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In his letter, Dr. Adams gives a heartfelt account of what he
experienced as an eyewitness, as well as his desire to use his training
and knowledge as a physician/psychiatrist to help those around him.
In his reply, Dr. Summerfield raises issues about perceiving the
victims of disaster, especially children, as victims, and cites the
experience of a community that experienced a disaster in the 1960's.
I expect this debate about whether or not to interevene in disasters
will continue for quite some time. However, throughout the history of
mental health, initial assumptions have usually changed when carefully
conducted research investigates the issue with a certain degree of
Research published by the BMJ, specifically the article by Stallard,
Velleman, & Baldwin titled "Prospective study of post-traumatic stress
disorder in children involved in road traffic accidents," (BMJ, Dec 1998;
317: 1619 - 1623) suggests that PTSD and acute stress reactions may be
found in children after certain common occurences when carefully
Regarding PTSD in general, I would like to point readers to the US
Government's National Center for PTSD website at www.ncptsd.org, as well
as their page titled "The Mental Health Consequences of the Tsunami
Disaster" at http://www.ncptsd.org/topics/tsunami.html which presents a
great deal of research relevant to disaster relief in developing
countries. Dr. Summerfield may be surprised at some of the findings.