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Interview with crisis manager Yves Legil after his intervention in the aftermath of the Nepal Earthquake

27.09.2015

Interviewee: Yves Legil, member of the Humanitarian Intervention Team (HIT) of the GSP [1] (Luxembourg Psychological Support Group) and the Luxembourg Fire Service.

Interviewer: Lilly Eischen, PsyCris project collaborator and member of the GSP.

L.E: After your intervention in Nepal three weeks ago in the aftermath of the terrible earthquake, it would be interesting if you could tell us about your experiences there.

Y.L: We were a team of four people from Luxembourg. We received the order from the WFP (World Food Programme), as part of the Telecommunications Cluster network, to provide Internet connection to all the rescue teams that were helping in the area as soon as possible. After the devastating earthquake in Haiti, it was seen that communications are of utmost importance to be able to communicate what help is needed exactly and coordinate it. Luxembourg, through “emergency.lu”, has specialised in providing an Internet solution for these situations that can start working after 2 or 3 hours. Previous systems needed between 2 and 3 days to start working.

We arrived in Nepal around 49 hours after the earthquake. And this is considering that we were stuck for a whole day in India due to the Kathmandu airport being completely overwhelmed.

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Five days passed until we were sent to intervene in an actual crisis area. In the meantime, we helped re-establishing Internet connections in Kathmandu, but also helped unloading trucks and setting up tents. The problem is that it was difficult to assess the overall situation and the extent of the damage in order to determine where the help was most urgent. In the beginning there were only 4 helicopters available, which was not enough to assess the situation of the country in so little time. Kathmandu had barely been hit by the earthquake, while other regions, such as Chautara –which is around 100 km from Kathmandu and is where we did our intervention– was completely in ruins.

We set out in teams of two to different points of Chautara. Chautara is a small city. Entering the city was difficult and it had been isolated from civilisation for some time because the only access road was closed due to landslides and it was impossible to use. No stone was left standing in the city, and the few houses that were left were in risk of falling down and could neither be entered nor lived in.

A field hospital was set up in Chautara. The UNDAC (United Nations Disaster Assessment and Coordination) team set up a Sub-OSOCC (Sub-On Site Operations Coordination Centre) with help from the IHP (International Humanitarian Partnership). We set up our emergency.lu VSAT antenna for these facilities so we could establish communication via satellite. We only stayed in Chautara for 48 hours.

L.E: How were the rescue teams feeling in general?

Y.L: There was a lot of frustration amongst the rescue teams because they weren’t able to start with the intervention. Many were held up in India before being able to take their flight to Kathmandu. So much time went by that the USAR (Urban Search and Rescue) teams had practically come for nothing. In general, it is assumed that it is only possible to rescue people alive from the rubble in the first 72 hours. Many USAR teams reached the affected area when it was already too late to help. Very few people could be saved.

Practically all these teams are certified by the INSARAG (International Search and Rescue Advisory Group), which means that they meet certain international guidelines that qualify them to carry out these actions. This certification is somewhat like a seal of quality that was created after Haiti. These guidelines classify teams as “Medium Teams” and “Heavy Teams”. I think nobody realised how difficult it would be to transport a Medium Team, comprising 40 or 50 people, with all their material and technical equipment to the affected area. There are tons of materials that have to be transported. It was practically impossible to do in Nepal. In Chautara, the USAR rescue teams had still not arrived one week after the earthquake, and those teams that arrived later were instructed to turn back while flying to their destination, because their intervention was not considered necessary anymore. Many of the rescue team members felt really frustrated.

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L.E: And what happened with the NGOs that were already there?

Y.L: There were many NGOs in the area this time round, unlike in other occasions. They arrived with the idea of “we have to be visible if we want funding”. Their goal was to do a good job in the eyes of the public in order to obtain lots of donations. This caused a great problem, as many NGOs arrived with no organisation and no experience. Nevertheless, other NGOs did a great job and saved many lives.

L.E: How did you see disaster preparedness in the area?

