Highlights of Points Made by Individual Speakers
- To be resilient, people, systems, and the infrastructure that supports those systems have to work together simultaneously to return to normal, whether that is the original state of normal, or a new normal.
- A capabilities-based approach to disaster preparedness develops core disaster response capabilities that can be deployed across a wide range of situations (rather than creating new plans, equipment, and responses for every disaster).
- Factors impacting resilience or the associated trauma in children include dose (magnitude of the situation), context, developmental period when exposure occurs, association with a capable caregiver, self-efficacy, and resilience of families and other systems.
- A child’s resilience is embedded not just in the child, but also in the relationships, culture, and all the other communities and systems the child may interact with.
- Schools are part of the community continuum, and teachers and child care workers are first responders. They should be trained on the typical responses and needs of children by age and development.
- Older children and youth can be provided with manageable but meaningful roles in recovery.
- The unfortunate onset of a disaster creates a critical moment to leverage the media on children’s behalf, show the challenges that communities face, and advocate for policy changes.
Presidential Policy Directive 8 (PPD-8) on national preparedness “is aimed at strengthening the security and resilience of the United States through systematic preparation for the threats that pose the greatest risk
to the security of the Nation.”1 As defined in PPD-8, resilience is “the ability to adapt to changing conditions and withstand and rapidly recover from disruption due to emergencies.” Session chair Kathryn Brinsfield, formerly of the White House National Security Staff and now the Acting Assistant Secretary for Health Affairs at the Department of Homeland Security, said that to really be resilient, people, systems, and the infrastructure that supports those systems, have to work together simultaneously to return to normal, whether that is the original state of things, or a new normal. PPD-8 takes a capabilities-based approach to disaster preparedness. The intent is not have new plans, equipment, and responses for every disaster, but to have core disaster response capabilities that can be deployed across a wide range of situations.
To further consider resilience interventions in children from a scientific perspective, a white paper was commissioned for the workshop and presented in this section. David Abramson, deputy director of the National Center for Disaster Preparedness at Columbia University, presented an overview of the white paper “The Science and Practice of Resilience Interventions for Children Exposed to Disasters.”2 The paper, authored by Abramson, Kallin Brooks, and Lori Peek, provides a review of the current literature on resilience research, and identifies several challenges to developing an evidence base for resilience interventions in disasters. Following first a discussion of research on the science of resilience in children, and then an explanation of the white paper, panelists provide real-world examples of specific strategies to foster resilience.
Ann S. Masten, of the Institute of Child Development at the University of Minnesota, said that the field of disaster research and awareness was motivated in large part by the incredible global devastation from World War II, and the millions of traumatized children impacted by bombings, radiation, displacement, and being orphaned.
1See http://www.dhs.gov/presidential-policy-directive-8-national-preparedness (accessed September 9, 2013).
2Full text of the white paper is available in Appendix G of this workshop summary and online at http://iom.edu/~/media/Files/Activity%20Files/PublicHealth/MedPrep/2013-JUN-10/White%20paper%20Abramson%20child%20resilience.pdf (accessed September 9, 2103). The authors are solely responsible for the content of the white paper.
Researchers in psychiatry, psychology, and other fields wanted to understand the impact of these kinds of experiences on child development, and what could be done to prevent problems and promote better development in children with these experiences.
Factors That Impact the Resilience of Children
Masten highlighted several of the top factors that impact the resilience of children in a disaster. Dose is key, not just the magnitude of the current situation but also prior exposure to adversity, ongoing adversities that often cascade following a mass trauma experience, and cumulative adversity. There is also much interest now in toxic stressors that can alter health, well-being, or epigenetic status in the long term. This also reinforces David Schonfeld’s earlier point clarifying that response to one event in a child’s life is actually a response to all of the events in that child’s life, and having providers maintain trauma histories can be helpful in understanding a child’s response to a singular event and how it might be impacted from previous stressors.
Other experiences of great adversity in children’s lives are relevant to understanding disaster, but context matters a great deal. Context matters not just in terms of the history and the nature of the exposures, but also the recovery context. One of the most powerful predictors of how children will do is to track the quality of the recovery context, she said.
