Topic: Disasters, terror and stress management

The Tsunami: Affected children and their families.

Jensen, T. K., Dyb, G., Hafstad, G. S., Nygaard, E., & Lindgaard, C. V. (2008). Tsunamien: Berørte barn og deres familier [The Tsunami: Affected children and their families.] Norwegian only. (Rapport 4/2008).

This report is about the experiences and reactions among families with children who were on vacation in the areas affected by the tsunami in South East Asia in 2004. Most of the travellers were on Christmas holiday in Thailand, and stayed in the areas where the waves hit.

The report is based on data from three studies from the tsunami program at the Norwegian centre for violence and traumatic stress studies (NKVTS). In the first study, parents who travelled with children at ages 6 to 18 were asked to reply to a questionnaire about the child’s acute reactions during the disaster and the child’s later functioning. In the next study a sample of these parents and their children were interviewed in their homes. During this interview they were, among other things, asked about their experiences, how they coped in the acute situation and the aftermath, their family functioning, their need of help, and how they evaluated the way the school coped with the situation.  The third study was a follow up interview about 2,5 years after the tsunami. In the follow up interview we were primarily interested in what longitudinal effects the disaster had for parents and children.

Heavily affected

Most of the families and their children were in areas heavily affected by the disaster. Both adults and children were caught by the water and many were in acute danger. Some lost one or more of their loved ones. Many were also exposed to other stressors before returning to Norway. They experienced the destructions, they saw people who were hurt or dead, and they experienced the despair of those who had lost someone. The relief of surviving was, for many, mixed with feelings of guilt and helplessness, because they could not do more to save others or help in the aftermath.

Many children had post traumatic stress reactions such as nightmares, intrusive memories, and problems concentrating after the disaster. There was an association between degree of exposure and level of post traumatic stress at the time of the first interview. Also, the child’s earlier developmental history and experiences played a significant role. For instance, children who had difficulties before the tsunami were especially vulnerable and developed more post traumatic stress reactions than other children. The children showed a considerable improvement during the follow-up period, and showed less post traumatic stress reactions 2,5 years after the tsunami.

Considerably less troubled than local children

Compared to native children who continued to live in catastrophe stricken areas in Thailand and Sri Lanka, Norwegian children were considerably less troubled by post traumatic stress reactions after the disaster. This might be related to the fact that the children came home to intact and safe environments, and that normal activities quickly could be resumed. They were also met with great sympathy, both at a local and national level. Their experiences could be shared and talked about, and most were met with understanding and care.

Family important

Results of this study also underline the importance of family ties. In the aftermath of the disaster, close family was of utmost importance for both adults and children. Almost all the children experienced being able to talk to their parents, and felt understood by them. Furthermore, the parents paid close attention to their children’s development and supported them when necessary. Peer relations were especially important for adolescents. The schools also seemed to handle the pupil’s experiences in a beneficiary way.

Survival and mastering of such disastrous experiences can influence people’s attitudes towards life. Many children and adults who experienced the tsunami reported positive changes in their views of themselves and others. They appreciated life more and many families experienced a high level of cohesion after the disaster.

Some children struggle

Even if most were better off than feared, it must be emphasised that many children still have problems which greatly influence their development. Some children have, in periods, had significant problems in school, and some have dropped out of school entirely. Many experience the world as less safe, they are jumpy, sleep badly, and have problems concentrating. For children who are developing, such problems can have significant consequences.

About one fourth of the children were referred to school health services (PPT) or psychological health care for children and adolescents (BUP) within 6 months after the tsunami. Mainly, it was the children who had the most difficulties who sought help. Most of the parents were satisfied with the help they received for their children. Almost all the parents also said that they appreciated being actively contacted by health personnel, whether it was their regular general practitioner, or a therapist. However, many wished for a further follow-up. Those who expressed dissatisfaction with the help they received were unsatisfied that no one contacted them, or that the health personnel lacked necessary competence.

Health services must maintain contact

This study gives an important contribution to our understanding of the aftermath such catastrophes can have for children and their families. The results show that many children can manage well, even after tremendous endeavours. For most of the children, it was sufficient that parents, friends, and the school were there for them, that they could share their experiences, and that daily routines and activities were quickly resumed. For the children who were most deeply affected however, or those who were in a particularly vulnerable situation, these efforts were not enough. Unfortunately, even though many of these children received help, everyone did not receive satisfactory treatment.

The results from this study suggest that the health services, after such a comprehensive disaster, should be “proactively waiting”. They should be proactive in the sense that they should actively contact the affected families and inquire about their need for help. If the needs are not immediately evident, they should maintain contact, so that they can pursue the development over a certain time period. If the need then arises, adequate help can be given.