PHUKET - Survivors of last week's deadly tsunamis are at risk of becoming suicidal or developing other serious neuroses as they grapple with the guilt of having lived while others died, mental health experts say.

"There is a suicide risk. After a while, a traumatic neurosis could appear that could lead to suicide," said Jean-Michel Coq, a psychologist with a French medical unit in Phuket, where hundreds were killed.

His colleague Toufik Selma cautioned though that while "suicide was a possibility, it is something rare".

Faced with the type of catastrophe unleashed across the region on December 26, "there is always a core group of six to eight percent of people who will develop a traumatic neurosis leading, eventually, to suicide," he said.

Thai psychiatrists and psychologists warned in the Bangkok Post daily on Monday of an elevated suicide risk among 800 survivors they had examined in two of the provinces that suffered the most deaths, Phuket and Phang Nga.

The magnitude of the disaster which has left nearly 5,200 dead and more than 3,800 missing in Thailand is without precedent.

"You cannot compare it with anything else because it is on such a large scale," said a British psychologist volunteering in Phuket, Frederik Jurriaanse.

"In France, we do simulations for our training. We never imagined working on a tsunami," said Joel Clero, an official with the French team here.

The specialists have listened to the stories of about one hundred people who survived the disaster or lost loved ones.

The symptoms they have detected are well known but have never been seen before in a similar context, they say.

The circumstance: an idyllic setting, a family Christmas far from Europe's dull winter skies, a trip sometimes planned for years and then suddenly a tsunami and the double trauma of having brushed with death and not prevented the death of someone else.

"There are people who feel guilty that they are alive," Clero said.

"One man told us: "I saw my wife's head being smashed and I let go of my baby."

"He wandered around Phuket for six days without sleeping or eating before agreeing to go home to Bangkok," Clero said.

It took relief workers dozens of hours to persuade him to leave, he said.

Others also "absorb" the pain of the survivors.

"One victim lost her child. Her brother (who came from France) kept going through it over and over. It was a recurring trauma, a bit like the children of the survivors of the Holocaust," Selma said.

A week after the disaster, most survivors are far from being able to begin the process of rebuilding their lives, the doctors said.

"Most of the people have not yet integrated the idea of death. They are still in the phase of paralysing shock," said Clero.

An example is the devastated and mourning survivors who are continuing their holidays as though nothing happened.

Others in denial are people who have immediately started working from their hospital rooms.

And one woman is trying to cope by planning to adopt a Thai child orphaned in the tragedy after her own baby was killed by the murderous waves that battered the resort of Khao Lak.

"People want to rebuild their lives because they are in a disaster zone," said doctor Francois Joly. "But in that lies a deep fragility."

AFP Source Article

GALLE, Sri Lanka (AP) -- Some banged their heads against the hospital wall. Some, wide-eyed, just stared vacantly, while others mumbled "the sea is coming," reliving the horrors of the massive tsunami that took with it their families and homes.

They were among the first people to be treated in Sri Lanka's southern port city of Galle for post-traumatic stress disorder, doctors said Tuesday. They worry the debilitating condition will engulf many who survived last week's massive waves.

The helplessness and agony are reflections of the loss of nearly 150,000 lives in 11 countries -- including Sri Lanka, Indonesia and Thailand -- after an Indonesian earthquake and resulting tsunami smashed areas around the region. Sri Lanka accounted for 30,229 deaths, and in Galle alone 4,141 bodies have been found.

Gamini Liyanage, 35, repeatedly pounded his head on the wall above his bed's iron headboard at Karapitiya hospital's main psychiatric ward. Suddenly, he bounced out of bed and tried to jump out a small window. Men in white hospital suits dragged him back to his bed, where he sobbed.

Nine days ago, Liyanage's 3-year-old daughter was yanked from his arms by the waves when he tripped while trying to escape the water that was rapidly filling his home.

His wife, Champika, escaped with their son but found her daughter's body hours later in what used to be their home.

"Even though I knew she was dead I carried her in my arms and ran about two kilometers [about a mile] to the hospital," Champika said, her eyes filled with tears. "We had so many expectations for her."

"I can never go back to where I lost my little girl," she said. The family also lost their livelihood, with Liyanage's retail salt business also washed out.

Dr. R. Reuban, a psychiatrist at the hospital, said he had dealt with several dozen cases after the tsunami.

Patients' symptoms included aggressiveness, slurred and incoherent speech, anxiety and suicidal tendencies, he said.

"There are many people whose level of grief has reached abnormal proportions," he said, adding that more patients were likely to arrive as they realize that loved ones, missing since the disaster, are dead.

"It's important that these people get as much support from their remaining family members and are able to indulge in funeral and religious rituals" to help the healing process, he said.

Post-traumatic stress disorder, or PTSD, is a psychiatric condition triggered by extremely upsetting experiences, ranging from rape, accidents and war, to terrorist attacks and natural disasters.

While nearly everyone exposed to such trauma suffers emotional distress, only a fraction develop PTSD. Unable to cope with the trauma, they become crippled by an extreme sense of helplessness or fear, which can interfere with their ability to look after themselves.

A one-day workshop was set to be held in Galle on Wednesday to train 60 medical students in disaster and trauma counseling, said Prof. Susarith Mendis, head of the medical faculty. They will be then be dispatched to southern Sri Lanka to try to help, he said.

It's that help that Champika clings to as she turns to Reuban with a question: "Can my husband be cured?"

He gives a hopeful nod.