Masten cited a growing recognition of sensitive periods in the course of development when children are more susceptible to certain kinds of exposures (e.g., radiation, toxins associated with disaster, traumatic stress). These exposures can be experienced directly by the child, or prenatally because the pregnant mother is experiencing severe trauma and stress. Studies in Finland in the aftermath of Chernobyl, for example, are showing biological sequelae in children who were prenatally exposed not to the radiation, but to the extreme fear and stress experienced by the mother during pregnancy. Many aspects of a child’s risk exposure, resources, and response capabilities are dependent on where the child is developmentally. Expectations of children and how they are going to be able to handle stress also varies developmentally as well as culturally. Individual differences, ranging from genetic variations to personality differences, impact how a child might interact with disaster experiences.
Neurobiology now has the tools to study epigenetic change and intergenerational transmission of trauma effects.
A large literature on resources and protective factors suggests that one of the most important factors for children to help them deal with adversity is a capable care giver. Self-efficacy is also important because it is attached to the motivational system that drives people to try to cope in the midst of adverse situations. Children also depend on the resilience of families and of many other systems.
Resilience as a Dynamic Systems Concept
The capacity for resilience is distributed across multiple, adaptive, interacting systems, Masten stressed. A child’s resilience is not just embedded in the child, but also in the relationships, culture, and all the other communities and systems the child may interact with (Sapienza and Masten, 2011). The capacity for resilience in a disaster is interdependent with resilience in other kinds of systems (e.g., economic resilience, global resilience in terms of climate change).
Masten emphasized that many systems influence the capacity that children have for resilience. Systems in the organism (i.e., the child) include, for example, the immune system, stress response systems, central nervous system, cognitive skills, executive functions, and motivation. Much of child capacity is also embedded in relationships. Secure attachment relationships with young children are with caregivers, but as we get older, attachment expands to friends, mentors, romantic partners, and to spiritual relationships (e.g., with a pastor or religious leader). Other systems in communities and societies that are important for children include schools as well as the emergency response systems, health care systems, and cultural practices.
To foster resilience in children, general guidelines from the literature are to plan developmentally, target and time interventions strategically, consider multiple levels of action, define and prepare first responders, and promote resilience of key systems for children. With regard to planning, Masten said to prepare for children medically, psychologically, and pragmatically. Recognize that teachers and child care workers are first responders, and train them on the typical responses and needs of children by age and development. Masten also noted that many first responders are parents, and they are likely to perform better if their own children are safe and protected.
The resilience literature also argues for reducing and mitigating risk. One way to promote better outcomes is to reduce or avoid exposure to risk, she said. For example, avoid separation of children from their attachment figures; monitor exposure of children to adversities, including the media; reduce stress of pregnant mothers; and help parents to regulate negative emotion. Other strategies emphasize the importance of restoring routine systems that symbolize normalcy to children, such as family meals, school and play opportunities, and cultural and religious practices. Support the natural and familiar helpers (families, school, and teachers) and adaptive systems in a child’s normal environment so they can support and comfort children. Masten also reiterated the points made by Houston and others about providing older children and youth with meaningful but manageable roles in recovery.
Resilience is common, and does not require anything special, Masten concluded. There is more than one way to achieve resilience, and given a favorable recovery context, most children will recover. The needs, vulnerabilities, and strengths of children vary individually, and by development, situation, and culture. Recovery depends on very fundamental adaptive systems (within the child, in relationships, and in the systems), and restoring and protecting these systems are high priorities.
Abramson cited the work of Wright and colleagues who classified the existing research on resilience into “four waves”: identifying individual factors associated with resilience; understanding how those factors develop as processes in complex systems; understanding how to foster resilience (i.e., interventions); and understanding the biology and the epigenetics of resilience (Wright et al., 2013). In conducting their research, the authors sought to address four key questions: What is the long-term impact of disasters on children and youth, and how does it relate to resilience and recovery? What does a resilience trajectory look like? How does one balance promoting positive traits and protecting against pathophysiological states? How can resilience be activated?
What Is the Long-Term Impact of Disasters on Children and Youth and How Does It Relate to Resilience and Recovery?