Y.L: Well, Nepal is in a seismic zone and that is why the United Nations had already adopted a series of measures to improve preparedness in the area before the earthquake. There are both UNHCR (United Nations High Commissioner for Refugees) and WFP offices in Kathmandu. Preparations were made and there was some equipment there in case of emergency. So, in addition to the airport, which was our team’s base initially, there were, for example, tents and five large containers with equipment and devices that could be sent directly from there. This logistics base was a great advantage when the crisis came and it was expanded afterwards.

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L.E: How did the affected inhabitants react to the crisis?

Y.L: The Nepalese are used to life in harsh conditions due to the climate, the height, the geographical situation and the topography of the area. For this people who live in the mountains it is normal to have to walk for two or three hours to reach a larger village. This means that they are generally used to things being more difficult and harsh and that is why in times of crisis they are more resilient than other countries’ inhabitants like, for example, those in Central Europe. Nepalese people are less used to comfort.

For example: while in our countries we wait around for the ambulance to get there, Nepalese people get to work and bring the patient closer to where the ambulance is going to arrive. Or instead of waiting for someone to bring them food, they are willing to walk two or three hours to reach a food distribution point. They accept these situations with no problem.

L.E: What was the situation in Chautara?

Y.L: After the first earthquake, the houses in Chautara were not habitable anymore and luckily the inhabitants did not use them to sleep that night, otherwise the number of victims would have been even more devastating due to the aftershock. Many inhabitants had settled in next to the field hospital and helped each other organise life after the disaster. Everybody participated, from children to the elderly, for example, to prepare meals. Everything was done in a disciplined way and everybody showed a great disposition to help each other.

L.E: What was the general situation?

Y.L: The truth is that it was strange to see that in Kathmandu almost no damages were reported. Some monuments had been destroyed and life went on as usual. Meanwhile, 50 kilometres away, no stone was left standing. This was mainly due to geographical reasons, as the earthquake did not have its source directly below the surface, but it was also due to the type of buildings. Houses in rural areas were not as strong and some of them were on a slope, causing them to slide down.

L.E: What was the situation regarding psycho-social support in the crisis area?

Y.L: For some time our team stayed in a hotel where we could have talked with a psychologist from Doctors Without Borders (MSF). The day before our return home this psychologist still had not received any visitors; there was simply no demand.

In my opinion, psycho-social support to inhabitants in a disaster area like this is not possible immediately after the disaster. It starts being possible in a second phase, and it undoubtedly makes sense in the long term. This issue has been considered and organisations such as World Vision, MSF and the Red Cross offer training for inhabitants of the affected areas so they can offer support to others. The main principle is that “support cannot be organised if we know neither the language nor the culture”. And this is even more important in the field of psychotherapeutic support. This field has to be more developed in the future. Some NGOs have progressed quite a lot in this area over the last few years.

L.E: What about preparation and support for the rescue teams afterwards?

Y.L: This is a very important topic for me, and I have already been working on it for some years. Even after Haiti nobody spoke about this issue, but there is dialogue about it now, and things are moving. For example, THW [2] (Federal Agency for Technical Relief) has been training their staff in psycho-social aspects for three years. In Luxembourg we do the same. I do not know what the situation in other countries is, but I suppose that armies do the same to prepare their soldiers for interventions in crisis areas.

L.E: In your opinion, how prepared are crisis managers for interventions abroad?

Y.L: In my opinion being well prepared for extreme situations before the intervention is of utmost importance, in general. This is true both for crisis managers and their families, as well as the members of the HIT teams that stay home.

The following aspects are important:

1.     Families’ preparedness

It is important that the relatives of the crisis managers deployed abroad are properly trained long before the intervention. The training should be short, and should help the families deal with fears and understand the problems, symptoms, possible reactions, etc. It should include all aspects and be summarised in a document to be given to the families.

