New Delhi: For the survivors of Sunday’s building collapse, it’s likely the beginning of a lifetime of psychological distress.Take the case of Dr Aastha, who was buried for nearly five hours after a building collapsed in Said-ul-Ajaib on May 30, claiming six lives. Rescued and then treated at AIIMS, the harrowing experience continues to haunt her.Aastha was studying for an exam at a mess next door to the building when the mess owner came running and told everyone to rush out. Before she could react, the building collapsed.It took her some time to process that she was trapped under the rubble. “I was completely numb, couldn’t understand what had happened or hear anything and could barely breathe,” she tells TOI over three months after the incident.“After some time, I heard people shouting. I realised I was trapped under the rubble. I was hurt and couldn’t move my body,” she says, adding that she tried to call out for help but could not utter a word from her parched throat amid the heat and dust. At one point, a friend managed to get through to her on the phone. The call became a lifeline, confirming that she was alive.Hours passed. Buried under debris, unable to move, struggling for air and her body hurting, Aastha waited. She recalls that it was only after nearly five hours that rescuers managed to reach her. Someone began removing slabs from above her, spoke to her, checked her vitals and asked her to remain calm. Eventually, she was brought out and taken to AIIMS Trauma Centre, where she stayed for five days. Another two were spent in the ICU.Aastha’s injuries were mainly on the right side — her hand and leg were affected and there was muscle injury. But the consequences did not end with her discharge from hospital. “When I came back to Guna, my hometown, I was bedridden for a while. There was swelling in my legs that worsened on sitting,” she says.Beyond the visible trauma were the less apparent ones. “I could not bear to look at videos of building collapses. They would come up on social media and I would carefully avoid them. It felt like I was still stuck under the rubble,” she said, adding that she did not receive psychological counselling after the incident.According to psychiatrists, survivors of such traumatic incidents can experience psychological consequences long after their physical wounds have healed.Dr Rajesh Sagar, psychiatry professor at AIIMS, describes a building collapse as a form of “life-threatening stress”, with survivors potentially passing through different phases of disaster-related mental distress.“In the immediate aftermath, some may develop acute stress symptoms. In others, symptoms can persist and cross the threshold into post-traumatic stress disorder, with anxiety, repeated recollection of the incident, flashbacks, distressing dreams, depression, emotional numbness, or a sense of detachment. For others, the symptoms may be milder, irritability, mood swings or persistent anxiety,” Sagar says.One of the most common warning signs, he says, is disturbed sleep, difficulty falling asleep, waking up repeatedly during the night, waking up too early or being jolted awake by dreams of the event. “The person keeps re-living the event that can lead to disaster-related mental health problems,” Sagar says.The response, he says, begins with recognising that these symptoms may be consequences of what the survivor has experienced, rather than simply a change in personality or behaviour. Keeping the person occupied, reconnecting him with hobbies and routine, and ensuring support from family and friends can help. Breathing exercises, mindfulness and cognitive behavioural therapy may be useful, while medication may be considered when clinically necessary.Importantly, disasters can also worsen pre-existing mental or physical illnesses. Some survivors may stop taking regular medication or abandon treatment amid the disruption, making screening and follow-up important.For those at the site of a collapse, the first challenge is survival itself. Dr (Maj) Rajesh Bhardwaj, founder of MedFirst ENT Centre, who had experience dealing with such incidents, says rescuers must resist the instinct to rush indiscriminately onto unstable rubble.“Adding weight or using heavy machinery too early can destroy air pockets where trapped survivors may still be breathing. Silence, careful identification of voids, safe extraction and immediate attention to the airway are crucial. Exposed victims should not simply be yanked out by their limbs, because spinal injuries can turn an otherwise survivable injury into permanent disability,” he says.
