Geographically, the Cook Islands consist of 15 relatively small islands in two scattered northern and southern groups. They occupy about 2 million km 2 of the Pacific Ocean approximately between the latitudes of 9 and 22 degrees South and longitudes of156 and 167 degrees West. They are part of the Polynesian area that is bounded by Hawaii in the North, Easter Island in the East, New Zealand in the South, and Samoa in the West. They lie to the South-East of Micronesia and to the East of Melanesia. Their climate is tropical, with seasonal patterns of heavy rainfall and high winds that intensify into migratory cyclones between November and April. Their economy is not strong, and is dependent on tourism, the export of copra, tropical fruits and vegetables, and pearls, and an annual grant from the New Zealand Government. They became a British Protectorate in 1888, and eventually in 1962 they became self-governing in association with New Zealand. Currently their total population is about 25 000, the majority of which lives in the capital of Rarotonga in the southern group.

Tropical Cyclone Martin struck the northern group of Cook Islands on the afternoon of Saturday 1st November 1997. It came from an unexpected direction with very high seas and winds gusting up to 90 knots. It had the greatest effect on Manihiki, a string of low-lying coral atolls around a deep and 5 km wide lagoon with a population of about 630 settled in the two villages of Tauhunu and Tukau. No weather-data gathering facility was nearby to give precise records, but eyewitnesses reported the crescendo as lasting about 30 minutes, during which time the biggest wave surged above 30 metres and cut a 200 metre swathe which left widespread damage in its wake. The final tally of casualties showed that eleven people were dead, 9 were missing, and many were injured. Housing was flattened, public facilities destroyed, crushed coral roads washed-out, and virtually all of the off-shore accomodation and equipment relating to the lagoon pearl-fishing industry was destroyed. Small boats, demolition timbers, and household contents were strewn everywhere, and sheets of cast-iron roofing were wrapped like tape around high trees. Sunken debris littered the edge of the lagoon to a distance of about 30 metres.

First Reactions

Within 24 hours Royal New Zealand Air Force responded to a call for emergency supplies, and on return flights it evacuated about 400 of the sick, wounded, women with young children, and others, in that order of priority, to the capital Rarotonga some 1200 kms to the South. Some 230 residents were left to take stock of the situation, search for the missing, and bring a semblance of control to the disordered environment. Conditions were so bad that questions were raised in official quarters about abandoning the island altogether.

The first outsiders on the scene sent back reports of the confusion and shock displayed by the inhabitants which prompted a formal inter-governmental request for assistance on the asessment and treatment of the prevailing stress and trauma. Subsequently I was briefed for an eight-day assignment with the following objective and tasks:

            1. To identify and minimise the immediate and on-going social and psychological impacts of
Cyclone Martin on the local community, enabling the community to move on from the trauma of the
recent cyclone;

            2.  To assess the social impact of Cyclone Martin, taking account of Cook Island/Manihikian
belief systems, on the Manihikian community;

            3.  To identify and counsel those suffering as a result of the Cyclone, giving priority assistance
to those who have suffered family loss;

            4.  To assess the capacity of churches, community groups, NGO's (i.e. non-governmental
organisations), families to provide support (in both Rarotonga and Manihiki);

            5.  To identify appropriate skilled individuals within local groups and provide them with training
and advice to enable ongoing support;

            6.  To establish a basic monitoring system to identify the symptoms of trauma which may surface
over the coming months;

            7.  To outline other training/monitoring requirements.

There was just sufficient time before departure to obtain the names of key personnel in Rarotonga with whom to liaise, and then to seek library references, select clinical questionnaires and rating scales, and to sort relevant teaching material before packing a versatile personal kit suitable for the rudimentary living conditions to be expected. The benefit of studying the cultural, political, and social history of the territory, and of scanning journals for previous research reports of cyclone activity, had to be deferred until later.

The Plan

Preliminary consideration was given to the operational definitions of health and of culture that might be appropriate for the circumstances, because they establish the subjective principles by which people a) order their lives and relationships, b) meet their community obligations, c) maximise their mutual satisfactions and well-being (Waxler-Morrison, Anderson, & Richardson, 1990; Culbertson, 1997), and d) offer the prospect of inducing positive physiological changes that facilitate recovery from illness (Benson & Stark, 1996).

