WHEN he awakened at the hospital a few days ago, David (not his real name), in his early 20s, did not recall what had happened to him or how he got here. But despite the blank memory, his body kept physically tensed up. He could not help doubling his fist and curling up his body. Delusions about many people trying to hit him haunted him from time to time.
As an injured survivor of Shanghai’s Bund stampede on New Year’s Eve, David was sent to Ruijin Hospital together with 11 other injured people. Hospital officials did not further identify David, who suffered a serious contusion of the lung.
The Bund disaster left 36 people dead, and the 49 injured received treatment at Ruijin Hospital, Shanghai No. 1 People’s Hospital, the Central Hospital of Huangpu District and Chang Zheng Hospital. Up to now, 29 injured had been discharged from hospitals, while 20 others are still receiving treatment. The number of the seriously injured decreased to four, with one patient’s vital signs still not stable.
When David was revived by doctors, his memory loss was a typical “avoidance reaction” common among people experiencing disasters, according to Dong Zhengchuan, a 25-year-old social worker who has been providing post-disaster psychological aid to two male survivors, including David, since January 3.
Dong is part of a group of professionals, including eight doctors and 40 volunteer mental health experts such as counselors and social workers, helping victims cope with emotional problems in the wake of the stampede disaster.
In most cases, the symptoms will fade naturally in a few days. Dong taught David a set of muscle-relaxing exercises and meditation to help him ease physically, and it worked.
“I told him that he could help himself. When the delusion attacked him again, he could try to recall the exercise and ease the feeling, so that he wouldn’t be afraid anymore,” says Dong.
Acute psychological stress reaction with symptoms affecting consciousness, behavior, emotion or body are common among people who go through terrible disasters, says Lin Guozhen, director of the psychology department of Ruijin Hospital.
“Though many people can just recover naturally in weeks, some people may suffer much longer and need systemic treatments,” says Dr Lin. “Proper intervention within 72 hours after the disaster is very helpful for the survivors to overcome the psychological difficulties more effectively.”
The World Health Organization says that 20-40 percent of people experiencing disasters typically suffer mild psychological disorders that go away within days to weeks; 30-50 percent suffer medium to serious psychological disorders such as acute stress disorder that need psychological aid to fix; while 20 percent may suffer serious psychological disorders that can last more than a year, such as post-traumatic stress disorder.
To reduce the possible psychological damage to the Bund stampede victims, the panel of eight doctors was teamed on January 3 in Shanghai, leading the 40 professional volunteers to help those injured and their family members in need.
Lin is leading a team of three social workers providing aid to the survivors in Ruijin Hospital. Symptoms including short-term memory loss, mania, inability to speak, terror and guilty feelings, as well as shortness of breath and sleeplessness have all been observed among the injured survivors in the first few days.
A 21-year-old woman kept curling up, shivering and was speechless for six hours until she gradually recalled her mother’s phone number.
A 27-year-old woman got so vehement and agitated when regaining consciousness that the doctors need to calm her down with tranquilizers before providing psychological aid.
A 36-year-old woman suffered terrible guilt and self-accusation after she took her nephew to the Bund that night that ended in the boy’s death.
And some other patients still suffered physical discomfort like rapid heartbeat, difficulty in breathing and problems in swallowing.
“Giving support and company rather than preaching are among the most-needed psychological aids for the survivors in the first few days,” says Lin.
Rather than reminding survivors of the terrible disaster or trying to persuade them not to think about it, the doctors and social workers all worked on convincing the victims that they were now safe. They gave them hugs or rubbed their hands gently to help them calm down.
The victims’ families were called to the hospital, as their company would help victims feel safe more effectively than unfamiliar professionals.
“We never intentionally mentioned the disaster in front of the victims, but if they chose to talk about it themselves, we would be patient listeners who gave explanation and comfort from time to time,” says Lin.
She says many of the injured were pulled from the second level of the piles. Feelings such as fear and guilt are inevitable, and victims need channels to discharge their emotions. The counseling included proper explanation to help them adjust themselves and accept the facts.
“For example, I told the woman suffering great guilty feelings that she had to admit that she had tried her best to protect the boy, yet something just happened beyond anybody’s control,” says Lin. “And as for those who worried about their disorders, we explained to them that these are just common reactions as human beings. They would be fine within time.”
Most of the stampede survivors at Ruijin Hospital are recovering well both physically and psychologically, according to Lin. Apart from the timely psychological intervention, some victims’ healthy personalities also played an important role in their recovery.
Though the family members of the victims, witnesses to the disaster, police and medical staff on the front lines are usually also among the targets for post-disaster psychological aid, the intervention this time focused mainly on the victims.
“We would offer help when obvious symptoms are observed on other people as well, but there seems not to be that much need so far,” says Lin. “Most of the survivors’ families seemed to behave normally despite the astonishment, and many of them felt blessed to see their children survived.”
Post-disaster psychological aid was first introduced in China during the 1994 Karamay fire that killed 325 people in Xinjiang Uygur Autonomous Region. It has gained in the past 20 years. Teams offering psychological aid were found in many disasters since then, including the 2004 Baotou airplane crash in Inner Mongolia that resulted in 55 deaths, the 2008 Sichuan earthquake that killed 69,227 people and the Yunnan earthquake in April 2013 that killed 196.
In 2010, about 70 psychological professionals were teamed to offer psychological aid to the victims, witnesses and firefighters in the fire disaster in Shanghai that left 58 residents dead in an apartment high-rise on Jiaozhou Road in Jing’an District.
With social worker Dong’s help, David was free from delusion on January 4 and by yesterday was reported to be recovering well from his flashbacks and other problems. Dong says that he would look after David throughout his stay in the hospital and make phone-call follow up when he is discharged.
Volunteers organized by the Shanghai Women’s Federation plan to keep following up with patients as they are discharged from the hospitals.