In certain areas of the Irrawaddy Delta, MSF teams report that up to 30 percent of their patients have mental health problems related to the surviving Cyclone Nargis that struck Myanmar on May 2.

MSF staff have encountered a large number of patients with profound sadness and depression as well as complaints such as lethargy, anxiety, sleeping difficulties, hyper-tension, palpitations, and other non-specific body complaints that are most likely related to psychological problems. To address theses mental health problems, MSF is integrating a mental health and psycho-social programme into its emergency response.

MSF Mental Health Officers arrived in the Delta in early June to implement the psycho-social program. They established a system of support to the community by training community health workers and counselors to assist traumatized survivors. Over the coming weeks, MSF will further scale up its response to the mental health problem.

MSF also started a school in Labutta Camp for 500 children. This simple initiative has a significant impact, helping to bring routine and some sense of normalcy back into the children's lives. The cyclone devastated entire communities. In areas totally flooded by the cyclone only the strongest swimmers and best climbers survived. In some of these areas there are no women left, as more men and younger people survived.

In one village 60 men, six teenage girls and one baby of six months survived. The baby survived because the father climbed a tree and tied both of them to the tree with his sarong. The mother and the other children in the family all drowned. In another village, only a single child survived. As the only child in the village, he has no one his age to play with, study with or share his grief with.

There are still dead bodies floating in the water, which rains have carried to the surface. The bloated corpses are a constant, distressing reminder to survivors of the cyclone's toll. Survivors are trying to deal with the trauma of having lost family, relatives and friends before their eyes. Many cannot sleep properly. At night some see the faces and feel the hands of the people they let go during the cyclone - of those they could not save.