: By Lisa M. Krieger
MULLAITTIVU, Sri Lanka - Every morning, fisherman Santhirathas Santhiapillar awakes and walks the soft white beach of this coastal village.
He's not looking for his boat or his home, both taken by the waves. Or his wife and two of their children, also gone.
What he's seeking, months after the Dec. 26 tsunami, is work. If he can find a job with someone who has a boat, he need no longer spend empty days in a refugee camp, haunted by the past. He can feed his one surviving child, 10-year-old Mary.
Then, maybe he can start healing.
``I want to get back to the sea. I want to work,'' said Santhiapillar, 39, a powerfully built, soft-spoken man. ``But there are no boats, no jobs. How long can we wait?''
In the weeks immediately after the retreat of the giant waves, the Sri Lankan coastal people had profound physical needs: hunger, thirst and shelter from the island's many poisonous snakes and the blistering sun.
Now it is their hearts that ache.
``I used to work hard, eight to 10 hours a day. It was unpredictable, but I could support my family,'' Santhiapillar said. ``Now, I don't know what to do with a child. I had never before combed her hair or anything.''
That had been the job of his wife, Purianayaki, 34. His job was to fish.Simple needs
Experts visiting the tsunami-ravaged regions say survivors don't need psychotherapy, Prozac or the once-popular debriefing sessions, during which a traumatic event is repeatedly discussed. Psychiatry is not a part of the Sri Lankan culture; there are fewer than a dozen psychiatrists in the entire nation and none in this isolated Tamil region in the northeast.
What they need is far more mundane: work, school, a chance for spiritual reflection and the chance to help others.
Fishing towns in Sri Lanka were particularly hard hit. While Sri Lanka does not have a caste system like India, fishermen are the poorest economic class.
The tsunami destroyed or badly damaged about two-thirds of the region's boats. Worst hit were the small non-motorized boats owned and operated by the poorest of the community. Survivors cannot afford to buy or build new boats, so donors have offered to supply them. But the new boats have yet to arrive; some have been held up at the port of Colombo by high tax bills.
This once-thriving beach community, where most families earned a living from fishing the azure waters of the Indian Ocean, has been reduced to rubble. Of the 6,000 residents who once lived here, 3,000 vanished in the waves.
Survivors have moved inland and are living in clusters of huts newly built of cinder block, their thatched roofs covered by plastic tarps bearing the names of international relief agencies. The only motorized vehicles are the massive air-conditioned sport-utility vehicles transporting agency volunteers.
The mothers tend to their children. The children go to school and play. But the fathers do nothing, because there is nothing to do.Fateful day
Santhiapillar sat on the rubble that remained of a once-elegant Catholic church, and recalled the instant that changed his life. ``On Sundays, I usually go to the sea. But it was drizzling. It looked like rain,'' he said. ``That day, my son said, `Today let's be together.' So we stayed at home to have breakfast. My wife brought breakfast. When all five of us had been served, I heard the noise. I saw a house, the third house on our street, coming toward us. That's all I know.''
London psychiatrist Manga Sabaratram has visited survivors in schools and camps in Mullaittivu and neighboring communities.
Their experiences -- and emotional responses -- vary greatly from one person to another, she found.
One patient had left her 3-year-old child in the care of her mother when she went to work the morning of Dec. 26. ``Now they're both gone,'' Sabaratram said. ``For two months, she tried to talk -- but her voice would not come out. It did not exist. Now she's beginning to talk. What does she say? She says she doesn't want to go back. She wants to leave the country.''
Another lost all three children. She found two bodies, but not the third. ``So she is walking from place to place, looking for the child, in hopes that it is still alive somewhere,'' said Sabaratram. The doctor hopes that a grieving ceremony that is planned in the village will help the exhausted mother give up her search.
``We do basic counseling, not therapy,'' she said. ``It's listening, helping them talk about their priorities, helping them learn how to solve one problem at a time.''
She visits a school next to a freshly dug cemetery and newly erected counseling tent. The school is luckier than others. It was untouched by the waves and reopened a week after the tragedy.
For the youngest survivors, she uses fairy tales and music to boost their spirits. Her college-age daughter tells the children stories, and Sabaratram plays a recorder while the children play along on smaller plastic models.
``Children don't want to sit and talk about their problems; that's not therapeutic for them. But music -- that can lift their moods,'' she said.
While teachers and school administrators tried to return children to schools quickly, healing will take time.
``They have not yet recovered. There are those who can't concentrate, or don't want to concentrate,'' said Sivagowry Sivagnanam, 30, a primary school teacher. ``But when they're in school, while they're learning, they forget. We try to make it so interesting so they will not worry.''
To ease their anxieties, ``we gave them a description of what happened, and why. We want them to not be afraid of the water, to have confidence,'' said Sivagnanam, whose school lost 50 of 500 students. ``Now they talk about the tsunami. They're not scared to use the word any more.''After classes end
But the hours after school are tough for children, especially for those who have lost a parent, brother or sister, she said. Sometimes the school holds evening homework sessions to keep them occupied.
Of the 5,905 families displaced by the tsunami in this district, 2,124 are living in refugee settlements. The rest are staying with friends and relatives.
The Mullaittivu district's emergency task force wants to resettle families in more permanent settings by giving each family land and assistance to build houses. But that will take money.
Permanent resettlement poses practical and political problems. The Sri Lankan government wants families moved away from the beach, but fishermen do not want to live inland, in snake- and mosquito-infested swamps far from their boats.
So officials are seeking landowners who own suitable coastal property to sell, making it possible to resettle the fishermen and their families off the beach, but out of the jungle. Until the government finds places for thousands of coastal residents, their lives are in limbo.
Some wealthier families have managed to raise private money to rebuild, but most poor fishermen have no access to private funds and are not able to secure a loan.
For now, survivors live in uncertainty. They spend their time searching for scraps of nets, then tying them together to cast out in shallow waters.
``They fish in lagoons for shrimp and sardines,'' said Thushiyanthan Kanapathipillai, a coordinator for refugee services at a camp of 2,500 people. ``But it is not enough to feed their families. They're depressed because they're not making anything and not doing anything.''Joining in effort
Experts say survivors also find relief from their own suffering by helping others. They need schools, churches, mosques and temples ``to congregate and be spiritual, so they can work through what they've experienced,'' said Dr. Richard Mollica, director of the Harvard Program in Refugee Trauma at Massachusetts General Hospital and Harvard Medical School.
Mollica and his colleagues recently returned from Banda Aceh, Indonesia, another region still reeling from the tsunami. His program has worked for 25 years to study the effects of war, violence and natural disasters from Croatia to Cambodia on survivors' mental health.
But, Mollica says, ``work is the single best anti-depressant to get through a crisis. The worst thing you can do is force people into long-term idleness and dependency.''
Fisherman Soosaipillai Arasaratram, 43, would agree. Like Santhiapillar, he used to take his bright red boat out to catch salmon, shark and kingfish. ``Now everything is destroyed,'' he said. In the refugee camp where he lives, he said, organizers are distributing new boats by lottery, but the pace is slow: ``Three boats at a time -- for 95 families.''
``By the time I get a boat, I'll be dead,'' he said. ``So we're just getting food and waiting. How long will we get this kind of support? If there is a job, I will do it.''