A third of the country has been completely submerged by the climate-induced deluge, the ramifications of which are more intense for children who made up nearly half of the 33 million people affected. More than 600 children have lost their lives in torrential rains that began lashing Pakistan in June, this year. Those who narrowly escaped floodwaters are displaced, suffering from infectious, water-borne diseases, and severe malnutrition. However, what goes unseen are some of the emotional damages these children are living through.
On the one hand, the sudden loss of home is jarring, on the other hand, losing a loved one is hard to process. Those who are lingering in camps are worried about insufficient services, fear for their safety, and unaware of the struggles that lie ahead. Those who returned found their houses rocked to ruins and their families struggling to regain their livelihoods.
UNICEF conducted a multi-sector needs assessment in flood-affected areas that exhibits that floods have impaired the resilience and psychosocial well-being of children and their caregivers, causing them to feel distressed. According to key informants, 31 per cent of girls and 35 per cent of boys are showing signs of stress. While 35 per cent of caregivers are also experiencing psychological duress, that prevents them from nurturing the care their children need post the disaster.
“Their protective environment and community structure is destroyed which is stressful and frightening and on whom they rely (parents or caregivers) on are unprepared and overwhelmed,” says Jabeen Fatima Abbas, a UNICEF child protection specialist who has been actively working on the frontline.
Getting back to learning is crucial for these kids in order to continue their education, but catastrophic floods have disrupted the country’s entire education infrastructure, preventing more than 2 million children from returning to education. To help restore the joys of childhood, healing, a sense of normalcy and hopefulness, several organisations have set up temporary learning centers and child-friendly spaces. Those who have taken cover in Kemari tent city also find solace in HAND’s safe space which is equipped with materials for learning, art and play.
Spaces like these help minimise the disruption to the learning and development opportunities that regular schools provide.
“We first went to their tents and ensured them that their children would be safe with us. Still, when these children first arrived here, they remained very quiet and barely engaged with us, but this has changed over time, and now they feel more comfortable and participate in recreational and learning activities,” informs Waleed Rasool, 26, one of the space facilitators.
8-year-old Muhammad Ibrahim is one of the children who regularly attends safe space. He had to flee his home in Qambar Shahdadkot with his parents and siblings, while his elder brother stayed behind to rescue his cattle. “We were sleeping when floodwater entered our house and we had to flee in the middle of the night,” tells Ibrahim. “I used to go to school in my village where I was in 1st grade. Here we too study and play. Playing cricket is my favorite thing but I also want to learn as much as possible so that I could become a soldier one day,” he adds.
Many welfare organisations have been on the ground since the crisis began, assisting the government and providing support to children and families affected by the calamity. They are trying to make them feel at peace here but what these children are yearning for is to return to their homes. “I miss my home, my usual life, and especially my brother. I really want to go back home,” expresses Ibrahim.
12-year-old Kareema has a similar story. She escaped the deluge with her parents and siblings and came to Karachi from Bhan Syedabad. Safe space provides her an opportunity to gather with other children in a protective environment where she can learn and play. Though Kareema is happy to arrive here safely, her family has been torn apart, “My uncle couldn’t accompany us. He stayed at home to save our cattle, but he couldn’t save the cattle either. I am very sad. I wish he could be with us,” laments Kareema.
The family is now living in tent city, hoping that they will be able to return home soon.
“The first thing I will do when I go back home is to see my uncle. I will also meet my cousins. I miss them too but I’m not aware of their whereabouts. There has been no contact with them since we left,” elucidates Kareema.
The catastrophe has forced many children like Kareema to leave her education in the middle. Although, various organisations are ensuring the temporary provision of formal education for these children, even so, distance is another barrier that refrains Kareema and many other girls like her from going to school. “My friends and I have stopped going to school because not only did we have to walk a long way to the classroom every day, but we also did not find it comfortable to share a space with boys,” she expresses.