Abramson highlighted three overarching findings regarding exposure to disasters, impacts, and recovery. First, disasters may be only a moment in time, but they exert a long-term enduring effect on children and youth. “Toxic stressors” may extend the effects of a disaster into the adult years, leading to complex comorbidities. Abramson referred participants to the Institute of Medicine and National Research Council report From Neurons to Neighborhoods for more information about the impact of toxic stressors on children (IOM and NRC, 2000). In addition to the stress of the disaster, the child may have other acute or chronic stresses in their life, as mentioned previously, and the effects can be cumulative. Second, children are embedded in larger social systems and their health and well-being is highly contingent on functioning support systems in their lives (e.g., parents, households, schools, community institutions, neighborhoods). And third, children and youth often want to be actively engaged in their own recovery.
Gulf Coast Child and Family Health Study
As an illustration, Abramson described the Gulf Coast Child and Family Health Study conducted from 2006 through 2010. This longitudinal cohort study followed 1,079 randomly sampled households in Louisiana and Mississippi for up to 5 years after Hurricane Katrina (including 427 households with children). During the course of the study, the percent of children living in a trailer or a hotel declined from 83.8 percent in 2006 to 7.5 percent in 2010. However, the percent of parents who reported that they were not coping well was consistently between 13 and 20 percent. Parents with mental health distress declined from 61 percent to 43 percent; however, Abramson noted that more than 40 percent of parents exhibiting mental health distress after 5 years is still an enormous number. Parents who felt their children were not safe in school remained high, at 25 to 37 percent. And more than half reported moving in the past year in the 2010 survey.
Abramson next considered what systems in the children’s lives had an effect on their mental health. Children were directly impacted by parental constraints such as mental health distress, inadequate social supports, minimal sense of community, or lack of a sense of “life recovery.” Household stressors accounted for the most effect (e.g.,
unstable housing, loss of income, not enough money for food, poor family functioning). Social stressors in the neighborhoods also had a statistically significant and substantial effect on the child’s mental health (e.g., drug sales, prostitution, gangs and crime, signs of vacancy). Interestingly, prior social adversity had no statistical effect. Almost 5 years after Hurricane Katrina, Katrina-affected children and youth had rates of serious emotional disturbance that was five times the national average of a comparable group. Understanding these long-term impacts can help inform resilience interventions, and recovery expectations, Abramson said.
What Does a Resilience Trajectory Look Like?
Developing a resilience trajectory (i.e., plotting the ability to withstand, adapt to, or recover from a disaster event) is hampered by the limited availability of pre- and post-disaster data, and the lack of defined and standardized resilience outcomes measures. Outcomes could be, for example, the percentage of children without pathophysiology, the percentage at an age-appropriate grade, or the percentage with a subjective sense of “stability.” However, there are issues with all of these outcome measures. For example, many children are too old for their grade in school because the family has been displaced and they did not attend school or attended sporadically, or the family is in a new school system that is more rigorous than the school system they came from, and they are behind. Subjective measures are impacted by bias, Abramson noted, and parents often underreport their children’s problems.
How Does One Balance Promoting Positive Traits and Protecting Against Pathophysiological States?
Resilience-based efforts are designed to promote optimal development in children, Abramson explained. Approaches used seek to enhance their healthy and adaptive cognitive, emotional, and social processes, and to develop their skills in solving problems, expressing emotions, and forming relationships. These promotional efforts often take place before a disaster, so that they can be activated after the child has been exposed to the stressor. Symptom-based efforts are employed to
Key Protective and Promotive Factors Highlighted by David Abramson
- Positive self-identity (self-efficacy; self-worth and self-esteem)
- Executive control and self-regulation
- Coping skills (problem-solving competence; stress reduction)
- Supportive relationships (parents, siblings, peers, trusted adults)
- Opportunities for “pro-social behavior” (helping others)
- Positive worldview (hopefulness; faith; communal solidarity; contextualized understanding of hazard/catastrophe)
- Stability (parental, household, institutional, communal, social routines)
reduce or address mental health problems. Approaches focus on decreasing psychological symptoms through individual and group therapies; using graded exposure and inoculation strategies to decrease stress; and applying “meaning making” to the stressors to help contextualize what the children have experienced (Peltonen and Palosaari, 2013).
