Dr. Felicien Ntone-Enyime described the airline crash on 5 May 2007 in Cameroon, in which a Kenyan aircraft exploded in the air soon after take-off, leaving 114 dead. There were no survivors. The passengers and crew were of 24 different nationalities from four continents. The plane was not located for more than two days. It was found in a roadless tract of mangrove swamp, and presented a shocking scene for emergency workers. The remains of passengers were spread over a wide area, and their identification presented terrible difficulties.
This disaster, though small when compared with the tsunami and the Pakistan earthquake, nevertheless presented many unexpected challenges in Cameroon’s capital, Douala. The country has only two psychiatrists, and it was ill-prepared for such an acute situation. It had no experience with providing psychosocial support after a disaster, let alone dealing with the international complications that resulted from this particular plane crash. In the first week the main focus was on retrieving the remains of the dead and attempting identification, and providing support to the emergency workers at the scene.
Recognizing the growing local need for mental health assistance, his organization MTN created several multidisciplinary teams consisting of a doctor, a clinical psychologist, a social worker from the social welfare department, and a social worker specializing in family matters. One team was stationed at the airport, one each was located at MTN agencies in Douala and Yaounde, and one was sent to the crash site to help emergency workers there. In addition, a special team arrived from Kenya.
Little attention was paid initially to the relatives arriving in Douala from around the world. These people were grief-stricken, in shock in a strange country. The dead passengers had been of relatively high social status, and in addition to their personal loss relatives were suddenly faced with the loss of a bread-winner’s economic support. Some felt an instant financial impact. There were specific social problems for widows, issues for families who had to pay school fees in the near future, and for families living outside their home countries. The problems with identification and the inability to provide death certificates had tremendous legal implications for families in their respective countries, as well as causing deep personal distress. Many were still waiting for a death certificate months after the crash. Without it, they experienced delays in pursuing insurance or other compensation claims, while their serious financial difficulties continued. Dr. Ntone-Enyime commented that information was difficult to obtain about insurance matters, rights, and payments that might be expected. In such a situation grief is combined with escalating family anxiety. The legal problems that arise after disasters deserve more consideration.
Dr. Ntone-Enyime made the following recommendations:
1. There is a great lack of human capacity for disaster relief work in many poorer countries, including capacity to provide mental health support, and this should be recognized.
2. The importance of being able to identify the dead and provide death certificates should be recognized. This means that disaster preparedness plans should include, as a very high priority, special training for the hygienic and forensic recovery of bodies and body parts.
3. Planning should include comprehensive strategies that take account of legal, cultural and financial issues that could be faced by survivors.