Meanwhile, Mahnoor Naeem, 22, another facilitator appreciates the incredible resilience of these children, “I enjoy spending time with them. Despite all hardships these children are positive and that’s what I appreciate the most,” observes Naeem.
Exposure to the disaster has triggered post-traumatic stress symptoms among these children such as sleeping difficulty, higher than normal irritability, anxiousness, being more withdrawn, fatigue, confusion, memory troubles, and somatic symptoms; headache and stomach-ache. Some of them have developed acute symptoms of mood disorders, PTSD and anxiety.
“If we do not act now to alleviate this distress, it will have a long-term impact on their mental health”, stresses Abbas.
It has been observed that younger age groups remain clingy with parents and are unable to express their distress; while those around 8 to 12 years of age can articulate their fears and feelings better. Adolescents express their frustration and sadness about the loss of learning opportunities and their fear of what the future holds for them. Many of them have had to leave schools and are now employed in some form of labor, but even so, they feel burdened and stressed when they are unable to do more - sufficient to support their families.
Exposure and vulnerability
“Their own small houses were the safe spaces that they had to leave behind. They’ve been exposed to some undesirable or indecent situations (i.e. fights or chaos during ration distribution) in the camps. While limited living spaces and lack of privacy also affects their psychological well-being,” notices Abbas.
“Moreover, since our social norms and practices are fundamentally gendered, psychological troubles also differ for boys and girls. Girls feel more insecure therefore, mobility within a camp setting is difficult for them. They are also more withdrawn, or less expressive given that they have privacy needs. It takes a little more time to engage them,” adds Abbas.
Quality health care is in short supply in most of the flood-hit areas, and those who need psychosocial support face even more limited options. According to UN data, 84 per cent of key informants could not identify any resource persons, community groups, or institutions providing support to children. Among the small percentage of key informants who could identify support structures the least cited was psychosocial support (8 per cent).
“It is important to reduce some vulnerabilities and risk to these children by building a protective environment at community and family levels, therefore, we are expanding the reach of community-based child protection and psychosocial interventions,” comments Abbas.
Community-based interventions include community engagement and social mobilisation activities on child protection risks as well as available services, and structured and sustained psychosocial activities for children and caregivers to strengthen individual and community resilience and self-coping mechanism. Not only children but caregivers are also receiving support through safe spaces and outreach activities. Many of them have benefited from the distribution of recreational kits, psychosocial support kits for self-directed activities and comprehensive communication kits that contain key messages, brochures and recorded audio.
Support tends to be greatest during the time immediately following the disaster. People are ensured to have access to basic needs for survival i.e. food, water, shelter, and medical care. However, support services wane over time, which is when communities feel abandoned and experience extreme emotional lows. This is when they are most in need of mental health services, which are often unavailable or inaccessible.
As the water recedes, flood victims are returning to their homes where the visible effects of mass destruction are revealing that nothing is left intact. It could be even more devastating for children to see their homes wiped away and surrounding infrastructure in shambles, as well as their parents struggling to make ends meet. Meanwhile, caregivers, who have lived through the same disaster, and are dealing with their own grief and loss, are unable to provide stability and routine for their children. Sometimes their frustration may also cause them to become aggressive toward their children who are already traumatised. Therefore, the emotional well-being of parents also needs to be supported as they in turn would support their children following the disaster.
One-time psychological intervention is not enough. Government should provide an enabling environment for the development of capacity for the provision of psychosocial support as an integral part of rehabilitation measures in flood-hit areas. It should also share its responsibility with local government, private sector, as well as civil society to strengthen the health system, child protection system and education system and to institutionalize psychosocial support to better respond to any disaster. Frontline workers; social welfare officers, health workers as well as teachers, should be trained and ensured that they are equipped with knowledge and skills to address the PSS needs, as well as child protection and gender-based violence.
There is an urgent need to provide support to those suffering now, in the months and years to come. Government and other organisations need to ensure that the response to mental health needs reaches the most vulnerable.
Photo credit: UNICEF/Pakistan/d'Aki