There have been some amazing stories of children who survived the Tsunami. Sadly these are the exceptions. By and large children are the most vulnerable in disaster situations, both at the time of impact, in the immediate aftermath, and sadly even many years later. In their urgent attempts to bring relief, and restore some semblance of normality, it is vital that aid agencies put into practice the lessons that have been learned about children in disasters.

It was heart warming to see little 14-month old Hannes Bergstroem from Sweden, reunited with his father in Khao Lak, and to hear that 13-year old Meghna Rajshekhar from the Andaman Islands survived two days at sea by clinging to a door. The reality though is that most children had little hope when the tsunami struck. Many were swept from the arms of their parents and had little chance of pulling themselves from the raging current. It is highly likely that the death toll among children will be as high, if not higher than for adults.

In the immediate aftermath children have less resources than adults with which to cope. The very young lack the language skills, or experience, to understand what has happened to them, or to communicate their needs. Their eyes often reveal a state of great shock. They need kind, sensitive care, and to know they are safe. Their physical needs must be met but just as important is to be reunited with parents or a primary carer. In some cases large numbers of children have lost their families and child friendly spaces need to be created where children are safe, cared for, and have access to food, clean water and sanitation.

As the weeks unfold children are the most vulnerable to disease. The World Health Organisation recently spoke of the post tsunami risk of outbreaks of measles, diarrhoea and cholera. Children bear the brunt of these infections, particularly those under 5. Thousands of children can die in one cholera outbreak. The possibility of such outbreaks after a disaster is extremely high because health systems, clean water and sanitation are disrupted. Agencies must act urgently to restore health services and to make available clean water, paying particular attention to access for children.

In a disaster situation victims are rendered powerless. A vital part of the recovery is for survivors to take back control and to start to rebuild their lives. This is just as important for children as it is for adults. Too often children are perceived as either mere beneficiaries or being in the way. Children, particularly adolescents can in fact contribute a great deal in the recovery phase. If well directed they can help with unaccompanied minors, collect firewood, distribute water and create stories and pantomimes that educate other children about vital recovery steps.

Restoring sign of normality is vital for re-establishing a child's sense of well-being. One of the most important steps is to re-open schools. This sends a clear signal that children affected by the disaster are important and introduces a healthy routine back into their lives. It is important that agencies focus on restoring damaged schools, replacing furniture, supplying books, pens and uniforms.

The unseen impact of a disaster is the psychological damage. Children are especially vulnerable and if symptoms are not addressed properly the impact can be carried for the rest of their lives. Toddlers will exhibit regression in behaviour, nightmares, muteness, clinging and irritability. Primary age children will have marked reactions of fear and anxiety, stomach aches, sleep disorders and display frequent re-enactments. Adolescents will experience a lack of interest in previous activities, confusion, lack of concentration, and sometimes a decline in responsible behaviours.

Agencies must act to give children and their parents skills in dealing with these psychological wounds. It is just as important to have child specialists on the response team as it is to have relief specialists. Emotional comforting is essential, as is talking, and reassuring. Too often parents who are already under enormous stress are left to cope on their own without any new information or skills on how to manage their own or their children's emotional reactions. Children are particularly vulnerable to post traumatic stress disorder but frequently will never associate these future behaviours with their disaster experience. The greater care taken now the less difficulties these children will experience in the future.

Perhaps the greatest mistake in any disaster response is simply to be unaware of children, and to carry on with out checking what their specific needs and contribution might be. Children's voices are not easy to hear in these situations. There is the tyranny of the urgent. There are so many pressing needs. Nonetheless agencies that take the time to listen to children, to care for them, to protect them, and to help them regain control, will do a lot of powerful good. To neglect this discipline in the hectic rush of the response is to overlook the very ones we dare to rebuild the future for.

By Ian Wishart
National Executive Director
Plan Australia