Report on Observation of Korean Ferry Disaster Support Facilities

Report on Observation of Korean Ferry Disaster
Support Facilities
Doctor – Naru Fukuchi

Introduction
On April 16, 2014, while on its way from Incheon Port to Jeju Island, Sewol—a large passenger ship—
capsized and sank off the southwestern coast of Korea. Because this disaster was widely reported in Japan aswell, it is quite well-known to the Japanese public. Two hundred and ninety-nine of the passengers and crewmen aboard perished in the accident; five people remain unaccounted for; and eight individuals involved in therescue efforts also died. The Sewol Ferry disaster had one of the highest death tolls of any marine accident inKorea’s history. In particular, many 11th graders from Danwon High School were on board, as they were on aschool trip. Two hundred and ninety-five of them died, and nine are still missing. Indeed, more individuals
perished in the accident than survived. This incident was caused by overloading, illegal hull modifications, anda delay in official aid due to politics. It was primarily covered as a “manmade” disaster. It devolved into a largesocial controversy involving the media as well, eventually forcing the President of Korea to resign.
Following this disaster, Korean interest in support initiatives for trauma-affected persons spiked, and quite
a few organizations and facilities whose goal was to support the many people affected by this disaster wereestablished. In 2015, the Korean Society for Traumatic Stress Studies (KSTSS,
http://www.kstss.or.kr/give/001.htm) was inaugurated, and with it, a system for providing psychiatric support
and practicing academic research also came into being. In FY 2016, a specialist from the KSTSS visited theMiyagi Disaster Mental Health Care Center to observe our work, and the following year, I was invited to Korea
to do the same. In this manuscript, I will report on three of the locations I visited: the Ansan Mental HealthTrauma Center, a group memorial altar for the bereaved families, and a commemorative classroom for thevictims. Finally, I would like to offer a bit of discussion on the nature of the loss to a community.
1. Ansan Mental Health Trauma Center
Immediately after the disaster, a government order mandated the creation of disaster psychology support
teams in the Ansan region of Korea, and their parent organization, the Ansan Mental Health Trauma Center,
was founded on May 1, 2014. The center’s missions are to ① provide services that will help survivors and thebereaved recover from their trauma ② use the support experience gained from this incident to construct a
disaster mental health support system, ③ deepen knowledge of trauma care and disaster psychological support,
and ④ strengthen community bonds and aim for harmony between the affected individuals and society itself.
At the time of my visit, the center had 34 staff in all: 4 psychiatrists, 10 psychiatric social workers, 1 mental
health counselor, 9 mental health nurses, 9 social workers, and 4 office staff. It had been created with interprofessional collaboration in mind. Between the year of the center’s founding and March 2017, the majority of thecenter’s visitors – 85% were the bereaved family members of the casualties of the disaster; this was followedby survivors, who accounted for 10%. Thus, the primary function of this center has been to treat feelings ofloss in the bereaved, and trauma among survivors.
The majority of residents did not seek the support of their own accord; not immediately after the event
occurred, and not even after the center was founded. However, the construction of the center itself accounts forthis reluctance. To make it easier for survivors and the families of victims to use, there is no grand sign in frontof a massive building, broadcasting the location of the center to the entire world. The center quietly and unassumingly functions out of a smallish room in an office building. It is tucked away amidst barbeque restaurants
and massage parlors. In fact, from the outside, one would be hard-pressed to guess that this building had anything to do with mental health. Furthermore, while its official name is indeed the “Mental Health and－129－Report on Observation of Korean Ferry Disaster Support Facilities

