Volume 29 Issue 1, 2014

OPINION: Children in disasters: the way forward

Beverley Raphael, Penelope Burns

Professor Beverley Raphael and Dr Penelope Burns suggest that better education for children, their parents and teachers, about disasters plays a significant role in their protection.


Article

A photo of Professor Beverly RaphaelA photo of Dr Penelope Burns

Children have greater vulnerability, both physically and mentally, in disasters but the ways children experience ‘disasters’ varies enormously. Both the impact of the disaster and the response of the child will be influenced by many factors. These include, but are not limited to, the age and developmental stage of the child, whether the child is alone or with family or trusted adults in familiar environments, and socio-demographic and cultural factors.

The particular hazard of the disaster influences the degree to which children may be affected. In Australia, natural disasters are frequent, seen in the media, and often, in ways, feel familiar to the child. But the severity and terror may be overwhelming in severe and sudden catastrophes such as Cyclones Larry and Yasi (Queensland) or the Black Saturday bushfires (Victoria). Disasters caused by human activities, such as terrorism are different and potentially threatening in other ways.

The nature of the exposure, such as the degree to which there is a threat to life of self or loved ones, the fear generated, and the consequence of loss, injury, damage and dislocation, may have on-going effects on the child and family, in terms of physical and mental health, social and economic problems.

Current education programs

Education programs for children about disasters have been implemented. These include models such as preparedness actions for cyclones with a school-based strategy planned for children, and homework planned with parents (Ronan, Crellin & Johnston 2012). More directly focused initiatives include, responding to warning messages, safety in the face of impact, school training on evacuation, the roles of teachers in gathering and checking children, and self-protection strategies. Programs include ‘Drop Down Low and Go Go Go’, ‘Stop Drop and Roll’ (NSWRFS 2005) for fire, and ‘Drop Cover and Hold’ for earthquakes (NZ Government 2012). Education in understanding warning, threat, and actions to be taken for protection and safety are critical. The messages need to be clear and simple with well-defined brief action statements. Training and practice can embed survival strategies as part of the child’s repertoire in a crisis.

Focusing education and training initiatives on the disasters children are most likely to experience is particularly important. In the Australian context, this includes floods, fire, cyclones, and storms. Media exposure learning may create unreal views. At one extreme there is inevitable destruction, death and helplessness, and at the other, there is invincibility. The realities of severe impacts can bring shock and fear to adults and children; and these may powerfully reverberate in times to come.

Training in context

The context of children’s lives will be critical when they are exposed to disaster. The importance of early reunion with family can be a powerful force for a child’s wellbeing and recovery into a safe world. Comforting children, particularly younger children, can help to settle their arousal and bring back a sense of security. Being with teachers and other known and trusted adults who are well informed in safety procedures and have educated the children in their care about what they need to do in an emergency will also be reassuring.

Calm, confident and effective action can lower arousal and give a sense that the threat can be addressed. The emergency, particularly if life-threatening, is likely to impact very significantly on children.

Younger children may not understand the finality of death but will respond to the fears of others. This reverberation may have effects that need to be addressed in recovery strategies. A young adolescent who was involved in a disaster where her own life was threatened and a friend died, stated in her distress, ‘we should not have had to know we could die’. The realities and permanency of death are often difficult to know and not easy to learn, even as one grows into adult life. The causes and threat of the emergency can directly, and indirectly, impact children of all ages and contribute to risk of post-traumatic stress symptoms or disorder, or other mental health consequences.

Similarly, the losses associated with disaster, ranging from the deaths of loved ones, including friends and pets, to the loss of home, and familiar environments, can have substantial impacts. The disruption of familiar life patterns may bring great sadness, grief and possibly mental health consequences. The parents’ own distress, trauma and loss may make it more difficult to comfort a child, yet also make it more critical that affection and shared sadness can pave the way to adaptations in life for the future.

