In March last year floods ravaged Charun Oveer, a remote village in Chitral district. All the turbines — the only source of electricity for the village – were destroyed.

A magnitude 7.5 earthquake hit the same region seven months later, turning many houses in the village into rubble.

The lights started to flicker again nine months ago. But these were not the turbines running again; these were laptops and satellite internet being powered by solar panels.

The hi-tech gear is part of an initiative in tele-psychiatry, providing mental health relief from a distance to a community recovering from a natural disaster in a far-flung area.

The organisation behind the project is Karachi Relief Trust (KRT), a disaster management agency founded in 2005 which works in different parts of the country.

Two weeks after the earthquake, the KRT sent a team of three professionals to Oveer to assess the needs of the affected populace. The earthquake had destroyed farms and buildings in the village. Its population of 1,600 lived in 140 houses, 89 of which were no longer there and at least 20 damaged.

But none of this had resulted in anyone losing their life. Oveer was facing a different problem altogether: psychological.

“We followed up every 12 hours to assess the situation and it became clear that fear ruled the minds of women and children,” explains Khayam Husain, the head of the KRT.

The villagers needed help in coping with the lingering aftershock. “People in the village had developed post-traumatic stress disorder, as well as symptoms of sleep loss, nightmares, flashbacks, loss of appetite, withdrawal,” said Dr Nuzhat Farooqui, a urologist at the Aga Khan University (AKU) and volunteer with the KRT.

Different groups chipped in with their resources for the project. Satellite internet was obtained from Supernet at reduced rates and solar panels were brought from Buni, a small town in Chitral district.

The Pakistan Association of Mental Health (PAMH), the AKU’s psychiatry department and Mashal, the Aman Foundation’s mental health programme, helped with programme development and execution. All the funding came from the KRT.

Tele-psychiatry facilities were already available in Pakistan, Taha Sabri points out, but this was the first time that a programme featured local mental health workers (MHWs) in disaster relief. Taha heads the mental health awareness initiative Taskeen, a project of the PAMH, and was tasked with putting together the mental health response team.

Sixty men and 100 women attended the sessions. “That’s ten per cent of the population,” Taha noted.

Almas Tariq, a teacher who specialises in remedial therapy, conducted trauma relieving exercises such as breathing exercises. Art and music therapy sessions were held for children devastated by the disasters.

But the goal was more than mere intervention. “The long-term goal,” Taha explained, “was to train suitable community members who could identify common mental health problems.”

With this aim in mind, 18 villagers were trained as community MHWs. Over a period of three days, the workers were given intensive training in mental illness and its symptoms. They were introduced to tools of counselling like taking a patient’s history and how to conduct trauma therapy.

By the end of November, the local MHWs had managed to screen 500 people. Of them, 57 were found to have functional impairments like PTSD or depression.

They were shortlisted for tele-psychiatry sessions held in December. A psychiatrist in Karachi would speak to his patients in Oveer village over Skype at least once a week.

TREK TO BUNI: Oveer lies at an altitude of 5,000 feet. During the winter, temperatures fall to minus two degrees centigrade, and the road up is tricky.

The difficulty in transporting supplies becomes a headache for doctors and patients when blood tests are needed.

Villagers have to make an arduous journey to Buni, a small town three hours away on foot where the Aga Khan Centre has a health unit, for blood tests.

But the villagers did get used to making the trek to Buni regularly as the KRT project is a 10-month-long initiative. It will end next month.

For follow-up, patients will have to visit the Aga Khan Center as it has tele-psychiatry facilities.

When the project began, Dr Nuzhat feared pushback from the community. “I thought that if we talk about mental health problems, people would say, ‘Hum pagal nahi hain! [We are not crazy].”

But she remembers meeting a mother who was worried her child was mentally disturbed after the disaster. Dr Nuzhat got the child assessed by a therapist and assured her there was nothing to worry about.

Dr Nuzhat attributes the villagers’ receptiveness and participation to Oveer’s high literacy rates. Women are more educated than men and many run NGOs on health, education and welfare.

“It’s an unusual place,” Khaayam observes. “The majority of the residents are Ismailis, but they live in harmony with other sects. There is a lot to learn from them about tolerance.”

Published in Dawn, July 15th, 2016