By Ye Jun (China Daily)
Updated: 2008-05-28 06:57

Psychiatrist Wang Jian is used to conducting consultations with patients in a single, quiet room, where there are paintings on the wall and comfortable couches to sit on.

But lately, Wang has had to half-squat when counseling quake victims in a factory in Pengzhou. The temporary shelter is for those made homeless by the May 12 quake in Sichuan province.

Volunteers play games with children in Mianyang's Jiuzhou Gymnasium, helping them overcome acute stress. [Xinhua]

There are more than 2,000 people on the site.

"Everybody has a story," said Wang, from Beijing Huilongguan Hospital.

One 30-year-old mother had lost her daughter to the disaster. The woman refused to speak or eat for two days before a psychologist helped her contact her mother and sister.

Another quake victim, a 12-year-old girl, had refused to talk, eat or drink, until a psychologist asked her if she had anything she wanted to tell him.

"I miss my younger brother," she cried.

Along with 21 colleagues, Wang spent two days talking with quake victims at the shelter. Twenty victims with severe psychological problems were screened, and Wang's team focused on them during the second day of work.

"Some people have shown fear, anxiety, and depression. They have nightmares, and difficulty falling asleep. These are natural responses to the disaster," Wang told China Daily by telephone.

"Other people show symptoms of elusion, heightened vigilance, and painful flashbacks. One person had slight symptoms of mania, and two had schizophrenia. But, generally speaking, most people's moods are relatively stable."

Wang said the fastest and most effective way to help these people is to use "psychological aid", in which the psychologists comfort and pacify victims through conversation. They also prescribe medicines for those with more serious problems.

But, he said he has had to adapt traditional treatment methods, such as group sharing sessions, breathing and muscle relaxation exercises, to suit the crowded environment.

Wang's 50-member team was the first psychiatrists and psychologists to arrive in Chengdu on May 17. They came from specialized psychiatric hospitals, including Beijing Huilongguan Hospital, Beijing Anding Hospital, and the Sixth Hospital affiliated to Peking University.

The team spent two days at two temporary shelters in Pengzhou, before moving on to four big hospitals in Chengdu to attend to people injured in the quake.

In the past week, psychiatrists and psychologists from across the country have arrived at various disaster areas to provide psychological support.

"This is the largest ever post-disaster psychological relief effort since the founding of the People's Republic of China," Wang said.

"Our mission is to offer psychological support for people in disaster-stricken areas, including ordinary citizens, the injured, medical staff and rescue workers."

Wang's colleague, Peng Yu, a 28-year-old psychiatrist, is on another team of 20 medical professionals in Mianyang's Jiuzhou Gymnasium, which accommodates more than 20,000 of the quake's homeless.

The team set up a tent next to the gymnasium, with a large poster saying "psychological health base camp". More than 10 people visited the counselors on the first day of the team's services.

Peng saw a woman in her 40s, whose daughter was missing before being confirmed dead two days ago. The woman had not been crying, and refused to eat anything. She was highly tense. Peng diagnosed her as being in a stuporous state from psychological causes. He was planning to give her tranquilizers and sleep medication.

"Somebody supported her here by hand. As her most urgent problem was electrolyte imbalance, I prescribed her a transfusion of glucose and physiological saline solution," Peng said.

The woman was able to cry after psychological treatment. She drank a bottle of milk and walked away by herself. The doctor said he would definitely see her again soon.

More than 16,000 people affected by the quake are staying at Mianzhu's new municipal gymnasium. More than 800 are children, said Li Xianyun, a senior psychiatrist from Huilongguan Hospital. Her tent was right next to the gymnasium on the street.

"A temporary school has been set up, and local teachers and children have participated actively in drawing, singing, physical education lessons and games," she said.

"It looked almost as if the disaster was far away from us. The disaster seemed not to have written anything on most of the children's happy faces, although one could still detect sadness in some."

Li said a number of children had nightmares.

"Mama, there is an earthquake!" they would wake up at night shouting.

Other youngsters refused to talk. Some looked normal, but would cry, and lose their temper easily.

Li said she told the parents their children's behaviors were normal response to trauma.

"As long as we create a stable living environment, guarantee eating, drinking and living conditions, and let the children participate in normal social activities, they will recover slowly," the psychiatrist said.

"The general condition is better than I expected," she said.

"Although they do worry about their future, the people are generally grateful for the central government's speedy response and the People's Liberation Army's rescue efforts, which has given people comfort, and a sense of safety."

"The problem now is how to keep up with the aid work, and make psychological support consistent, to relieve the pressure on victims and give them hope for the future."

Wang said that while the majority of psychological problems at present fall under acute stress disorder, which shows right after the disaster, post-traumatic stress disorder, which can be more serious and longer lasting, will not appear until months later.

"This is just a beginning," he said. "There is so much work to be done."

(China Daily 05/28/2008 page19)