Floods leave a legacy of mental health problems — and disadvantaged people are often hardest hit


Sabrina Pit, Western Sydney UniversityYet again, large swathes of New South Wales are underwater. A week of solid rain has led to floods in the Mid-North Coast, Sydney and the Central Coast, with several areas being evacuated as I write.

As a resident of the NSW Far North Coast, which has had its share of devastating floods, many of the tense scenes on the news are sadly familiar.

Unless you have lived through it, it is hard to understand just how stressful a catastrophic flood can be in the moment of crisis. As research evidence shows, the long term impact on mental health can also be profound. And often it is the most disadvantaged populations that are hardest hit.

Disaster risk and disadvantage

In many places, socio-economic disadvantage and flood risk go hand in hand.

In a study published last year, led by the University Centre for Rural Health in Lismore in close collaboration with the local community, colleagues and I looked at population data following Cyclone Debbie in 2017. We found people living in the Lismore town centre flood footprint experienced significantly higher levels of social vulnerability (when compared to the already highly vulnerable regional population). This study would not have been possible without the support of the Northern Rivers community who responded to the Community Recovery
after Flood survey, nor without the active support, enthusiasm and commitment of the Community Advisory Groups in Lismore and Murwillumbah and community organisations.

Notably, over 80% of people in the 2017 Lismore town centre flood-affected area were living in the lowest socio-economic neighbourhoods. The flood-affected areas of Murwillumbah and Lismore regions included 47% and 60% of residents in the most disadvantaged quintile neighbourhoods.

By examining data from the 45 and Up study, we also showed that participants living in the Lismore town centre flood footprint had significantly higher rates of smoking and alcohol consumption. They were also more likely to have pre-existing mental health conditions such as depression and anxiety, as well as poorer general health.

Research from Germany and the US has shown flood risk is often a significant predictor of lower rental and sale prices.

So even before disaster strikes, residents in flood-prone areas may be more likely to battle with financial and health issues. Our study showed disaster affected people also had the fewest resources to recover effectively. When floods arrive, the impact on mental health, in particular, can be acute.




Read more:
Underinsurance is entrenching poverty as the vulnerable are hit hardest by disasters


Floods and mental health

A flood can be extremely stressful in the moment, as one rushes to protect people, property, pets and animals and worries about the damage that may follow. Can you imagine clinging to a rooftop in the rain in the middle of the night and waiting to be rescued?

The damage caused by floods causes enormous financial pain, and can lead to housing vulnerabilities and homelessness, especially for those without insurance — and research reveals a pattern of underinsurance in disadvantaged populations across Australia.

Even if you are lucky enough to have insurance, waiting to have your claim assessed and approved, then dealing with a shortage of tradies can take a real toll on your mental health. The waiting and the uncertainty can be especially hard.

Other flood research by colleagues and I, led by the University Centre for Rural Health, showed business owners whose homes and businesses had flooded were almost 6.5 times more likely to report depressive symptoms. Business owners with insurance disputes were four times more likely to report probable depression.

Flood affected business owners whose income didn’t return to normal within six months were also almost three times more likely to report symptoms of depression.

Lack of income can clearly cause stress for the individual, their family and their larger network. Small businesses play an important role in rural communities and employ a large number of people so the sustainability of local businesses is crucial.

We also found the higher the floodwater was in a person’s business, the more likely the person was to experience depressive symptoms.

People whose business had water above head height in their entire business were four times more likely to report depressive symptoms. Those who had water between knee and head height in their business were almost three times more likely to report probable depression. All this adds up to an increase in mental health issues that often follows a flood.

Six months after the flooding, business owners felt most supported by their local community such as volunteers and neighbours. However, those that felt their needs were not met by the state government and insurance companies were almost three times more likely to report symptoms of depression.

Preparedness and awareness

So, what can be done?