At the outset the concept of mental health espoused by the ethnically related New Zealand Maori was thought suitable to apply to the Cook Islanders, because it includes mental, physical, socio/cultural, and spiritual components (Durie, 1985). The concept was also consistent with the four-fold concept of general health promoted by the World Health Organisation (1986), and in conjunction with Maslow's (1987) model for universal human development, it offered a plausible base for considering the shattering psychological impact of any catastrophe. The concept was also congruent with the conventional categories of symptomatic stress reactions (DSM IV, 1994: ICD WHO, 1997) in which room was left for cultural variations (Lewis-Fernandez & Kleinman, 1995).

The cross-cultural assignment also high-lighted the need for a reconsideration of the concept of culture - defined by the anthropologist Firth (1980) from his earlier fieldwork in the Cook Islands as 'a symbolic system - a frame of ideas and emotional attitudes for representing and coping with the world'. In short, culture describes the interconnections between objects, actions, and meanings for any given group of people, no matter how sophisticated or otherwise might seem the society to which they belong. In the words of Culbertson (1997, p.11), the concept of culture can be regarded as:
 

Thus a strategy had to be contemplated for the delivery of service that would give due recognition to the indigenous welfare personnel and to the established social service system that operated within their country. If it were satisfactory, the combination would a) have well-established community links, b) permeate language and cultural barriers, c) be accessible to give support for a longer time than could that of any visiting consultant, and d) build on that required for the solution of the typical kind of chronic family conflicts and entanglements and circumstantial adversity, to that for the recovery from acute post-disaster injury and trauma.

Consequently my preconceived plan was:
 

Because disasters of all kinds, whether natural, technological, or human (Taylor, 1989) provoke the desire for a simple explanation of their occurrence, attention had also to be paid to any local beliefs that might have been adopted to account for catastrophe. Such explanations inevitably reflect the prevailing educational, experiential, and intellectual climate, and they are usually either religious or scientific, or a mixture of both. Religiously, whether predominently Buddhist, Christian, Confuscian, Hindu, Jewish, Moslem, or Pantheistic, the hope is that such an explanation in terms of cause and effect under human control might lead to remedial action for restoring a state of righteousness (Private communication, Dr James Veitch, Department of Religious Studies, Victoria Unversity, February 2 1998).

Scientifically, the search for causation of catastrophe is also to prevent or to mitigate any repetition. It uses rational and objective methods of inquiry, near-replication and computer-simulation techniques where possible, and complex data-analysis of reliable records where available. The search enters the relevant biological, natural, social, and technological fields as necessary, and the findings are published for wider scrutiny and executive consideration. The aim ultimately is to persuade funding bodies to put appropriate procedures, regulations, and systems into place to prevent a recurrence, and to re-design equipment, refine techniques, and install mechanisms to give early warning of danger.

Conceivably, where for some reason the methods of science either are not or cannot be followed, or they provide inconclusive results, there might still be recourse to alternative religious explanations - if only for the sake of preserving group cohesion at a time of great uncertainty.

As far as the Cook Islanders are concerned, they have long been prone to suffer the effect of tropical cyclones, although little is known of the original ethnic and pagan explanations for their occurrence. Later when they were converted, they were taught by missionaries to regard such calamities as Divine punishment for their personal and collective transgressions. In 1835 the Reverend John Williams wrote that their 'sanguinary modes of punishment were (not) in accordance with the merciful spirit of the religion they now professed', and he advised the application of Christian principles to social life as a substitute for the 'ferocity and revenge by which all classes were previously influenced' (Gilson, 1980, p.28). Thus instead of punishing others for transgressions, the Cook Islanders were encouraged to leave the punishment to God and to consider their own wickedness.

The lesson was well taken and retained over the years since then, as in fundamentalist churches everywhere in the world. Self-blame was pronounced at the 1979 South Pacific regional conference on disaster preparedness (South Pacific Bureau for Economic Cooperation, 1979), despite the consideration since the 1950's by scientists and some politicial leaders in the Pacific region of forces other than the immoral to explain major global climatic warming and associated sea level changes (Brook, Basher, Bruce, Parsons, & Sullivan, 1991, p 2).