Education for recovery

Education must extend to parents and family, both for their needs, and for their children. The complexity of family structures and functions, with diverse, blended and single parent structures will need to be understood and encompassed. Such education should also include building on resilience. On-going education to assist children in their recovery is important. This needs to involve teachers in their understanding of the effects a disaster experience may have on children’s educational capacities, the behaviours that may signal potential health, mental health, or behavioural problems, and whether to refer a child for assessment and possibly treatment. Important resources have been developed to assist teachers and parents to manage such issues and when to seek help (McDermott & Cobham 2013, Wraith & Australian Red Cross 2010, Raphael 2010, Kenardy et al. 2011, Roberts 2009). Valuable and effective school based programs have been developed, trialed and found to be effective for dealing with mental health problems that may have developed as a consequence of disaster experiences, or that reflect exacerbations of existing problems, such as anxiety disorders. These include models such as those of Pynoos, Steinbery & Brymer (2007) and the excellent Australian programs developed by McDermott and colleagues (2013). These latter have integrated assessment and treatment into school-based programs with positive outcomes that both educate and treat.

Educating children, their families, their schools and communities about disaster is important. Such education needs to be clear, practical and focused. It should aim to encourage people, including young people, to tune into their strengths as well as what they can do to protect themselves and others. It needs to be attuned to the threats and the hazards and the potential impacts. Ideally, such knowledge should include aspects of prevention, preparedness, response and recovery. Above all, actions are central: what are the actions that have priority, and how can these be learnt? There should be rote learning of the body’s language of protection and response. The advanced and well-researched warning systems for bushfire risk in Australia are good indications of clear messages of protection and safety (NSWRFS 2005).

Our children are vulnerable both physically and mentally in the face of disasters. Adult support in preparing children to address the many challenges in crises is critical. To do so is not about embedding fear, but recognising and building on the strength and courage that are the core of resilience and hope for children and their parents. As suggested by indigenous Australians ‘our children are our future’.

Children have died in disasters across the world including in Australia. Let us honour these children by educating and building skills and knowledge for the future of all children in the face of threat and the many hazards of life.

References

Kenardy J, De Young A, Le Broque R & March, S 2011, Childhood Trauma Reactions - A Guide for Teachers from Preschool to Year 12. At: www.som.uq.edu.au/media/277122/teacher_manual_conrod.pdf.

McDermott, B & Cobham, V 2013, A Road Less Travelled: a guide to children, emotions and disasters. Teneriffe: TFD Publishing.

NZ Government 2012, New Zealand ShakeOut. At: www.shakeout.govt.nz/individuals.

NSWRFS 2005, Bushfire Safety. At: www.rfs.nsw.gov.au/file_system/attachments/State08/Attachment_20050308_89B60606.pdf.

Pynoos, R, Steinberg, A & Brymer, M 2007, Children and disasters: public mental health approaches. In R. Ursano, C. Fullerton, & L. Weisaeth, Textbook of Disaster Psychiatry, pp. 48-68. Cambridge: Cambridge University Press.

Raphael, B 2010, Resilience and Self Care for Principals and Teachers. At: www.earlytraumagrief.anu.edu.au/uploads/ACATLGN_Raphael_ResilienceSelfCare_D1.pdf.

Roberts, M 2009, Resources for Teachers School Recovery Tool Kit. At: www.earlytraumagrief.anu.edu.au/school-communities.

Ronan, KR, Crellin, K & Johnston, DM 2012, Community readiness for a new tsunami warning system: a quasi-experimental and benchmarking evaluation of a school education component. Nat Haz 61:1411–1425.

Wraith, R & Australian Red Cross 2010, Helping children and young people cope with crisis: information for parents and caregivers. At: www.redcross.org.au/files/helping_children_and_young_people_cope.pdf.

About the authors

Professor Beverley Raphael is Professor of Psychological and Addiction Medicine, ANU, Professor of Population Mental Health and Disasters, UWS, and Emeritus Professor of Psychiatry, UQ. She is the Foundation Professor of Psychiatry at the University of Newcastle. Her clinical and research areas focus on policy and program development in population mental health, prevention, child and adolescent mental health as well as the impact of trauma and disaster.

Dr Penelope Burns is a Senior Lecturer in General Practice, UWS, and a PhD candidate at ANU looking at the roles of general practitioners in disasters. She has been involved in undergraduate and postgraduate disaster education. Her clinical and research areas include systems development and processes for general practitioners, the management of animals in disasters, and the evaluation of disaster education. 

This article reflects the opinions of the author and are not necessarily those of this publication.