Trauma Center,” it is also known as the “Onmaun Center,” (Sincere Heart Center), and it is by this latter namethat it is known by among the people of the area.
The center also endeavored to provide survivors and the bereaved with places and spaces for them to easily
gather and meet. As a productive space, they have made provisions for activities like art therapy using paintings,
clay, pressed flowers, etc., and created pin batches and key chains for educational activities. For activities
centering the body, gatherings for traditional performing arts such as meditation, yoga, and taiko were planned.
A room with a kitchen stands in the center, and volunteer staff provide meals and participate in the activities.
In such a warm environment, people connected and supported each other (Picture 1). Besides, staff frequently
visited the community, sold artworks created by bereaved families at bazaars, and focused on activities thatenlighten the general public, like flash mobs made up of the surviving high school students. I felt very deeplythat the center’s greatest concern was ensuring that the survivors were not isolated from the rest of the community.
There is a small subset of people for whom activities of the aforementioned sort will not be enough to achieve
recovery. The center also provides trauma-focused medical care and therapy for such individuals. In addition
to general psychiatric and psychopharmacological treatment, both provided by psychiatrists, the center is home
to specialists capable of providing EMDR, Biofeedback, PE cognitive behavioral therapy, Accept and Commitment Therapy(ACT). For families, they have also provided group programs that encourage trauma recovery,
psychological education to prevent secondary trauma, and post-traumatic growth (PTG) workshops. Further,
multidisciplinary teams are formed, and individual meetings with counselors, connections to local resources
via social workers, and phone/home visit support are all provided.

Picture 1: Onmaun Center Cafeteria

2. Group Memorial Altar
The group memorial altar for bereaved families was about 10 minutes by car from the Onmaun Center. We
arrived at a large parking lot-type area, consisting of one large building that looked like a gymnasium and several
small prefabricated trailers parked neatly in rows. The rows I saw there reminded me very much of temporary
housing units back home. Inside the large building, pictures of all of the high-school students who had lost theirlives in the disaster had been placed on the altar, with flowers strewn around them. Visitors wrote their names
in a registry, received a wreath of flowers, offered it at the altar, and prayed for the solace of the spirits of thedeparted. While many Korean people follow the Christian faith, my experience of this ritual left me with theenduring feeling that something quite similar to Japanese culture flowed through it. As I looked at the altar
positively bedecked with flowers, I realized that even though three years had passed since this disaster hadoccurred, so many people still visited this memorial. At the center of the gymnasium, a large model of a ship
meant to evoke the Sewol-ho had been placed, held aloft by two hands (Picture 2).
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In the large plaza outside the school, 10 prefabricated containers had been built. Ten buildings for each of
the 10 Danwon High School 11th graders who had perished in the disaster (Picture 3). This area was meant tobe a space for the families of the victims to gather and participate in activities together. During my visit, several
families had gathered in this area to work, on leathercrafts, completely absorbed by the work. In a separatebuilding, away from the trailer, a woodworking shop had been set up, and the men (fathers) were making tools,etc. A priest was also stationed inside the very same building, and a church had been set up for those who
wished to pray. Two months before I visited, the sunken Sewol had been raised from the ocean, and I heardthat many families had flocked to watch the process, all to be as close to their children as they could. This wasthe reason so few families were participating in the activities that were being held in that space that day. Upon
hearing this story, I saw how strongly these Korean families believed that one should not shy away from orforget the pain and trauma one has endured.