Resilience- and symptom-based efforts can complement each other. By enhancing resilience-based efforts, we may be able to avoid stress-induced mental health symptoms. By addressing mental health problems resulting from stress, Abramson said, we may be able to achieve optimal development and resilience (see Box 9-1).
How Can Resilience Be Activated in Children?
Abramson summarized four ways that children’s resilience can be “activated.” Many times, it is through extemporaneous policy decisions. For example, the Joplin School District made the decision to open 87 days after the tornado that devastated 6 of their 10 school buildings. This was an immediate and clear policy decision that was not governed by other preexisting policy decisions or plans, and it set a very clear objective for recovery (discussed further by Besendorfer below).
Another approach is through policy advocacy and community engagement. Save the Children’s Program on Resilient and Ready Communities, for example, works to ensure that the emergency operations plans in a community have taken into account all of the child institutions, promoting policy infrastructure so that decisions do not have
to be made extemporaneously (discussed further by Spangler below). The Communities Advancing Resilience Toolkit is similar, but takes more of an asset building approach, Abramson explained.
A third way to activate resilience in children is through programs and interventions. Abramson divided these into two basic categories: pre-disaster moderators as primary prevention for those who may be exposed (e.g., preparedness education, stress reduction training, public health) and risk-activated moderators as secondary prevention for those who were exposed (e.g., Vietnamese American Young Leaders Association [VAYLA] and Rethinkers, discussed further below).
Finally, resilience can be activated through providers and the workforce. The Joplin Child Care Taskforce, for example, is working to train providers in the community to address many of the psychological needs the children are facing.
He offered several examples of programs that increase self-efficacy, including the Masters of Disaster curriculum of the American Red Cross, Boy Scouts and Girl Scouts preparedness badges and awards, the Wisconsin Responding to Emergencies and Disasters with Youth (READY) camp and classes, Teen Citizen Emergency Response Team (CERT), and the Youth Council at the Federal Emergency Management Agency (FEMA) (the latter discussed by Houston in Chapter 6). These are very similar, Abramson said, in that they all occur before the disaster, and focus on building skills and self-efficacy.
Promoting Positive Worldview in Children
The white paper research also identified several examples of projects that promote a positive worldview after a disaster. The New York City–based 9/12 Generation Project is a day of volunteer service held on 9/12 (i.e., the day after 9/11). VAYLA was established in New Orleans after Hurricane Katrina to fight a toxic waste dump that was going to be located in their neighborhood, and has since evolved into a robust youth engagement and empowerment initiative in New Orleans for youth of all race and ethnicities. The Urban Resilience Program in Israel is very targeted toward preparation for terrorism in an effort to provide stress reduction.
Abramson elaborated on the Rethinkers program, which promotes both a positive worldview and empowerment. Rethinkers was started as a summer program in the aftermath of Hurricane Katrina, with 20 middle school students in New Orleans. The students were charged with helping
to find solutions to fix the problems in their schools. The students surveyed more than 500 other children from a sampling of schools in New Orleans on issues that matter to students. The Rethinkers have produced reports, held press conferences, and made recommendations to the city, some of which have been acted on. They have also led campaigns to make changes to bathrooms, cafeterias and food, and discipline policies. They have now expanded to rethink nutrition, weight and obesity issues, architecture, digital media, food justice, gardens, and restorative justice.
Challenges to Building an Evidence Base on Resilience in Children
The authors of the white paper identified three major types of challenges to the development of an evidence base for resilience interventions: definitional, operational, and political. The definition of resilience is a topic of considerable debate, as can be understood by the varying definitions from different sources in this report alone. Is it a process, an outcome, or a latent construct? Is it the presence of a positive state, or the absence of a pathological state? Most scholars would agree, Abramson said, that resilience only manifests in the face of a stressor. How can you determine baseline resilience of a community if resilience can only be measured in the presence of the stressor. Operationally, disasters are rare and unpredictable events and the factors underlying resilience are complex, multilevel systems (biological, psychosocial, social, cultural). Finally, from a political perspective, the federal government, which is the largest purchaser of academic research, does not generally fund direct resilience intervention services, so it has little reason to fund resilience research. Most of the resilience program funding comes from the nonprofit and philanthropic sectors, which have little surplus for funding research, Abramson said. In addition, many of the issues around resilience are “root cause” problems, social problems such as health disparities and social inequities, for which there is limited political advocacy especially in the face of constrained budgets.