In the present decade all of the Pacific Island Governments have begun to accept the findings of scientists that cyclones are atmospheric, climatic, and oceanographic events whose intensity varies with the five-year cycles of the El Nino - Southern Oscillation and the phenomenon of global warming (Basher, Collen, Fitzharris, Hay, Mullan, & Sallinger,1992; Goodwin, 1997). They have also begun to work with the United Nations Disaster Relief Office on regional hazard reviews, five-year planning of external technical assistance, summarizing existing schemes, setting priorities, and improving management capacity and infrastructures (UNDRO, 1990). Most recently they have joined countries in the Carribean and the Indian Ocean to form the Association of Small Island States (AOSIS) to voice their concerns about the slow progress of the developed nations in the prevention and mitigation of the disastrous effects of climate change (Private communication, Dr.Tom Clarkson, National Institute of Water and Atmospheric Research, Wellington, January 6 1998).
 

The Plan and Implementation

With much of the foregoing in mind, the first two days in the region were spent in the capital Rarotonga with key politicians, administrators, hospital and welfare personnel, and a few of the Manihikians who had either been evacuated from their island, or who had chosen to take temporary respite from the sorrows and rigors of the devastation there. Coincidentally the politicians happened to have worked in various capacities in 1979 in Auckland in connection with the identification of victims of the DC 10 crash on Mt Erebus who were brought to the mortuary there (Taylor & Fraser, 1981), and they well understood my stress/trauma role and function. One administrator raised the question about the evacuation of the entire island population, and was interested to learn that, other things being equal, recovery was better for those who were able to work through their anxiety and grief with the group involved in the event, than for those who were dispersed (Milne, 1979).

The few patients from Manihiki still in hospital were on the road to recovery, and they were keen to be reunited with their families on the island again - as were those who had sought temporary refuge in the Manihiki hostel in Rarotonga. The hostel was clearly a restful haven in the capital for its far-away island people, and it offered a focal point of contact for friends living nearby. It also gave the evacuees a sense of ownership and belonging when both feelings were in jeopardy from the cyclone, and it provided the casualties on discharge from hospital with a welcome place for recuperation.

An initial meeting with six welfare workers from four Government approved religious organisations and voluntary social services developed into a two-session disaster orientation seminar. As expected, the workers had made contact already with the Manihikians who were in the capital, and from this recent experience they expressed a desire to adapt their rudimentary counselling skills from those already acquired for longer term family work to that required for brief supportive intervention after disasters. They wanted help in phrasing questions so as not to offend, in supporting those dealing with survivor guilt because others (especially the younger and more devout) had died, in helping resisters to unlock and appraise their hurtful memories, in meeting the specific needs of different age-groups and different victim groups, in brushing-up on the conventional range of psychological symptomatology, in separating prior dysfunctional reactions from those of the recent disaster and from the pains of recovery, in coping with their own reactions to widespread grief, and in discussing the prevention of their own helper-fatigue and stress.

Subsequently the topics were addressed in seminar fashion, with handouts to mark the major points. Then to induce a more immediate sense of reality, a video tape of complete interviews which Rarotonga TV had made with a few evacuees (only snatches of which had appeared in the media time-slots), was used to demonstrate the value of extracting the full story from survivors and of encouraging them to put their own construction on events. Luckily in this instance, the technique adopted by the tv interviewer was not constrained by the need to produce byte-size bits of information for media purposes.

On Manihiki Itself

The leading members of the two communities of Tukoa and Tuahunu, were most welcoming, and they made sure that translators were on hand to help me explain myself in simple terms to the initial village gatherings. There I had briefly to answer questions covering my personal life, beliefs, background, and disaster experience before getting the clearance to proceed with my task.

The subsequent response was far better than I had expected, with upwards of 30 villagers making direct contact of a personal kind over the next few days, and many more making known their attitudes, thoughts, and feelings in general conversation when walking along bush tracks, eating meals together, or crossing the lagoon in boats from one village to the other. During our meetings none showed signs of despair and decompensation, several displayed the familiar post-disaster signs of grief, anxiety, and anger, and there was the occasional mention of difficulty in sleeping at night through the continuing storms. In short, those remaining on the island appear to have worked satisfactorily through the initial stage of shock which earlier observers had reported, although they were still somewhat unsettled by their ordeal.

