“Disaster mental health”: lessons from Aberfan
BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7485.254-a (Published 27 January 2005) Cite this as: BMJ 2005;330:254All rapid responses
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Masterly summary of present day attitudes. Would that the victim complex and the over ready response in the way of counsellors et al for everything could be at least slowed down. It now seems to be a reflex response with little evidence base to support it. In the meantime the government, the professions seek to have more and more control over the individual. True, responsible freedom is exchanged for a promise of being looked after and made "happy" by central organisations.
Leo Dolan
Competing interests:
None declared
Competing interests: No competing interests
I'm afraid that my BMJ paper on violations of the Fourth Geneva
Convention, and other war crimes by Israeli authorities, could hardly be
more evidence based.Like almost all of those who have been hostile to what
I recorded, Dr Zermansky refuses (and perhaps cannot bear doing so)to look
at the sources I cite. These are both in the text and spelled out several
times in rapid responses. There is also the testimony of many others
amongst the 500+ rapid responses with firsthand accounts in support of the
paper. I have just listed all sources again in a rapid response to the
appalling reply by the President of the Israeli Medical Association (who
is also Council Chair of the World Medical Association,charged with
policing medical ethics worldwide)published in this week's BMJ. Please
turn to this. Is this material all "unsubstantiated biased propaganda", Dr
Zermansky?
Competing interests:
None declared
Competing interests: No competing interests
I was surprised to read Dr Summerfield's carefully argued evidence-
based letter on disaster mental health. It is an important contribution
to scientific debate on a subject in which emotional reaction and the
desire to help may have prevented objective debate.
My surprise probably reflects my own prejudice against Dr
Summerfield, fuelled by his previous evidence-lite political diatribe on
the Israel-Palestine conflict(1).
Perhaps as editor you should re-read both of Dr Summerfield's
contributions. You might then begin to understand why, although both
articles relate to international events and politics, the one is an
important and valid contribution to scientific debate, whilst the other is
no more than insubstantiated biased propaganda. As editor it is a major
part of your role to ensure that your pages are not debased by the latter,
which undermines your credibility. Maybe we might try to forgive Dr
Summerfield his political blind spot, but I am not sure we should allow
you the same luxury.
Reference
1. Summerfield D. Palestine: the assault on health and other war crimes.
BMJ 2004; 329;924
Competing interests:
I am a doctor, a clinical researcher, a Jew and a Zionist
Competing interests: No competing interests
experience of aberfan survivors
At the following site:
http://www.nuffield.ox.ac.uk/politics/aberfan/ESRC.html
I read the following paragraph:
The bereaved of Aberfan were not offered much counselling; what they
were offered is described in Lacey (1972) and Miller (1974). There is now
a large body of literature on the long-term trauma suffered by disaster
survivors (see, e.g., Joseph et al 1997 – the latest of a series of papers
on the Herald of Free Enterprise – and Marks et al 1995 on the aircrew who
survived the Kegworth disaster).
The villagers had done admirably in rehabilitating themselves with
very little help. A Government gesture was needed to restore confidence
and only complete removal of the tips would do this. Many people in the
village were on sedatives but they did not take them when it was raining
because they were afraid to go to sleep. Children did not close their
bedroom doors in case they should be trapped.
My work afterwards was more like that of a pastor. People had to face
not only grief but bitterness, anger and even guilt. The first real thing
that happened were the terrible nightmares people suffered, reliving the
event time and time again. That went on for months. There was a terrible
worry and pressure on people while the tip was still there, and every time
there was a row over what was to be done about the tip my surgery would be
full the next day. The stress and anxiety triggered off by what to do
would affect people’s health.
It was predicted at the time that a lot of people might suffer from
heart attacks brought on by the stress and grief, but that didn’t happen.
Other experts predicted
that there would be a number of suicides, but that didn’t happen
either. These people hadn’t allowed for the resilience of the families
involved. It was psychological problems that hit worst.
One thing that did happen within a short time afterwards was that the
birth rate went up. Also many people were drinking a lot more and for some
time after I had to deal with people who had serious drink problems, and
for people who already had health problems, those problems increased.
From the time of the disaster for about the following six years I
dealt with people who suffered break downs. There was no set pattern or
any time when it could be expected to happen. It happened at different
times for different people.
After the disaster I warned the community would have to come to
accept its guilt. This guilt came out in many ways. There were the so-
called guilty men who were blamed for what happened; they suffered
themselves and were the victims of a hate campaign. But it wasn’t only
them. Women who had sent their children who hadn’t want to go to school
that day suffered terrible feelings of guilt. … Grief and guilt came in
many different ways. There was a strange bitterness between families who
lost children and those who hadn’t; people just could not help it.
Aberfan doctor
We were a generation that lost out. We lost out on our education and
on our futures. I can’t think of any of us who ever did really well and
most of just stayed and grew up in the village. We haven’t gone far at
all.
Pupil, Pantglas Junior School
All of this seems to fly in the face of the 'leave them alone and
they'll get over it' theory in the article.
Helen Rees
Competing interests:
None declared
Competing interests: No competing interests