Courtesy of Crisis Center Faculty of Psychology, UGM, Indonesia In collaboration with

1. COPING TO DISASTER LESSON LEARNED FROM ACEH & BANTUL Courtesy of Crisis Center Faculty of Psychology, UGM, IndonesiaIn collaboration with Royal Children Hospital,AIHI/Nossal Institute for Global Health-UNIMELB, &World Vision Australia - Australia

2. Quick facts about Aceh • The western part of the Indonesia • 3 hours flight from Jakarta (capital city) • Rich Islamic culture (one of the first communities in Indonesia to be introduced to Islamic tradition) • Long history of conflict (between Indonesian Government and Aceh Freedom Movement (GAM)

3. Quick facts about Earthquake And Tsunami • The earthquake • 9,0 on the Richter Scale (RS) • Tremors at higher than 4,5 RS continue up to 2 months after the major shock • Minor to major property destruction, injuries and death. • Intense psychological terrors: Fear of a recurring tsunami and being trapped in collapsing building.

4. Aceh Jan 2005 Courtesy of Rahmat Hidayat

5. Quick facts about Earthquakeand Tsunami The tsunami • Up to 34 meters high • Up to 7 kilometers from the shoreline • Minor destruction to total demolition • Mud and debris, including corpses littering residential areas • Injuries and permanent disabilities, and number of death on an unprecendeted scale

6. Aceh Jan 2005 Courtesy of Rahmat Hidayat

9. The Ring Modelcourtesy of Rahmat Hidayat • Assumption: varying degree of destruction, varying level of personal involvement. • Methods: In-depth interview with survivors. • The ring: • Ring I: total demolition by the tsunami • Ring II: partial destruction by the tsunami • Ring III: flooded area • Ring IV: earthquake effected area • Ring V: outside the disaster area

10. RING I: TSUNAMI’S TOTAL DEMOLITION • Totally demolished by the force of the tsunami. • Area: 0 – 3 km. from the sea shore. • Survival rate: 20% or less. • Survivors losses: • Houses and properties, including capital wealth. • Most of all members of direct family.

11. RING I: PSYCHOLOGICAL PROBLEM • Accute stress dissorders: Immediate effects of the traumatic experience. • Accute feeling of helplessness. • In-depth interview reveals some positive thinkings: • Having miraculously survived, they got the feeling of God’s mercy. • Unconditional acceptance of the losses.

12. RING II: TSUNAMI’S DESTRUCTED AREA • Partial destruction by the force of the tsunami. • Area: 3 – 5 km from the sea shore. • Survival rate: 50%. • Survivors’ losses: • Properties and damages on the house. • Some members of direct family.

13. RING II: PSYCHOLOGICAL PROBLEM • Survival factor: efforts, including running, swiming, climbing, etc. • Chances for helping others. • Wathching the drowning or disappearance of the loved ones. • Psychological problems: • Accute stress dissorders. • Guilty feeling. • Anxiety regarding the future.

14. RING III: TSUNAMI TIDE • No significant physical damage. • The tide brings along mud and debris, including corpses of the victims. • Survival rate higher than 80%. • Most seek for refuges at refugee camps and relatives’ houses.

15. RING III: PSYCHOLOGICAL PROBLEM • Stress disorders related to the immediate effects of the traumatic experience. • Anxieties related to the anticipation of possible disasters in the future. • Psychological problems related to inactiveness and discomfort of the camp.

16. RING IV: EARTHQUAKE AREA • No direct impact of the tsunami disaster. • Survival rate close to 100%. • Not seeking for refuge. • Losses: • Minor to major damages from the quake. • Losses of distant families. • Further stressors: • Earthquake tremors. • Issues of further tsunamies. • Issues of diseases.

17. RING IV: PSYCHOLOGICAL PROBLEM • Minor to mild stress disorders related to the quake. • Anxieties related to possible (bigger) disasters in the future.

18. RING V: DISTANT AREA • No physical effect of both the quake and the tsunami. • Within and outside NAD. • Relatives of friends in the calamity areas. • Uncertainty regarding the safety of the relatives or friends. • Emotional bond and economic dependance (e.g., students) with the relative or friend. • Minor to mild grief. • Affective dissorder, including depression and suicidal tendencies.

