What Comes the Day After the Disaster?

Written by Charlie Labarda //

It was going to be a hot day. The sun was up, but the electricity was down. We were in one of the relocation sites for families displaced by Super Typhoon Haiyan (local name Yolanda)—the strongest storm to make landfall on record last November 2013. We were there as volunteers to conduct a workshop among poor families to address health problems they faced. Fifteen thousand families in the city were forced to relocate to the northern tip of the city after their homes were destroyed by storm surges measuring up to 20 feet that inundated coastal communities.

Five years after the disaster, memories of that terrible day still linger, as tears well up in the retelling of their experiences and the remembrance of lost loved ones. Many wounds are still healing while they try to rebuild their shattered lives in a new place far from their usual support systems. These new locations have no potable water supply, unreliable electric power, and few opportunities for livelihood. But at least these people have a roof over their heads.

But how do you recover from such a disaster? How do you help restore lives and bring back the excitement to live? The first few months bring an influx of volunteers and relief activities that provided comfort and sustenance for many survivors and. But as life settles down and the last international NGO volunteer packs up, the deep impact of the disaster begins to unfold.

In conversations survivors relocated from their homes, we discovered symptoms of insomnia, stress, psychological distress, and chronic posttraumatic stress. More than four years after the disaster, the pain still is palpable from a quavering voice and teary eyes as they recount stories. Time may dull memories, but pain lingers near the surface, ready to break out at a moment’s notice. In a country where physicians prefer to move overseas for work and health professionals are considered as exports to bring in hard currency, resources for health services are scarce. This is especially for mental health. Just like many other communities in the Philippines, many survivors have not accessed health services in the past several years. Even if they decide to seek counseling, there are only a handful of trained psychiatrists and clinical psychologists in a region of four million people.

The challenge is how to address the long-term consequences of traumatic experiences during the disaster and the chronic stressors they face in their relocation. One intervention project that we are deploying is the use of lifestyle medicine. This approach effectively deals with the rise in chronic, lifestyle-induced health problems like diabetes, hypertension, and cardiovascular diseases. It appears not only to help with these health problems, but also with mental health. Research shows that physical exercise and diet is linked to better mental health outcomes in various populations. If we can capacitate families to take care of their health through changes in their lifestyle, including sleep, diet, and physical exercise—together, and with cultural resources like spirituality, then we might address some of the post-disaster problems they face.

We are still in the early stages of our work, but remain excited about the possibilities of empowering survivors and providing them with tools to help them emerge stronger the day after the disaster. We look forward to when the faces we now see in front of us will look back at us with the strength and brightness of a new day.

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Dr. Charlie Labarda, MD, is a Fellow at the Resilience Institute of the University of the Philippines and an Assistant Professor of Medicine in the School of Health Sciences at the University of the Philippines-Manila, Philippines. Currently pursuing a research PhD in the Department of Psychology at The University of Hong Kong, his research interest is at the interface of disaster public health, mental health and community health behaviors. He can be contacted at: charlslabarda@gmail.com.