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Japan: Aiding the Aid Workers

This post is part of our special coverage Japan Earthquake 2011.

More than two months have passed since the Tohoku earthquake and tsunami in Japan and while those who weren’t affected directly by the disaster have been able to go back to a normal life, around 110,000 people are still living in evacuation centers according to police estimates.

The lack of privacy, separation from their original community, unemployment and a deep sorrow for the loss of loved ones has been a harrowing experience for many victims who are physically and emotionally exhausted.

Map of earthquake/tsunami evacuation centers in Japan.

Map of earthquake/tsunami evacuation centers in Japan.

Hiroshi Moriwaki explains [jp] the different types of trauma experienced and encourages care of both children and adults as, although at different levels, the tragic experiences they have undergone have emotionally debilitating after-effects:

我々の目の前には、日々さまざまな事が起こります。ただ事故やトラブルなど、
想定外の事が起こったとしても、ある程度までは健全な対応をとる事ができます。
しかし天災や人災・犯罪など、「自我のコントロール」を超えた暴力的・侵入的な刺激には、
対応ができなくなり、強い衝撃となって「心の傷(トラウマ)」となります。
この「トラウマ」には、大事件・大災害等による急性の外傷と、
虐待やいじめ等による慢性の外傷があります。

Many things happen before our eyes every day. When something unexpected happens, like an accident or some kind of trouble, we are able to deal with it to an extent.

However, we become unable to deal with violent/intrusive stimuli that go beyond ‘self control,’ such as natural disasters or crime. They impact us strongly and become emotional wounds, or trauma.

There are two types of ‘trauma’ – acute trauma from serious incidents or major disasters, and chronic trauma from things such as abuse or bullying.

その症状には、悪夢・フラッシュバック・頭痛・腹痛・吐き気などがあり、
特に子どもの場合は、衝撃を受けた時そのままの体験を生じる事があります。

Symptoms can include nightmares, flash backs, headaches, stomach aches, and nausea. Children especially may experience flash backs that are exactly as it was felt at the time of receiving the shock.

今回の大震災で、通常生活では体験することのない感情に多くの被災者が直面しました。
大震災が目の前で起こり、大災害が迫る大きな恐怖の中で、もしかしたら家族や友人が目の前で災禍に巻き込まれ、あるいは震災後になって、悲しい姿に直視するケースもあったでしょう。

多くの大人たちは、これまでの喜怒哀楽・愛別離苦など人生経験を通して、消化できたとしても子ども達にとっては、心の傷が生涯のこる事が想定されます。
自衛隊や警察・消防など、ボランティアの方々にも必要性が出てくるかも知れません。
こうして「PTSD」を内容を整理しただけで、訓練された専門家でなければ対処できない事、そして今後、長期にわたる復興の中で、心のケアが必要であることが分かります。

産官学連携での長期対応が、必要になってくると予想されます。

During this major earthquake, many victims faced emotions that they would not normally experience in everyday life. As the earthquake happened in front of their eyes, and in midst of fears of the huge disaster approaching them, some may have witnessed their family or friends getting engulfed in the catastrophe. Some may have had to face the sad sight of their loved ones’ [bodies] after the disaster.

Even if most adults were able to digest these experiences through past life experiences or various emotions they had felt before, it will most likely leave lifelong emotional scares on young children. Support may also become necessary for the volunteers, such as the Self Defense Force, police, and firemen, etc.

Just from observing these different forms of ‘PTSD’ [Post Traumatic Stress Disorder], we can see that it is something only a trained professional can deal with and that long term emotional care is necessary during this recovery period.

Long term support from a industry-government-academia collaboration is expected to become necessary.

Some patients are moved to an elementary school after the earthquake, Fukushima. Image by Natsukado, CC BY-NC-ND.

Some patients are moved to an elementary school after the earthquake, Fukushima. Image by Natsukado, CC BY-NC-ND.

Since the event, teams of volunteers and professionals such as doctors, nurses and psychologists have flocked to the affected areas to help. Sometimes with direct medical intervention, sometimes by just lending an ear to the refugees’ tragic stories or worries.

