Impact of the tsunami on psychosocial health and well-being.

Natural and man-made disasters affect everyone in their path. Some people are nevertheless more vulnerable than others and suffer in different ways and to different extents. The tsunami highlighted a number of pre-existing factors that made some people especially vulnerable and it also brought out the ways in which other people became vulnerable as a result of disaster. Major social and demographic shifts occurred, and the social fabric of communities was severely eroded. Gender, age, extent of personal loss, personal experience in terms of how direct or indirect exposure emerged as key factors together with loss of place, problems of temporary and permanent housing, poor income generation and uncertainty about if and when it would be possible to return to original home sites and communities. Host communities were also affected, albeit indirectly. How and to what extent people were psychologically 'damaged' in, and by, the tsunami nevertheless remains poorly defined because of the paucity of real-time monitoring and the fact that in some countries there was little agreement on the nature and classification of psychosocial problems and morbidity.