Rebuilding Motivation for School Following Conflict and Disaster

1. Rebuilding Motivation for School Following Conflict and Disaster Lessons From Liberia and Katrina

2. Goals of the Workshop To gain knowledge about the cognitive, physical, and psychological effects of exposure to mass trauma in school-aged children. To understand the educational consequences and specific classroom behaviors associated with exposure effects. To gain initial familiarity with intervention strategies for dealing with the educational consequences of disaster exposure To Plan for Possible Disaster at my school

3. Workshop Elements • Overview of Natural and Human Caused Disasters • Katrina and Liberia Examples • Exercise on Responses to Disaster, Trauma, and War/Conflict • Evidence about Responses • Consultation Exercise • Planning for Disaster • Planning Exercise

4. Characteristics of a DisasterHalpern & Tramontin, 2007 • Swiftly occurring, intense acute beginning. • Unpredictable. • Community wide collective impact---Can be Global in scope. • Significant disruption of physical and social ecology. • Affects residents and help givers. • Vulnerable populations most affected (poor, elderly, mentally ill). • Exposure dose-response relationship

5. Human Caused Disasters • Fires---Residential most common---93% of Red Cross Responses—most in Dec, Jan, Feb. Candles, electrical, portable heaters, smoking or matches---most at night. Arson, Type I, II, III conflagrations. • Transportation Disasters---Plane crashes, railway/subway, shipping, etc. • Building collapse, Oil Spills • Terrorism and WMD’s---biological agents, chemical agents, explosives. • War and Civil Conflict

6. Natural Disasters • Floods---most common—co-occur • Landslides • Hurricanes—category 3 • winds 110mph—storm surge • Tornadoes---Okl, Txs, Ks • Earthquakes • Wildfires • Droughts • Tsunamis • Intense heat • Blizzards • Epidemics---avian flu, HIV, SARS

7. Prior Assumptions of Disaster Intervention • Objective is to mobilize staff to attend to needs of survivors • Generic interventions---no effort to tailor to characteristics of a population • Experience increased awareness that race, ethnicity, and culture have profound effect on individual coping and responses • Fundamental changes now needed at institutional level

8. Social Ecology Theory • Environments nested, each inside the next—Russian lacquer dolls (Bronfenbrenner) • Beyond single settings--Relations Between environments is crucial • Ecological transitions---cause shifts in roles and settings. • Perceived environment has direct influence

10. Civil War in Liberia Children were Catastrophically Affected! http://www.educationandtransition.org/resources/liberia-rebuilds-education-system-after-years-of-civil-war/

11. Civil War in Liberia Conflict began in 1989---Charles Taylor and rebel incursion. Characterized by ethnic killings and violence intermittently for 14 years. UN Security Council Resolution 2008 extends peacekeeping forces until September 2012. 49% of women reported one or more acts of sexual violence from combatants.

12. Educational Fallout of Civil War • Schools Closed for 14 years • Entire generation without schooling • Many lost parents, family, suffered brutality, severe trauma, or participated themselves as combatants “A Long Way Gone”. • Formed Communal Living arrangements, started small businesses---delivery on bicycle or motor scooter. • Spent after work at Porn Video Houses. • How to restart schools, attendance, learning and aspiration.

13. Our Work • Consult to establish Department of Psychology and Mental Health Library at University of Liberia • Proposal to train teachers in mental Health Skills Following Disaster. • Consult with Faculty and Administrators

14. Mental Health First Response Storm of the Century Lessons From HurricaneKatrina Lessons from Hurricane Katrina

15. 90,000 square miles affected

16. Katrina’s Mental Health/ Educational Impact • 1,000,000 evacuees over age 16---Public health emergency in Mississippi, Louisiana, Alabama, Florida, and Texas. ½ of evacuees had returned as of Feb 06 • US Unemployment is 8.3 % Katrina unemployment rate is 22.5% among returnees (6 month mental health consequences). • Number of calls to mental health hotline increased 69%. Number of deaths reported same as prior year. • Schools Closed for months • Peers and neighborhoods dispersed • Trauma effects after schools reopened for students, faculty, and staff.

17. Typical of worst hit areas 1000 square miles

19. Interventions We Conducted • Brief, solution-focused Counseling • Case Management • Specific assistance (e.g. breathing machine for sickle cell child, special baby formula) • Articulation and Referral to local services. • Vocational counseling • Consultation and support with first responders, healthcare providers • Emergency coverage • Diffusion of conflict situations • Door to door canvassing (tent and trailer parks)

20. Disaster Exposure Effects Exercise • 1248 • Handout • Discussion

21. Physical Effects of Disaster Exposure • Acute repiratory syndrome • Labile HBP • Dizziness and Fatigue • Reduced lower left hippocampal volume • Immune suppression • Increased basal cortisol • Asthma • Headache • Diabetes increase/chronic illness increase (e.g. lzheimers, etc. • Sexual Dysfunction • All cause mortality

22. Negative Effects of Disaster and Conflict

23. General Strategies for Recovery • Seek Social support and connectedness • Psychological First Aid (Red Cross) • Cognitive Reframing CBT • Meditation • Yoga • Deep Muscle Relaxation/ Desensitization • Life planning • Restoration of sense of safety • Unproven strategies • Critical incident stress debriefing • EMDR

25. Disaster and Culture • Culture aides healing---protective factor provides comfort and reassurance. Stories, rituals, legends, spirituality may help adjust to losses. Highlight communal trauma may assist. • Consult natural leaders---clergy, tribal elders, etc. Involve as “brokers” in interventions. • Survivors are helped best when services are culturally concordant. Indigenous responders may be most effective---recruit and train workers from community. • Community and natural supports are crucial to recovery and may actually strengthen a community. • During disillusionment, intra-group tensions may rise and minority groups may face blame or anger.

26. Cultural Competence Continuum • Destructiveness---Cultural difference viewed as a problem---may attempt to limit, dismantle or even destroy a culture. • Blindness---midpoint---color or culture make no difference. See themselves as unbiased • Proficiency---Hold diversity in esteem, do research find new therapeutic approaches, hire staff, adapt policies prior to disaster.

27. Equipping Educators to Manage the Educational Consequences of Disaster Exposure • Remind yourself---everyone is affected (you too). • Pay attention to your own reactions---denial will lead to non-recognition in others. • Self-care is critical---airline oxygen mask notion. • Learn to identify residual effects in students, colleagues and family members. Use the checklist. • Consult, normalize, utilize social support. anticipate, and educate. • Plan constructive futures.

28. Consultation Exercise • Assist a faculty member to cope with educational issues post-disaster

30. Disaster Planning and Preparedness • Personal and Family Level Plan—have a meeting place and a phone chain. • A go-kit, medications, valuable records on a thumb drive, cash, water and energy food, radio, location of shelters. • www.fema.gov/pdf/library/pfd.pdf.

31. School Plan • School Plan---make sure school has a written plan for dealing with the press, and phones, and lockdown. • Review elements of the plan periodically with all. • Go kit, names and addresses phone contacts of parents, medical needs of students, Keys. • Pickup Arrangements

32. Community Plan • Be familiar with evacuation plan. If none exists, press for one. Check to see that personal plan syncs with community plan.

33. Disaster Planning Exercise • Personal Plan • School Plan • Community Plan