7 am at Sanglah Hospital.
I could not believe what I was seeing. Volunteers from every
walk, stepped out of their lives with a “boots and all
attitude” to do what it took to get the job done, and
not to stop until it was finished. Nurses, doctors, housewives,
managers, students. They were all there. “What can we
do?” each one asked, as they sensed the mass confusion
and begged for guidance through the unthinkable. The doctors
and nurses set to work. They knew what they had to do, and
with the most basic of tools to work with, they did a remarkable
job. The others that had offered their services were directed
to the rooms and wards, to find the wounded, hold their hands
and comfort them. A brief talk was all we could afford these
volunteers to prepare them for the horror that they would
witness at the bedside. “Don’t look at the wounds,
look past the burns, and the bloodied bandages”, they
were told. “Look at the person inside. They need your
support, your touch. If you cannot touch their hands (for
many of them were burned), stroke their head, and comfort
them with your voice”. Most took up their posts with
remarkable courage. Some could not. “I’m sorry,
I just can’t” they whispered through their tears;
they were ushered to administration duties where they busied
themselves tirelessly. To admit an inability to cope must
be admired with the same awe as the bravery of the bedside
troopers.
Monday, the day of the dead.
A few hours sleep and I woke with a delirious misconception
of a peace that the dawn would bring. The worst is over now,
take some time out. I read the home page “Bali Terror…….Bomb
explodes in Kuta nightclub”. I had to read it twice.
Yes it had really happened, the nightmare was real, and the
places and names that were so familiar were on news reports
everywhere. The worst was not over, rest would not come, confusion
still reigned paramount. 6.30 am and the phone starts. “How
can I help?………where can I give blood?…….Is
it true that………? I know your busy but…….My
niece is missing and……?Where do I go for information
on……..?” Where do they go? WHERE DO I GO?
I collected my thoughts and realized, that the survivors had
been dealt with as best we could for the time being………the
dead, however, had come as an afterthought in my list of triages
and urgent treatment. Come on now, I told myself. You’re
a nurse. Death is not new to you. You have to go. The phone
rang again. “Kim, would you mind giving us a hand at
the morgue. Some of the families are there and will need some
support”. Of course I would, I was on my may. Some thoughts
as to what I would encounter that day, found me at the local
supermarket. Boots gardening gloves, disinfectant, and menthol
oil. I collected masks, a surgical gown and hat, and dressed
in clothes and shoes that I knew I would burn at the end of
the day. When I entered the mortuary grounds, I felt like
a total clown, dressed in protective clothing from head to
toe I was greeted once again by the same faces. Most were
dressed in nothing but singlets, shorts and thongs. The “ordinary
people” doing the most “extraordinary” jobs.
They were all there; surfers, housewives, business men, retailers
& students. I need not expand on the horror instilled
in each and every one present. The sights, the smells, the
grief. Somehow all these “ordinary” people had
put aside their fears and concerns for self, to do what it
took to get the job done. As I stood and watched, I wondered.
How would we all cope with the visions, dreams and emotional
trauma that would certainly come back to haunt us, long after
the last soul had been put to rest.
Coping.
Thanks to so many support systems that have fallen into place
there is no lack of counseling services for all to attend
(at least for the time being). Many people have taken advantage
of these services, and many have not. Some may feel that seeking
such a service is an admission of weakness, inability to cope.
Others may be questioning themselves as to their complete
lack of emotion at these recent events. Some members of the
community that were not involved in the “hands on”
activities, and have not been personally affected by the bombing,
may feel guilt at not having suffered. Like it or not, we
will all be affected, we will all grieve in some form or another.
Grieving is healing process. It is NORMAL. Let’s look
at what we should expect to feel, or what behavior we may
expect in those around us.
