This article outlines generic steps to take in the aftermath of a disaster. Specifically, it charts out internationally established methods of identifying children and youth experiencing problems and the broad category of responses toward them.

The basic principle communicated in courses and workshops on management of humanitarian crises states that a natural event (e.g. earthquake, flood, rain, volcanic eruption) is not a disaster itself. It becomes a natural disaster because of the human management element i.e. the worse the scale of preparation, protection and caution, the worse the scale of the disaster. Therefore all acts of violence, particularly those on a large scale also qualify as disasters albeit man-made disasters. Strategies for both types of disasters however should not only be pre-emptive but also extend to the aftermath of the event as experiencing a dangerous event has long lasting impact on both adults and children because of changes in a familiar environment. However, children feel it more keenly because of limited understanding of an event as well as displacement from their routine environment.

Symptoms and Analysis

The National Association of School Psychologists (NASP) is an international organization that disseminates knowledge and resources to support teaching professionals and school psychologists in enhancing learning and the mental health of children. NASP notices differences in the way children express distress based on their ages. They identify the following symptoms as a marker of disturbance in children:

1. Preschoolers — thumb sucking, bedwetting, clinging to parents, sleep disturbances, loss of appetite, fear of the dark, regression in behavior, and withdrawal from friends and routines.
2. Elementary School Children — irritability, aggressiveness, clinginess, nightmares, school avoidance, poor concentration, and withdrawal from activities and friends.
3. Adolescents — sleeping and eating disturbances, agitation, increase in conflicts, physical complaints, delinquent behavior, and poor concentration.’
   
   The degree of reaction to the event will depend on risk factors such as exposure to the actual event, personal injury or loss of a loved one, dislocation from their home or community, level of parental support, the level of physical destruction, and pre-existing risks, such as a previous traumatic experience or mental illness.
   
   Longer term post-traumatic stress disorder (PTSD) may potentially be observed in children and youth who:

• Had threats to their physical safety
• Thought they might die during the disaster
• Report that they were very upset during the disaster
• Lost their belongings or house as a result of the disaster
• Had to relocate in the aftermath
• Attended schools following the disaster that had multiple schedule changes, double sessions or a lot of disruptions.

Responses

In a situation where children are too young or inexperienced to comprehend and understand how an event that has occurred, they look to adults in their life for a cue on how to react and process the event. Since it is likely that parents will also be affected in such an event, schools or school teams can play an important role in providing a safe, familiar environment. In the eventuality that the case is reversed and the locus of event is the school itself, then adults in the family can take on the role of acclimatizing children to the changes in their environment.

The first step for any disaster management effort is to identify children and youth who are at high risk and plan interventions (individual, group or family based) for them. The second step is to buttress and support all the important actors (e.g. school teachers, family members) in a child’s sphere. This can be done by providing information on children’s reactions, possible queries and how to handle them. Additionally a move must be made to establish a routine as similar to the child’s earlier routine as possible.

Child psychologist Annette Le Greca and her team have developed a pioneering disaster manual on children in natural disasters. This manual was developed after Le Greca worked with children in the aftermath of Hurricane Andrew in the USA in 1992. The manual is directed at professionals and parents working with elementary school children. The current version of the manual is titled “Interventions for Posttraumatic Stress in Children and Adolescents Following Natural Disasters and Acts of Terrorism” and serves as a foundation point for teams planning interventions to do for children under stress.

The manual shows that certain factors helped children and youngsters cope better over time. These included:

• Having a wide range of social support from family and friends that helps provide children with suggestions on how to cope.
• Specific activities could include asking children to work together in groups.
• Getting back into normal roles and routines and focusing on the children’s competency in their usual roles and in times in the past when they have experienced anything frightening and how they have coped.
• Encouraging children to talk about disaster-related events (e.g. through verbal activities such as stories and other expressions such as drawing and painting). A more direct and helpful method could include talking about other people and children who have experienced similar natural disasters in history and in contemporary times. The emphasis should be on how these communities and people recovered.

Le Greca’s manual and workbooks also highlight strategies and occurrences that would disrupt healing for children and young adults. These include:

• Low levels of support from family and friends
• Blaming (oneself or others) as a way of coping (extremely negative)
• Anger (at oneself or others) as a way of coping (extremely negative)
• Children who had high levels of anxiety and adjustment difficulties before the event were likely to have greater PTSD symptoms afterward

The central focus of response reactions are based on the realization that children do not often know how to ask for help.

In 2006, UNICEF developed an episode for its popular eight year old cartoon character Meena. The episode ‘Life Has Changed’ was aimed at helping children cope with the recent tsunami (2004) and earthquake (2005) disasters in the Asian region. In this episode Meena meets a little girl, Neela, who was separated from her family during an earthquake. Meena takes her home, talks to her and plays with her. Meena’s family also steps in to play a supportive role.

“We know from our experience in all sorts of disasters, not just the tsunami, that children suffer tremendous psychological damage,” said Dr. Esther Guluma, UNICEF Deputy Regional Director in South Asia. “The Meena film and books will help caregivers, teachers, parents, and communities understand how to deal with children as well as help the children understand their feelings after a disaster.” (Li, 2006 on the UNICEF website)

Helping children cope with disasters is not a short-term intervention. Children and youth, particularly those with increased risk factors need to be monitored closely for long-term assistance. As with all contingencies, a plan of action should exist before the event rather than an ad hoc post-event assembly. It may seem like a futile effort particularly if there is no foreseeable reason to apprehend a natural or man-made disaster. However, for children the more immediately they are surrounded by adults who have a sense of purpose, the greater the children’s sense of security and the quicker their ability to engage and process the event.

About the Writer:
Ms. Moizza Sarwar worked at the Sindh Education Foundation before moving abroad for higher studies. Presently, she is a Ph.D. student at Oxford University, United Kingdom. She regularly writes for various journals and publications.