Many lives were lost in Kanniyakumari during cyclone Ockhi in 2017 but the mental health issues among survivors, continue even six years later.
Mental health professionals say that those who have suffered significant loss after a disaster, might experience recurring flashbacks, insomnia and negative thought patterns, endure depression and post-traumatic stress, often requiring intervention and advanced forms of treatment.
As climate change intensifies extreme weather events, doctors and psychology researchers believe it is vital to include long-term mental health support along with the financial compensation, for those affected by disasters.
This story discusses the mental health of disaster survivors. It might be disturbing to some audiences.
November 30, 2017. The deep-sea fishermen of Kanniyakumari, a coastal district in India’s southern tip, found themselves confronting an unforeseen extreme event – a very severe cyclonic storm.
The India Meteorological Department (IMD) issued an early warning of heavy rainfall and wind for the day before, on November 29, 2017, with special instructions to the fishing community to ‘not venture into the sea’ around 2:30 pm. However, since deep-sea fishers typically require 25 to 45 days to return, it became impractical to alert those who had already set out to sea.
Cyclone Ockhi, however, was on track and surged in, leaving an indelible mark on their way of life. Almost six years after the cyclone, the coastal communities are still healing from its impacts.
This correspondent travelled to Neerody, Eraviputhanthurai, Thoothoor, Chinnathurai, Thengapattanam, Vallavilai villages of Kanniyakumari to interact with the fishers impacted by Ockhi.
The stories of the survivors, however, have not been easy. They continue to grapple with the challenge of rebuilding their mental and emotional resilience, almost six years after the cyclone.
Robinson Johnson (35), a deep-sea fisherman and one of the Cyclone Ockhi survivors in Eraiviputhenthurai, a coastal village in Kanniyakumari district. Photo by Narayana Swamy Subbaraman/Mongabay.
Surviving an arduous three-day battle after his boat had sunk in the sea, Robinson Johnson, a fisherman from Eraviputhenthurai, a village adjacent to Thoothoor, managed to reach Kalpeni Island in the Lakshadweep archipelago. Despite defying the odds, his life has yet to return to normalcy even after years. “I wasn’t able to return to sea for several months. I decided to raise cows and supply milk around the neighbourhood. However, being a fisherman, I lacked sufficient knowledge about raising cattle, rendering the business unprofitable. So, I had to return to the sea despite conflicting feelings about it.”
Johnson mustered the courage to resume fishing after 11 months from the time he stopped. “When the sea is calm, the impact isn’t as strong. But whenever the winds pick up, those haunting memories resurface, echoing the voices of fellow fishermen lost in the cyclone. To cope, I intentionally shift my focus, engaging in various conversations with my fellow fishermen,” shared the 35-year-old, who tries not to think about Ockhi even today.
“When government officials visited us after Ockhi, their inquiries solely revolved around the sea incidents during the cyclone. No one inquired about our current well-being or mental state. We are the ones who rebuilt ourselves both emotionally and financially,” Robinson revealed, highlighting the lack of mental health care.
Salom Kasmir, a fisherman from Thoothoor, a town in Kanniyakumari bordering Kerala, found himself stranded on his country boat (a small boat with a motor that runs on kerosene or petrol, which cannot go into deep seas for weeks and returns to shore within a few days) with his three uncles during the ravages of Cyclone Ockhi. He recalls that he pleaded for his life to God and promised that he would never return to the sea if his life were spared. Kasmir has kept that promise.
However, he lost two of his uncles at sea. After surviving the disaster, he remains burdened by the enduring physical injuries, as persistent back pain prevents him from standing properly. “How can I think of the physically demanding fishing anymore, even if not for the promise?” he asked.
“The mere thought of venturing into the sea triggers haunting flashbacks. Even the annual prayers for those lost in Ockhi still serve as stark reminders of those moments to me,” shared the 39-year-old, who was unrecognisable to his own family when he returned to the shore after the cyclone, with a swollen face and body caused by extreme exposure to seawater.
Antony Raj (43), a deep-sea fisherman in Thoothoor, a coastal village in Kanniyakumari, went into the sea to look for fishermen stuck due to cyclone Ockhi. Photo by Narayana Swamy Subbaraman/Mongabay.
Antony Raj, 43, was fishing further up the coast, near Mangalore, during Ockhi, where the winds weren’t as strong as in Kanniyakumari. On December 4, 2017, armed with five boats and a 35-member team of fishermen from seven villages, Raj set out to rescue those who were still stuck in the sea after the cyclone. The team spotted around 25 bodies that were unidentifiably swollen. They shared the photos with the government and the media.
“We also got connected with fishermen, who reached us through the wireless, desperately crying for help, ‘Kaapathunga! Kaapathunga!’ (‘Save us, Save us!’ in Tamil). Before they could provide their GPS location, the connection was lost. The regret of not being able to save fishermen who fought the battle alive for five days still weighs heavily on me,” Raj shared.
