Reshma’s future: Wellness after disaster

Published : 12 May 2013, 02:09 PM
Updated : 12 May 2013, 02:09 PM

What is it like to sit in a dark room for hour after hour, never seeing another living human being? What is it like to know that above you is a colossal wreck, blocking your exit – to see the dead bodies of your co-workers around you, to imagine other corpses trapped in the rubble above you? What is it like to face the great uncertainty of not knowing if you will live or die, to be caught without a future?

What was it like to be Reshma Begum during her 17 days ordeal in the Rana Plaza ruin? How did it change her?

Rescued just two days ago, Reshma remains hospitalised in Savar. She is one of only a handful of people to survive so long in a ruin after a disaster, and to date, we know only a few details of her miraculous story.

Nonetheless, previous disasters allow some insight into Reshma's mental condition and her future.

In this atrocity, as in other life-threatening disasters, survivors, rescuers and their family members can suffer from a condition called post-traumatic stress. The symptoms include anxiety, sleeplessness, panic, an inability to stop thinking about the dangerous event, and intense fears that the danger will happen again. In some cases, survivors can hallucinate or lose touch with reality, thinking they are experiencing the dangerous event again.

Survivors emerged from Rana Plaza in a wide array of mental states. One widely reproduced image shows a man thrusting his arms in the air, shouting, after 48 hours trapped. At first glance, the image is a blissful show of vigorous energy. But the man's face was cloaked in fear and anguish. He had fought for survival; he was too confused to stop fighting. He was not yet well.

On her emergence from the wreckage, Reshma was surprisingly calm. Having been uninjured and relatively well-nourished, she could walk and talk. She had even alerted rescuers to her presence by shaking a pipe against concrete. She did not seem to be in such severe psychological distress.

Yet she clearly suffered a great deal in the Rana Plaza collapse. It would be normal for her to have strong fears right now, to think a great deal on what has happened to her, and to have exceptionally strong wishes for protection and safety. This is normal and even beneficial – post-traumatic stress is, in part, how the body and mind realign to embrace the reality of the atrocity that has happened.

But the suffering can go on and on. When post-traumatic stress lasts more than one month, it becomes post-traumatic stress disorder (PTSD). This condition includes fear, insomnia, intrusive thoughts, and more. The survivor can have trouble being close to others, and believe they are quite alone in the world. Some sufferers stop believing they have a future. This is not the body and mind realigning; this is the body and mind misshapen and stuck. The condition can last a lifetime if it is not treated, although mental health care can often help the person heal.

PTSD can happen to anyone. It is not the survivor's fault. Certain circumstances make it especially likely. It occurs more often in people harmed in personal attacks (as opposed to mass disasters). It is more likely when people who are hurt get ostracized, abused or mistreated after surviving the dangerous event. It is also more likely when someone is injured, or when they have pre-existing disability.

Reshma has the relative luck of surviving a mass disaster with no major injuries. She has the well wishes of people all over the planet. She has a loving sister named Asma who is supporting her.

And yet she carries an unenviable burden: she knows an uncertainty that very few of us will ever face. To be a miracle also means to be alone. To feel alone is often part of PTSD.

Being a miracle also means being touted as a symbol of national unity and resilience. Both Sheikh Hasina and Khaleda Zia have visited her; the two leaders abruptly stopped arguing and actually agreed on something. A write in a local English daily has asked, "We have rescued Reshma; will Reshma rescue us now from the depths of despair?" Instant global celebrity and a demand to uplift a politically chaotic nation of 150 million: that is a surreal, overwhelming burden for a person who just finished surviving 400 hours of grim uncertainty.

From Reshma's story, we can take the knowledge that humans are incredible survivors. We can take courage, clarity, and an impetus to promote Bangladesh's collective well-being. We can turn to our own task of working towards a healthier society.

While we do this, let's also take care to respect Reshma the human. She deserves a chance to become well and avoid long-term PTSD if possible. (All the survivors of Rana Plaza, rescuers, and grieving families deserve the same.) She also deserves a special measure of privacy – so that this hospitalized young lady, who must recast her understanding of the world in the light of her extraordinary experiences, can be with her family, rest, heal, and eventually tell her story in her own way, when she is ready.

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M. Sophia Newman is a mental health researcher and writer living in Dhaka.