Michael Abrahams | The children of the storm

In the 1990s, a landmark study was conducted in the United States examining the long-term effects of childhood trauma. Over 17,000 participants were interviewed. At the time, 10 adverse childhood experiences (ACEs) were identified, related to abuse, neglect or exposure to dysfunction in the home.

The experiences were: physical abuse, emotional abuse, sexual abuse, physical neglect, emotional neglect, exposure to domestic violence, mental illness or drug abuse, parents being divorced or separated, or having a family member being incarcerated. Participants were given a score of one for each ACE.

Researchers found that, with elevated ACE scores, not only was the likelihood of mental and physical illness significantly increased, but the life expectancy was also negatively impacted, with most respondents with high scores, of seven and above, dying before the age of 60 years.

Many experts consider childhood trauma to be a public health crisis in the US, and the same can be said for Jamaica. Research in our country has found that, on average, our ACE scores are relatively high. When scores reach or exceed three, there tends to be a rise in negative outcomes, and much of our population has scores above this threshold. Health is defined as physical, mental and social well-being, and childhood trauma has the potential to negatively affect all three. This has implications for several sectors of society, including health and education, and it impacts our criminal justice system as well, as it contributes to crime and violence.

The passage of Hurricane Melissa has negatively affected thousands of Jamaicans. Although it was the western end of the island that was directly hit, even people in areas not impacted by the storm have been traumatised just by hearing and reading stories and seeing images. For those in affected areas, the trauma has been significant as the hurricane was the most powerful we have experienced on record, and there was widespread devastation and dozens of fatalities.

PRIORITY

The well-being of children who have survived the storm must be a priority. The hurricane has the potential to, and likely has, escalated ACE scores for many children. Going into the hurricane, many of our children have already been significantly traumatised. For instance, physical abuse has been normalised in our country. Corporal punishment is extensively used, especially with our boys. Neglect has also been normalised. Far too many Jamaican children grow up with grandmothers, aunts and other family members while their parents are missing in action. To make matters worse, sexual abuse of our children is not uncommon.

Experiencing a natural disaster, such as a Category 5 hurricane, is, in itself, an ACE. Being forced to flee from dwellings that have been significantly damaged or destroyed, and witnessing people and their homes and possessions being blown or washed away, can cause severe trauma, the effects of which can last a lifetime. However, events and life-changing experiences during the aftermath of the disaster present even more challenges, leading to additional ACEs or the intensification of pre-existing ones.

For instance, homelessness, which has been identified as another ACE, is now a reality for many, including children. Some hurricane survivors may have already been living in poverty prior to Melissa, and this may now worsen, with the same being said for food insecurity and hunger. The disruption of many children’s education, resulting from many schools being damaged, is yet another factor that must be taken into consideration.

OTHER SCENARIOS

The hurricane can also set up other scenarios that may place children at risk of being further traumatised. For instance, following major natural disasters, there tends to be an uptick in domestic violence. Not only may children witness this in the home, but they may also become victims themselves. Those staying in shelters are at an increased risk of molestation, as are those living in homes damaged by the hurricane that are now less secure. There are survivors who are right now experiencing depression, anxiety, post-traumatic stress disorder (PTSD) and other mental disorders, as a result of the trauma they experienced during the hurricane, and children are no exception.

However, in the case of children, their brains are still being wired, making them vulnerable to long-term psychological sequelae. Their immune and endocrine (hormonal) systems are also being developed and are vulnerable to being derailed by trauma. The mental dysfunction can lead to years of aberrant behaviour affecting education, employment, relationships, and other important areas that can alter the courses of their lives. The combination of the effects of stress on the bodies of afflicted children, plus unhealthy lifestyle choices that they may make as they try to cope with their traumas, sets them up for physical health disorders as well in the long term.

The mental health of many survivors has been significantly compromised and, as relief efforts continue, this issue must be addressed. But children, who are more vulnerable, deserve special attention. Everything that can be done must be done to comfort, protect and nurture them.

Michael Abrahams is an obstetrician and gynaecologist, social commentator, and human-rights advocate. Send feedback to columns@gleanerjm.com and michabe_1999@hotmail.com, or follow him on X , formerly Twitter, @mikeyabrahams