Because of the very nature of their job and the fact that they're used to working in emergency situations, the aid workers tend to work very long shifts and their dedication is often taken for granted. Too often, however, it is forgotten that among those doctors and nurses there are those who are victims themselves and have lost family or friends or houses.

It is for this reason that private and government related centers have begun a campaign to educate the aid workers against the dangers of overwork and to warn them to take care of themselves first, in order to be better able to help others.

Reporting the experiences of a friend, @jishin_care tells of the emotional and physical stress doctors have to deal with. According to the author of the blog called ‘Information on Psychological Care Related to the Earthquake’, although doctors and nurses are trained to do their best in emergency situations, it's in such difficult situations as this that they most need the support of other people:

私も、被災地へ医療派遣された友人の話を聞きましたが、それはもう大変過酷な状況であり、その間、よくぞ持ちこたえられたものだ、さすがプロフェッショナルだと、頭が下がる思いでした。
同時に、彼の心身の疲労へのサポートは、大変重要な課題であると痛感しました。特に、全力を尽くしたけれども、資源や人手が足りず、十分な援助ができなくて申し訳なかったと自分を責める話を聞くと、胸が締め付けられました。
彼ら援助者は、「緊急時での」「強く」「弱者を救う」存在です。
一般にそう認識されています。
そのため、彼らのケアやサポートは、後回しにされてしまうことは予想に難くありません。
しかし、想像を絶するような現場で様々な死や悲しみや怪我などを取り扱い続けること、その中で冷静を保つ努力をする(涙を見せないなど)ということは、どんなスーパーマンにも心身に負担が来て当たり前のことです。
それだけ、大変な状況で大変なことをしているのです。
だからこそ、援助者のストレスをケアし、サポートすることは、援助者自身の心身の健康のためにも必要ですし、それがひいては、より多くの被災者を援助していくことにもつながるのです。
また、援助者は、「救う立場の自分たちが弱音を吐いてはいけない」という思いが強いために、その辛さや苦しさを口にすることを我慢してしまいがちです。
ですから、援助者をとりまく家族や友人や職場組織の皆さんが、援助者へのサポートの必要性を十分に理解し、適切なサポートをしていくことが大切なのです。

I also heard some stories from my friend who was one of the doctors dispatched to the disaster area. He was working under such harsh conditions and I felt the utmost respect for his true professionalism for holding on during the whole ordeal.

At the same time, I became acutely aware that support for his emotional and physical fatigue is a very significant issue. I especially felt sympathetic when I heard him blaming himself for not being able to provide sufficient aid despite his efforts, because of the lack of resources and manpower.

Aid workers are viewed as ‘strong’ in ‘times of emergency’, ‘to help the weak’. Because of this, it’s not difficult to imagine that care and support for them tend to take a backseat.

But to continually deal with various kinds of injuries, death, and grief under unimaginable conditions, and to try to keep one's cool (such as show no tears) in such a situation will inevitably put emotional and physical strain on anyone, even if they were some kind of superman. It’s only natural.

They are doing difficult things in difficult situations, which is why is it important to provide care and support to aid workers, for their emotional and physical health as it will ultimately lead to helping more victims.

Also, aid workers tend to hold back expressing their pain and anguish because of their belief that ‘we are the ones providing help. We can’t be weak’. Therefore, it is important that families, friends and organizations around them fully understand the need to support aid workers and provide appropriate support for them.

Finally psychologist Satoko says [jp] that the volunteer and professional aid workers should not consider their sense of ‘disaster fatigue’ as a weakness:

被災者の方の中にも、援助者として頑張っている方がいます。
どうか無理をなさらないでください。

具体が悪くなったり、疲れたりすることは当然のことで、
それは、けっしてあなたが弱いからではないのです。

There are some victims who are helping out as volunteers. Please take care and don’t overwork yourselves.

It’s natural to fall ill or get tired.

It’s not because you are weak!

This post is part of our special coverage Japan Earthquake 2011.

The Japanese posts were translated by Rino Yamamoto.

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