加德满都报道：一位女孩，20出头，坐在拉姆纳期•辛医生面前，在加德满都巴尔克地区瓦大哈医院。她眼睛发红，面黄肌瘦，看起来与实际年龄不符。自4月25日尼泊尔地震后她160小时没有睡觉了,并且一直烦躁不安。

“她遭受了严重的心理创伤，”辛医生这样告诉《印度时报》（TOI）记者。辛医生曾经是尼泊尔警察医院的院长。“她一分钟也没有合过眼，持续一周了。这是尼泊尔要应对的另一个灾难。”整个国家成千上万人出现急性精神症状，包括极度抑郁、严重的适应障碍、惊恐发作和很多精神病学家关注的创伤后应激障碍（PTSD）。

随着心理问题危机日益紧迫，地震袭击尼泊尔后许多医生和精神病学家聚集在一起，应对这样一个毫无准备的心理健康基础设施建设问题。整个尼泊尔目前只有一个精神卫生专科医院，在全国的24所医院里只有一个专门针对心理障碍的科室，对于目前大量需要帮助的人们而言远远不足。

辛医生认为，需要立即进行心理干预的人数约25000人，这只是保守估计。PTSD一般在灾后约六星期表现出明显症状，医生们已做好最坏的打算。

在帕坦医疗健康科学研究院，拉比•沙克亚医生，也是尼泊尔精神病学会的副会长，新德里全印度医药学会的校友，说：“每天大约有30个新患者赶来治疗，其中10个需要入院治疗。我所看到的是令人震惊的，我们在进行一项长期而艰巨的工作。”

沙克亚医生说，很多人抱怨大地的震颤已经颤动进了他们的身体深处，一位妇女抑郁到了甚至不能忍受汽车经过的颤动，一点微小的震颤都会引起她的痉挛。

辛医生和沙克亚医生说，幻觉是普遍现象，难民营里的幸存者及志愿者都有。一些从受灾地区返回的志愿者颤抖非常严重甚至需要使用抗抑郁药。

“他们看到了很多残肢断臂，看到这样的丧亲之痛使他们自己也产生了问题”。沙克亚医生说，“精神卫生问题日益严重。我们看到有的人有自杀倾向，失去亲人的人觉得他们也失去了活下去的理由。适应障碍者开始抽烟、过度饮酒，这样的现象非常普遍，这是一场恶梦！

期林克斯医生在加德满都说，通常这种程度的悲剧发生，大约有30%受到影响的人们需要心理援助，这个数字也被兰格斯·SM教授2001年的一篇关于印度古吉拉特邦地震的论文所证实。一篇联合国的报道称尼泊尔地震导致8百万人受到不同程度和范围的影响。

尼泊尔的医生们既没有准备，也没有专业人员和基础设施来应对这场精神危机。“我们没有能力”，辛医生说。

现在，他们只希望那个来自汉尼玛·达克的女孩能够安然入睡。

(作者：阿纳德•苏德斯 翻译：程思 校对：隋双戈)

Hidden in earthquake debris, a Himalayan mental wreckage

Anand Soondas, TNN | May 3, 2015,06.47AM IST

KATHMANDU: A girl, perhaps in her early 20s, sits in front of Dr Ramnath Singh at the Vayodha hospital in Kathmandu's Balkhu area. Her eyes are red, the corners scraggy, belying her youth. She hasn't slept for about 160 hours ever since the day the quake struck Nepal on April 25, and has been fidgeting continuously.


"She's suffering from severe psychological trauma," Dr Singh, a surgeon who earlier headed the Nepal Police Hospital,told TOI on Saturday."She hasn't closed her eyes for a minute; it's been a week now.This is the other disaster Nepal will have to cope with." Across the country, thousands are exhibiting signs of acute psychosis,deep depression, grave adjustment disorders, panic attacks and what psychiatrists club under post-traumatic stress disorder(PTSD).

It's a growing emergency that doctors and psychiatrists in disaster-hit Nepal are putting their heads together to deal with, a problem many of them said the health infrastructure here is unprepared to tackle. All of Nepal has one dedicated government mental health hospital. Inits 24 hospitals it has a unit each to treat psychological disorders. That's hardly enough for the hordes of patients who'd need help.

Singh puts the number of people needing"immediate psychological intervention" at about 25,000. But this could be a conservative estimate. PTSD symptoms are more apparent after about six weeks of a calamity, and doctors are bracing for the worst.

At the Patan Academy of Health Sciences, DrRabi Shakya, vice-president, Psychiatrists' Association of Nepal, said about 30new patients are streaming in for treatment every day. "Ten had to beadmitted," added the AIIMS, New Delhi, alumnus. "What I've beenseeing is shocking. We're in for the long haul."

Shakya said many complain that the tremor has"gone inside their bodies". He spoke of a woman who's been sodistressed by the temblor that she can't bear to be near passing cars."That small vibration sends her into spasms," he said.

Singh and Shakya said hallucination is so common that it's everywhere — in refugee camps, among survivors and volunteers.Some volunteers returned from an affected area so shaken that a few had to be given anti-depressants.

"They'd seen so many severed bodies, such bereavement that they came back with their own problems," Shakya said."Existing mental illnesses have been aggravated. We're getting people with suicidal tendencies, people who've lost families and think they've no reason to live. Adjustment disorders where people have begun smoking or drinkng excessively have become fairly common. It's a nightmare."

Shrinks in Kathmandu said in a tragedy of this scale, about 30% of the affected need psychological help, a figure attested by Rangaswamy Srinivasa Murthy, professor of psychiatry at India's Nimhans, in a paper about the 2001 Gujarat quake. A UN report says the Nepal quake has left 8 million affected in various forms and degrees.

Doctors said Nepal is neither ready nor does it have expertise and infrastructure to handle a mental health crisis of this order. "We don't have the capacity," Singh said.

For now, they only want the girl from HanumanDhoka to sleep.

本文英文原文网址链接：http://timesofindia.indiatimes.com/world/south-asia/Hidden-in-earthquake-debris-a-Himalayan-mental-wreckage/articleshow/1178399175pxs

（编辑：林俊锋）