The emotional wallop of a humanitarian crisis can be significant, and in children it can present more subtly than in adults. Learning how to identify and treat children who are negatively impacted by living in war-torn nations or surviving a disaster is key to halting what may otherwise become a vicious cycle of intergenerational trauma.
Jamla Rizek, DNP(c), MBA, MSN, RN, CEN, CPEN, NHDP-BC, NRP
That’s the message Jamla Rizek, DNP(c), MBA, MSN, RN, CEN, CPEN, NHDP-BC, NRP, a nurse educator and leader with the United States Public Health Service, delivered yesterday to attendees at the session “Pediatric Psychosocial Considerations in Disaster and Humanitarian Crises.” The key, she explained, is figuring out the best way to reach a child depending on what kind of trauma they’ve been through, whether individual, interpersonal or collective.
Children who live in countries ravaged by war or who become refugees have to grow up fast, Rizek said, and they may not have the skills to process their experiences. “The opportunity to talk to others that are like them, to interact with kids, to go to school – they didn’t have those opportunities, so their coping skills will be a little different,” she stated. If children grow up in this environment and have offspring of their own, they will then project those experiences onto their children, perpetuating the cycle of developmental trauma.
One problem is there’s a sense in the medical community that children don’t experience post-traumatic stress disorder. Rizek, who has deployed to disaster zones to treat pediatric populations, emphatically refutes this. But PTSD in kids can look different than expected, she noted. A stomachache may be the single complaint a child has, but that pain reflects enormous emotional turmoil.
Recognizing a child in distress is the first step, and figuring out how to help is next. “If this is somebody who went through a traumatic experience, talking about it may not be the best way to open up and to start that healing process,” Rizek said. While adults may benefit from talk therapy, children often respond to other strategies. Rizek showed a short video of a father and young child who were refugees listening to bombs falling. They decided together to laugh excitedly each time they heard a bomb, which helped defuse the child’s stress.
Children who don’t have a “safe zone” can benefit from homey spaces. Refugee centers can be brightened by asking children to draw pictures to be hung on the walls. She relayed the story of a colleague who wore Mickey Mouse ears when meeting with kids at a processing center, making her a huge hit. A spate of books targeted toward children who are refugees also can help kids feel less alone.
PTSD and trauma are not limited to children in war-torn areas, of course. The COVID-19 pandemic greatly affected children, some of whom were scared for sick siblings. Many children lost the social and communication skills that the structured environment of the school day would have provided. These children need help just as much as those living through war.
Rizek wants to make sure all children at risk of PTSD are cared for appropriately. “These kids are our future regardless of where they come from,” she reminded the audience. “And they’re going to be taking care of us, so we really have to do our due diligence to work with what they’ve experienced and provide that support so that trauma doesn’t continue on for generations to come.”