HEALING THE PAIN
Now, health officials are taking a closer look at mental health and how to boost Sri Lanka's ability to treat those afflicted.
For a population of 19 million, Sri Lanka has only 41 psychiatrists. This year, the government introduced a new mental health policy aimed at strengthening such services in rural areas.
International and local non-governmental organisations are also helping by running programmes, including family support and counselling services.
Mr V.D. Niranjith, director of Shadow, a local psycho-social NGO, describes the situation like this: "There are three parts to a human being: body, mind and spirit. There are doctors and priests to heal the body and spirit, but for the mind, there is nobody."
To bridge the gap, several local doctors are being trained in basic mental health care by the IMC and psychiatrists around Sri Lanka, said Dr Budosan.
"They can identify people with problems, give medication or refer them to a hospital," he said. "The idea is to integrate mental health into primary health care."
Sri Lanka is now looking to train at least 250 mental health workers by 2010. Many NGOs have also come forward to educate locals to provide support for those affected.
Former school teacher Sumanthy Markandu, 38, who lives in Batticaloa, an hour's drive from Kalmunai, has been trained by a Dutch NGO to counsel tsunami survivors.
"We refer the difficult cases to the hospitals," she said. "The doctors and nurses said we should work hand in hand, as there just are not enough resources in hospitals for this work."
Along with two other counsellors, she visits the refugee camps every weekday to offer a listening ear and advise those who need help.
Housewife S. Rajeshwary, 46, complained that she could not eat and suffered bouts of anxiety for six months after she lost the eldest of her five children to the tsunami. The 20-year-old youth was in school when the tsunami struck.
She poured her heart out to Madam Sumanthy, and they have been meeting weekly since June.
Now, Madam Rajeshwary said she has regained her will to live and her appetite.
Grateful to her counsellor, she said: "I will always appreciate what she has done for me."
Whether this kind of progress can be made with others still stricken emotionally by last year's disaster remains to be seen.
Nine months on, basic hurdles remain, not least the fact that many survivors continue to live in temporary shelters.
Mr Felician Francis, a facilitator at local support organisation The Mangrove, said: "You cannot expect their mental health to be okay if they have not even settled down properly.'
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