News & views from Nepal and South Asia

Mullaitivu August 31, 2010 - Few studies of children in Sri Lanka have examined the daily stress they continue to face since the tsunami and civil war, focusing instead on the direct impact of both, according to two studies in the latest Child Development journal.

Family trauma and economic problems, including domestic violence, the death of relatives or losing access to healthcare, housing and schooling can be more closely related to a child’s mental health than the 2004 tsunami or the civil conflict that ended in May 2009 after two decades of fighting and three failed peace attempts. The government is trying to boost services in the conflict and disaster-affected north and east to help children in distress.

“Significant variance in children’s distress and development is explained by daily stressors caused and exacerbated by, or even unrelated to conflict or natural disaster,” the authors wrote in one study of 400 Sri Lankan youths aged 11 to 20. Little research uses this “ecological perspective” to measure the ongoing and cumulative impact of multiple disasters on children, according to Child Development.

The escape

Kannan*, 9, from the Tamil ethnic group fled with his family during the height of Tamil rebel fighting in 2009 from Kilinochchi in northern Sri Lanka – the rebels’ military base – to the neighbouring province of Mullaitivu.

“I was scared. Blood was everywhere,” he told IRIN. How such children recover from war depends on the extra attention they get, said Mahesian Ganeshan, a child psychiatrist in eastern Sri Lanka. “These children need extremely caring environments within families and outside the family environment to overcome the horrific and traumatic experience.”

Most children in northern and eastern Sri Lanka have lived through either war or the tsunami, or both, according to the UN Children’s Fund (UNICEF), which, with the government, has identified at least 4,000 children, a number of them former child soldiers, needing urgent support. Further assessments should be made to establish how many more children may need extra help, said Mervyn Fletcher, UNICEF’s head of communications in Sri Lanka.

Response

A senior consultant to the government’s child protection authority, Hiranthi Wijemanne, told IRIN: “With the prolonged conflict and the resulting psycho-social distress and trauma compounded by the tsunami, we definitely need more [children’s mental health services]. With the numbers [of affected children] involved, a more community-orientated and public health approach is preferable to the ‘western, individual’ model, which we cannot afford as the needs are great.”

He said the government was hiring more mental health specialists and the University of Colombo psychiatry department and the government planned to implement a community-based programme to train public health officials in working with children.

Jaffna College, a private school for primary and secondary students in northern Sri Lanka, has started admitting students from displaced families on special admission programmes that include extra guidance and counseling. “These [are] children who had seen the death and suffering continuously for months,” the college’s principal, Noel Vimalendran, told IRIN.

UNICEF is helping to train 269 government employees – whose agencies span probation, social services, police forces, women’s development and counselling – in 14 of the north’s 33 administrative regions to improve services to protect children. In addition, the children’s agency will train more than 1,000 community workers in at least 150 agencies in how to reduce children’s risk of accidents from unexploded ordinance (UXOs).

Handicap International, Caritas and Motivation UK are rehabilitating disabled children, while Save the Children UK is helping former child soldiers adapt to life after civil war.

“The most important aspect of all this is the end of a violent environment for children,” said Wijemanne. (IRIN)

Thatta, Pakistan 30 August 2010 - "The water is coming!" was the cry in the streets of Thatta, about 200 km east of Karachi, as shutters came down on shops; wives, children and a few belongings were packed into vehicles and sent off to neighbouring Makli in the hills a few kilometres above threatened city. Merchants closed their shops and did what they could to strengthen their doors against water and thieves.

On 28 August, water gushing out of one of more than 10 breaches in the embankment containing the Indus River entered a suburb of Thatta, a town of around 200,000 inhabitants, a huge port on the Arabian sea where the river debouches.

By evening the town was quiet, with very few people still around; two old men sat gossiping in a lane, confident that the Indus would not rise that high. When morning came, the flow of the water had slowed because some of it had been diverted, but no one was certain that the danger had passed.

More tragedy

A bigger tragedy has been unfolding in Makli, which usually houses about 30,000 people. In the past week hundreds of thousands from Thatta have sought shelter with friends and relatives in Makli, and between 100,000 and 150,000 people have fled their drowning villages in the district and moved into every available space.

