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The Multilayered Effects and Support Received by Victims of the Bali Bombings

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The Multilayered Effects and Support Received by Victims of the Bali Bombings Centre for International Health The multilayered effects and support received by victims of the Bali bombings: A cross cultural study in Indonesia and Australia Gwendoline Patricia Brookes This thesis is presented for the Degree of Doctor of Philosophy of Curtin University of Technology November 2010 DECLARATION To the best of my knowledge and belief this thesis contains no material previously published by any other person except where due acknowledgement has been made. This thesis contains no material which has been accepted for the award of any other degree or diploma in any university. Signed: Gwen Brookes 10th November, 2010 i ACKNOWLEDGEMENTS This has been an epic journey that I could not have achieved without the help and support of so many people. Firstly to my family - in particular I want to mention my soul mate and husband Denis whose patience and encouragement knows no boundaries. Also to my son Jonathan for his technical support, great cups of tea and gentle sense of humour. To Caroline my daughter for her diligence and patience during the initial editing and for not moaning too much when she had to take out or put in so many commas. Also for the endless joy she and Oliver have given our family by the addition of the lovely Archie - our first grandchild. To Valerie Dulmage, my sister whose bravery and resilience during her health difficulties and subsequent recovery was monumental and helped me realise my periodic struggles with this study, in the big scheme of things, were quite small. Then there are my wonderful friends who have been in the background encouraging me all the way. In particular, I want to thank Marg Hocking for her sense of humour, endless patience and support, and particularly for being my friend. Also a big thank you to Tim Hocking for his expertise and to Chris and Roger who form the rest of “team Hocking” for their support and technical help. It is also important, despite her protests that she didn't do anything, I thank Hilary Ashman, who helped with editing, ever balanced viewpoint, spiritual support and encouragement. I would also like to acknowledge my other friends, especially Caroline Hontomin, and the women from my book club and psychologists group for understanding my absences on so many occasions. Also to the late Mary Crogan, a special friend and gifted psychologist, for being so supportive of this study despite her illness and for helping me remember the importance of true friendship. I would also like to thank the staff and management of YKIDS and YKIP in Bali who gave their support to the study. Shirlyana Putru from YKIDS was seconded from YKIDS to help with the study. I am very grateful to Shirlyana for her gentle enthusiasm, patience and cultural guidance. The assistance of Ketut Cakra is also ii deeply appreciated along with the women from BIWA especially Sita von Bemmelow and my friends Jane.H. Patten, Foen Nahas, Kim Patra, and Professor Partha Muliawan and Associate Professor Made Setiawan of Udayana University Bali. Thank you also to Amanda McIlroy and Jan Pearce from the Kingsley football club who gave much of their personal time, and lots of encouragement and support for the study from day one. Without their support this study would not have been possible. I would also like to recognise the contribution of Dr Pam O'Connor, friend and gifted psychologist, for giving me the impetus to commence this study in the first place. She did say I would thank her once it was complete, but maybe not during the process. Finally to my supervisors, Associate Professor Jaya Earnest, from Curtin University of Technology and Dr Julie Anne Pooley of Edith Cowan University in Western Australia. They both gave so much of their time, energy, advice and encouragement, particularly when my physical and intellectual energies were at a low ebb and most of all helped me believe I could complete this study. Their wisdom and support has been greatly appreciated. iii DEDICATION I dedicate this thesis to the 202 men and women from 21 countries who lost their lives in the 2002 Bali bombing, to the men and women I interviewed for this study and to the many volunteer and professional responders who came together in a quest to help. iv ABSTRACT Introduction In the past decade terrorist attacks and suicide bombings have killed, injured and intimidated thousands of people in many countries. In the aftermath of an attack a significant proportion of the population present with symptoms of depression, post traumatic stress disorder, and physical health problems (Boscarino & Adams, 2009, Norris et al., 2002, Bride, 2007 ). The present study examined the impact of the Bali bombings in 2002 when two bombs were deliberately exploded in the Sari night club and Paddy’s bar, in the popular tourist area of Kuta, in Bali, Indonesia. Aim of the study The overarching aim of the study were to examine the multilayered effects and forms of support received by directly affected victims and their indirectly affected family members in both Indonesia and Australia. The perceptions of members of the Indonesian and Australian emergency response teams, community volunteers and key informants were also examined. Methods A qualitative case study approach was used in this study, as it was important that participants told their story in their own words and according to their own unique experiences. In total 50 in-depth semi-structured interviews were conducted in Bali and Perth, with first and secondary level victims, professional and volunteer responders, and key informants. An in-depth analysis of available literature was also undertaken with a focus on the multilayered effects of terrorist attacks and the forms of post attack support that is offered to victims and their families. Other qualitative methods such as home visits, observations and documentary data collection facilitated triangulation of the data. In addition a personal reflective diary recorded the observations of the researcher during a two month field trip in Bali in early 2008. The conceptual framework for this study was based around the work of the Psychosocial Working Group (2003). Within this framework three dimensions relating to resources that help people cope in the aftermath of a disaster are explored. v They are: human capacity (encompassing the skills and knowledge of the people); social ecology (encompassing familial, religious and cultural resources) and finally culture and values (encompassing cultural values, beliefs and practices). The framework was modified in this study to enhance the examination of the participant responses using the concepts of disrupted and reinforced resources. Results In both Bali and Perth victims of all levels reported many symptoms of distress in the initial aftermath of the bombing. Most of the effects reported could be termed normal distress reactions to a very abnormal event. The poor economic situation in Bali appeared to compound and exacerbate the effects for many of the Balinese victims. As a result many of the injured and their families were left almost destitute. A number of victims described symptoms such as depression, suicidal ideations and fear during thunderstorms and the many cultural celebrations on the island. In Bali and Perth, first level victims described the importance of practical, economic, emotional and spiritual support from their families and the community. The narratives of mateship, families and communities responding to help are innumerable and are an invaluable and unique insight into this disaster. In addition, the study highlighted that many of the volunteer and professional responders also reported effects such as emotional numbing and derealisation. For most it was a temporary and understandable reaction to the difficult tasks they had to undertake. Recommendations for policy, practice and a modified framework are proposed that may be used by professionals and non-professionals in the aftermath of a terrorist attack, particularly when needing to choose appropriate and culturally relevant interventions, or by organisations who may be involved in strategically planning a response in the event of an attack. Conclusion Although the focus of this study was a terrorist attack, the recommendations and framework proposed in chapter 9 of this study can be generalised to other forms of natural and man-made disasters. They are intended for use by professionals, non- professionals and agencies who are involved in a response in the aftermath of vi complex emergencies. The recommendations are derived and drawn from the in- depth analysis of the participant interviews, and the literature. The Bali disaster showed the strength of human spirit, the resilience of victims at multiple levels and the willingness of people and countries to help each other in times of extreme distress. This framework is intended to promote a psychosocial response to any disaster situation based on the knowledge that communities have pre-existing inherent resources which can be utilised in a terrorist attack. vii TABLE OF CONTENTS DECLARATION ....................................................................................................................................... I ACKNOWLEDGEMENTS ........................................................................................................................ II DEDICATION ....................................................................................................................................... IV ABSTRACT ..........................................................................................................................................
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