Survivors Face Years of Recurring Nightmares

Psychologists are warning that mental health problems caused by last week's tsunami could prove harder to resolve than the physical damage caused.

Some survivors say they are plagued by recurring nightmares about walls of water, many locals are afraid to return to beachside homes, and officials warn that suicide rates could rise dramatically as parents struggle with feelings of guilt at losing children.

"Many of the survivors I've spoken to are unable to control their emotions; they cry uncontrollably," said Karine Le Roch, clinic psychologist with the American Refugee Committee. "In extreme cases, they suffer severe sleeping disorders because they are so afraid to go to sleep."

Psychologists estimate that 20-30% of people who face traumatic events eventually develop symptoms, such as alcohol abuse, lack of concentration at work and an inability to develop close relationships. After the Bam earthquake in Iran last year, about half of the population were surveyed for mental health problems. Around 50% of those screened - nearly 27,000 people - were found in need of psychosocial help.

Ms Le Roch worked in Bosnia for two years, but says the mental trauma caused by the tsunami is different. "With a natural disaster like this, there is a feeling of helplessness - they think, 'why make long-term plans, when I can die all of a sudden?' "

Although the Thai government has offered to build temporary beachside housing, many refugee families are refusing to come down from the hillsides. Others are afraid to go back to jobs on the sea. Ali Theeranuch Saweangphon, a guide for snorkelling tours to Koh Phi Phi, saw three customers die, and saved two others who were severely injured. "I'm frightened to go into the water," she said. "I'm terrified that I might see a body down there."