In the aftermath of the terrible disasters that have struck our region this summer, what can we learn from the recovery of those affected by previous traumas?

Dr Lachlan Fraser, a Victorian GP who was hit hard by the 2009 bushfires, has recently written of his own journey of recovery.

Two years on from disaster, what have I learnt?

Dr Lachlan Fraser writes:

Even with preparation, nobody is ready for a disaster.  You operate on instinct and rational, drawing on personal reserves and resources around you.  I lost my home and clinic in Marysville, Victoria, in the Black Saturday bushfires of 7 February, 2009, saving myself and dogs and an empty car.

I suffered lacerated tendons in my hand in a futile attempt to save my home.  The warnings and evacuations were all too little and too late for most, with thirty-eight people dying in our vicinity.  Our tourist town was virtually destroyed, in what was one of Australia’s worst natural disasters.

The initial reaction was shock and near disbelief, having been so close to the destructive and uncontrollable forces of nature.  The body count of acquaintances, friends and patients mounted up over the coming weeks, and grief rapidly set in.  Tears rolled for the people and town that we had lost.  Over those weeks I attended funerals and memorial services for twenty-four of our residents.

There would be time in the months and years ahead to regret the personal treasures and life histories that were incinerated.  Only some burnt metal or ceramic pieces would survive, though these were precious when found sifting through the piles and piles of ash.

The practicalities of rebuilding one’s life involved finding accommodation, registering with Red Cross (as a survivor) and government services for grants, loading up on supplies at those wonderful relief and material aid centres, and checking the insurance policy.  Over the next year there were necessary jobs to get around to, such as replacing passport, house title, birth certificate and citizenship papers, and applying for the various grants from donated and government sources.

GPs interact with all sorts of age and social groups, dealing with their emotional problems, and are very well placed to lead in the recovery period. 

In the days and weeks after the fire, several other locals and I compiled a list of survivors, unaccounted and deceased to post on the internet.  Our contacts enabled such a list, and media reports of the dead were used.  With information updates and discussion forum, we helped a wide range of people, giving us something constructive to focus on.

We were locked out of our ruined town for six weeks as the forensic investigations into the deliberately lit fire occurred, but there were town meetings two kilometres out at the golf course.  People look to natural leaders, such as their GP, to be a reassuring voice, who can speak up for the community, and I began to assume such a role.  The media are also hungry for the story, and it is important to provide them with information that aids the recovery effort and rebuilding into the future.

In the first days and weeks there was a deluge of phone calls and emails from concerned family, friends, colleagues and many others.  Everyone was well-meaning and you wouldn’t want them to ignore your situation, though it is rather overwhelming.  The offers of help,  places to stay and visit, and material and financial aid were extremely generous, buoyed by the magnitude of what had been lost.

As a doctor, it was wonderful to have the community health centre re-established nearby over the next weeks, thanks to my secretary/nurse, the local Alexandra Hospital, Eastern Ranges GP Association and Rural Workforce Agency of Victoria, assisted by the state government and others.  Donated books, computers and equipment were welcome as we felt it was unlikely we would ever lose everything and thus didn’t have insurance for our contents.  Locums were subsidised for the next year, visiting for the next year from as far afield as Brighton.

Our clinic was fully computerised from 2005 but we lost many valuable hard copies of patient files.  Our back up memory stick and CD were held at one of the Marysville home of one secretary, but destroyed there as she and her husband barely escaped with their lives.  We were fortunate to later find an older version (2005-2007) with the secretary nearby at Alexandra, but have had to put a lot of work into rebuilding files from 2007/2008 and replacing pathology, x-ray and specialist reports and updating medication lists.  Storing the data outside your own town would appear the safest option, if not in cyberspace in the future.

Our clinic gratefully received the RACGP Victorian Practice of the Year 2009 to recognise those who drew it all together, and Rural Workforce Agency of Victoria honoured myself with the community contribution award in 2010.  The final challenge was being flooded out by storm run-off in the weeks before accreditation, and having to relocate to Alexandra for several weeks.  The new health and sports facility in Marysville should be complete towards the end of 2011.