“Even now, as I set out to sea, my mind continues to replay the voices that pleaded for their final lifeline. I wonder about the possibility of their survival on a distant island, or their tragic demise lingers as I navigate the sea,” he said.
Mental health impacts post disasters
Dr. K. Sekar, consultant and former head of the Department of Social Support in Disaster Management (DPSSDM), National Institute of Mental Health and Neuro Sciences (NIMHANS) Bengaluru, in conversation with Mongabay-India said, “After any disaster, a significant portion of the affected population experiences mental health issues as a normal response to the abnormal scenario. While many of these tend to lessen over time, some people who have suffered significant loss might endure enduring mental health effects such as depression and post-traumatic stress disorder, often requiring intervention from mental health experts.”
According to Sekar, the flashback from the events could be intrusive and unavoidable for some. For some others, it could even trigger their memories of the tsunami. It may lead to hypervigilance, complemented with physical impacts like severe sweating, tremors, and faster heartbeats. “Without timely intervention, some even resort to alcohol or substance use to cope,” he said.
Survivors might also experience challenges such as insomnia and negative thought patterns. These psychological issues require more advanced forms of treatment, added Dr. Sanjeev Kumar Manikappa, Associate Professor, DPSSDM, NIMHANS.
Contrary to the usual stigma surrounding mental health, the people from Kanniyakumari who were impacted by the cyclone were extremely receptive to receiving help, argues Dr. S Divya Prabha, Counselling Psychologist and President of Chennai Counsellor’s Foundation. Prabha was part of a ten-member team that provided psychological counselling in Kanniyakumari twice during January and March 2018, post cyclone Ockhi.
However, these two visits were not sufficient, says the mental health expert. “When we first visited in January, there was a deep sense of frustration among the people due to numerous visitors who offered no substantial assistance. To address this, we ensured a follow-up visit in March. However, these individuals required ongoing and consistent long-term support, which can be done only by the government through an employed team of psychologists and social workers,” added Prabha.
“A fisherman’s livelihood hinges on mental strength; once that is eroded, his life follows suit. I would estimate that around 50% of fishermen have not yet resumed their work at sea after Ockhi. They are stuck with low-paying jobs on the shore. The remaining 50% are gradually returning to the sea, though their mental fortitude isn’t as strong as before,” Leo Tolstoy, chairman of Eraviputhenthurai Boat Owners Welfare Association, told Mongabay-India.
Insufficient compensation for financial setbacks added to mental strain
The immediate financial repercussions of Ockhi were significant, resulting in an estimated revenue loss of $1.85 million (around Rs. 154 million) due to the loss of 106,250 human-days in fishing activities. The families of missing and deceased fishermen were allocated Rs. 20 lakhs each, while the survivors were compensated with Rs. 50,000 each if injured. Some fishing families received Rs. 5,000 each as a one-time livelihood assistance. Notably, family relief amounting to Rs. 15.38 crores was disbursed to 30,778 fishermen and 1,568 returning fishermen were granted Rs. 2000 each for food allowance as a one-time compensation. However, the fishing communities express dissatisfaction, deeming the compensation inadequate given the substantial loss.
When the compensation offered is disproportionately small in relation to the substantial losses, acceptance becomes difficult, explained Sekar. “Consequently, an immediate reaction often manifests as guilt – ‘Why did I venture into the sea during a cyclone?’” he added, highlighting the mental health impact of inadequate compensation.
“Once we’ve offered food, shelter, and other essentials, we often believe our responsibilities are fulfilled. However, these aspects only address the physical aspects of disaster management. The trauma that follows a disaster might not be immediately visible, and administrators sometimes mistakenly assume their duties conclude with providing compensation. Compensation, though significant, is just one facet of disaster management. The psychosocial component is equally vital, comparable to any physical aspect,” shared Manikappa.
Mary Francis and Francis Fernandez
Francis Fernandez (55), faced severe economical losses due to Ockhi leading to financial and mental burden on the whole family. Photo by Narayana Swamy Subbaraman/Mongabay.
“Even today, fear grips us when my husband goes out to sea. Before Ockhi, it wasn’t like this. Deaths at sea were not uncommon, but the extent of devastation was unprecedented, making it unforgettable. Yet, we cannot avoid fishing as we lack other education or skills,” shares Mary Francis.
Francis Fernandez, 55, Mary’s husband, is a fisherman from Iraviputhathurai. He had mortgaged his house to secure a loan from a private bank for his boat purchase. “My boat, valued at Rs. 18 lakhs, suffered irreparable damage during Ockhi. I also lost the expenses incurred for sailing, amounting to around Rs. 5 lakhs. This financial setback has made it difficult for us to repay the loan, and as a result, the bank officials have displayed an auction notice in front of my house,” Fernandez narrated.
