Wildfire, CA - Photo credit: Mike/Flickr
By Dr. Irwin Redlener
The massive fire catastrophe in LA will be remembered as one of the most devastating disasters in modern U.S. history. Having worked on the prevention of, response to, and recovery from megadisasters for many years, I have watched how the devastation of such events impacts communities and people, especially people with important vulnerabilities like chronic illnesses, mobility challenges, and other conditions, including people who are economically fragile.
But, as a pediatrician, I am especially concerned about what children face during and after large-scale disasters.
Here are some of the key issues germane to children impacted by a massive, fast-moving fire:
Babies and young children will not be able to move from immediate danger on their own and must be carried and protected by adults or grown children.
Panic, exacerbated by acute parental anxiety in an emergency, can result in severe anxiety in children.
Shock, followed by acute and persistent grief, are concerns if a loved one is injured or killed in the fire.
Shock and “loss trauma” may also follow the loss of a pet, the family’s home, or particular possessions, including special or “comfort toys” like a particular stuffed animal.
Acute dislocation with rapid evacuation to an unknown place accompanied by uncertainty regarding where to go or how to get there can be extremely unsettling to children.
Once arriving at a place of safety from the fire, children will need treatment for acute injuries, food, water, temporary shelter, and a sense of what will be happening next.
Children will immediately feel the acute “loss of normalcy” that may be their reality for an extended period of time.
Disconnection from school and friends, grieving for loss in general, and destruction of home and community are extreme challenges for children of any age. Some children are highly resilient, but resiliency is almost never inexhaustible.
Children exposed to fire, smoke, and toxic debris may face immediate exacerbation of chronic illnesses like asthma, allergies, and skin conditions.
Long-term problems associated with inhalation, ingestion, or contact with a variety of toxins produced by the fire – as well as fire retardants applied by responders – may also present health problems for children.
Here are steps that parents, responders, and agencies dealing with children should consider:
“Normalcy” and routine are essential elements that help children cope with disruption and trauma. The faster these factors are re-established, the better.
Reassure children and answer questions honestly in an age-appropriate manner. Reassurance for a 4-year-old is very different than reassurance for a 14-year-old.
Having a “comfort toy” or other important possession may be beneficial to children of any age.
Stay close to your children and establish routines as soon as possible, including regular mealtimes and bedtimes – even in temporary shelters.
Minimize exposure to news reports regarding the fire as much as you can.
Take advantage of psychological first aid that might be available at the evacuation destination.
Seek stable shelter, even if short-term, for the family as soon as feasible
Identify access to school, preschool, and daycare as soon as feasible
Stay in touch with close relatives or friends – but advise them about how to speak with your children in ways that do not exacerbate anxiety!
For families not yet impacted by the fire but potentially at risk:
Preparedness matters for families who live in high fire risk or other disaster-vulnerable communities. Preparedness reduces “evacuation anxiety”!
Keep a “go-bag” handy for essential needs in the event of an acute evacuation
Don’t forget essential medications and medical records are not available online.
Critical documents like passports, licenses, mortgages, or other information that may be hard to replace
Baby and infant supplies
“Comfort toys”
Pet food, as needed
Irreplaceable memorabilia
· Know evacuation routes and destination options in advance of the disaster
· Keep car gas tank at least half full – or charged if electric