Picture 2: Interior of the group memorial altar

Picture 3. The number of trailers reflects the number of Danwon
High School students who lost their lives in the disaster3. Memorial Classroom for the victims
Immediately after the incident, photos of the victims were placed on their desks at Danwon High School,
and their friends and acquaintances would leave offerings there when visiting them. Two hundred and ninetyfive of the 325 students that went on the school trip that day fell victim to the disaster. I can only imagine thesort of turmoil the school went through afterward. After some time, the constant visits by pilgrims began to getin the way of normal classes, and the bereaved families suggested vacating the classrooms of the victims as akind of memorial. Of course, this idea sparked a standoff between the families of the victims, the school, andthe government. Eventually, after much discussion, a decision was reached: a facsimile of the classroom would
be built in a separate area. That is how the Memorial Classroom came to be (Picture 4).
I visited this classroom alongside some others. The caretaker of this facility was the father of one of thevictims. He took my visit from abroad as a sign of honor and gladly allowed me to take pictures inside thefacility. Ten classrooms and one teacher’s room had been reproduced inside the facility (Picture 5). Each classroom had a blackboard, lockers, lectern, and desks exactly matching the number of children that once studied
there. On top of each desk sat the photo of the student that once sat there, and the rest of the desk surface wascovered in offerings left by visitors: candy, flowers, portraits, and messages. I noticed that some of the desks
did not have anything on them. I asked my companions why this was, and they told me that some of the victims’
families had refused to place photos of their late children in the classroom.
At the end of the corridor, 10 pictures were arranged, one of each class, all taken before they left on theirtrip. The walls of the corridor were filled with a painting of mourning done by an artist. Alongside the attitudeof mourning, some of the images strongly condemned the actions of the government and the crewmembers of
the Sewol, and I felt just how angry the people of Korea were over this disaster. Displaying commemorative
photos of the classes that perished or a strongly critical mural are perhaps not things we Japanese would do,but they spoke strongly of national identity and culture that believes that letting out one’s feelings is far better
than bottling them up inside.
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Picture 5. Memorial Classroom Interior

Picture 4. Memorial Classroom Exterior

Summary
The high-school students that survived the incident and the families of the victims did not seek out support
on their own. That is why the Ansan Mental Health Trauma Center provided proactive home visit counselingin addition to the usual psychiatric therapy you would find at any clinic. The efforts of these trauma center
employees to deliver mental health support to the environments in which the disaster-affected people lived
and worked were quite similar to our efforts. These individuals took great caution to ensure that disasteraffected people would not be cut off from their communities, and they provided a variety of places and ways
for disaster-affected individuals to meet, mingle, and stay connected. Men were unlikely to seek out support
on their own and were also unlikely to take part in gatherings. Thus, the center picked activities for the allmale get-togethers that could be of use to the community (cooking, fieldwork, woodworking, etc.). This issomething we have done in Japan. It may well be a fundamental biological instinct for communities to cometogether in times of peril, and we have seen this phenomenon occur in different cultures. On the other hand,the sorts of content that make it easy for individuals to gather or not vary considerably between cultures.
I felt differences in how and to what extent emotions were expressed here. We try to hide away painful
experiences and do not attempt to put them on display for others to see. However, in Korea, the surviving
high schoolers organized a flash mob, and the bereaved families put on a dramatization of the incident itself.
As I watched all this, I felt a twinge of pity along with a stark realization of the differences in our cultures.
At the “Memorial Classroom for the Victims,” work criticizing the government and the crew of the ship was
put on display, alongside artwork meant to express the sentiment of mourning. It was almost as if they realized that suppressing one’s anger is unnecessary, and expressing it is an individual’s right. Further, when
meeting a visitor from abroad, rather than being overconcerned about what they might think, their attitudes
indicated that they wanted me to learn as much as I could about the happenings that day, and they freely
shared a great deal of information with me. It is well known that avoiding trauma prevents one from recovering from it. While this habit of laying one’s emotions bare is not something we are used to, I believe there
is something here for us to learn.
My observation experience showed me that the people of Korea do not view this disaster as a personaltragedy, but rather a community one. Healing this wound is the entire community’s responsibility. I realizedthat to prevent people from becoming estranged from another, one of the most important issues we must
tackle is the construction of a framework that allows us to connect with and support one another. This attitudeunderlies the work we have done in the wake of the Great East Japan Earthquake, and by continuing to share
our struggles, we will be able to ensure much better mental health for all.
This manuscript is adapted from material published in Vol. 15, Issue 2 of Traumatic Stress, the journal ofthe Japanese Society for Traumatic Stress Studies. I would like to thank Vice President So Ra An, Dr. Donghee Cho, and Jinhee Hyun of Daegu University for all of the help they gave me in writing this.

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