From Research to Action
In closing, Abramson described the Gulf Coast Population Impact Project as a case example of how research moves to action.3 The project objective was to characterize the ways that the Deepwater Horizon oil spill affected children in communities along the Gulf Coast, and to identify resources and services that would most benefit these children.
Secondary data were used to develop an oil spill impact score and identify heavily impacted communities. Researchers then interviewed 1,437 parents in Alabama, Florida, Louisiana, and Mississippi regarding exposure to the oil spill, and physical or mental health effects. Focus groups were also conducted with children, caregivers, health care providers, educators, and community leaders.
The data showed that poverty and exposure to the oil spill were most statistically significant factors in well-being. Key health and wellness themes that emerged from community engagement were lack of access to care (especially for mental health), clusters of unexplained symptoms (e.g., nose bleeds, ear bleeds, skin rashes), unsupervised children and unsafe behavior, and dwindling recreational and occupational opportunities. Participants in the focus groups also cited economic pressures and cascading stressors (e.g., not enough food, parental depression, eroding cultures) and the inability of the community to sustain economic opportunities, social programs, and provider networks. For many communities, Hurricane Katrina and the oil spill were not really two disasters, but one long continuous disaster, with acute stressors layering on top of chronic stressors. Abramson relayed that in one of the fishing communities, 1 out of every 11 girls in the high school was pregnant. According to a local community leader, “the only thing to do around is go fishing, get high, or get pregnant, and we can’t go fishing anymore.”
This data compelled the researchers to take action and the SHOREline (Skills, Hope, Opportunity, Recovery, and Engagement) youth empowerment project was developed. The goal is to build a network of high school chapters that will develop and enhance their agency, self-efficacy, positive worldview, and pro-social behavior. Youth help other youth recover from disasters. The project does not ask the youth about themselves, Abramson explained, but rather, how can they help others in their families and communities. This resilience
3Children’s Health after the Oil Spill: A Four-State Study Findings from the Gulf Coast Population Impact (GCPI) Project—http://academiccommons.columbia.edu/item/ac:156715 (accessed November 12, 2013).
intervention will be measured, and reported on in the future, Abramson concluded.
After discussing resilience research highlights and concepts from Masten’s research and identified in Abramson’s white paper, the summary now shifts to on the ground case studies of resilience examples in children and best practices in disasters. Because this area is still new and evolving, it is somewhat of a moving target, but continual sharing of strategies and communication across sectors—again broadening stakeholders—can help develop understanding of children in this vulnerable state.
Joplin Schools as an Example of Resiliency
Angie Besendorfer, assistant superintendent for the Joplin (Missouri) Public School District, began her presentation with a safety message urging everyone to reevaluate their school tornado shelter plans, in particular, to find safe areas other than interior hallways (where students have traditionally been taught to line up and duck and cover). Security cameras that were still functioning when the tornado hit the Joplin school buildings on Sunday, May 22, 2011, show that those hallways became wind tunnels where equipment and soda machines went flying.4 Had the tornado been on a school day, she said, “it would have been horrific.”
Besendorfer played a brief news video to show some of what the city of Joplin experienced. Three thousand of the approximately 7,700 students lived in the direct path of the storm. Seven students and 1 school staff member were killed, and 4,200 students were without a school at the end of the storm. Nine schools and the administration building were hit by the tornado, six of which were a total loss. Around the city, 8,000 homes, 400 business, and 18,000 vehicles were damaged or destroyed, and 161 community members were killed.