Firstly, we can boost preparedness. Risk and preparedness education may be especially needed for people who have recently moved to flood-prone regions. Many who have moved to regional areas recently may not be aware they live in a flood zone, or understand how fast waters can move and how high they can reach. Education is needed to raise awareness about the dangers. People may need help to prepare a flood plan and know when to leave.

Secondly, supporting people and local businesses after a disaster and assisting the local economy in its recovery could help reduce the mental health burden on people and the business community.

Thirdly, mental health services must be provided. A chaplaincy program was implemented in Lismore by the local government to assist business owners with emotional and psychological support after Cyclone Debbie and ensuing floods. This program was largely well received by business owners for having provided psychological support and raising mental health awareness.

However, the ongoing lack of mental health support remains an issue, especially in rural areas, and is exacerbated by disasters.

Fourthly, insurance disputes and rejection of insurance claims were among the strongest associations with likely depression in our research. We must find ways to improve the insurance process including making it more affordable, improving communication, by making claims easier and faster and boosting people’s understanding of what’s included and excluded from their policy.

No single organisation, government or department can solve these complex problems on their own. Strong partnerships between organisations are crucial and have been shown to work, as is direct and real-time support for flood-affected people.




Read more:
You can’t talk about disaster risk reduction without talking about inequality


This story was updated to add more detail about the author’s research funding, collaborative partners and affiliation. It is part of a series The Conversation is running on the nexus between disaster, disadvantage and resilience. You can read the rest of the stories here.The Conversation

Sabrina Pit, Honorary Senior Research Fellow at the University of Sydney, Honorary Adjunct Research Fellow, Western Sydney University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Social housing, aged care and Black Americans: how coronavirus affects already disadvantaged groups


Hassan Vally, La Trobe University

While it’s true anyone is at risk of catching and becoming ill with COVID-19, it’s becoming increasingly clear this virus discriminates.

From early in the pandemic, we’ve seen how COVID-19 disproportionately affects older people and those with other health conditions, who are more likely to develop severe symptoms and die.

But as well as discriminating on the basis of biology, this virus discriminates on the basis of socioeconomic disadvantage. It ruthlessly picks on the most vulnerable in society.




Read more:
Our lives matter – Melbourne public housing residents talk about why COVID-19 hits them hard


The Melbourne tower blocks

The recent COVID-19 cases in social housing, which saw nine public housing towers in Melbourne’s north put into hard lockdown, brought this into sharp focus. These tower blocks accommodate some of the most vulnerable people in our community.

People living in these buildings experience high levels of unemployment and job insecurity, generally exist on low wages, have limited access to education, are often from migrant backgrounds, and in some instances are victims of trauma.

The fact we saw the virus spread through these towers should be no surprise given what we know about how it spreads in crowded conditions and shared spaces. Physical distancing is almost impossible when you have big families living in two-bedroom units.

An elderly person is assisted by a carer.
Aged care residents are at higher risk from COVID-19.
Shutterstock

Importantly, for cultural and language reasons, generic health messaging may miss the mark for these groups.

These factors combine to put social housing residents at increased risk of contracting the virus.

Aged-care facilities

Another group this pandemic disproportionately affects is aged-care residents. In aged-care facilities we have a perfect storm: an environment conducive to virus transmission and residents who are among the most susceptible to serious outcomes from infection.

Add into the equation the well-documented system deficiencies and workforce issues that have plagued Australia’s aged-care sector, and we have another situation in which some of the most vulnerable in our society are disproportionately affected by COVID-19.

We’ve seen this in Australia and around the world. Once you have community transmission of COVID-19 it’s hard to keep it out of aged-care facilities, and once in, outbreaks in this setting can be difficult to stop.




Read more:
4 steps to avert a full-blown coronavirus disaster in Victoria’s aged care homes


African Americans in the United States

The disproportionate effect of the pandemic on the most disadvantaged, vulnerable and marginalised in society is not just evident in Australia, but throughout the world.

There is perhaps no better example than the plight of African Americans in the United States. Figures released in May reported Black Americans were dying at almost three times the rate of white Americans from COVID-19.

