On May 12, 2008, a 7.9 magnitude earthquake struck southwestern Sichuan Province in China, leaving more than 80,000 people dead and 370,000 people injured. The quake's epicenter was in Wenchuan, in the northwest of Chengdu, the capital of Sichuan province. Some 90,000 buildings collapsed and more than 10 million people left homeless. Up to 40 international staff and 16 national staff of Doctors Without Borders/Médecins Sans Frontières (MSF) have worked in affected areas providing relief materials, medical care, and psychological support. Today, MSF continues to offer psychological care to affected people in Sichuan.
Emergency Period
Distribution of Relief Materials
The first MSF teams arrived the day after the earthquake to conduct assessments. Results of initial assessments revealed urgent needs for shelter, drinking water, and medical materials. Most pharmacies in the area were destroyed by the quake and people faced dire shortages of medicines. In collaboration with Sichuan's Red Cross, MSF donated 4,310 family-size winter tents for more than 25,000 affected people and 300kg of medical equipment and drugs in Mianzhu City, approximately 60km east of the epicenter. MSF also donated 800 rolls of plastic sheeting and other basic items.
Medical Care
While the local and national response was massive, specialized medical care was needed for the injured people, as hospitals in affected areas had been severely damaged and many were unusable. An MSF team including orthopedic surgeons provided support for a triage referral center in Guanghan city in the hard-hit prefecture of Deyang. Another MSF team of two nephrologists provided support in three Chengdu hospitals to treat patients suffering from crush syndrome. MSF also provided clinical support to a hospital in Hanwang, Mianzhu city.
Psychological Care
After the earthquake, people lost family members, saw others hurt or killed, witnessed massive destruction, and had to flee their homes. Many people were grieving the loss of loved ones and were clearly in need of psychological care to regain a sense of balance in their lives. MSF psychologists provided psychological counseling to victims of the quake in hospitals in Chengdu and Guanghan. During the emergency period, MSF psychologists offered “psychological first aid”, which includes active listening, conveying compassion, encouraging social support, and screening for more severe psychological problems.
Post-Emergency Period
Psychological Care
Almost two weeks after the earthquake, reconstruction efforts were underway in Sichuan, but many people felt anxious and fearful of aftershocks, experiencing a wide range of stress-related psychosomatic symptoms. From June 1, 2008, a team of MSF psychologists offered education and care in Longmenshan Township, Pengzhou, to normalize reactions and teach the use of self-help techniques to manage symptoms. Another team of MSF psychologists offered care in Hanwang, Mianzhu city, to reassure people that fear and anxiety are normal reactions in such circumstances. By September 2008, 163 patients were followed and 290 consultations conducted in Mianzhu. In Pengzhou, MSF conducted a total of 39 sessions of psychological education for 746 people and 54 sessions of individual counseling.
Reconstruction Period
Almost six months after the quake, rebuilding of collapsed buildings was underway, but many people were still living in temporary housing and unsure of their future. People continued to suffer from mental disorders such as post-traumatic stress disorder (PTSD), anxiety, sadness, and hopelessness. Moreover, there were a limited number of trained psychologists in China who could provide psychological clinical care to patients.
Current MSF activities in Sichuan
From November 2008, in collaboration with the Chinese Academy of Science and Crisis Intervention Center, MSF has been providing psychological care to people suffering from psychological disorders due to the earthquake in Mianzhu city and Beichuan County, one of the worst affected areas in Sichuan.
Under the supervision of MSF psychologists, 10 Chinese counselors have been providing counseling at consultation rooms set up in five temporary housing sites in Bayi School, YonXhin, Wudu, ZhuLin, and Leigu, in the area of Mianzhu and Beichuan. After the counselors conduct home visits to assess possible patients, they screen for psychological support needs and then provide therapy for patients.
By March 2009, MSF teams had assessed more than 650 people, followed 300 patients, and conducted about 1,500 consultations. MSF also provides training and supervision to Chinese counselors to help them dealing with patients and assure a good quality of care.
