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On the 26th of December 2004, a magnitude 9.3 Mw earthquake occurred along Northern Sumatra and the Nicobar and Andaman Islands, this resulted in a catastrophic tsunami which affected 12 countries; of these, four countries (Indonesia, Sri Lanka, India and Thailand) were hit the worst.
The human impact due to the tsunami, with more than 175,000 lives lost, was enormous in terms of families affected, displaced or reported missing. Almost two million people lost their homes and had to find shelter with family, friends or in temporary settlements.
The majority of Asians who died, were buried or cremated without being identified. However, most developed nations endeavoured to selectively identify citizens who had died as a result of the tragedy.
The psychological impact could not be quantified immediately after the tsunami. Although varying estimates have been offered by different schools of therapists and ideologies, everyone would agree that there will be some degree of long-term impact on the mental health of populations affected the tsunami. Unfortunately, most of the counties affected by the tsunami did not have a mental health policy at that time.
Although it is clear that every effort should be taken to identify bodies, the tsunami revealed that Sri Lanka had neither policy nor capacity to identify dead bodies.
The State has a critical role in standardizing and guiding the task of handling dead bodies (recovery, identification, transfer, and final disposal). It must ensure that ethical, social and legal norms are followed, while guaranteeing that the dignity of the deceased and their families is respected in accordance with their cultural values and religious beliefs.
Developing adequate capacity (including human resources) along with a political commitment for implementing such a programme, is an important and challenging task.
The use of psychosocial interventions to address trauma-exposed populations is a new & developing field. Although the term ‘psychosocial interventions’ became popular and was used more frequently after the tsunami, it appears to have had different meanings to different groups and individuals.
The Oxford English Dictionary defines ‘psychosocial interventions’ as ‘pertaining to the influence of social factors on an individuals mind and behaviours’. This is also interpreted as ‘social intervention that has secondary psychological effects and psychological interventions that have secondary social effects’. The term ‘social intervention’ is used for interventions that primarily aim to have social effects, and the term ‘psychological intervention’ is used for interventions that primarily aim to have psychological effects. It is acknowledged that social interventions have secondary psychological effects and that psychological interventions have secondary social effects as the term psychosocial suggests.
The term ‘psychosocial interventions’, in the context of disaster management, does not refer only to highly specialized interventions by mental health experts. In fact, most psychosocial interventions for disaster-affected people can be carried out effectively by community level relief workers, if they are trained and supervised to do so.
The psychological impact of the uncertainty about the fate of a missing relative and the related socio-economic consequences, have been discussed by a conference panel (ICRC, The Missing Conference, 2003).
To our knowledge, only a few organizations stressed the importance of identifying dead bodies as an essential part in ‘psychosocial interventions’; especially as a public health intervention to prevent long-term consequences. The International Committee of the Red Cross (ICRC) was one of them.
The WHO (2005c) has also discouraged the unceremonious disposal of corpses ‘to control communicable diseases’. Dead bodies carry no or extremely limited risk for communicable diseases.
The bereaved need to have the possibility to acquire the body, in order to conduct ceremonious funerals and say goodbye (assuming it is not mutilated or decomposed). In any case, death certificates need to be organized to avoid unnecessary financial and legal consequences for relatives.
Although it is clear that every effort should be taken to identify bodies, the tsunami revealed that Sri Lanka had neither policy nor capacity to identify dead bodies.
The State has a critical role in standardizing and guiding the task of handling dead bodies (recovery, identification, transfer, and final disposal). It must ensure that ethical, social and legal norms are followed, while guaranteeing that the dignity of the deceased and their families is respected in accordance with their cultural values and religious beliefs.
Developing adequate capacity (including human resources) along with a political commitment for implementing such a programme, is an important and challenging task.