One of the main reasons Black Americans face a higher health burden from COVID-19 is their increased rate of accompanying health problems such as heart disease, high blood pressure and diabetes.

This burden is amplified by the fact many are excluded from the basic access to health care we take for granted here in Australia.




Read more:
We could have more coronavirus outbreaks in tower blocks. Here’s how lockdown should work


And it’s not only the health effects of the virus which hit the disadvantaged harder. These people are also much more vulnerable to the indirect economic impacts of the pandemic, by virtue of their lower financial resources to begin with.

Looking across the globe

COVID-19’s discrimination against the vulnerable also extends to entire countries. Poorer and less developed nations, such as in Africa and Latin America, will potentially suffer the most in the immediate and longer term.

With weaker health systems, scarcity of medical resources (less equipment such as ventilators, for example) and large, vulnerable populations, these countries are less able to cope with a crisis of this magnitude.

And beyond the demands placed on their health systems, these countries have less capacity to withstand the economic shocks of the pandemic. Its effects could well catapult them into further crises, such as food insecurity.




Read more:
Coronavirus discriminates against Black lives through surveillance, policing and the absence of health data


We know infectious diseases, like other health conditions, are highly influenced by the social determinants of health. That is, the conditions in which people live, learn and work play a significant role in influencing their health outcomes.

Broadly speaking, the greater a person’s socioeconomic disadvantage, the poorer their health.

In shining a light on these inequities the pandemic also provides an opportunity for us to begin to address them, which will have both short and longer term health benefits.The Conversation

Hassan Vally, Associate Professor, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

New Threats, Old Enmity Pummel Nepal’s Christians


Armed group that forced over 1,500 government officials to quit now threatens pastors.

KATHMANDU, Nepal, September 16 (CDN) — A year after police busted an underground militant Hindu organization that had bombed a church and two mosques, Nepal’s Christians are facing new threats.

An underground group that speaks with bombs and has coerced hundreds of government officials into quitting their jobs is threatening Christian clergy with violence if they do not give in to extortion demands, Christian leader said.

The Nepal Christian Society (NCS), an umbrella group of denominations, churches and organizations, met in the Kathmandu Valley yesterday (Sept. 15) to discuss dangers amid reports of pastors receiving phone calls and letters from the Unified National Liberation Front (Samyukta Jatiya Mukti Morcha), an armed group demanding money and making threats. The group has threatened Christian leaders in eastern and western Nepal, as well as in the Kathmandu Valley.

“The pastors who received the extortion calls do not want to go public for fear of retaliation,” said Lok Mani Dhakal, general secretary of the NCS. “We decided to wait and watch a little longer before approaching police.”

The Front is among nearly three dozen armed groups that mushroomed after the fall of the military-backed government of the former king of Nepal, Gyanendra Bir Bikram Shah, in 2006. It became a household name in July after 34 senior government officials – designated secretaries of village development committees – resigned en masse, pleading lack of security following threats by the Front.

Ironically, the resignations occurred in Rolpa, a district in western Nepal regarded as the cradle of the communist uprising in 1996 that led to Nepal becoming a secular federal republic after 10 years of civil war.

Nearly 1,500 government officials from 27 districts have resigned after receiving threats from the Front. Despite its apparent clout, it remains a shadowy body with little public knowledge about its leaders and objectives. Though initially active in southern Nepal, the group struck in the capital city of Kathmandu on Saturday (Sept. 11), bombing a carpet factory.

The emergence of the new underground threat comes a year after police arrested Ram Prasad Mainali, whose Nepal Defense Army had planted a bomb in a church in Kathmandu, killing three women during a Roman Catholic mass.

Christians’ relief at Mainali’s arrest was short-lived. Besides facing threats from a new group, the community has endured longstanding animosity from the years when Nepal was a Hindu state; the anti-Christian sentiment refuses to die four years after Parliament declared the nation secular.

