Trauma hits quake victims

Hundreds of thousands are living in tent cities

By BBC South America correspondent Peter Greste

With El Salvador still mourning the thousand or more people who perished in the earthquake a month ago, Tuesday's earthquake came as an additional devastating blow.

More than 200 people have been killed and nearly 2,000 injured in this latest quake and the figures are expected to increase.

Loss of kin can be compounded by daily strife

The authorities are still trying to assess the cost of the first tremor both in human terms and material damage, and the last thing the country needed was another disaster.

By official estimates, January's quake damaged or destroyed more than a quarter of a million homes, forcing hundreds of thousands of people to take refuge in emergency camps.

And on Monday, 12 February, the federal government declared thousands more homes near the site of the most devastating landslide to be at least temporarily uninhabitable for fear of further land slips.

There is a risk that the internal psychological structure of those people can be lost

German Casas, Medecins Sans Frontieres

"It's true that this is another blow for El Salvador," said President Francisco Flores as he toured areas hardest hit by the latest disaster. "But I call for calm. We have to be calm."

Deepening scars

If the latest quake has caused significant new physical damage to the country, psychologists say it could well have an even more devastating psychological impact.

No more "home sweet home"

One expert working in the emergency shelters said while some people believe a country learns how to cope with disasters from previous experience, the reverse is true.

"Natural disasters tend to occur regularly here, and people are unable to recover fully from one before another comes along," said German Casas from the French agency, Medicins Sans Frontieres.

"Their resilience gets worn down and they tend to react far more dramatically to each successive crisis."

And El Salvador has had more than its fair share of crises, both natural and man-made.

Apart from the latest two earthquakes, the country suffered heavily in Hurricane Mitch two years ago; in flooding during successive years before that; in another devastating earthquake that killed 1,500 people in 1986; and during a bitter civil war that lasted through the 1980s.

At the funeral of the last person to be pulled alive from the so-called Santa Tecla landslide a month ago, the priest asked the question that must have been at the top of most El Salvadoran's minds.

"Why Lord? Our country has been through a war. Our country has had tropical storms and we've suffered an earlier earthquake. Now this. Why us? Why?"

Thousands have died, many more are missing

La Babilonia is typical. It's a tiny island village that was one of the closest points to the January earthquake's epicentre.

Here live subsistence farmers growing beans, papaya, bananas and melons. In a good year, its barely enough to survive.

The villagers abandoned their fields during the war when the fighting grew too intense. Then, Hurricane Mitch two years ago destroyed what they'd managed to rebuild.

Then bizarrely, last month's earthquake forced sea-water up through the ground, leaving the fields encrusted with salt and turning the crops as dry as paper.

It contaminated their fresh water supplies and tore away their tenuous grip on survival.

"We don't know where we're going to go, but we're going to have to get out of here and find somewhere else to live.

More than anything we're looking for something not as dangerous because every year we're suffering," one villager said.

Time 'no great healer'

Not only is the suffering unending, but psychiatrist German Casas has found that it seems to be compounded with each successive disaster.

"When we interview people, and children in particular, about this latest catastrophe, they recount scenes from other disasters that have happened in their past, such as Hurricane Mitch," he said.

"It clearly shows that their defences are being worn down and they're much closer to their limits now than they ever were in the past."

We simply don't have the resources, and it takes so much effort

Maria Martinez, survivor

The question now, is what this does for Salvadoran society.

It's survived so far, thanks in part to strong family and community bonds.

But those communities have been torn apart and reformed so often that the ties are now perilously weak. Mr Casas doubts people can cope on their own.

"A family needs a place of refuge every day - a safe place to cohabit. People get used to familiar things like a house, a tree or a neighbour.

But when a catastrophe happens all of that is lost. And there is a risk that the internal psychological structure of those people can also be lost with it."

They tend to react far more dramatically to each successive crisis

German Casas

Maria Martinez was one of those who lost almost everything.

Her home was one of those buried beneath the Santa Tecla landslide.

Fortunately nobody was there at the time, but the earth claimed all that they owned.

Amid the squalor of the plastic tent she and her family of two sons and daughters now call home, she explained her plight through a veil of tears:

President Flores: Called for calm

"I don't know how I'll cope. We've been forced to move and start again so many times, that I'm not sure we can do it all again. We simply don't have the resources, and it takes so much effort."

With no prospects for escape from the refugee camps, and no community support, families are already starting to collapse.

The authorities here are now desperately concerned that the next logical stage is only a tiny step away - domestic violence, delinquency, drug abuse and crime.

There's only so much punishment a single country can take.