The Inner Landscape of the Children Who Survived Typhoon Haiyan

The similarities are striking - we've been in this place before.

The past echoes in my brain and I feel as if I am sitting in my living room the day after Christmas in 2004. Now, a week after yet another global disaster, the Emergency Phase kicks solidly into gear. Food, water and shelter arrive, temporary shelters spring up, headlines tell of the horrors that have taken place, photos show decomposing bodies, videos capture children wandering the streets. Incidents of unrest emerge as survivors clamor for their most basic needs. The world remains in shock as doctors plead for supplies.

Are we in Haiti in 2010? Is this Indonesia in 2004? Perhaps this is Turkey in 1999, or Pakistan in 2005, or is this Chile in 1960, the strongest earthquake in history? Wait, is this Japan just two years ago?

No, this is now, the year is 2013, and it isn't an earthquake that caught us off guard. This was a storm - a huge "super typhoon" we saw coming, and we were given warning that an impoverished island nation was directly in its path. So we watched, waited, and now, a week later, many act surprised.

It seems we have learned little from past experience even in the US where Hurricane Katrina should have taught us to be better prepared to respond when predictable disasters strike. Yet in the last decade, while we've had plenty of opportunities to get our global act together when it comes to assisting other nations who suffer major disasters, again we've fallen short to deliver what is necessary in the entire scope of disaster relief.

Please don't misread my commentary here. I am grateful that US aircraft carriers headed for the region, their presence and our troops now beginning to make a huge difference. But I do wonder why they weren't closer days earlier - why people had to wait 4, 5 even 6 days for basic help to arrive. Might they have been stationed closer to the area?

And yes, I am grateful, too, for the work of institutional relief groups whose delivery of water, food and medical supplies is at the heart of this first response. Most of these groups do extraordinary work meeting the immediate needs of a devastated populace. They are our heroes, too, and despite much controversy surrounding some group's management of donated funds, do much of the dirty work so necessary in disaster response.

I've written extensively about disaster on this site, repeating what I see as the three phases every disaster passes through. We are solidly in the first phase now, the Emergency Phase, and most funds donated to causes like the Red Cross, Mercy Corps and Oxfam will go to feed, clothe and protect survivors of this typhoon. Over the next few weeks, we'll look back and note that today was the turning point, the true beginning of the Emergency Phase that will last well into December. Slowly but surely, bodies will be collected and counted, missing persons will be listed and families will grieve. Food, water and medical supplies will be delivered and procedures will be put into place that help ravaged communities begin to return to some sense of normality. Sanitation concerns will linger until proper systems are established and order is restored, but calm will eventually prevail.

I sat with my family on December 26, 2004 watching in utter disbelief as images of another island nation decimated by walls of black water flashed across our television screen. Sri Lanka, an island nation just East of the earthquake that caused the massive tsunami in Indonesia, lost its innocence that day and along with it more than 36,000 of its citizens. Nearly a million people were displaced and almost 100,000 building were destroyed in that small nation alone. The death toll in the entire region was close to 230,000, one-third of them children. More than a million and a half people lost their homes.

Fully aware of what would follow the Emergency Phase of that massive disaster, the Fortunate Blessings Foundation, which I direct, immediately organized a mental health team and was on the ground within three weeks. Unlike Thailand, whose capital city Bangkok was not impacted, Sri Lanka's capital city of Colombo was hit as was the entire perimeter of the island. This fact resulted in the destruction of 70% of government offices and a loss of 30% of government employees. The country was crippled; when we arrived, the relief camps were already serving 125,000 meals a day and kids needed help.

In Colombo, and all along the southeastern and southern coast in cities like Kalutara, Beruwala, Hikkaduwa, Galle, Matara and Tangalle, our Second Response team conducted trainings and introduced a special program, "PLAYshops". We were hosted by the medical school there, training 70 doctors, and supported by community organizations like Impakt Aid and Navajeevana whose tireless dedication to recovery was both inspiring and inexhaustible.

Less than two years later, in Bantul, Indonesia, another earthquake struck destroying or damaging 80% of the homes there. Again, Second Response deployed to the area a month later following close behind Emergency Phase first responders. Throughout the region, we conducted PLAYshops in tents and on top of rubble, working with parent and teacher groups who quickly learned how to help children release their fears, grief and anger through our effective body-centered therapies.