When conversions were a punishable offense in Nepal 13 years ago, Ishwor Pudasaini had to leave his home in Giling village, Nuwakot district, because he became a Christian. Pudasaini, now a pastor in a Protestant church, said he still cannot return to his village because of persecution that has increased with time.

“We are mentally tortured,” the 32-year-old pastor told Compass. “My mother is old and refuses to leave the village, so I have to visit her from time to time to see if she is all right. Also, we have some arable land, and during monsoon season it is imperative that I farm it. But I go in dread.”

Pudasaini, who pastors Assembly of God Church, said that when he runs into his neighbors, they revile him and make threatening gestures. His family is not allowed to enter any public place, and he is afraid to spend nights in his old home for fear of being attacked. A new attack occurred in a recent monsoon, when villagers disconnected the family’s water pipes.

“Things reached such a head this time that I was forced to go to the media and make my plight public,” he says.

Pudasaini, his wife Laxmi and their two children have been living in the district headquarters, Bidur town. His brother Ram Prasad, 29, was thrown out of a local village’s reforms committee for becoming a Christian. Another relative in the same village, Bharat Pudasaini, lost his job and was forced to migrate to a different district.

“Bharat Pudasaini was a worker at Mulpani Primary School,” says Pudasaini. “The school sacked him for embracing Christianity, and the villagers forced his family to leave the village. Even four years after Nepal became officially secular, he is not allowed to return to his village and sell his house and land, which he wants to, desperately. He has four children to look after, and the displacement is virtually driving the family to starvation.”

Since Bidur, where the administrative machinery is concentrated, is safe from attacks, Pudasani said it is becoming a center for displaced Christians.

“There are dozens of persecuted Christians seeking shelter here,” he said.

One such displaced person was Kamla Kunwar, a woman in her 30s whose faith prompted her husband to severely beat her and throw her out of their home in Dhading district in central Nepal. She would eventually move in with relatives in Nuwakot.

Pudasaini said he chose not to complain of his mistreatment, either to the district administration or to police, because he does not want to encourage enmity in the village.

“My religion teaches me to turn the other cheek and love my enemies,” he said. “I would like to make the village come to Christ. For that I have to be patient.”

Dozens of villages scattered throughout Nepal remain inimical to Christians. In May, five Christians, including two women, were brutally attacked in Chanauta, a remote village in Kapilavastu district where the majority are ethnic Tharus.

Once an affluent people, the Tharus were displaced by migrating hordes from the hills of Nepal, as well as from India across the border, and forced into slavery. Today, they are considered to be “untouchables” despite an official ban on that customary practice of abuse and discrimination. In the villages, Tharus are not allowed to enter temples or draw water from the sources used by other villagers.

Tharus, like other disadvantaged communities, have been turning to Christianity. Recently five Tharu Christians, including a pastor and two evangelists, were asked to help construct a Hindu temple. Though they did, the five refused to eat the meat of a goat that villagers sacrificed before idols at the new temple.

Because of their refusal, the temple crowd beat them. Two women – Prema Chaudhary, 34, and Mahima Chaudhary, 22 – were as badly thrashed as Pastor Simon Chaudhari, 30, and two evangelists, Samuel Chaudhari, 19, and Prem Chaudhari, 22.

In June, a mob attacked Sher Bahadur Pun, a 68-year-old Nepali who had served with the Indian Army, and his son, Akka Bahadur, at their church service in Myagdi district in western Nepal. Pun suffered two fractured ribs.

The attack occurred after the Hindu-majority village decided to build a temple. All villagers were ordered to donate 7,000 rupees (US$93), a princely sum in Nepal’s villages, and the Christians were not spared. While the Puns paid up, they refused to worship in the temple. Retaliation was swift.

The vulnerability of Christians has escalated following an administrative vacuum that has seen violence and crime soar. Prime Minister Madhav Kumar Nepal, who had been instrumental in the church bombers’ arrest, resigned in June due to pressure by the opposition Maoist party. Since then, though there have been seven rounds of elections in Parliament to choose a new premier, none of the two contenders has been able to win the minimum votes required thanks to bitter infighting between the major parties.

