be faster than one of those F-1 cars, leaving trials of stories

of miraculous transformation and structural destruction
of churches, schools and rehab center
for good and for worst

One hundred years is a relatively short period for a community to complete its transition and long enough for the future to take its roots. Are we satisfied with what we have seen so far, and what are the hits and misses?

If we could put away our differences to celebrate this occasion, we could also come together for our future's sake. It's time to reflect, analyse and assess our situation.

May God bless you all!

Centenary Greeting!

tags: zo, zomi, zogam, lamka

No Hope

2009-12-05T00:50:00.005+05:30

Walk around the state of Manipur, you would find many young men –educated and uneducated; some may even belongs to an insurgent group and some could be a wrecked-out daily labourer; some walk with big dreams and empty pocket, and some are aimless wanderers. They all may speak different dialect; they may come from different background, tribes and upbringing. But one thing they have in common is that they don't know the roles, functions and duties of the Government towards them.

Go and ask them what they want the Government to do for them; most probably they won’t know how to answer, or what to say at all. But ask them about their lives, their families, and their backgrounds, you would most probably find hundred things that the Government can do for them.

Go and ask the old woman what sort of help she got from the Government, she would say nothing. Ask her what she wants from the Government; she would most probably have no idea. Ask her if she knew any welfare scheme for an old and poor woman like her, she won’t have a clue. Think of the amount the central and state governments have spent on all those welfare schemes.

Go and ask one young insurgent why he chose to be what he is, his answer, most probably would be he had nothing else to do at home. Then, ask yourself 'why' he had nothing at all to do at home and think of 'what' he can do and 'why' he can’t do what you think he can do, then, you will know who failed them.

For a lot of wronged youths, joining one or the other insurgent groups has become the sole viable option to vent their discontentment, and demand redressal because they feel they are being denied a fair treatment. They may never knew in which way they are being wronged, but at least they know how to compare their situation with youth their age of other states or countries, and they could clearly see the differences. They may never be able to tell you eloquently what they are deprived of, but you don’t need to be a social scientist to know what they are deprived of.

Their feelings of discontentment and humiliation make them become an easy fodder for insurgent group who had been waiting for this opportunity. It’s high time the government wake-up and perform the duties of a government.

It may be difficult to bring awareness to people who had resigned to their fate, and waking up a government that pretend to be as deaf as a statue and as mute as the Chief Minister himself. But then it has to be done, in one way or the other.

tags: zo, zomi, zogam, lamka

WILL SOMEONE APOLOGIZE TO ME FOR '97?

2009-09-29T13:57:00.002+05:30

Recently I read about a series of significant historical apology made by leaders for something that was done many years ago like the Australian Prime Minister Kevin Rudd’s apology to the Aborigines for inflicting grief, suffering and loss that happened more than half a century ago. And, that get me to thinking if I can ever expect anyone at all to apologize to me for what happened in ’97, and for its aftermath, the consequences and scars it left on my life?

They said that an apology is the first-step towards starting any kind of healing process. And for sure, even after a decade, I’m still nursing those consequences. Every time I cursed my lot, I can trace its root to ’97 –for throwing me out of school and out of my normal routine of life; for taking away my home and friends, for filling my childhood memories with horrible images and thus, stealing my childhood.

I am not the only one affected. There are more, much more, who were at critical stages of their life at that time, and who, otherwise, have been promised much by life but could not achieve just because of what happened. Those people deserve an apology even much more than me.

First of all let me clear that I’m not referring to us apologizing to them or vice versa (if that is possible it will be superb). But for the time being I’m referring to something like a father to son apology. Some of us may argue if an apology is needed at all, saying that we all had gone through the same situation, or that we were only defending ourselves or that there is no reason for us to apologize since it’s not our fault.

It is true that we needed to protect ourselves particularly at that time and especially in view of the inherent apathy of our state government. But who are we protecting when we started killing people of our own or when we extorted, harassed and exploited the very people that we were/are supposed to be protecting?

It’s very well if you argued that we were left with no choice or option but to strike back. It may sound a bit cliché but there always is choice and options if we want. I am not saying that we could avoid it or the situation could have been handled in a better way, but I am saying that we could have mitigated its impact better especially among the younger generation, and don’t let its effect, especially the psychological aspect, linger on for so long. By the way, they says it takes two to tango, so what did we do, consciously or unconsciously, for them to do what they did?

It is also true that we all went through the same ’97. But no, CAPITAL NO, it was NOT the same situation that we went through in ’97. You and I were at totally different footing at that time and we are not the same either now; our socio-economic status were not the same; our conditions were not the same; our losses were not the same; its impact on the region, village, family and individual were not the same either. In fact, some of us even gained from it, when some of us lost everything… Under no parameter can this be called the same!

