How schools can help kids heal from disaster trauma
MANILA, Philippines – Days before Typhoon Yolanda (international codename: Haiyan) even entered the country, thousands trickled in evacuation centers with a few of their belongings, mostly clothes and food that would last them days.
In Cebu City, however, Joey and Lorna Eguia came with books.
On the day of the landfall, November 8, while the winds violently displaced everything in its path, the couple waited for the typhoon to pass by folding origami with kids in the evacuation center.
Weeks after the strongest typhoon in recent history ravaged the Visayas, the couple, together with about 20 volunteers, continued therapy sessions for children through storytelling and reading.
The brains behind mobile library and family literacy program Books in Bags also introduced a new strategy called Bibliotheraphy or "the use of literature to help people cope with emotional problems, mental illness or changes in their lives."
Bibliotherapy is just one among many techniques used by teachers and professionals in schools after disasters like Yolanda.
Philippine Psychiatric Association (PPA) president Japhet Fernandez-de Leon, who assisted victims in northern Iloilo, said what survivors need first and foremost is psychological first aid.
“[We conduct] psychological first aid days to several weeks [after disasters],” she said, adding that this also includes meeting basic necessities like food, clothing, shelter, and money.
“[But] even without intervention, most of the survivors will be able to overcome. Not all may need it. But if you do it, it will facilitate healing.”
De Leon said World Health Organization (WHO) findings show less than 20% of survivors and victims of disaster become long-term patients who exhibit “adverse” reactions even months after the traumatic experience has passed.
But at the early stages, she said, reactions like anxiety are normal to an abnormal situation. Thelma Barrera of the National Center for Mental Health (NCMH) and psychiatrist Dinah Nadera both agreed. (READ: Doctors in disasters)
“Right now, every abnormal symptom is probably normal. You can never label [them] abnormal,” Nadera said.
Teachers are victims too
Last Tuesday, November 26, Barrera and her team held psychosocial processing at the central office of the Department of Education (DepEd) for teachers who fled Yolanda-stricken areas. (READ: Hard choices for teachers after Yolanda)
While Education Secretary Armin Luistro earlier said educators are “the sobering...calming effect in any crisis,” Barrera said teachers are no different from any other disaster victims. They need debriefing too, but training them to conduct psychosocial processing would benefit thousands of affected children, she said.
DepEd said 886,256 students in regions IV-B, VI, VII, and VIII were affected by Yolanda. In Tacloban City, which bore the brunt of school infrastructure damage, 52,251 were affected. (READ: Mental health, infections main concerns in Tacloban City)
“If you'll be able to process their experience – we will give them pyschosocial care – they, too, can take care of their students once school resumes,” Barrera said.
Nadera said teachers usually ask children to express “in the most comfortable way” their thoughts on the disaster, incorporating this in subjects they teach in school. For instance, Science teachers may teach water purification and integrate debriefing, while English teachers may ask their students to write about their experience in their formal themes.
Most of these teachers must be trained by professionals under the Health and Nutrition Center of DepEd. Center director Dr Ella Naliponguit said they only train teachers who themselves already went through the debriefing process since it also takes a certain skill to conduct therapy sessions and detect depression among students.
How to do it in classrooms
“The most important for a child is a sense of normalcy, sense of safety and security. If it's routine, predictable events are needed; you can't make them do unpredicatable events,” Nadera said in a mix of English and Filipino, adding that if normalcy is still difficult even weeks after the disaster, doing something creative can help the children.
Play and art therapy is the most common technique for grade school pupils, where healing stories are told through literature, songs, drawings, and even puppetry.
Storytelling also applies for high school students, but psychological first aid may already be administered since they can already process their experience through group discussions.
De Leon said that in both age groups, psychosocial intervention must be done in small groups composed of not more than 20 members.
Road to normalcy
On Monday, December 2, classes will resume in Tacloban City. The education department has always reiterated the importance of going back to school as soon as possible after disasters, and mental health professionals understand why. (READ: Schools told: Accept students affected by Yolanda ASAP)
“DepEd knows that: the sooner you can let these children go back to school, the better for them because that signals normalcy – it's normal again. They're back to going to school because for the children, that is work. Play is work for them, school is work for them,” Barrera said in a mix of English and Filipino.
Naliponguit enumerated what usually happens on the first day back.
- No formal classes yet
- Conduct informal activities like free play
- Discuss what happened
- Later on, the teacher has to identify children who were really affected. This can be seen by the emotions: Does this child need further assessment or help? Does he/she need a trained psychologist, or is discussion enough?
- Play again, but make sure to give time for discussions
It's a long shot for the Tacloban division – among the last of divisions to resume classes – whether children will really go back to school on Monday, but it's one step closer to normalcy and an opportunity for children to start picking up the pieces again. – Rappler.com