Trauma rampant after China earthquake zones

updated 5:37 p.m. ET May 27, 2008

DEYANG, China - Liu Yisi sits on a hospital bed, reading a comic book. His nose is bruised, swollen and cut, and his left arm is heavily bandaged.

While his physical injuries from China's May 12 earthquake are healing, mental trauma has made the 13-year-old withdraw into mostly silence.

Li Fuhong, a psychology professor who voluntarily drove nearly 200 miles to the disaster zone, speaks softly to Liu. He coaxes the boy to tell him what happened when he escaped the ruins of his school in the city of Mianzhu and makes him repeat these words: "The bad events are over. The future will be better. I need to be strong."

The teenager is lucky to be getting help. Across central China's disaster zone, many other such victims with mental trauma are going untreated because health services are already strained.

Hospitals and clinics were destroyed along with so much else across Sichuan province in the quake, leaving acute shortages of staff and facilities. In the immediate aftermath, medical services have focused on treating crushed and broken bones, amputated limbs and on preventing disease outbreaks.

Experts warn that mental trauma could be a hidden toll for many survivors.

Dealing with loss
The government says the quake may have killed more than 80,000 people, leaving many more to deal with the deaths of loved ones. Millions have had their homes shattered and their lives thrown into turmoil. No government estimate of people needing psychological help has been released, although the state-run Legal Daily newspaper quoted an expert as saying they could number as high as 600,000.

Teams of psychologists, psychiatrists and volunteer counselors like Li Fuhong have gone to the hardest-hit areas, where mental health professionals have been swamped.

"China has been struggling to help thousands of people distressed and traumatized in the unprecedented earthquake that ravaged many parts of Sichuan," the official Xinhua News Agency said last week. "Many volunteers and experts have rushed to quake zones but psychologists are still in great demand."

In the past, there has been a social stigma attached to mental illness in China. Increasingly fast-paced — and stressful — lifestyles stemming from two decades of economic success have forced a greater awareness of the problem.

Xinhua reported last year that there were 16 million mental patients in the country but services at the grass roots level were still lacking, and public awareness was minimal. Health officials have said that by of the end of 2006, there were only 1,124 mental institutions, with 146,000 beds and 19,000 psychiatrists or assistant psychiatrists.

Greg Baker / AP An earthquake survivor, left, talks with a psychologist.

Hospitals left standing by the quake have been overrun with serious injuries. The government has rushed more than 10,000 doctors or nurses to the area and a dozen field hospitals have been erected, Health Ministry spokesman Sun Jiahai said Tuesday in Beijing.

Signs of mental and emotional strain are widespread.

Relatives, weeping inconsolably, fall to the ground in front of plastic-wrapped bodies of sons and daughters killed in a school collapse in Hanwang. In the town of Beichuan, so badly damaged that it has been abandoned, villagers stare blankly in shock at what used to be their homes. Some talk with gratitude about having escaped with their lives — only to dissolve into tears.

Metin Basoglu, head of trauma studies at London's Institute of Psychiatry at King's College and the director of the Istanbul Center for Behavior Research and Therapy in Turkey, said 80 percent of the survivors could be expected to suffer short-term effects of post-traumatic stress disorder, a condition that can develop after a person is exposed to a terrifying event in which physical harm has either occurred or was threatened.

Half will have longer-term problems, which include obsession with the trauma, nightmares, flashbacks, emotional numbing, loss of interest in life, irritability, memory problems and hyper-vigilance — a state of constant alertness.

"Fear is the most serious problem," Basoglu said. "Many people will find that their fear of earthquakes interferes with their everyday activities," including sleeping, bathing — even walking into a building.

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