"What Katrina Looked Like,” by Alex, 7-years-old at the time of the storm. ©Lori Peek, 2007.
Implications for Public Health
Help children recover from disaster by addressing the ongoing simultaneous needs in all spheres of their lives—including family, housing, school, friendship, extracurricular activities, and health and well-being.
Following Hurricane Katrina in 2005, we embarked on a seven-year study of the recovery experiences of children and youth from New Orleans. We believe the lessons from Katrina can help public health practitioners and emergency managers now. Indeed, what we learned from those young people, their families, and their teachers can be of use to those providing aid and assistance to the children affected by recent major disasters.
In the spirit of assisting the most recent survivors, we offer six groups of recommendations that came out of our research. These are based around what we refer to as the “spheres” of a child’s life. In each section, we highlight actionable recommendations for professionals and caregivers to help children after a disaster.
Children who have experienced a hurricane or other disaster need routines and predictability in their family life. They also need compassionate and age-appropriate coping support since they might also be dealing with other simultaneous crises, such as divorce or illness in their families. Children whose families have fewer resources are especially in need of these forms of support, information, and opportunities. Single parents—often mothers—also need additional support during displacement, such as trustworthy childcare services. Mounting research suggests that when parents are coping in healthy ways, it helps children to recover as well.
Children who are displaced also need clear, meaningful information about their extended family members. Ideally, they should have a chance to communicate with them and be reassured that their displaced family members are safe and that they will see them again. Having a reunification plan is especially important for families and communities.
In temporary shelters, children need child-friendly spaces to rest, play, and study and adults should be present to protect and comfort them. Shelters also need to consider the feeding needs of infants and young children; the safety of girls, boys, and transgender children and youth; and privacy for all kids. Whenever possible, it is beneficial to offer outdoor spaces for children to play in both shelters and temporary housing sites, and community leaders should be cognizant of accessibility issues for children with disabilities.
As the recovery and rebuilding process begins, we recommend that housing assistance be a funding and policy priority, especially for low-income renters. Temporary housing should be carefully screened for the health and safety of children and youth, who are physically more susceptible to mold and toxins. Displaced residents—including children and youth—should have a voice in communicating and shaping post-disaster housing options.
Schools should have a comprehensive strategy for natural hazards and a plan for other potential disasters to ensure an effective response when the unthinkable happens. After a disaster, affected children need to resume their education and get back to a predictable school routine as soon as possible, which means that planning for educational continuity is paramount.
Schools can offer optional peer-oriented and/or peer-led groups and should ensure that licensed professional counselors, social workers, and school therapists are available to help on-site. Training school staff to provide mental and behavioral health support to students and to recognize signs of distress is highly valuable. Lesson plans and assignments can be designed to engage students in projects relevant to their lives (such as risk mapping) and support them emotionally (such as with art therapy).
Children and youth need opportunities to help others, and schools can provide them with chances for projects such as service learning, fundraising, community action, or mentoring. Teachers may also be recovering from the disaster, and so short- and longer-term support for them is also important.
The importance of friends and peer groups during displacement is often overlooked and should be recognized and supported. Adults can support these important relationships and if possible help children locate and reconnect with their friends in the aftermath of disaster, as their friendships can help them feel connected and secure. Furthermore, adults should remember that missing crucial milestones, such as proms and class trips, can be upsetting for children, as these are events that they share with their closest friends and peers.
Helping children communicate with their old friends—via phone calls, visits, texts, or social media—can lessen fears and concerns about their friends' well-being. As children and youth find themselves in new, unfamiliar surroundings, they may also need help adjusting to new peer groups and making new friends, so matching them with classmates in their new schools through “buddy programs” can be helpful. We also found that the children of Katrina did many creative things to help other children, such as sharing poems or singing songs with friends, and this ultimately accelerated their own recovery.
Children who are involved in sports, a religious institution, or organizations such as Scouts or 4-H Club can discover skills and strengths and develop social networks outside of family and school. In the aftermath of a disaster, children often lose access to such important extracurricular activities. As children either return to the disaster-affected neighborhood, or settle into a new place, they should have the opportunity to be involved in age-appropriate activities. To help facilitate that, they may need help with transportation, fees, and uniforms, among other things. Children and youth also benefit from being able to share their experiences through creative mediums, so providing them a space for writing, art, theater, and dance is recommended.
Children and youth can also get involved before disaster strikes and learn how to contribute effectively to emergency preparedness and response. There are many programs available such as the Pillowcase Project, Teen CERT, Ready Kids, and Prep Rally that are dedicated to engaging children of different ages in getting ready for disaster.
Health and Well-Being
The emotional and physical health challenges, such as food insecurity and asthma during non-disaster times are a fundamental part of their recover. Health and well-being are not distributed equally—low-income children and children of color face more health challenges during non-disaster times, such as food insecurity and asthma, and have less access to affordable, high-quality health care. Additionally, factors like a child's age, hazard proximity, and exposure to disaster and other chronic threats can influence how a disaster impacts a child's health and well-being. Healthcare providers have a vital role to play in helping children before, during, and after disaster.
Children’s physical and emotional health are interconnected, and they should receive care for both. Children need fresh air, exercise, and an environment free from environmental risks, such as spilled oil, sewage, asbestos, black mold, mildew, and contaminated soil. Their exposure to hazardous materials in the rebuilding process should be limited as much as possible. Since disaster effects are often enduring, children need access to long-term emotional assistance.
All the Spheres of Children's Lives
Children, and especially the most socially disadvantaged children, may have simultaneous and ongoing needs in all spheres of their lives. As we watch the recovery from recent record-shattering disasters, we are reminded of how critical it is that attention be paid to the youngest survivors of disaster and that collectively we prioritize their needs.
This article originally appeared in the Research Counts series on October 6, 2017. This is an updated version.
Tips for Talking to Children and Youth After Traumatic Events
Substance Abuse and Mental Health Services Administration
Guide for parents and educators for talking to children and adolescents after a traumatic event.
Post-Disaster Reunification of Children: A Nationwide Approach
Federal Emergency Management Agency
Guide for jurisdictions to enhance family reunification procedures as part of national preparedness efforts.
Child Trauma Toolkit for Educators
The National Child Traumatic Stress Network
Provides guidance and information for school administrators, teachers, staff, and parents on working with traumatized children in the school system.
Save the Children
Save the Children tool kit that includes emergency preparedness games and activities for children in preschool, kindergarten, and elementary school.
Pediatric Preparedness Resource Kit
American Academy of Pediatrics
Guidelines and information for facilitating collaboration and discussion between public health and pediatric leaders regarding pediatric emergency preparedness.
Pediatric Disaster Preparedness and Response Topical Collection
American Academy of Pediatrics
Guide for health care providers who care for children in a disaster that includes information and best practices on a variety of topics, games, and activities.
For a list of all the tools included in this special collection, visit the Children and Disasters Tool Index.