Médecins Sans Frontières (MSF)?teams currently providing medical and relief aid in Asia Pacific after several natural disasters are integrating mental health care into their activities. More than a week after the traumatic events, they are beginning training local counsellors as well as giving direct psychological support.

International Humanitarian organisation Médecins Sans Frontières (MSF) workers - including surgeons, nurses, psychologists and logisticians assessed the needs in the city of Padang and in the surrounding area to find the unmet needs. [©Juan-Carlos Tomasi/MSF]

There were fears of more devastation when a tsunami warning was issued on Thursday morning after earthquakes struck off Vanuatu in the South Pacific. Thankfully, there was little damage but there was panic on several islands. In the Samoan islands, part of the population again sought refuge on higher ground. It was a week after an earthquake and subsequent tsunami which took 137 lives and destroyed many houses.

Counselling by local volunteers in Samoa. "Obviously people are traumatised," says Veronique de CLERCK, the Emergency Coordinator in Samoa for Médecins Sans Frontières, after spending several days evaluating the area which took the full impact of the tsunami on the southern coast of Samoa. "They have lost all their assets and some people have lost a large number of relatives. There was one family who lost thirteen family members. People need time to mourn and to bury their relatives and friends but after a few days, they are probably more ready for counselling." Psychosocial support is already being delivered, even on a mobile basis in the bush. "There have been a lot of volunteers – Samoans themselves have been putting up their hands and saying they want to help, which is great. However, they lack the experience to address such specific problems." In the next few days, a Médecins Sans Frontières psychologist will train a team of Samoan counsellors, who will be able to offer psychosocial support as well as identify people who need more professional counselling, and refer them to psychologists.

Group psycho-education session was launched by MSF close to Padang Alei, in a place where part of the village was swept by a landslide. [©Juan-Carlos Tomasi/MSF]

Mourning without corpses in Indonesia. In Indonesia, many people have disappeared and any hope of finding survivors has almost vanished. Bodies are still trapped under the rubble and the relatives are waiting. Marlene LEE, an MSF psychologist, provides support to some families in the most affected areas. She said: "Yesterday we went to Tandikat, one of the most affected areas, in the hills north of Pariaman, where several villages were destroyed by a landslide. People who have lost family members are still waiting for the bodies to be retrieved." But because most of the roads have been destroyed it is especially difficult to bring in the heavy machinery needed to search the rubble. People go back to the site each morning and sit the whole day waiting for the search teams. "It's very important that people are able to give their loved ones proper burials as soon as possible," said Marlene. "A lot of these people are in a difficult state now. Most are still in shock, they are grieving, they have not slept for a long time, they have lost their appetite, and they have many worries about the present and the future. There are a lot of unanswered questions."

Difficult life conditions in the Philippines. There are also urgent worries facing people in the Philippines some of who have not yet received adequate aid or are living in difficult conditions. Thousands of people are still sleeping in evacuation centres and some will probably have to wait several weeks before being able to go back to their homes, as some areas are still flooded. "We are still living in this corridor. It's noisy, windy...it is not a place for a family," one father said in an evacuation centre in Pasig. Next to him, a woman was anxious because her home had been destroyed. "I don't know what to do....I have lost everything". For some, identified as the most vulnerable, MSF is offering help in the form of primary health care and mental health care plus the distribution of relief items distributions and water and sanitation work.