The couple was forced to keep their three daughters out of school/college for two years due to financial constraints. “Only after a break, they resumed their studies,” continued Mary Francis.
“For losing my boat worth Rs. 18 lakhs, the government compensated me with Rs.40,000. Even repairing needed Rs. 7 lakhs. So, we had no choice but to sell it as scrap for Rs. 1.5 lakhs. Our circumstances were so dire at that time to even contemplate fighting for a higher amount. When faced with a lack of money for food, would you oppose the few thousand that are being offered, even if you know the compensation is not justified?” questioned Francis.
Women and children are impacted disproportionately
The family members of the deep-sea fishers also go through the same stress as the victim, Sekar said, speaking about the high comorbidity among family members. “For example, an anxious father might upset the children and strange behaviour from a husband would impact his wife.” With many fishing families also majorly dependent on the men for the family income, the family suffers in many ways, added Manikappa.
Amalathasi’s husband was lost at sea after Ockhi and declared dead. She and her two daughters are still struggling to come in terms with his death. “At least, if we had received his body, it might have offered some solace. My elder daughter, at 26, is not inclined to marry and is consumed by her father’s memory, sinking into depression. There is no respect for a woman in this society after losing husband. Even my relatives neglect me and further complain of not marrying off my daughter in time,” shared the 45-year-old, who believes they no longer have the life they once had, both emotionally and financially. Amalathasi is currently a homemaker.
“We even visited families that had lost all the men in their households. We couldn’t do anything beyond listening to their stories at the time. Returning each day after our visit, the painful stories had also impacted us. As a way to cope, we would share our own experiences with each other,” Prabha, the counsellor who visited the families after the cyclone, recounted.
The predominant presence of churches in Kanniyakumari district has played a crucial role in the wellbeing of fishers. As per the 2011 census, almost half the population in the district follows Christianity. Speaking anonymously, a district health officer in Kanniyakumari stated, “There are qualified mental health professionals at the churches to even provide the people with the right tools and resources in supporting the people.”
“In Christianity, human bodies are considered sacred. But we didn’t receive the remains of those who went missing. Therefore, even this year, people from our villages went out to sea and scattered flowers at the sea in their memory,” Fr. Rajesh Babu, a priest at the Eraviputhenthurai church.
These simple approaches, such as drawing upon spirituality, if one has religious beliefs, can be beneficial instead of resorting to complex methods, believes Sekar. “Engaging in recreational activities aligned with their interests can also provide help.”
The way forward
The Intergovernmental Panel on Climate Change (IPCC) in its sixth assessment report, discusses the impacts of climate change on mental health and states, “…climatic events may result in a range of potential mental health outcomes, including anxiety, depression, acute traumatic stress, PTSD, suicide, substance abuse and sleep problems, with conditions ranging from being mild in nature to those that require hospitalisation.”
IPCC AR6 WGII lead author Susan Clayton, a professor of psychology and environmental studies at the College of Wooster, USA, in conversation with Mongabay-India, said, “Mental health support does not only come from trained professionals. Providing more opportunities for people to connect with each other and to learn self-care and coping techniques can also help, and these efforts can be located within existing community structures such as schools or community groups.”
Attending to people’s needs for connection with each other and for information about anticipated climate events can strengthen their ability to be resilient in the face of disasters, Clayton argues. “It is even better if governmental support for mental health care following climate events can be made available,” she added.
As climate change intensifies extreme events such as cyclones and storms, it is imperative to address mental health impacts along with financial compensation. According to health experts, mental health is now receiving the rightful attention it deserves, unlike in the past. “Now, mental health services are available in Tamil Nadu, where mental health professionals are available district-wise in community health centres through the mental health progamme,” Sekar said.
Under the National Mental Health Programme, the Government of Tamil Nadu introduced District Mental Health Programmes (DMHP). The primary goal of DMHP is to prevent mental health issues and promote sustained mental health support within the community through Primary Health Centres. Community health workers at the grassroots level in each district undergo training conducted by medical officers to deliver mental health services, thereby building the district’s overall mental health capacity.
The district health official from Kanniyakumari however, opines that these programmes are discussed only in theory. “There has been a lack of concrete steps taken towards the actual rehabilitation of mental health,” they countered.
“Government officials may consider mental health as a less pressing need than other priorities such as rebuilding physical infrastructure. But mental health is part of population health – people who are experiencing mental health challenges are less able to care for themselves and to function effectively as citizens. Emphasizing the health and economic costs of poor mental health can be a compelling argument for public policy,” Clayton continued highlighting the need for policy discussions on mental health.
Meanwhile, Manikappa suggested that the psychological support be extended until the survivors’ rehabilitation is fully accomplished, which might span a year or even two, contingent upon the promptness of their compensation.
Mongabay-India reached out to the Director of Tamil Nadu State Disaster Management Authority and the District Collector of Kanniyakumari for comment and did not receive a response at the time of publishing.