On December 26th, 2004, the shores of twelve states of the Indian Ocean were hit by a gigantic flood weave. Because of the closeness to the epicentre of the earth quake and the big impact of the weave that hit the coast most victims of the natural catastrophe were found in Aceh. More than 160.000 people died and more than 500.000 people lost their homes. The tsunami destroyed 3.000 kilometres of streets, 14 of 19 ports, 120 important bridges, 2.000 schools and eight hospitals in Aceh.
Even before the tsunami the economical and social situation of the majority of the population of Aceh was devastating. For more than three decades the region Aceh has been involved in a civil war. Almost half of the population didn’t have access to drinking water, a third of the children were undernourished and almost 40 percent of the people didn’t have any access to medical treatment. From 1999 to 2002 the poverty rate doubled. In 2003 the region was prohibited for all foreigners by the Indonesian government and was only opened up again by the tsunami catastrophe for international relief aid and press coverage.
A ceasefire between the conflicting parties was agreed on that led to a peace agreement in August 2005. The tsunami caused the whole political and social context to change. Hundred thousands of people became refugees because of the natural catastrophe after the civil war having already disrooted many of this people.
Due to this situation the preconditions were and still are very problematic for effective help. Other then in other tsunami affected areas the society in Aceh is marked by decade long isolation, violent conflicts for political self-determination and the strict interpretation of the Islam. The Sharia (doctrine of the Islam including moral and judicial duties) was introduced as part of the laws.
In regard to the forces in the country the situation in Aceh is grim. In the civil war educational institutions, especially higher schools and universities were systematically destroyed and many of the remaining teachers died in the tsunami – so today there is only one trained native psychologist in Aceh. Contrary to that there are half a million victims of the tsunami who lost their relatives, their homes and all possessions. More than two thirds of them still live in camps and barracks without sufficient sanitation. Families with five to seven persons live together on 12 qm² on average without any possibility to have a private sphere.
The people don’t have any possibility to continue with their normal lives and a daily routine that are essential for overcoming the shock due to the circumstances in the camps and the fragmentation of the families. The continuously insecure and violent living conditions prohibit a natural dealing with and overcoming of the shock experience and have caused a posttraumatic stress syndrome (PTSD) – mainly among women and children as the most vulnerable members of society.
Even though religion is providing help for the affected people in this region and has a stabilising and securing effect through prayer rituals, at the same time a necessary psychological dealing with the individual, emotional shock experience is prohibited. For example according to the Koran the mourning ends after a set time of 60 days and after that no public sign of sadness and desperation is permitted. So the posttraumatic stress syndrome becomes visible in severe depressions, psychosomatic illnesses, among children in auto-aggressive and among adults in aggressive behaviour.
Even though international organisations reacted to the emotional situation of children in the scope of emergency aid by the initiating various psycho-social programmes, often the staffs of governmental and non-governmental organisations or other community representatives (teacher, religious authorities) that work in the camps don’t have sufficient qualifications.
The attempt to prepare helpers for their tasks through intensive capacity building in paedagogics and psychology could hardly be absorbed and understood by them since they often didn’t have enough or insufficient knowledge in this field. Besides the use of often unsystematically implemented activities as painting and play therapy most helpers – who also live in the camps with the affected people – only use known religious activities because of fatigue and excessive demand. Beyond that these activities are mainly used for children, adolescents and adults are mostly unconsidered. Therefore the children remain in an environment in which their most important attachment figures still suffer from the shock experience.
Positive stimuli through activities are still overlaid and negated by the consistently existing uncertainty and psychic illness that the children sense in their families. Particularly children suffer from anxieties, night mares, sleeping disorders, feeling of guilt, loneliness, depression, disturbance of perception of the environment sometimes until total apathy. They participate in normal life just superficially but they are defenceless to any stress. As a whole, untreated trauma symptoms lead in the long run to a consistent and dramatically restriction of the capability to concentrate and to perceive and as mentioned above often to aggressive and auto-aggressive behaviour, this for example peaks in the appearance of more sexual violations of women. The helpers in the refugee camps are not able to deal with the complex situation because they took over this position by virtue of their position as teachers, religious authorities or employees of local community initiatives without special knowledge.
In order to complement the already existing programmes in the refugee camps and to qualify the existing professional knowledge in Indonesia and to establish or re-establish an emotional basis for the perception of activities of self-help among the victims, the following 3 years programme 2006-2009 is prepared which will establish a qualified system in the field of trauma therapy especially for women and children as victims of the tsunami.
The name of the programme is Programme for Trauma Therapy of Tsunami Victims in Aceh financed by Bundesministerium fur Wirtschaftliche Zusamenarbeit und Entwicklung (BMZ).
Private Holder is terre des hommes Deutschland e. V. (Tdh), Ruppenkampstraße 11 A, 49084 Osnabrück, Deutschland and the Project Holder in partner country is Himpunan Psikologi Indonesia Wilayah DKI Jaya (Himpsi Jaya) Jl. Flamboyan Asri DIII No. 20 – Puri Flamboyan – Jakarta, Indonesia
Target areas of the project are the refugee camps in Blang Pidie (Southwest Aceh), Aceh Besar (province in the hinterland of the capital Banda Aceh) and Aceh Jaya (by the tsunami mainly affected west coast). Direct target group of the project are 6.000 women and children in the refugee camps.
Indirect target group as beneficiaries of the project are two Indonesian psychologists, twelve therapists from Aceh with a basic training in psychology and 90 helpers from the refugee camps (community workers of the public health system, social workers, teachers, religious authorities and other representatives of the communities)
Establishment of a psycho-social service for qualified trauma therapy of altogether 6.000 children and single women as victims of the tsunami in the three regions of the province Aceh is the overall objective and the specific objective is the establishment of an educational system rooted in Indonesia for the treatment of the post traumatic stress syndrome disorder (PTSD) of victims of crises and catastrophes through the implementation of specific methods of treatment with a focus on the introduction of EMDR.