Phases of Emotional response to a disaster:
l Impact phase: During the first few days, individuals may
feel stunned. This may give way to feelings of disbelief,
numbness, fear and confusion.
l Crisis phase: After the initial impact has been absorbed
mixed feelings can become apparent. Denial, excitability,
anger, irritability, apathy. Physical symptoms may include
fatigue, dizziness, headaches, and nausea.
l Resolution phase: During the first 12 months grief, guilt,
and depression are often prominent.
l Reconstruction phrase: Reappraisal, acceptance and new self-concept
occur.
Common symptoms that may be experienced.
l Emotional – Daze, grief, anxiety, guilt, anger, numbness,
helplessness, shame, emptiness, decreased ability to feel
pleasure/interest/love. Children may regress.
l Cognitive – Nightmares, poor concentration, unwanted
memories of the disaster, self blame, confusion, indecisiveness,
worry.
l Physical – Difficulty sleeping, tension, fatigue,
headaches, nausea, change in appetite, change in libido.
l Interpersonal reactions – Distrust, conflict, withdrawal,
problems with work or school. Children may become clingy or
aggressive.
All these feelings are common, even NORMAL, and should be
recognized as a healthy part of a healing process. Their intensity
should begin to subside approximately one month after the
disaster. Small groups should be encouraged to meet, even
small dinner parties, coffee mornings, or a casual impromptu
cup of tea will all be therepuetic in bringing these emotions
to the fore, so as they can be expressed, processed and laid
to rest.
Significant symptoms that may require ongoing professional
consultation:
l Severe persistent symptoms – Marked depression, panic
attacks, extreme numbing, inability to control emotions, problems
with self-care.
l Re-occurrence of existing psychiatric conditions.
l Terrifying memories, persistent nightmares, and flashbacks.
l Substance abuse – overuse of alcohol, or drug dependence.
l Aggression.
These symptoms can occur immediately or months after the
event. They may take several years to subside. Any one experiencing
this, or who knows of someone who is, should seek appropriate
counseling.
Children.
Children may react in ways, that as adults we may not recognize
as such. Naturally a 3-year-old may react differently to a
12-year old, and I will not go into a detailed account of
what to expect from each age group. It is important to realize
however that a child’s concept of tragic events will
differ vastly to those of an adult. Children expect that parents
(or other trusted adult parties) have the ability to protect
them from danger. In the event of disaster, it becomes evident
that “big people” have lost the ability to control
the situation. The child may then express grave fears as to
what will happen to the world, and develop a pre-occupation
with danger and vulnerability. Even though we may try to protect
our children as best we can from what has occurred, we should
never underestimate the impact that disasters have on them.
Television, media, and stories from schoolmates are all taken
in with open eyes and minds. Commonly children will become
very demanding, over-reacting to minor ills and wounds, expressing
feelings that they are unloved, and quarreling with siblings
or schoolmates. It is important for us as parents or carers
to recognize this as a reaction to a situation rather than
truancy or misbehavior. Be honest and open with children (sparing
unnecessary ghoulish details), and answer their questions
simply but truthfully. Reassure them that while everyone is
shaken by the event, that they are still loved; take a little
extra time to listen and rub the sore leg, or tend the wounded
knee, however trivial it may seem. Encourage expression through
play acting, painting or writing. Once again if you child’s
symptoms are severe or persitent, speak to a professional.
.
Healing together.
Bali is a small Island with even smaller communities. No one
is untouched by October 12th. All have or will suffer losses,
whether it is loss of loved ones, financial loss, or just
the loss of “Bali” as we once new it. One thing
that has not been lost is the community spirit. Ethnic groups
and religious parties have been brought closer instead of
wrenched apart. This is a unique phenomenon indeed. The ugliness
of looting, ethnic blame / cleansing, etc, just did not happen.
Our Island is truly blessed. Until next edition stay happy,
healthy, stay young …let’s heal our wounds together.
Kim Patra is a qualified Registered Nurse / Midwife, and
mother of three, who has been living and working in Bali for
past 15 years. She has assisted many traveller (... and others)
either as a flying medical escort or just a voice on the end
of the phone! Kim is happy to discuss any health concerns
that your may have. Her e-mail contact is info@chcbali.com
