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Thursday, January 14, 2010

Haiti: Natural Disaster Response Resources, Thoughts on Trauma and Children

Trauma is trauma.

Sometimes we inflict it. Sometimes it happens to us.

Sometimes it's both, as it is with combat veterans. While this blog focuses on military experience-derived injuries and stresses such as TBI and PTSD (clinical and encyclopedia definitions), traumas of all sort and stripe share one thing: surviving something life-threatening or outside everyday occurrence.

Being raped; a victim of an explosive hostage situation or other terrorist activity; in a severe auto, airplane or other vehicular accident; on the receiving end of domestic violence and/or abuse; serving in combat; or involved in a natural disaster like Haiti, for some may spark future PTSD symptoms.

We, however, are still in rapid response/logistical needs mode:

In extended, Red Cross tips for helping disaster victims and a piece on how many in the U.S. are affected by the tragedy.

For those lost and hurting, this little reflection:

Like a bird
Singing in the rain,
Let grateful memories
Survive in time of sorrow.

-- Robert Louis Stevenson

In educational interest, article(s) quoted from extensively.

Obviously, the world would be a better place without trauma and all of its messy aftereffects.

But, the fact is, there it is: trauma is an integral part of our environment and even some of the systems and structures we use as human beings aiming to avert disaster, resolve conflict or gain attention to our cause. When it visits you, trauma may be like an unwelcome temporary guest or a horrific long-term ghost.

Strong and consistent social support -- something we should practice every day at every level, not just when disaster begs -- has routinely been shown to be a strong factor in supporting the successful transition from trauma victim to thriving survivor.

From David Baldwin's Trauma Information Pages:

Emotional Health Issues for Victims
by the American Red Cross

Disasters affect people in many ways. In some disaster situations it may mean loss of loved ones, including relatives, friends, neighbors, or family pets. In others, it means loss of home and property, furnishings, and important or cherished belongings. Sometimes it means starting over with a new home or business. The emotional effects of loss and disruption may show up immediately or may appear many months later.

It is very important to understand that there is a natural grieving process following any loss, and that a disaster of any size will cause unusual and unwanted stress in those attempting to reconstruct their lives.
Some Initial Responses to the Disaster

* Fear
* Disbelief
* Reluctance to abandon property
* Disorientation and numbing
* Difficulty in making decisions
* Need for information
* Seeking help for yourself and your family
* Helpfulness to other disaster victims

Some Later Responses

* Change in appetite and digestive problems
* Difficulty in sleeping and headaches
* Anger and suspicion
* Apathy and depression
* Crying for "no apparent reason"
* Frustration and feelings of powerlessness over one's own future
* Increased effects of allergies, colds, and flu
* Feelings of being overwhelmed
* Moodiness and irritability
* Anxiety about the future
* Disappointment with, and rejection of, outside help
* Isolating oneself from family, friends, or social activities
* Guilt over not being able to prevent the disaster
* Domestic violence

Special Effects on Young Children

* Return to earlier behavior, such as thumb sucking or bed wetting
* Clinging to parents
* Reluctance to go to bed
* Nightmares
* Fantasies that the disaster never happened
* Crying and screaming
* Withdrawal and immobility
* Refusal to attend school
* Problems at school and inability to concentrate

What You Can Do to Help After the Initial Crisis

Help for You and Your Family

* Recognize your own feelings.
* Talk to others about your feelings; this will help relieve your stress and help you realize that your feelings are shared by other victims.
* Accept help from others in the spirit in which it is given. Wouldn't you help them?
* Whenever possible, take time off and do something you enjoy.
* Get enough rest.
* Get as much physical activity as possible, such as running or walking.
* Give someone a hug; touching is very important.

Help for Your Child

* Talk with your child about his or her feelings and your feelings. You will find that many of your feelings are shared, regardless of your child's age. Encourage your child to draw pictures of the disaster. This will help you understand how he or she views what happened.
* Talk with your child about what happened, providing factual information that she or he can understand.
* Reassure your child that you and he or she are safe. Repeat this assurance as often as necessary.
* Review safety procedures that are now in place, including the role your child can take.
* Hold your child. Touching provides extra reassurance that someone is there for her or him.
* Spend extra time with your child, especially at bedtime.
* Relax rules, but maintain family structure and responsibility.
* Praise and recognize responsible behavior.
* Work closely with teachers, day-care personnel, baby-sitters and others who may not understand how the disaster has affected your child.

Help for Your Community

* Listen when you can to those who are having problems.
* Share your own feelings about the disaster.
* Be tolerant of the irritability and short tempers others show -- everyone is stressed at this time.
* Share information on assistance being offered and possible resources.

Joseph Brownstein, ABC News:

People in Haiti may suffer physically after Tuesday's earthquake near Port-au-Prince. But some who will suffer long-term effects from the disaster will be far from the disaster zone.

Thousands of Haitians have moved to the U.S. and elsewhere -- and psychologically, it can be as hard to watch the crisis from a distance than to be in the thick of it. They worry about family back home. They have a personal link to the country. Expatriates are at risk for psychological trauma that may last for years after the rubble has cleared. ...

"We catch emotions from each other like a virus, and trauma is certainly one of those emotions," said Raison.

Evidence of this, he said, can be seen in studies of the children of Holocaust survivors, who may encounter more stress in their lifetimes than their counterparts whose parents did not go through it, even though they themselves may not suffer any more in their own lives. ...

Other factors may also play a role in how much the tragedy strikes them.

"There is some interesting research that happened post-9/11 about the effects of watching traumatic events on television and reading about it in newspapers and magazines," said Dr. Joan Cook, a psychiatrist with Yale University who specializes in traumatic stress.

"There is indeed a significant relationship between watching media coverage of trauma -- i.e., terrorist attacks -- and stress symptoms," she said. "However, it is unclear if watching these events are the cause of the increased distress or if people who are more prone to stress reactions watch more coverage of the trauma on TV. ...

While some of these factors can create more stress for people with loved ones in Haiti, there are things they can do to help themselves -- and possibly their loved ones as well.

"If a person can respond to adversity with action, with corrective action…that in some ways [alleviates] the situation, that's hugely protective for peoples' mental health," said Raison.

Community can help as well. ...

"In general, two of the strongest variables related to recovery from a traumatic event are subsequent life stress and social support," said Cook. "So let's hope that the Haitians currently in the disaster zone and those residing in this country get all the support and information they need to recover from this horrible event."

Doctors said most people will not need professional help to move past the tragedy, but a fair number might.

"My guess is that, all other things equal, there would not typically be long-lasting effects of the disaster on Haitians currently residing in U.S.," said Cook. "That said, there are always qualifiers and thus, it might depend on the level of devastation."

Read more>>

Sending out energy and thoughts of resilience to all of the emergency search & rescue crews and medical professionals convening on Haiti. May you be guided and protected in your work. May many more be rescued from the rubble, saved to rebuild and repair their shattered lives.

And my final thoughts go to the children.

As a former American Airlines flight attendant based out of Miami International for a time, I had one occasion to work a Haiti trip sometime in the late '90s, a quick "turn-around" from Miami's airport to Port-au-Prince and back.

I recall how our passengers (especially the children) handled themselves with such sweetness. Clearly, they were excited to be on an unusual adventure, flying -- many for the first time -- and all dressed up in their Sunday best; but they were poised as well as excited. They made such a lasting impression on me.

Read about the present circumstances of the children of Haiti, and I dare you not to care. We each should, in our own way, consider what we can do to best support their physical and psychological needs now and in the months and years to come.

My thoughts and heart are with them tonight.

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