You may not want to admit it, but ’97 does have an impact on each one of us, and most likely, in the negative way. You may be trying to see the bright side and counting your blessing or thanking your luck for surviving it but you have to admit that you could have been more than what you are now if not for what happened in ’97.

But the problem is who will apologize. Will our respective community leaders take responsibility and apologize? Well, we all doubt that so much it almost sound funny! So where do we start? You and I can very well apologize to each other, but still, someone, some people, with authority and claim will still owe us an apology. And I am not sure if I would ever hear that in my life time.

I have no claim to represent or have authority to speak for anyone other than me. So I am going to speak for myself and start by saying –

I APOLOGIZE FOR WHAT HAPPENED TO YOU IN
’97!

Will you too apologize to me… please?

No Tourist Season For Lamka?

2009-07-27T13:56:00.001+05:30

Recently my Boss had to tour the North-East for a series of pre-bid meetings. Imphal was her last-stop and she said she might visit CCPur (Lamka, we call it) if I can suggest something worth seeing there. I sheepishly scratched my head not exactly sure what to suggest.

The holidayer to Manipur that I knew of, come in two seasons. The first batch started as soon as the summer holidays started and ends just before school/college re-opened. They are mostly college students or families with school going kids. The second batch started from early December and ended in January. These winter holidayer are mostly servicemen and women or family without children. These people are not the typical tourist, they are holidaying back home.

To be very honest, I don’t remember ever seeing hordes of well-heeled tourists or back-packers in the street of CCPur. Well, Khuga dam is no Hoover dam, and our patchy hills and mountains are not the Nilgiris. And as for marketing our tribal identity, just remember, we don’t exactly live in the jungle any more and girls in hot-pants do not exactly portray the kind of tribal image people may expect. Even today, the few ‘strange face’ that are occasionally seen in our street are there only on the invitation of our churches or are there to visits or inspect one of our many rehab centres.

Well, Gamnuam Home, Shalom Rehab, etc. are not the type of tourist attractants we want. But, for a starter we can develop a botanical garden which will not only attract tourist but also preserve our much folk-lored but evidently endangered orchids. We can also develop a dedicated market for out tribal handicraft from cane, bamboos works to our various colorful shawls, etc. And to develop that, we don’t even need the government; we can use the people participatory approach involving the communities in the process through the NREGS. All we need is someone or an institution to lead and do all the planning.

CCPur seems to scarce rather than attract tourist, and we have to change that. We may not have much to offer that will compel visitors to stay the night, but we can at least develop something that will make CCPur a ‘must-stop’ for every visitor to Manipur.

tags: zo, zomi, zogam, lamka

Miss. Mayawati: The Wrong Dalit Icon

2009-06-27T13:21:00.000+05:30

If the father of the Indian dalits, Dr. BR Ambedkar, had been alive today, he would be proud to know that the class for whom he bitterly fought social acceptance are starting to make their marks in most sphere of life from the Head of State to Chief Ministership.

But I cannot help wondering what he would think when he sees the omni-present hand-bag clutching statues of Miss. Mayawati in parks and recreation centres that also usually happened to bear his name?

Ms. M. Yes, during the last general assembly she had been touted as a force to reckon with. The result may have disappointed her and the many psephologist but whatever she had achieved so far in term of political havocs and media frenzies, considering her back ground and personality, are something that cannot be underestimated.

But, at the same time one cannot help but be aghast upon hearing her speeches. Her language were usually unpolished, raw, vulgar and most often a baseless character assassination of her political rivals. But the worst thing about here is that she never seemed to be apologetic about her unabashed abuse of power.

Her few press conferences were well-timed and opportunistic, and I am yet to hear her talk about fiscals, social or development policies. If she wanted to be taken seriously, she must freely interact with the press talking about her dreams, her vision and the step she took to further the situation of the dalits and the country as well and allowing us all to know her better. But sadly enough, she dictated the press only for verbally abusing her political rivals.

She is one of the few prominent dalits in India and much was expected from her, but without ever allowing us to let us know here true self, she just looked like an ignorant, opportunistic, corrupt and greedy politician who exploited her social back ground to achieve here selfish ambition.

There is no denying that she want to leave her legacy after she is gone, but the only legacy that she may leave as of now seems to be a badly plundered state, a divided society, and her hand-bag clutching statues. Well, at least the pigeon will be thankful to her for that.

tags: zo, zomi, zogam, lamka

The Horror Of OZ

2009-06-03T17:35:00.002+05:30

The recent spate of racial attacks on Indian Student down at Australia has grabbed more than enough media attention in India. I’m glad it does. It brings to focus the issue of discrimination and abuses based on racial line. It is one subject most Indian often overlooked or chose not to acknowledge until and unless they perceived themselves as the victim.

