By Ron Bhola BBC News, Grenada It is five months since Hurricane Ivan hit the Caribbean island of Grenada, killing nearly 40 people and causing much destruction, but the island is still in bad shape. Only one building in 10 survived Ivan unscathed and even some of the buildings' designated hurricane shelters were severely damaged. The day after the hurricane, like most Grenadians, the largely voluntary officers of the National Emergency Relief Organisation (Nero) were left in a state of shock. It is an unfortunate coincidence that the name of the Roman emperor accused of fiddling while Imperial Rome burned is also the acronym for Grenada's disaster preparedness agency. Indeed, many Grenadians angry at what they saw as a complete failure to manage the relief effort following Hurricane Ivan dubbed the agency "Zero" rather than Nero. Doctors overwhelmed The island's extensive public health system collapsed and many of the serious cuts and bruises could only be treated at the main hospital in the capital, St George's. The island-wide disruption to electricity and water services also had unforeseen medical effects, which left the doctors overwhelmed. "People had no medication because their homes were destroyed, diabetics had no insulin because it had to be refrigerated, we had a lot of gastro-intestinal diseases and we had a higher incidence of strokes and heart attacks," says Dr Dolland Noel, a senior registrar in medicine at the General Hospital. One-third of Grenada's population of 90,000 people lives in and around the historic port of St George's. The parish registry for the area shows the number of people aged 50 or older who died in the month after Ivan jumped by a half compared with the year before. Apparently some people just gave up the will to live. Dr Noel says Hurricane Ivan also resulted in increased depression, anxiety and post-traumatic stress disorders. Flashbacks The government was quick to mount a counselling initiative for front-line medical and emergency staff, which was extended to school children. Even now, some infants are frightened by strong winds. Jacklyn Sealy-Burke, of the local non-governmental organisation Grencoda, co-ordinated a nationwide counselling programme. She says one of the ugliest aspects of the hurricane was the looting which followed almost immediately after the winds subsided. "Some businessmen and their employees who witnessed it suffer flashbacks," she says. Mrs Sealy-Burke adds that for most people the long-term cure for the stress brought on by Ivan will be the repair and rebuilding of their homes. Financial hardship, lack of insurance and shortages of construction materials mean many Grenadians have been unable to repair their homes. The striking blue tarpaulin covers continue to act as temporary roofs for many large businesses in St George's, the old Georgian parliament, York House, the Catholic Cathedral and the main Anglican and Presbyterian churches. American carpenters The government has announced several soft loan and grant schemes to help fund repairs to private homes. But much of the international aid is being funnelled through non-governmental organisations like the Red Cross which has distributed galvanised sheets for roofing. In another case, the Salvation Army and carpenters from the American Mennonite church have partnered a grass roots community group, the St Andrews Relief Organisation, to repair the homes of the poor on the east coast. But from her newly repaired wooden house on a hill overlooking the Atlantic Ocean, Glenis Felix voices the concerns of many who were forced out of their homes by the hurricane. "I worry about this year. I'm afraid another Ivan could put me back in the same stress again and leave me homeless with my children." Reprinted from bbccaribbean.com