They all need food and water. Hundreds of people line the main roads, waiting for a private donor's vehicle with flour or water to pass by; everyone scrambles for the few bags that are tossed out and the scene quickly turns violent. "We have become like animals, but hunger takes out the worst in every being," said a displaced man watching a fight with tears in his eyes.

Every bottle of water and bag of food is fought over; people get hurt every day. Last week a woman died after one such tussle. "I don't like what I am doing but I have to do it – we will run out of flour in two days and I have to feed my children," said Rahim Dino, who survived a gash in his head but lost his bag of flour.

The donors toss bottles and food out as they drive around, and desperate people run after the vehicles. "We are not dogs – I tell my children not to go out onto the road – rather we die," said Allah Rakha, who fled his village three days ago.

Politicians arrive, look around, and drive away. There are very few tents, and some are aligned to political parties. Police and soldiers watch the crowd but no one seems to be in charge. Men, women, children and babies sit on the ground under open sky in the rain and heat; many succumb to exhaustion as the temperature climbs above 30 degrees Celsius.

The inhabitants of Makli have never seen so many people - they are in the grounds of the hospital, in the park, even in the graveyard. "This is like it was when Pakistan and India were partitioned and we had refugees," an older resident remarked.

Zohuar Khan, who drove my taxi from Karachi, has never witnessed such destitution. "This is the end!" he says in disbelief. There are 15 people from his village staying in his one-room house in Karachi.

On the way to Makli a man and a woman have collapsed at the roadside but families squatting nearby share their tiny reserves of sugar and salt to make a solution to help rehydrate the woman. Zohuar and Asghar Ali, an official from Sindh Radiant, a local NGO, and I help them into the taxi and take them to the nearest mobile clinic a few kilometres away.

"The crisis has just broken in southern Sindh [where Thatta is located] and is still unfolding. Even with limited resources we have managed to stabilize the situation in the north," said Fawad Hussain, of the UN Office for the Coordination of Humanitarian Affairs (OCHA), who is coordinating the NGO response in Sindh Province in southern Pakistan.

Heartbreak

Hussain said he did not have the resources to respond, but noted that UN agencies were also overwhelmed. He has managed to secure 10,000 tents, which "I know is too little, but can provide shelter to at least 50,000 people - the tents should get there [Makli] in a day or two," he told IRIN.

He said the politicisation of aid was another issue that should be addressed. "In terms of humanitarian aid principles, if political parties establish any relief effort they have to do it "on non-political grounds".

Makli is filled with heart-breaking sights: malnourished women trying to breastfeed their babies, little children chewing on pieces flat bread made of rice flour. Most of the displaced people were paddy farmers in the Indus River Delta. "Rice is all we had, and we are running out," said one mother, shaking her almost empty flour tin.

Help is on the way. Irfan Malik, programme officer at the World Food Programme (WFP) in Sindh, said they were awaiting reports from their assessment team and would start food distribution in Thatta district in a day or two, but the scale of the disaster would make it difficult to cater to everyone's needs immediately.

In the first phase WFP will provide aid to about 330,000 of the estimated 1.8 million people so far affected in Sindh - the numbers are climbing as flooding continues. More than 20 million people have been affected by the floods in a disaster described as the "worst ever" in this part of the world.

On 29 August, I see several families packing their belongings as I prepare to leave. "There is nothing here – we know we will die if we stay longer – no one is giving us any food," said Sher Mohammed.

"We will wait for someone to give us a lift to, maybe, Karachi – we understand there are camps there." Most of the displaced families have used all their savings to pay for transport out of their water-logged villages to Makli. "Everyone has made money out of the floods – vehicle owners, shopkeepers who have hiked up the prices of food and even bottled water," he said.

Ghulam Hussain Khwaja, president of Sindh Radiant, said Thatta district was one of the most disaster-prone areas in Pakistan; a seismic fault line runs through the area, and the coastal areas are vulnerable to floods and cyclones. "Communities often get displaced, and yet we do not have a permanent strategy in place," he commented.

His father, Iqbal Khwaja, a veteran journalist and a correspondent for Dawn, a local national daily, said the authorities needed to act promptly to redeem the people's faith and trust in public institutions.

As I leave Makli the taxi is mobbed by desperate and sometimes angry people looking for any kind of aid. "Koi aake humhara dukh dard hi soon le [At least someone can come and listen to our pain]," says a displaced woman, wiping the sweat off her face. (IRIN)