Country: Myanmar Source: Médecins Sans Frontières Two months after the devastating earthquake, clean-up continues in Mandalay city. But beyond the rubble, mental health needs remain.Thirty-year-old tailor Ma Thiri* lost her home and livelihood in the 7.7-magnitude earthquake that hit Myanmar on March 28. Her memory of the day that changed everything remains vivid.“People were shouting and screaming in panic, telling everyone to run out onto the streets," she says. "While everyone was shouting, I turned and looked back. The flames were already engulfing my house. There was no way I could go back and grab anything.”Community groups and local volunteers have been crucial in helping people like Ma Thiri navigate these difficult moments. Doctors Without Borders/Médecins Sans Frontières (MSF) teams are supporting these efforts by providing mental health and psychosocial sessions and group recreational activities for children at several locations where people are sheltering across the city of Mandalay.Ma Thiri's neighborhood, built on the site of a landfill in Sein Pan, Mandalay city, was largely destroyed in a methane gas fire ignited by the earthquake. Now Ma Thiri is sheltering with her family on the grounds of a local monastery, facing uncertainty about where they will live next and whether she will be able to restart her small business. Despite her anxiety, she tries to stay resilient.“I am able to sleep, but when I feel deeply sad, I can't cry in front of my parents,” says Ma Thiri. “I'm the one they rely on to provide for them, so if I show my pain, I fear it will make things worse for them. That’s why I have to keep myself strong.”Mandalay city was badly affected by the disaster, and people are still working to clear the rubble, sorting salvaged materials into piles as construction workers toil through long shifts. Community groups have helped restore a sense of normalcy after the earthquake, organizing group donations and supplies in solidarity with those affected.But for Ma Thiri and many of the families made homeless in Mandalay city, there are new challenges to confront. Two months on, people are coming to terms with the initial shock of the disaster and those who lost their homes are now living in shelters at sites around the city. Some are grieving for family members and friends who did not survive. Many are anxious about the immediate future, and worry over housing, income, health care, and education. Meanwhile, frequent aftershocks are regular reminders of the disaster and prompt fears of new earthquakes.“I lost my home—the most important thing for a person, the belongings and property I’ve worked for,” says Ko Min Lwin*, a meat vendor and community volunteer who also lost his family home in the Sein Pan fire. “Everyone wants to live in their own home, their own space. Even though I am deeply saddened by what I've lost, I don't know how to express it in words.”Mental health and psychosocial supports was limited in Myanmar even before the earthquake.“Some people have now suffered three times—through conflict, displacement, and the earthquake,” says Ko Hein*, a mental health counselor. “And now, again, they must relocate. There is a lot of anxiety, but there is limited space to discuss these worries.”Living conditions impact children the mostAfter the earthquake, up to 350 families sheltered in tents at a camp in the village of Sinka, outside Mandalay city. While many have now returned to their own homes or to stay with relatives, around 30 to 40 families, including children and elderly people, are still living in difficult conditions next to the village football field, an area prone to flooding.“My wife tried to reach our 7-year-old daughter during the shaking, but the tremors were so intense that she couldn’t get to her,” says Ko Toe Myint*, a community member. “Being alone during the quake frightened her deeply. Since then, she doesn’t want me out of her sight. She insists on sleeping between us at night.”For those now living with their families in camps, regular routines have been disrupted and once-familiar spaces, including many homes, have disappeared. In such living conditions, it can be difficult for families to maintain a sense of stability, which is vital for the mental well-being of children.MSF’s group recreational activities for children living in temporary shelters are intended to help provide a space for fun and friendship, where they can enjoy moments of normality together.“Children are one of the groups most influenced by their environment,” explains MSF mental health activity manager Kyoko Araki. “They cannot choose where they live and where they grow up. It’s particularly important to create spaces and moments for them to enjoy life. It’s very therapeutic to be able to keep doing what they were doing before the disaster.”Creating a space to process feelingsElsewhere, many families whose homes were damaged or destroyed are being accommodated in temporary shelters around the city, including on football fields and school grounds. At MSF group sessions, they can share self-care advice with one another and discuss the challenges of post-earthquake life. Although school classes are due to resume soon, most participants are unsure where their families will be staying in two weeks’ time. The group sessions provide a space for decompression and mutual support.“We cannot change their living situation, unfortunately,” says Araki. “But psychologically speaking, these sessions provide an opportunity for people to discuss a topic that isn’t often spoken about publicly. It’s also important to take this time to process.”“Going forward, how people are treated after disasters like these can make a big difference for their future well-being,” Araki explains. “So psychosocial support can make a difference, especially the longer you commit to a community. This project is in an initial phase, but we hope to develop more activities depending on the needs of the communities.”For Ma Thiri, the response of the community and local organizations to the needs of her family and neighbors has been a source of reassurance. She hopes she and her family can quickly restore a degree of stability in their lives. “When community groups and organizations started showing up and providing support, I slowly began to regain some hope. The next step is to think ahead.”*Names changed