In Samoa and Japan, again hosted by medical schools and nurses associations, local caregivers took our four-hour training and then went to outlying areas where they conducted PLAYshops. This exponential model helped us to reach thousands of children in a very short period of time. And most recently in the Northeastern United States, we did the same thing - recognizing that when the Emergency Phase winds down, it is imperative that there is an authentic Recovery Phase before The Reconstruction Phase commences.

Without attention to the inner landscape of children, far more cases of PTSD emerge in a population impacted by traumatic events like Typhoon Haiyan. So rather than simply wait to see which kids will demonstrate symptoms of PTSD in the period of three to six months after the fact, doesn't it make sense to go in sooner than later to prevent PTSD from forming? That is our conviction.

And now we return to the case at hand -- what is happening in the Philippines -- the horrific events still fresh in our minds. If history tells us anything, soon these stories will be relegated to the back pages of newspapers and disappear from the evening news. For a while, we will hear more stories of heroism, infrastructure damage, government assessments of rebuilding costs and official estimates of deaths and casualties. None of this will make any difference at all in the lives of those children who survived and who desperately need emotional support and an opportunity to be kids again - to run, laugh, scream, wiggle and play.

When the Emergency Phase of this disaster shifts to the Recovery Phase, we are prepared to deploy our Second Response Trauma Teams to the areas impacted by Typhoon Haiyan. We bring our experience to support children and adults with deeply repressed emotions and post traumatic stress. No "disorder" can be diagnosed yet and nothing is set in stone. There is time to act to prevent thousands of children from living with the burden of PTSD and the physical, emotional and material costs this diagnosis carries with it.

We feel it is vitally important to distinguish our work from the very capable and well-meaning care that is usually provided to traumatized children. Our work is not counseling or talk therapy; it is body centered. With it, we have two goals: our first aim is to prevent and reduce children's post-traumatic stress-related symptoms, depressive symptoms, somatic complaints, functional impairment, separation anxiety and generalized anxiety; secondly, we immediately build capacity on the ground so that future events and ongoing needs can be met with similar, effective responses by local caregivers and existing groups.

We witnessed remarkable changes in children within very short periods of time. Our study of tsunami-traumatized children in Sri Lanka acknowledges our success and our methods have been applied cross-culturally to American, Palestinian, Sri Lankan, Israeli, Thai, Indonesian, Japanese, Samoan and Chinese children with equal success. PTSD, characterized by stress-related reactions such as asthma, skin problems, irritable bowel, nightmares, insomnia, hyper-vigilance, anxiety attacks, etc., can be prevented in these populations rather than wait to treat it.

The biggest challenge we face is that many agencies focus only on palliative approaches, quiet counseling and minimally expressive therapies that are primarily cognitive in nature. While these efforts do carry value and we acknowledge their worth in this regard, they often do not reach the invisible wounds of a disaster like this typhoon that become more somatic, body-centered, and latent imbalances - ones that later become physically systemic, causing the symptoms described above. These problems are preventable.

It is our intention to train caregivers, social workers, teachers, parents, health ministries, mental and physical health personnel, and others in the Philippines in order to help children before PTSD sets in. We can teach and demonstrate our methodologies and pass on this expertise to local teachers, parents, and health professionals as well as to volunteers and staff of existing disaster relief agencies on the ground. We have done so repeatedly in the past, and what we do is very simple, completely non confrontational and deeply respectful.

To the children, our work occurs as games, as pure joy and fun. We are extremely good at what we do -- facilitating a natural release of fears, grief, anger, and other emotions -- and we effectively demonstrate to caregivers ways to understand the nature of PTSD and identify special cases and the needs of children who are severely dissociated. Our methodologies are safe, highly effective interventions that children love and eagerly embrace.

We leave behind a basic Guide for Caregivers that has already been translated into several languages and will be available in Tagalog. We are extremely sensitive to and knowledgeable about cultural attitudes, local customs and the unique resilience and pride of many different ethnicities. Our teams bring a body-centered, psychosomatic approach to PTSD using play therapies that are universally adaptable, culturally acceptable, and simple to learn and practice. Underneath what looks like play are detailed, well-researched games and exercises that specifically address unresolved fear, anger, grief, and other emotions that can no longer be accessed cognitively due to dissociation. We have age-appropriate games and are skilled at reaching younger children or resistant teenagers who otherwise may not participate.

Before the rush is on to rebuild the areas devastated by Typhoon Haiyan, and as the Emergency Phase transitions to the Recovery Phase, we urgently need support to enable our teams to reach as many of the 2,000,000 children who have been impacted by this disaster. Now is the time to prepare and act.

Please go to to donate. Thank you for your support for Second Response.