19. MENTAL HEALTH RECOVERY PROGRAM (Jan 2005-June 2008) Crisis Center Faculty of Psychology, UGM IndonesiaIn collaboration with Royal Children Hospital,AIHI/Nossal Institute for Global Health-UNIMELB, &World Vision Australia - Australia

20. Program Purpose

21. LOGFRAME • Activity 1. Integration of the program with the provincial mental health service, national policies and other relevant mental health programs, policies, services and institutions. • Activity 2. Establishment of mental health community centers in Banda Aceh and Meulaboh. • Activity 3. Increase local capacity in basic management and mental health service administration. • Activity 4. Increase capacity of local mental health clinical service delivery • Activity 5. To raise awareness of mental health, mental ill health and mental health services in the community.

22. MAIN PROGRAM

23. Outreach Counseling • Daily counseling service delivered by the two field center of Crisis Center, namely Balai Zaetuna (BZ) in Meulaboh and Rumoh Seurunee (RS) in Banda Aceh • Outreach counseling delivered by the two center in some baracks, primary health care (puskesmas) and other satelite centers.

24. BALEE ZAITUNA Kec. Samatiga Kec. Johan Pahlawan Kec. Meurebo Kec. Kaway XVI Klinik Bumi SEHAT Gampong Cot (Endang) Desa Suak Timah (A.H.Dwijuwono) Barak Desa Cot Seumeurung (A.H.Dwijuwono) Puskesmas Johan Pahlawan (Marty) RSU CND (A.H.Dwijuwono, Marty, EndangEka) PUSTU Suak Ribee (Marty) Puskesmas Meurebo (Endang) Puskesmas Kaway XVI (Eka) POS KESEHATAN SATELIT (POSKESLIT) Desa Leuhan (Eka) PUSTU Desa Blang Beurandang (A.H.Dwijuwono) PUSTU Desa Keude Tanjong (Eka) PUSTU Desa Padang Sikabu (A.H. Dwijuwono) SERVICE AREA of BALEE ZAITUNA

25. SERVICE AREA of RUMOH SEURUNEE RUMOH SEURUNEE Kec. Banda Raya (Banda Aceh) Kec. Kuta Alam (Banda Aceh) Kec. Baitussalam (Aceh Besar) Kec. Syiah Kuala (Banda Aceh) Kec. Ulee Kareng (Banda Aceh) Puskesmas Ulee Kareng (Tuti) Puskesmas Mibo (Bintang) Center/Rumoh Seurunee (Bintang, Tuti, Farah) Puskesmas Kopelma Darussalam (Tuti) Barak Blang Krueng (Bintang, Tuti) Desa Lam Asan (Bintang) Barak Cadek Baet (Bintang, Tuti) Puskesmas Lambada Lhok (Bintang) Barak Klieng Meuria (Tuti) Barak Lampineung (Bintang)

26. JUMLAH KLIEN Balee Zaituna’s client

27. JUMLAH KLIEN Balee Zaituna’s client

28. JUMLAH KLIEN Balee Zaituna’s client

29. Rumoh Seurunee’s Client

30. Rumoh Seurunee’s client

31. Total Number of Client2005-2007=1907 person

32. Training of Psychological Support and Mental Health Early Detection Recruiting & educating community leader to be mental health caders: teachers, primary health care teams and religius leader In collaboration with the local government

33. Training of Psychological Support and Mental Health Early Detection

34. MENTAL HEALTH PROMOTION through MEDIA Poster Introducing Stress Buletin Healthy Family and Parenting Family communication

35. PromosiKesehatan Mental Melalui Media Konsultasi  Local Tabloid Counselling coloumn Leaflet Enhancing Self Confidence Introducing Psychologist Psychologist VS Medical Doctor

36. ADVOCATION ON MENTAL HEALTH POLICY WORKSHOPs (high level representative, stakeholder) STUDY TOUR (introducing MH systemVictoria,Sleman District) BUILDING PERSONAL RELATIONSHIP INSERTING SERVICE INTO PRIMARY HEALTH CARE

37. ACHIEVEMENT

38. BANTUL EARTHQUAKE

39. MODUL PSCHOLOGY OF DISASTER • Lesson learned from Aceh and Bantul • International Workshop (UGM-Ruth Wraith (RCHI-Melb)-Witruk(Liepzig Univ Germany))

40. Content of The Modul • Psychology as a content (micro skill) - assessment - disaster preparedness - disaster management - intervention • Psychology as a package (macro skill) Psychologist among non psychological science