Discussion

Many questions have been asked about the mental health response effort. Some have wondered what it achieved and what benefits came to the people of Kenya. There are no simple or accurate answers to these questions. However, as psychiatrists and mental health professionals, we live in a world where the challenges to our profession extend beyond our clinics and hospitals [10].

For this reason, post-disaster mental health response is an integral part of the duty of the mental health team. Controversy continues to surround the usefulness or otherwise of early intervention and in particular debriefing, since studies have shown diametrically opposed results. This valid academic discussion is, however, quickly thrown out in the face of reallife disaster. The community expects and demands help from the mental health experts.

Some of the interventions were as creative as they were untested and may have had little intrinsic long-term value. The roadshows are a good example of this. The people, however, seemed to respond positively to the initiatives, much as the team itself appreciated the comedy nights.

A strong and efficient mental health team came into being. Following other disasters in the region, the team was quickly assembled and was transported across the continent (Ivory Coast) to offer services to survivors of Flight KQ 101 on January 31, 2000.

The question of research following a major disaster is complex as it involves both moral and scientific considerations. Delay in initiating data collection limits opportunities to obtain early information needed to understand mental health effects of disaster. Secondly, if researchers do not act quickly, important data may be lost forever. It is for these reasons that we decided to put in place a research and documentation team, which among other things developed a 57-item self-administered questionnaire, capable of generating the DSM-IV diagnosis of PTSD. In so doing we were fully cognizant of the fact that conducting methodologically solid investigations of mental health is extraordinarily difficult in the chaotic and complex settings of disasters, particularly those associated with terrorism. Some might disagree.

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