MSF teams in Sichuan Province, China, focusing on mental health, shelter, and basic relief items

Interview with Tony Marchant, outgoing Emergency Coordinator in Chengdu, Sichuan Province, China.

What are the main needs of the people in Sichuan today?

Following extensive assessments in the affected region, MSF teams have found that the response in terms of food, water, sanitation and hygiene is largely adequate in most places. Over five million have been left homeless by the quake, so the need for shelter is tremendous. MSF has distributed 4,560 tents in close collaboration with the Chinese Red Cross, as well as plastic sheeting to the families in need. Many survivors have not only lost their houses and belongings, but also friends and/or relatives. Many are still in shock after the terrible experience of the quake. They clearly need psychological support.

Are there specific groups in need of mental health support?

When we come across survivors here, they tend to say that things are OK and they can cope with the situation. Like this old lady on Wednesday who told us she was fine and we could focus on assisting others. But when we started asking questions, tears started flowing quite quickly. The same day, a bulldozer driver came to us asking to see one of our psychologists. He had been removing dead bodies from the rubbles since the quake and was feeling very bad, and having nightmares about his terrible daily experience. Several specific groups are in need: school children, as many school buildings collapsed and many have lost their schoolmates and parents; the elderly are a group sometimes left unattended; disabled patients suffering from major trauma injuries and for whom it is even more difficult to get back to normal life and cope with the situation.

What are the plans for MSF mental health work in Sichuan?

MSF psychologists have offered support and counselling in reference hospitals and they have provided training to medical staff on how to provide basic psychological first aid to support the patients. A team of four psychologists will work in two locations where people displaced by the quake have sought refuge. In Long Men, Pengzhou city, a mountainous area where about 10,000 people are living in 10 temporary settlements, we will set up a tent next to the medical facilities where 3 MSF psychologists will provide consultations and counselling. Another team will start psychological support in a temporary settlement for around another 10,000 displaced people in Hanwang, Mianzhu city. In parallel, MSF teams will continue to respond to basic needs of the people in the affected areas of Long Men and Hanwang. We will distribute more tents, basic items such as washing basins, and even clothes when needed.

Is the local response covering all other needs?

In the many different emergencies I have witnessed, I have never seen such a response from the national authorities. On top of that there has been a lot of social mobilisation, volunteers coming into the affected area to offer their support. In a large-scale disaster such as the Sichuan earthquake you could find large unmet needs. But there are very few gaps, mainly in the fields of mental health, basic relief items, and shelter. MSF is trying to respond to these gaps. At the medical level, MSF offered some clinical and surgical support to hospitals in Guanghan and Hanwang. A team of 3 nephrologists from the International Society of Nephrology provided expertise in kidney problems often linked to hyper tension, in three of the largest hospitals in the provincial capital of Chengdu, as well as in the temporary triage referral hospital in Guanghan.

Almost three weeks after the earthquake, can you feel the start of recovery?

So far people have been totally reliant on assistance from the government and non-governmental organizations, both local and international ones. The first phrase - the rescue operations - has mostly been completed. Now we see signs of reconstruction - the construction of pre-fabricated housings, schools and general infrastructure is underway. Nevertheless, many survivors have lost everything and they have to continue to rely on governmental and non-governmental assistance to recover from such an extensive disaster. Without doubt it will take years for the people here to get back to a normal life.

What is the next plan for MSF?

MSF remains in Sichuan and will work essentially in the field of mental health and distribution of basic relief items. We carried out medical activities in the phase of relief operations including nephrology, surgery and internal medicine but these emergency activities have now come to an end. But MSF will continue to follow up on extra medical and basic needs of the people injured and affected by this disaster.