SANTIAGO, Chile – Chilean authorities have employed measures to help those affected by the earthquake and tsunami last February.
Beyond physical trauma and material losses, the psychological damage suffered by the survivors has not gone unnoticed by the Chilean authorities.
Dr. Alfredo Pemjean, a psychiatrist and chief physician of the Mental Health Department of the Under Secretary of Public Health, has been appointed by the Chilean government to head the campaign to help the victims with mental health problems.
In an exclusive interview with Infosurhoy.com, Pemjean discusses the Chilean government’s strategies to address the psychological damage the earthquake has caused among its citizens.
Infosurhoy.com: What strategies are being used by the Chilean government to help with the psychological damage inflicted by the natural disasters?
Pemjean: It is important to note that Chile has lived through several cumulative experiences with regard to natural emergencies in the past 20 years: five earthquakes, a tsunami, and the continued eruption in Aysén – of the Chaitén volcano – among others. Since 1993 – the year of the earthquake in Antofagasta – we have elaborated policies to protect the mental health of the population.
Two days after the latest earthquake in Chile, in other words, on Feb. 29, the Health Ministry ordered that mental health be made a priority. A multidisciplinary committee was established to treat the reactions we knew would occur. The main parameter was to anticipate and be prepared.
We have already had, for four years, a “Plan Nacional de Protección a la Salud Mental en Emergencias y Desastres” (National Mental Health Protection Plan during Emergencies and Disasters), which consists of having prepared three professionals for each Health Service all over the country, charging them with heading up the ways to address these disasters, from the first 72 hours, or “critical” stage, to the “reconstruction” stage, two months from the time of the disaster and a return to “normalcy” once this period has passed.
Infosurhoy.com: How would you define the mental illnesses and reactions caused by the earthquake?
Pemjean: I would say that they are normal. One shouldn’t over-diagnose pathologies, when what happened were natural behaviors in a completely abnormal situation: symptoms of anxiety, uncontrolled behaviors and depression.
Infosurhoy.com: Is it wrong to use the concept of post-traumatic disorder in regard to the mental illness that was caused by the earthquake?
Pemjean: Of course it is wrong. That is a severe clinical diagnosis that does not manifest until three months after an event. It is also difficult to diagnose, and in our countries there is a much lower incidence.
Infosurhoy.com: How would you rate primary healthcare in Chile?
Pemjean: Primary healthcare in our country is very well developed, and it is the first line of containment and intervention to help the population in times of emergencies, not just for healthcare in general, but also for mental health. Therefore, we must continue to support it. The actions applied in Chile are avant-garde and did not exist in Latin America until 1993. There are psychologists stationed in every healthcare center, no matter how rural or small they may be, about 1,500 psychologists in the whole country. This has meant that the general health team is reinforced with an effective multidisciplinary program. This is how we have been able to address emotional containment, and of course, medicinal attention for the affected population.
Infosurhoy.com: What would you stress regarding the performance of civil servants?
Pemjean: Their many heroic acts and the unselfish giving of their time and the many examples of dedication they displayed. They also were affected by the earthquake (losing homes and workplaces, etc.).
Infosurhoy.com: How has this work been linked to actions by the Pan American Health Organization (PAHO)?
Pemjean: We have received consultants and a budget from this organization which, as is known, is tied to the United Nations, allowing us to prepare a plan to provide instruction to 12,000 civil servants, with workshops, so they may offer emotional support and set up support networks in times of emergency.
Regarding international support, the case that comes to mind is Peru. An interesting effort was made to support the victims of its last earthquake, leading to an agreement regarding mental health [support] between our two countries.