An eighth round of elections is scheduled for Sept. 26, and if that too fails, Nepal will have lost four of the 12 months given to the 601-member Parliament to write a new constitution.

“It is shameful,” said Believers Church Bishop Narayan Sharma. “It shows that Nepal is on the way to becoming a failed state. There is acute pessimism that the warring parties will not be able to draft a new constitution [that would consolidate secularism] by May 2011.”

Sharma said there is also concern about a reshuffle in the largest ruling party, the Nepali Congress (NC), set to elect new officers at its general convention starting Friday (Sept. 17). Some former NC ministers and members of Parliament have been lobbying for the restoration of a Hindu state in Nepal; their election would be a setback for secularism.

“We have been holding prayers for the country,” Sharma said. “It is a grim scene today. There is an economic crisis, and Nepal’s youths are fleeing abroad. Women job-seekers abroad are increasingly being molested and tortured. Even the Maoists, who fought for secularism, are now considering creating a cultural king. We are praying that the political deadlock will be resolved, and that peace and stability return to Nepal.”

Report from Compass Direct News

Indian church planter kidnapped and imprisoned


A church planter in Orissa State, India, who was on his way to a training meeting, has been kidnapped and imprisoned by local authorities, reports Michael Ireland, chief correspondent, ASSIST News Service.

According to Empart, an international non-profit church planting organization, Kusulia is a church planter in Orissa, faithfully serving the Lord in his tribal village.

Empart says Kusulia has been not only sharing the gospel with the people in his village but also helping the local community with health education and teaching children to read and write.

On January 29, 2010 Kusulia was traveling to a local monthly meeting with other church planters.

As he got off the bus, he was confronted by the local police. “Are you Kusulia?” they asked. As soon as he responded “Yes”, they arrested him and threw him into a police vehicle.

Kusulia asked police: “Why are you doing this?”

The Empart report says Kusulia asked again and again, explaining that he was a Christian worker and showing them his Bible.

An officer told Kusulia: "We know you are a terrorist…keep quiet.”

In recent times, anti-Christian groups in Orissa have been making false accusations against Christians by using new government terrorist laws to persecute them.

Once a person is accused of being a terrorist, they have very few legal privileges and are treated very badly. Most lawyers are unwilling to help a "terrorist."

The meeting Kusulia was due to attend was with other church planters in the area who work with Empart.

When Kusulia failed to attend the meeting, Empart leaders realized that something was terribly wrong.

Empart says none of the workers would ever miss an opportunity to train, worship together and support each other, unless they were in serious danger.

They soon learned that someone had filed a false report with the police, claiming that Kusulia was a member of a terrorist group called Naxalite (an Indian Maoist group).

Empart leaders have been to the police station and made every effort to prove that Kusulia is not a terrorist, but the police are refusing to accept their evidence.

Kusulia is still in police custody.

Empart says: "Please pray for his protection and peace for his family and church. Please also pray for the protection of other church planters in Orissa from similar allegations and persecution so they can boldly proclaim God’s word to those who have never heard the gospel. Like it says in Acts 4:29 Now, Lord, consider their threats and enable your servants to speak your word with great boldness.

Empart works with local church planters in transforming un-reached communities in Asia by training local people to start churches in their local communities.

"Our vision is to plant 100,000 churches in un-reached areas by 2030- restoring, releasing and resourcing them to fulfill the Great Commission, through partnership with the global body of Christ, the group says.

Since 1998, Empart has been changing lives for eternity. Millions of unloved children, desperate women and disadvantaged communities are finding hope and hearing about Jesus for the first time through Children’s Homes, Literacy Programs and micro business training run through local churches.

The group adds that the legal cost of trying to prove the innocence of its fellow Christians in these situations is high.

Report from the Christian Telegraph