In the registration area of the medical clinic set up at Our Lady of Guadalupe Catholic Church in Rosenberg, Texas, Project HOPE volunteer Dr. Nancy R.F. Miller, a licensed mental health therapist, uses the wait time to slowly introduce herself to storm-weary patients recovering from Hurricane Harvey.
"People coming into the clinic to seek medical attention have lost everything to Hurricane Harvey,” said Dr. Miller. “As a therapist, I cannot sit behind a desk in a room and wait for people to come in to talk to me. Rather, by providing outreach, I can help facilitate the initial contact and assist in raising their comfort levels and willingness to approach me for counseling support.”
To ease the apprehension, Dr. Miller has been conducting health education sessions for everyone in the waiting room. “I talk about basic health care after a hurricane, about the water and vector-borne illnesses, the need to clean with a bleach solution and the importance of having an up-to-date tetanus shot and then I move on to talking about the effect of disasters on one’s emotional and mental health.”
Prepared with culturally sensitive brochures on coping with disasters written in several languages and an interpreter, Dr. Miller discreetly canvases the room, letting people know where she is located, if they want to come and talk.
One by one, they begin to trickle in and begin to tell their stories.
In Texas, Dr. Miller was a first-time volunteer for Project HOPE, but working in disaster situations is one of her specialties. “I responded to Haiti’s 2010 devastating earthquake, in Uganda I worked with refugees. I served after Katrina, and was part of the therapy team that provided services after the Virginia Tech shooting. Just recently, I returned from Charlottesville, Va., helping people cope after the domestic violence that occurred.”
Dr. Miller says one of the important roles of counseling after a disaster is being able to connect and refer people to other needed services. “People may have long-term mental health illnesses before a disaster strikes and disasters can intensify those illnesses,” she said. Soon after Hurricane Harvey, when Dr. Miller first arrived in Texas, a family brought their son in to see her. Their son suffered from an untreated chronic mental illness. The stress of the hurricane exacerbated his symptoms. With Dr. Miller’s help, the family was able to access the resources needed in order to receive the ongoing care that he required.
A mother of grown children visited Dr. Miller in the early days after the hurricane. Her ex-husband, a shop-owner and the father of her children, was tragically killed during the flooding in Houston while trying to protect his business. Her children were devastated by their father’s sudden death and Dr. Miller was able to provide consolation and advice to the mother on how to comfort her children through their grieving process and in the future.
Weeks after Hurricane Harvey, Dr. Miller says many of the clients are now past the acute emotional impact of the monster storm, but now other emotions are sinking in including helplessness, depression and anxiety.
“After a disaster like this, where people lose everything they own, many are feeling fatigued, irritable, confused and not able to make decisions. I attempt to provide a safe and calm environment while assessing their stability, and then they begin to tell their stories. As we progress we address the ways on how they can cope with their stress,” she said.
Disasters are taxing on children as well. “We often see regression in behaviors of children after major disasters like this one. Sometimes there is increased fighting with siblings, disturbed sleep patterns, and fear of being separated from family members. I always advise parents to reduce media watching, be more patient and try to get the children back on schedule,” she said. “For example, schools opened last week in Rosenberg providing a more normal routine for the children and families.”
In addition to helping direct survivors of Hurricane Harvey, Dr. Miller also worked with staff at the church, volunteers and other community health professionals in the area, monitoring morale, listening to their experiences and providing lunch and learn trainings. “As a disaster mental health specialist, I not only provide services to victims and families, but also work with local staff and volunteers to make sure their needs are met. I do what I can to inspire and support the workers as they assist those impacted by the disaster” she said.
“It is important to promote an individual’s resilience after a disaster. What I have noticed in the Rosenberg community, they are survivors. Many of these people just went through recovery with Hurricane Matthew last year, and other flooding earlier this year. And now Harvey. The populace we are working with in Rosenberg are Hispanic, lower income families with limited resources. When dealing with such complex trauma, I try to foster their protective factors such as the strength they receive from their faith, family and friends.”
In fact, it is the community resilience that helps inspire Dr. Miller. “This community is exceptional in the way they have just come together, turned their multipurpose room into a warehouse and set up a medical clinic. The government, private organizations, spiritual communities and NGOs are all collaborating and supporting each other as well as the community members -- it’s amazing to see,” she said.
Dr. Miller returned home this week, and as relief efforts in Texas continue, HOPE is now also responding to the devastating impact of the Hurricane Maria in Puerto Rico, where addressing mental health needs will be an important part of overall recovery. “Physical medical care is essential after a disaster like this, but mental health is just as important. In fact, mental health is now a component of the UN Sustainable Development Goals,” she said. "There is no health without mental health. Project HOPE understands the connection and has integrated mental health into primary care of disaster response efforts."
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