KATHMANDU, September 1: For many survivors of the Bhotekoshi and Trishuli River floods, the disaster did not end when the waters receded. Fear, anxiety and shock are now emerging among those who survived the devastation.
Healthcare workers at hospitals and holding centres say flood victims are increasingly showing signs of psychosocial distress, making psychological counselling an urgent need.
Dr Amit Prajapati, medical superintendent at Rasuwa Hospital, said many victims arriving for treatment were showing signs of shock and anxiety.
“Some of them say they can still hear the sound of the flood,” he said.
Dr Pomawati Thapa, chief of the Non-communicable Disease and Mental Health Section at the Epidemiology and Disease Control Division (EDCD), said signs of panic and anxiety disorders had been identified in around 1,000 people at holding centres.
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Those who have lost family members and property and have become isolated are showing early signs of trauma, she said.
Clinical psychologist Dr Suraj Shakya, a professor at Tribhuvan University Teaching Hospital, Maharajgunj, said psychosocial problems could become more pronounced two to three weeks after a disaster.
In the immediate aftermath, survivors may experience anxiety, grief and concerns about how they will meet their basic needs. People with pre-existing mental health problems may develop additional symptoms, while even those without a history of mental illness can develop psychological distress after such a traumatic event.
For some, the symptoms may subside within two to four days. But for others, anxiety, sleeplessness and loss of appetite can persist for weeks.
Shakya said early psychological support is crucial to prevent such problems from worsening. At the first level, he said, survivors need someone to listen to their concerns, identify their immediate needs and help coordinate access to essential services.
Reuniting survivors with their families and relatives can also provide important emotional support, he said.
While psychosocial problems may gradually ease after about a week of counselling for some people, Shakya said symptoms can persist for three weeks or even a month in others. He urged the government to make separate arrangements to support those requiring continued mental health care.
Dr Thapa said trained psychosocial counsellors and three mental health experts had already been deployed to most holding centres in coordination with mental health organisations, partner agencies and the Ministry of Health and Population.
Counsellors at the centres are assessing the needs of survivors and helping coordinate essential support, including food, shelter and clothing. Various mental health helplines are also operational.
According to Thapa, the Mental Hospital's 1115, 1166 and 1098 hotline services, as well as hotline services operated by KOSHISH and TPO Nepal, are available to those seeking support.
She said the government was also preparing to address cases of fear, anxiety and other psychosocial problems that persist beyond a month.
Spokesperson for the Ministry of Health and Population Dr Sameer Kumar Adhikari said psychiatrists should be deployed alongside medical teams treating injured people in flood-affected areas.
However, reaching survivors remains a challenge. Dr Thapa said counsellors have been unable to reach some villages after floods washed away bridges connecting them to the main areas.
She said efforts were underway to send counsellors to those remote communities as well.