My injuries healed in the first two months and I became heavily involved in the recovery efforts of Marysville and the Triangle region, including fire-affected Narbethong, Buxton and Taggerty.  The first year I lived in outer Melbourne before moving to the temporary village at Marysville, and subsequently to Alexandra.  The locum doctors were instrumental in allowing me to see patients when I could.

It was important that the local community had a voice in dealing with government agencies, and to that end representatives from the town’s progress associations, our Lions Club and golf club were appointed to the Marysville and Triangle Development Group (MATDG, affectionately known as MadDog).  Four months after the inferno, elections were held and I joined that body which was an effective advocate for the first year and a half.  There were heated discussions at our meetings and in the community  — ideally local politics are set aside for a clean start on what is a mammoth job ahead.

The local shire government is too far removed for the sense of community and interaction that is needed immediately post-disaster.  The shire and state government did set up a Community Recovery Committee in each fire-affected region or town, with the Marysville one established after MATDG, causing some division and a dilution of precious energy and human resources.  People drop out of the recovery scene over the months, having been to many meetings, and it really is up to the government to foster community spirit and interaction for the long term.

There are many ideas and offers of help, not all of which can be acted upon or taken up.  Some people are too old or frail to rebuild, others have to move away for children’s schooling and for work, and others are better living nearby in established centres.  For those with the pioneering spirit the challenge of rebuilding a home, business and town has its rewards and heartaches.  Some outsiders are attracted to these opportunities, with their initiative welcomed.

Everyone had a fire story, some miraculous and some less so but equally important.  As a GP it is important for patients to tell these stories, as well as the traumas of insurance (or the lack of), lack of facilities, accommodation and jobs, and problems with rebuilding one’s home and/or business.  Inevitably people will follow different courses emotionally, depending on their personal strengths and weaknesses.  For some there is depression, anxiety, relationship breakdown, violence, and alcohol and drug abuse.  For others there are wonderfully positive experiences, such as a sense of community, making new friends and learning new skills, such as my drumming with the newly formed steel drum band “Pans On Fire”.

I attended workshops provided by the Australian Psychological Society on “Skills For Psychological Recovery”, to train psychologists and other counsellors who were busy in these regions assisting after the disaster.  These skills were fine-tuned after Hurricane Katrina in New Orleans, and were being established for the first time in Australia.  One important lesson is that there are ups and downs for everyone in the time ahead, triggered sometimes by anniversaries and reminders of the fires.  The disastrous floods in Queensland and Victoria have churned up such memories for us, as our hearts go out to those people.

Personally I had an incredible year after the fires, becoming a leader in my community and well known to the media.  As a long distance runner I was able to maintain my running as a stress release, and use my experience to establish the inaugural Marysville Marathon Festival in November 2009.  We attracted nearly 3000 entrants across all the distances, and this is set to be an annual date on the calendar.

From the organising committee I met my future wife, and we are now expecting a baby daughter later this year.  There were so many positive gatherings and experiences through 2009, from the help offered, to meeting the PM, our Governor and Premier, mining magnate Andrew Forrest, the family of Lindsay Fox, the Dalai Lama and having a mini-concert by Simon & Garfunkel after meeting Greg Norman and other celebrities.

Involvement with major disaster would hopefully not occur many times in one’s lifetime.  It is a unique opportunity to learn, to grow and to show leadership.  Make the time to get involved in the grief process, share your thoughts with others and join in the recovery planning.   Do take holidays away and opportunities for recreation, and accept that counselling is helpful for many people, though all may not necessarily need it.

The road to recovery is one of years, with ups and downs along the way.  Pitfalls may be encountered if you take shortcuts or stall along the way.  I wish a safe and prosperous journey for all.

• This article was first published by the RACGP; it is re-published here with the permission of Dr Lachlan Fraser and the RACGP.