Prior to the storm, the school district was already on a first-name basis with city leaders, chamber leaders, and federal and state
4The security camera footage can be viewed on the school district website at http://www.jet14ondemand.com/ondemand/musicvideo.php?vid=9974a0414 (accessed September 9, 2013).
representatives. Also in place was the Bright Futures Initiative, a network which links business, social services agencies, and faith-based partners to schools. The district also had strong communications strategies, including social media, phone calling systems, a website, and relationships with media outlets. According to Besendorfer, having these aspects already in place greatly benefited the school system’s resiliency and recovery.
The immediate response focused on finding people from the total school family of about 9,000 employees and students. Outreach was done through social media, teachers’ relationships with students and parents, phone calls, media, and simply walking the neighborhoods. The district felt that it was important to provide some sort of closure, and with 12 days left in the school calendar, the school year was declared finished and an event was held at every school, whether it was standing or not. These were set up as celebrations to start the summer, Besendorfer said, but they offered closure and let children, families, and teachers see each other and know that they were all okay. Another aspect of the immediate response was attending the funerals of the students who passed, and the family members of students, being there to support the children in their tragic losses.
Importance of Establishing and Meeting Expectations
Besendorfer explained that the school district established a clear goal immediately following the storm; school would start again on August 17 of that year, just 84 days after the tornado hit. In addition, summer school was started on time and for the first time, it was extended through July and transportation was provided (as many parents had lost their cars). Summer session was really one way to provide a safe place to be for students who needed it, and although the program was for elementary students, middle school and high school students could serve as helpers.
Temporary education facilities were set up in leased spaces, for example, in the mall. Progress on the creation of spaces was shared through the media. It was important to reassure the community that there were going to be quality places for their children to attend school, so that people would stay in Joplin and recover together. The district stressed the message that it might be a temporary location, but it was not a temporary education. Groups of students toured the facilities so that they could share the progress with their friends and foster excitement about starting school. This was particularly important for the high school students who
lost their school and wanted to quit. But when they came to see the facility at the mall, unlike anything they had had before, and learned they were going to get laptops, there was renewed interest. The short-term response also included taking care of the adults. All administration and staff at the hardest-hit schools were required to have a 30-minute visit with the counselor.
Additional support was provided during the course of the 2011-2012 school year. In partnership with the Ozark Center from Freeman Hospital, counselors and caseworkers were embedded in all of the schools in the district, not just those damaged by the tornado, because everyone was ultimately impacted. Besendorfer noted that they were originally called trauma counselors, but they were renamed “hope counselors.” Another intervention was Winter Camp during Christmas break, again, for students who needed somewhere safe to go. The district also worked with the governor and FEMA to create a playground and a community building in the FEMA village. Mercy Hospital hosted community dinners twice per month at the schools to help bring people from the neighborhoods back together. Finally, the “Sunshine Squad” was a group of people who would come to a school and do something for the kids, and then something for the teachers, just to “lighten the air.”
For the school year 2012-2013, the hope counselors are continuing in the schools through a grant. Besendorfer noted that there were even more counseling needs in the second year after the tornado, and there was currently no funding for year three, although several grant applications had been submitted. Also in the second year, all of the school counselors received Cognitive Behavior Therapy in Schools (CBTS) training. Three thousand students are still in temporary schools while replacement schools are under construction. Besendorfer added that all of the temporary school sites and the schools that were affected have temporary storm shelters, and safe room additions are being added to all of the elementary schools (with mitigation funding through Sections 404 and 406 of the Stafford Act).
In summarizing her overview of Joplin schools as an example of resiliency, Besendorfer said that schools are part of the community continuum, and having a relationship with the whole community is very important. Approaches that were successful included setting clear goals and making them very public. This creates accountability but also gives
people hope. Celebrating frequently is also critically important. Celebrating the opening of school, the first football game, or groundbreaking for new schools helped children to make the positive presupposition that everything was going to be all right, and helped them to behave as if it was. The schools became a part of the community pride. Perhaps the most important asset to recovery, she concluded, has been the school staff, and she closed with a video of staff and students telling their stories of resiliency and hope.5
Save the Children
Save the Children was founded in England in 1919, established in the United States in 1933, and now works in more than 120 countries around the globe. Kathy Spangler, vice president of U.S. programs for Save the Children, said that in the United States, it is the leading advocate and responder for children in emergencies. Save the Children is working to mobilize communities in all 50 states to better protect children in emergencies through federal and state advocacy, and policy change. Toward this end, the organization produces an annual national report card that provides a state-by-state assessment of school and child care emergency planning for evacuation, reunification, meeting functional and mobility needs, and multiple disasters. States are ranked on their policies each year, and Spangler said that currently, only 17 states meet the very minimal requirements in all four areas. Spangler reiterated the theme expressed by others that the unfortunate onset of a disaster creates a critical moment to leverage the media to speak on children’s behalf, to show the challenges that communities face in meeting their needs, and to advocate for much needed policy changes.