For example:

  • In which way and why could the behaviour of a crisis manager change after returning from a disaster area and how should we behave in case it does? Is there reason to worry or is it normal? How should we treat those that have just returned and how should we handle the situation?
  • What does a crisis manager need after returning from a crisis area?
  • How should we handle the media if they telephone the house?
  • Official support: families need to know that their country’s authorities are going to do everything in their hands to guarantee maximum safety to those crisis managers abroad.

L.E: Is this training for families already available in Luxembourg?

Y.L: A training programme has been designed and will be launched in Luxembourg for the first time in autumn of 2015.

L.E: Is this training available in other countries?

Y.L: Yes, the THW used it this year for the intervention in the Ebola crisis. The NOAH [3] (Aftercare and Support Service for Victims and Families) also played a very important role.

2.     Assistance telephone line for families during the intervention abroad:

A 24-hour assistance telephone line has to be available for families to ask questions or ask for the latest news at any moment.

For example: If there are aftershocks in the affected area, communications can be destroyed in a matter of seconds. The media will announce the aftershock shortly after it happens. The crisis manager may not have time to send an SMS to their family to tell them they are safe. After an earthquake, it takes some time to re-establish communications. This period of uncertainty feels like hell for the families and it is very difficult to endure. In our experience, telephones run hot in these periods. In those moments, it is necessary to have help and/or an information system that can transmit the latest news to families as soon as possible.

2.     Psychological support before and after the intervention

I am convinced that crisis managers and their families need psychological support both when leaving their country and when returning. This support is important. It doesn’t have to be the most important thing, but should always be available if questions or problems arise. The idea is to have this service available without it being mandatory.

For example: a crisis manager in Haiti told me this: “When I was told during the flight that you would be waiting at the airport when I arrived, I relaxed, as I knew that I would have support if I needed it…”. At that time, I was not working in crisis management, but in psycho-social support for crisis managers returning to the same airport.

The person who provides this support can also deal with the media, which is of utmost importance so that relatives are treated appropriately (where, how and when photos can be taken, what should be avoided, etc.).

3.     I also believe that it is important to hold a meeting after the interventions for those team members that went abroad to exchange experiences, deal with problems and reach some conclusions based on what was learnt.

4.     Information for HIT team members that stayed home

In my opinion, the HIT team members that stayed home should be informed regularly, every two days if possible, about the situation of their workmates in the crisis area. These teams are often special teams with a small number of members that know each other really well and worry about each other. All team members know the feeling of being abroad in a crisis area and think about it, and that is why it is important and desirable to provide information regularly about the situation, also to improve the teams’ cohesion.

5.     Measures to promote the teams’ cohesion

Two or three times a year, events should be organized to strengthen the bonds between team members, for example, having a barbecue or going bowling. The spouses and families of the members of the crisis intervention teams should also participate so they can get to know each other better. If something happens, this can be a support factor for the team and the crisis managers themselves.

6.     Checklists should be created before the crisis intervention:

Before the intervention abroad there is a series of difficult topics and procedures that have to be dealt with, in case the crisis manager is injured or passes away. This is something frequent in interventions abroad and that is why the idea of death is very present. After all, these are all extreme situations.

For example: A helicopter fell in Nepal and eight rescue team members died. Also, four or five people died in Haiti and, all around the world, around 100 NGO members sacrificed their lives in interventions last year. Kidnappings and shootings are also becoming more frequent. Risk of death is present in every moment when intervening abroad. That is why many documents and procedures should be completed: wills, insurance contracts, government procedures and assuring the family’s economic stability. Additionally, forms should be filled out with basic personal information, such as medical information, allergies, blood type, GP, medical history, dentist, dental record. Three contact people should be specified, as well as how many times (every day, every week, never…) the head of the team should contact the family during the intervention abroad.

It is important to realize that, in case of crisis, the manager has to be available and return to the area in a matter of hours (one or two hours). There is no time to prepare anything. The manager has to focus completely on the intervention and prepare mentally for it. Any stressful factors must be previously cleared, so that the crisis manager can completely focus on their task. That is why completing checklists beforehand is vital, so that the manager is sure that all necessary matters have been dealt with and that their family’s situation is safe.

