Crisis has a very strange way of changing the rules of society. The country
watched in horror and disbelief as the looting, beatings and suspension of
the rules of conventional behavior were displayed on television. It is
shocking to see how quickly human behavior reverts to its most primitive
form in a catastrophe.
Many American Indians sat and watched the unfolding disaster, wrought by
Hurricane Katrina, and noted the slow response to assist, creating a sense
of apprehension and foreboding. Watching with great sympathy the forced
evacuation of thousands of people from Louisiana brings to mind the forced
evacuation of thousands of Cherokee Indians from Georgia and North Carolina
to Oklahoma on a journey we now know as the Trail of Tears in 1838 -- '39.
The similarity between the two events, however, ends there.
The evacuees in Louisiana have good reason to evacuate: the devastation of
flooding and total disruption of normal life. The Cherokees were forcibly
removed for no other reason than the desire for their land and their space.
Hearing the distress of mothers separated from children, missing family
members and the complete loss of homes and everything in them -- including
family pets -- has created total panic and chaos for thousands of people.
The level of public health response is one that this country has not faced
since Sept. 11, 2001. The present state of emergency calls for enormous
financial and human resources to resolve.
The crisis lays bare the fragile public health and the medical, law
enforcement and governmental response to this disaster, not to mention the
aftermath of dealing with a vast array of social, physical and
psychological problems, including post-traumatic stress disorder.
PTSD is an anxiety disorder that can develop after exposure to a terrifying
event or ordeal in which grave physical harm occurred or was threatened.
The observance of a traumatic event also qualifies. Events that may trigger
PTSD include violent personal assaults, natural or human-caused disasters,
accidents or military combat. People with PTSD have persistent frightening
thoughts and memories of their ordeal and feel emotionally numb, especially
with people with whom they were once close. They may experience sleep
problems, feel detached or numb, or be easily startled.
PTSD is a condition that recently has been applied to the American Indian
population as historical trauma. The phenomenon will become more widely
known and accepted with this disaster. Dealing with the symptoms will
require a greater response to not only the physical but emotional,
spiritual and mental health needs of the thousands of displaced evacuees.
Some characteristics of PTSD can be exhibited as difficulty sleeping, loss
of appetite, abuse of drugs and/or alcohol, difficulty holding a job,
inability to concentrate at school or work and problems with relationships.
MENTAL HEALTH IN INDIAN COUNTRY
A report issued by the U.S. surgeon general reports the ratio of mental
health workers is approximately one psychologist per 8,333 American Indian
or Alaska Natives as compared to one per 2,213 for the general population.
Some reservations share a psychologist, while some areas of IHS share one
psychiatrist. There is a great need for American Indians to enter the field
of psychology to work with the devastating effects of historical trauma.
The symptoms exhibited by American Indians can be directly attributed to
historical trauma. The high rate of alcohol and substance abuse, poor or
weak family relationships, and high poverty rates, coupled with other
factors such as racism and discrimination, create unacceptable outcomes.
The long-range effects on American Indian society and the larger society,
in general, can be measured in dollars.
Not knowing the true level of depression in American Indian communities
hinders the work of social service agencies, tribal alcohol directors, IHS,
tribal schools, family therapists and other professionals working in the
field of behavioral health.
In the United States, behavioral health-related issues cost $300 billion
annually in compensation claims, absenteeism, lost productivity,
incarceration, direct medical expense and employee turnover. When people
are distracted by personal problems, employee absenteeism is a readily
observable symptom, as is forgetfulness, accidents and errors. This burden
is oftentimes paid for by the employer, which on reservations is the tribe.
In recent figures received from one reservation hospital, a physician
reported 975 cases of child abuse, neglect and sexual trauma in one year in
a population of approximately 20,000 people. The resources needed to work
with and assist these traumatized young people is a massive undertaking and
virtually impossible to accomplish with the current resources.
So it is with great sympathy that Indian country observes the devastating
effects of Hurricane Katrina, and with the understanding that it will take
a very long time to overcome the crisis.
Carole Anne Heart is the executive director of the Aberdeen Area Tribal
Chairmen's Health Board. She can be reached at (605) 721-1922 or
firstname.lastname@example.org. Visit www.aatchb.org for more information.