Photo: People living under the tents after the massive earthquake  Photo Courtesy: Ruby Shrestha The massive earthquake of 7.9 Richter Scale along with many after shocks have left a big scar on Nepal. The aftermath of this devastation is becoming quite scary. In the mean time the possibility of great epidemic is in its peak. Scared of various diseases and scarcity of food, many people have left Kathmandu valley in search of safety and peace. Now the streets of Kathmandu are empty and the places which used to be filled with crowds are silent. The aftershocks have been felt regularly; these minor shocks have terrorized people even more. Right when everything was settling down and people were trying to get back into their lives, Tuesday's quake of 7.3 magnitude has shaken the heart of Nepal. It has been more than just a natural calamity; it has become a major traumatizing factor and the most disturbing part is that there is no end to this. It has caused around eight thousand casualties and more than fifteen thousand have been injured. Property have been destroyed. Kathmandu, once called the city of temples has become the city of ruins. Many cultural heritage have fallen to the grounds and the these scenes add misery to our pain. More than the physical pain this great destruction has gravely affected the mind of people. A natural disaster that occurs on a large scale can raise the degree of stress and can lead to depression and other mental illness, especially among those who have lost their loved ones and livelihood. Therefore, it is important to help the victims on ways to mentally cope with the situation by supporting them with immediate response mechanisms, teaching them effective coping strategies and helping them to understand the disaster itself. It is well known that people who have lost their loved ones and livelihood are more likely to suffer from significant severe psychological distress compared to those who have not. These kinds of disasters not only affect the victims but also develop a kind of mental and psychological disorder in the rescue workers and medical teams. It is difficult for rescue workers to cope with a scenario where they are exposed to mutilated bodies (especially of children), mass destruction of property and life-threatening situations. Changes in the appetite, headaches, inability to sleep, anger, suspicion, apathy and depression are the effects of such tragedies. [caption id="attachment_6663" align="aligncenter" width="620"] Photo: A young boy standing by his ruined school
Photo Courtesy: Kundan S. Rana[/caption] Time and time again when natural disasters hit various places of the world, thousands are killed, causing immense emotional and psychological trauma for scores of victims who survive. Poor planning, insufficient machinery and equipment, loose infrastructure and unpreparedness for a natural disaster can cause delay in the rescue and relief operations and further aggravate the psychological consequences of earthquakes. Women and children are most likely to suffer from post-traumatic stress, anxiety and impaired well-being; therefore, it is necessary to give substantial psychological support and counseling to help them cope with the aftermath of such events. Anxiety and trauma are caused not only in the people of the affected areas but also among people who live in close proximity. The people of Nepal were already worn down by political instability; Now this natural disasters, poverty and lack of service from the state have made them more vulnerable to mental health disorders. Thousands of people are staying in the open grounds with limited food and shelter following the earthquake. It is believed that the psychological effects of the disaster could take months to fully emerge. “We have lost our house and everything we own to the earthquake. I have not been able to sleep or eat for days because I fear the earthquake will hit again," said Chandra Poudel, an earthquake victim from Sitapaila. “I am grateful that none of my family members were killed in this disaster,” he added. Like Poudel, many have fear that the quake will hit again. There are rumors all over Nepal that have been keeping people awake for nights. Some say a quake of 9.0 or more will hit sometime soon while others claim that there will be series of quakes for three days. All these rumors are false and are generated only because of innocence of people and by those who are trying to scare others. The best way to treat patients suffering from mental stress after a natural disaster is counseling. Some get alright after a certain period of time while other need counseling by a professionals. Victims who have severe anxiety and depression need medical treatment. [caption id="attachment_6664" align="aligncenter" width="412"] Photo: An inverted triangle showing the effect of disasters on mental health[/caption] The government should include counseling training programs to all the medical officers, including doctors, nurses, health assistants, paramedics and volunteers. This will help in the management of treating the victim’s mental stress not only in some limited area but all over Nepal. Some progress has been seen in treating the victims with mental stress over the time. Some organizations are taking initiatives to help cope with the situation that has been troubling us. So let's work hard, let's unite for the betterment of our community. We need to rise again and for that a serious commitment is needed. Let's not only pray, let's work for Nepal.