I had little need to be concerned about the reluctance of people to talk to an outsider, because the culture proved to be oral rather than written, and close interpersonal contact was a feature of their everyday lives. They were also fluent enough in English, many having been to New Zealand for secondary education, and they spoke from personal experience rather than book knowledge. They also used dreams, indulged in premonitions, and embellished their stories with tales and legends from the past. In these circumstances, it was not surprising to hear that immediately after the cyclone one village had extended five of its daily community meetings specifically to allow more time for the villagers to share their personal perceptions of the cyclone.

In assessing the situation, my aim was not to extract and document in detail the many harrowing accounts of rescue, endurance, survival, and grief against incredible odds. The recording of those individual stories, awesome, inspirational, simple in expression, rich in variety, and independent in confirmation, is left for others. Rather, following the seminar precepts, my focus was on helping the survivors clear any emotional seizures and blockages of memory they might have, and to be alert for symptoms of psycho-pathology that might require further attention. Following van der Kolk (1994), my assumption was that a shift of stored sensations from non-declarative to declarative memory would facilitate the mastery of traumatic experience, and bring them into a working schemata for everyday life.

In a couple of instances, the power of the 'memory-evocation' technique for trauma reduction was enhanced when walking with villagers through the rubble and litter of their settlement. There, in immediate virtual reality, instead of long afterwards in recall in a consulting-room as is most often the case, they retraced the journey which they had taken frantically to 'higher' ground - i.e. all of four metres above sea-level. En route they re-entered shaky structures that produced memories of people, organisations, possessions, and events, many of which brought tears. But sometimes the reconstruction of events brought gales of laughter - such as that of swimming in a turbulence of polluted sea-water alongside animals near the piggery. Along the way they opened factors behind their selection of paths made to safety while trying to avoid falling trees, jagged metal, and flying shards of glass, and they were thankful that the cyclone had come in daylight, else there would have been more casualties. They expressed regret for not having been able to persuade more of their bewildered community to tag along with them, and they criticised those who had chosen to ignore hurried warnings about the imminence of the cyclone. They did not think highly of those who behaved irresponsibly, either by taking to drink at the critical time or by looting the unprotected households and shops..

The more responsible had risen to the occasion. Some had made quick house-calls during the brief preparatory phase of the cyclone. Others had provisioned boats and launched them on headropes to lie down-wind until needed, and made several journeys to shepherd the elderly and the children to safety - in one case a man carried a frail and elderly woman aloft through bush for about 2 kilometres, and was still not satisfied that he had done enough to help. Whether afloat or ashore the more resilient shared their space, shelter, food, and personal concerns. When the tumult passed, and before outside help could arrive, they had organised searches on land, lagoon, and reef to rescue the living, to recover the dead, to treat the injured, to worry about the missing, and to clear the fallen trees from tracks. Only then did they begin to consider the enormity of their plight, and to contemplate the effect of their uninsurable property losses from le force majeure. But their time for reflection was limited, because the new cyclone season had only just begun and they had to contend with the possibility of a repetition when the wind howled and the surf crashed on the diminishing coral chip barrier of beach that previously had offered their villages some protection.

A few of the respondents struck discordant notes that were typical of those levelled at every official organisations after any disaster - for example, about having insufficient radio warnings of the path of the cyclone, for being slow to raise the alarm, slow to effect air searches, and for searching according to a predetermined plan instead of one to meet the fresh circumstances. Others were critical of the local clergy and others in positions of authority in Rarotonga who publicly attributed the cyclone to Divine intervention for the transgressions of the community (individually and collectively), to the over-utilisation of pearl farming, failure to attend church, and working on Sundays. But although they did not refute the arguments openly for fear of causing social disruption, between themselves they declared that a) because the changing weather pattern was world-wide it was not a matter for which Cook Islanders could be held responsible, b) the politicians had changed their stance, because previously they had praised the same local pearl-farming industry for its contribution to the national economy, c) church attendance should not be obligatory and enforced by fear of disasters, and d) among those who worked on Sundays there might have been Seventh Day Adventists who worshipped on Saturdays and could not therefore be said to deserve the punishment.