For instances, when Indian actor, Shilpa Shetty, alleged that she was racially abused at a TV show in the UK, the media and people of India cried wolves. Contrast that with the time when a coloured Australian cricket player, Andrew Symonds, alleged that he was being racially abused by an Indian player, Harbhajan Singh. Most Indian, instead of condemning the Indian Player, choose to mock the Australian, or ignore the issue altogether.

Indian abroad have become quite sensitive towards the issue of race today, but back home, it doesn’t cut much ice. Most Indian in India don’t know what constitute racism or discrimination, or for that matter, what racism is all about. That is not so surprising considering that India is the one country where segregation based on the line of caste/ class has been accepted as a normal social order.

Racism exists all over the world in one form or the other. Even in the developed world where people are more sensitive and awareness are higher, racism and discrimination still existed, but are hidden, unspoken and unexpressed. In India it’s different. People still curse their birth because they can never change their social standing no matter what. For instance, even in the richest family, inter-caste/race marriage is still a big taboo.

If you belong to any of the lower caste, people will judge you from your surname, and your surname will decide if you can enter a certain place/temple, or touch a certain thing. If you happened to be a racial minority, you don’t even get to give your surname, people take one look at you, and you are already judged. As a minority, each and everyday one has to face some sort of discrimination –it can be mild, coated or blown-out abuses.

What happened at Australia is awful and should be condemned. But what happened at India is also equally awful, and should be equally condemned. But the big difference is that, the Australian Government has acknowledged the incident (though reluctantly), while in India, such incidents will be conveniently swept under the carpet as a normal outcome of the social order.

I really do wish those people who took out to the street for the students down under will also look closer at home and stop being a perpetrator and stand-up for the minorities which they failed to notice all these years. I hope, at least, a lesson is learnt.

-for related post, please click the following;

1. India & Discrimination

2. India & Racism

That Little Village My Parents Love So Dear…

2009-05-23T14:36:00.001+05:30

Every alternate year, I went back to that little village despite dreading the seemingly endless journey. Despite being provided with options and having alternate and much better places to live, my parents insist to continue living in that obscure little mountain village often inaccessible during rainy season, with a distant mobile phone network that works just a few days a year.

That little village is also the place where they brought us up their six children. It must be the one place they wanted to brought up their children and grandchildren but that’s not the case for my parents. None of us stayed back and none wanted to live there in the future so we all tried to make up by spending our summer and/or winter holidays with them rather than getting away to one of those exotic location often advertised in those glossy magazines like most people do. Of their eight grandchildren two were born in their presence and the last one was over a decade ago now.

That doesn’t meant I don't like the place. No matter what that little village is the one place I still called home and my heart still beats for it. Despite my untiring complaints of everything, from the lack of privacy to my inability to use my mobile phone or wifi-internet connection, and despite my unending whining about the lack of basic infrastructures and the government’s apathy, I still yearn for that village and the simple people who live there.

My mother sent me off to live with my Brother just before I entered my teenage years not only because of the ethnic troubles at that time, but also to escape the drug-prone environment. Moving to Delhi has been dramatic for me in many ways. But I'm not complaining or blaming my Mother, rather I thanked her for letting me face the real world early without waiting for the inescapable reality we are ought to face in the future and being caught unprepared.

My whole family has been scattered across India and abroad. My parents are getting old and there are slim chances of a family get-together. I often wondered if my parents ever felt lonely and regret sending all of us off. Mother always explained that it’s for our own good and with the hope that we can make something out of ourselves.

I can’t say we made something out of ourselves with pride –to other, we are still nothing but we did it okay. We all would loved if our parents wanted to live with at least one of us in a city, but they have sacrificed enough doing without us and we are not going to ask them to part with the one place they love. Apart from that, I often observed how handicapped and worthless they felt in the few occasion they came to visit us.

In the village, they have farm and garden to keep them busy, animals to take care of, have close relatives as neighbours who sought their advice for every decision and can take care of them if the needs be. They have a full and dignified life there, the only thing amiss is their children. If they had lived with us, they have to give up all that since life in a city call for a totally different life style. We don’t want them to make so many changes and adjustments so late in their life or feel sorry about themselves for the remaining years of their life.

We know how much they miss us and we miss them too. It’s a sacrifice –a sacrifice to maintain dignity, to show our respect and love and as a token of thanks –a sacrifice that we all understand. That’s the reason why we never wanted to drag them away from the one place they love –the place that we all realized we are still in love with.