Children’s Task Forces
One of the best practices shared by Spangler is the establishment of a Children’s Task Force. First used by Save the Children in 2005 in New Orleans in the aftermath of Hurricane Katrina, the convening of a children’s task force is now institutionalized in the immediate response to a disaster. The task force engages key stakeholders, including federal, state, and local partners and nongovernmental organizations, to prioritize
the response and recovery needs of children and child-serving programs. A related best practice is the establishment of a working group (a subset of the task force) to focus on child care recovery. The sooner child care can be operational again, the sooner families can get back to work and get reestablished in their communities. A key challenge to making a rapid assessment of the impact of a disaster on child care is the lack of any central database or registry of facilities, Spangler said.
For Hurricane Sandy, three task forces were established, for New Jersey and New York at the state level, and for New York City. Save the Children is planning to continue its work with Hurricane Sandy recovery through June 2014. Following the immediate response, the organization’s focus has shifted to child care recovery. Save the Children has awarded around 200 recovery grants to child care facilities in New York and New Jersey. Save the Children is also partnering to provide its Journey of Hope psychosocial recovery program to children and their caregivers. Because the tornadoes in Moore, Oklahoma, were in May, at the end of the school year, the focus there was also on child care recovery, as well as expansion of summer camp programs. Grants to local organizations such as the YMCA facilitated free attendance at camp for more than 350 children in affected communities.
Emergency Planning and Response Programs
Another best practice highlighted by Spangler is the Child-Friendly Spaces program, which is the organization’s key emergency response program. It meets immediate needs by setting up care and activities for children in shelters and other places where families congregate during disasters. By the end of 2012, Child-Friendly Spaces had served 1,485 children in 16 Hurricane Sandy shelters. Child-Friendly Spaces were also set up within 6 hours of the Sandy Hook Elementary shooting in Newtown, Connecticut, and operated for more than 2 weeks in conjunction with crisis counseling services for families.
Save the Children has also developed the Resilient and Ready Communities Initiative, a national program to improve community planning to protect children in emergencies. Resilient and Ready Communities was born out of Save the Children’s work across six high-risk regions in the United States. It is focused on systems building, and core elements of the initiative have been utilized at the state and local levels, and in large urban and small rural settings. Trainings to build local capacity to protect children in emergencies have been provided in
communities of all sizes in all 50 states through webinars and online learning. Spangler noted that Resilient and Ready has been recognized by the J. Getty Trust and the American Red Cross as a strategy that has brought together disparate systems into a more organized capacity-building approach.
The six key components of the initiative are (1) engaging key stakeholders through training, awareness raising, and advocacy; (2) assessing current capacity and monitoring progress; (3) informing practice and emergency planning improvements; (4) evaluating resiliency post-disaster; (5) renewing and refreshing resiliency through continuous improvement; and (6) mobilizing communities in support of children’s protection through relationship building and meaningful engagement. As examples of activities in these core areas, Spangler said that Save the Children is currently working with Columbia University to develop a child-focused preparedness assessment tool to help communities identify gaps and focus areas. The organization is also working in a number of county-level jurisdictions in California to draft children’s annexes to their emergency management plans.
Although it’s clear that defining and understanding resilience in children is difficult, especially in the wake of a disaster during their developmental years, continued research and case studies from youth groups and child advocacy organizations from around the country can help to identify best practices and tactics children need to recover from adverse events. Engaging youth groups and looking at cross-sector outreach between public health professionals in health equity, social justice, and disaster risk reduction could show new ways of achieving a similar goal of building a stronger community where children can grow.