L.E: Another current issue: is it worth sending a psychologist to support the intervention team to the crisis area?

Y.L: In my opinion, the person supporting the team does not have to be a psychologist. Actually, it is probably better that they are not. If the person supporting the team is a peer, an equal to the rest of the team, this could be very useful. They could intervene to provide psychological attention only where necessary. A peer could also be useful, for example, to deal with the necessary procedures and documents if there were missing people from Luxembourg in Nepal. There is no Luxembourg embassy in Nepal and, due to this, if necessary, the Luxembourg government would have to put a member of our team in charge of these procedures until an envoy of the embassy arrived to the area. We have to consider that these responsibilities could become too much of a burden for the team, as they are not trained for that kind of situation.

L.E: Did you feel sufficiently prepared for your intervention in Nepal?

Y.L: I can answer this question with a “yes”. Thanks to my training as a fire fighter, as a member of the GSP and the HIT team, as well as my experience in other interventions abroad (e.g. the tsunami in Thailand), I felt well prepared and knew what we had to do. The fact that my family had been prepared properly also gave me support and peace of mind. Another advantage is my collaboration in the organisation of the HIT team, where I work on developing many SOPs (Standard Operation Procedures) where the psychological support aspect is very important.

L.E: How is the reception at the airport after an intervention abroad?

Y.L: Here we definitely have to ask the question of how we want to be received after being a crisis manager. Who do we want to see in the airport? Our family, the organisers of the team, our workmates, the directing team, politicians, the media, the Minister, the Head of State? On the one hand, our family and friends are enough, because we do not want to attract too much attention. On the other hand, the intervention team has been closely followed by the media, and they will be there to report. The team has also represented the country in a national or international task; additionally, we have the “emergency.lu” project, which, of course, we want people to know about. That is why I believe a somewhat official reception when returning from the crisis area is part of our job.

Personally, I find it difficult to stand the racket the media causes when we just arrive, but two or three days later I start thinking about it as an important recognition of our work. Actually, we do not want to be shown in the media, but later we feel proud when we appear in the news bulletin. Sometimes I have wondered what the team would feel if only our families waited for us when we returned home. That would not be normal either.

What is really important for crisis intervention teams when returning home is the agreements with the media about what they show. Until now, we have always had a good relationship with the press. We have agreed that they can only take photos when we signal them, that we do not want children’s faces nor tears. In the images we only want to see happiness. Until now, the agreements have always worked quite well. The media has always been polite to me. They have only published happy images and respected my wishes, which I think is very positive. Doing good work with the press before arriving is really important.

In case a team member passes away during the intervention, we would have to think about other ways of organising the arrival, especially to protect the family.

L.E: What positive effects can the PsyCris project have on crisis management?

Y.L: One idea I have would be to create a guide to prepare rescue teams within the PsyCris project framework.

The Red Cross has already done some work in this area. World Vision has also published similar works. A common guide could be created with all the partners of the project, from which every country can later extract the most important elements that adapt to their specific situation.

Regarding biofeedback training, I would like to say that, as a way of preparing rescue teams, I would have to be critical about it. I doubt that all the teams would accept it. Intervention teams abroad are very experienced. I feel that it is possible to adapt to these extreme situations, by living through the harsh experiences encountered in crisis areas, which affect the rescue teams 24 hours a day and worsen over time. Crisis managers might perhaps need to learn relaxation techniques, as they are constantly subject to the stress of always being available for emergencies. However, I do not know if biofeedback, which seems to be a very psychotherapeutic technique, would be the best method. Perhaps, methods such as autogenic training or similar ones could be more suitable.

L.E: Thank you very much for the interview.

 


[1] [Translator’s note:] GSP: Groupe de Support Psychologique du Luxembourg

[2] [Translator’s note:] THW: Technisches Hilfswerk, a German government agency.

[3 ] [Translator’s note:] NOAH: Nachsorge, Opfer- und Angehörigenhilfe, a German government body.

 

 


 

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