The more compliant and less articulate did not question the face-validity of the punishment placed on them, although they knew that among those primary victims were the devout and honourable (including a clergyman), and some very young children. They also did not question the possible justification of the punishment on them as the sacrifice they should make for the misdemeanours of others. As grieving relatives and close friends they had recourse only to the teachings of the punitive God of the Old Testament, rather than to the loving God of the New. They accepted the moral attribution levelled by the preachers daily on them, and at a time when they were grieving and struggling to regain enough courage to continue with life, they began to scrutinise their behaviour for sinfulness.

To an outsider like me, psychologically, and perhaps spiritually, the obligation imposed on believers to discover and make explicit their presumed responsibility for unspecified immoral behaviour, could not but have eroded their self-esteem, impeded their recovery, and exemplified the maladaptive method of coping with trauma (Holahan, Moos, & Schaefer, 1996). But despite my misgivings, it has to be admitted that a superficial semblance of normality returned to the community within the space of a few days. The survivors had strengthened temporary shelters, made safe water supplies, established rosters for daily chores, and contained roaming pigs. Humour became manifest, children were given freedom to play, toys were recovered and repaired, and vegetation began to sprout. Families began to filter back to any shelter they could erect near their home plots (with valuable Red Cross emergency family-pack victuals in hand), and teen-agers were allotted space out of ear-shot to enjoy their salvaged sound equipment. Leaders held open discussions about the viability of re-establishing two villages as against just one, and about the position, structure, and function of the new hurricane shelter/community halls which outside agencies were rumoured to have promised. Everyone awaited the arrival of outside authorities with proposals for the re-siting, rebuilding, and financing of recovery programmes, of technicians to report on the state of the pearl-seeding industry, and of news about the desire of evacuees to stay away or return.

In short, some 19 days after the cyclone, the pace of life had picked up, and the community was gradually moving from the reactive mode into that of the recovery. There was a certain closure of the experience with a memorial service by the side of the lagoon, and a decision made to commemorate the day of the cyclone each year.
 

Return to Rarotonga

Further discussions were held with the counselling group on return to Rarotonga concerning our respective activities since we met six days before. None had encountered serious problems in their work with evacuees from Manihikiin the interim, and a few had initiated welfare and recreation plans for them in the capital. Clearly there was scope for developing a creative programme for parents on topics relating to infant, child, and family health, cooking, craft-work, mechanical repairs, house maintenance etc., as well as others specifically for children and for adolescents. Plans were made to check for any delayed psychological reactions to the cyclone, and for extending the coverage to the Manihikians who might already have joined their families in New Zealand.
 

Overview

 Altogether the intense and brief experience left me a humbler and wiser, if sadder person. Humbler, because of the many interlocking tales I heard at first hand of extreme altruism, compassion, endurance, and selflessness of the survivors. Wiser, because I saw evidence of the manifest strength of the local community groups in attending to the essential routines of seeking and rescuing their members after the catastrophe long before outside assistance could reach them. Sadder, because the unmodified punitive Old Testament theology denied the beleagured community access to that of the more supportive New Testament, and was in conflict with a) the interactive concept of health, and b) the accumulated body of knowledge relating to forces in the natural world.

The dose of humility was inspirational, the wisdom helped to confirm the findings of earlier disaster response studies (and confirmed the applicability of Masow's theory of hierarchical human motivation), and the sadness led not to the denigration of religion, but to a consideration of what might be done through religious organisations to persuade them a) to put more emphasis on healing and forgiveness rather than fear and punishment, and b) to disseminate the findings of the climate change scientists through the educational system. In this way there might be a chance for the phrase 'Acts of God' to be retained as an anachronism for actuaries alone to use when accounting for uninsurable property loss, instead of remaining a vestigial justification for the imposition of blame on survivors of catastrophe at a time when they need an uplift of spirit.

But such criticism apart, the preliminary cross-cultural considerations, and the involvement of indigenous helpers, showed that conventional talking-out techniques of trauma reduction could usefully be applied to people in countries other than those in which they originated.

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