Mental Health Center

Tsunami Aftershock: Grief, Sickness

I'm shocked and horrified about the thousands of deaths from the tsunamis! It's like unreal. And the photos are wrenching my heart. Yesterday I was at my desk in tears from photos of the loved ones and their losses. The looks on the survivors faces after learning of the deaths of loved ones and the loss of homes. Little kids and all ... oh god it's horrible ... the pics are all too vivid ...

Dec. 30, 2004 -- The staggering death count from the Asian tsunami -- 114,000 and rising -- overwhelms us. Yet disease and mental health problems will kill and sicken several times this number, experts say.

What can we expect to see over the coming days, weeks, and months? How can we cope with our own feelings? What should we say to our children? WebMD asked several experts:

• Randall D. Marshall, MD, director of trauma studies and services for the New York State Psychiatric Institute, New York State Office of Mental Health; and associate professor of clinical psychiatry, Columbia University College of Physicians and Surgeons. Marshall has expertise in the diagnosis and treatment of posttraumatic stress disorder (PTSD) posttraumatic stress disorder (PTSD), and has studied and written about the role of psychological trauma in anxiety disorders, psychotherapy of traumatized individuals, and the biology of PTSD.
• Phyllis E. Kozarsky, MD, professor of medicine and director of the Travel Well Clinic in the division of infectious diseases at Emory University School of Medicine. Kozarsky specializes in clinical tropical medicine and travelers' health. With the CDC, she conducts international surveillance of travel-related morbidity and emerging infectious diseases.
• Nancy Cahir, PhD, a child and family therapist in Atlanta.

Tsunami Aftershocks: Disease

Tsunami survivors now face three serious problems: lack of food, lack of clean water, and poor or nonexistent sanitation. Aside from the very real threat of death from hunger and thirst, these problems mean desperate people will be forced to consume contaminated food and water.

"We have to look forward to tremendous problems with foodborne and waterborne diseases: dysentery, cholera, hepatitis A, typhoid fever, and diarrheal diseases," Kozarsky tells WebMD. "Children are going to be very vulnerable to diarrheal disease and cholera. Those can kill very rapidly if support isn't there. Probably there are large numbers of children who can't find their families. And we know hospitals and clinics were destroyed also. There may not be any structures for people to go to for health care."

This is far more than enough. But it's not all. Long before the tsunami, most of the affected areas suffered from mosquito-borne diseases -- malaria and dengue fever in particular. The waves have receded, but they've left huge pools of stagnant water in their wake.

"Think of the explosion of mosquito populations and the explosion of malaria and dengue fever," Kozarsky says. "Those are huge items in a population where there may be a tremendous number of homeless people. These numbers may make the mortality seem low. If you say OK, in the tsunami we lost 70,000 people, disease may take a toll as great as that."