by Robert W. Block, MD, FAAP, President, American Academy of Pediatrics
@DrBobBlock on Twitter
Children are not just small adults; their growing minds and bodies have unique physical, physiological, developmental and mental health needs. These differences become especially apparent—and warrant increased attention and care—before, during and after a disaster strikes.
Children breathe faster than adults, spend more time outside, and have proportionately greater skin surface exposed to the environment, making them uniquely vulnerable to biological or chemical substances. Because these agents are heavier than air, they accumulate close to the ground, right in the breathing zone of children. Children’s organs are also still developing, so lasting damage can be done during a chemical outbreak, and their smaller physical size means they aren’t able to use equipment like oxygen masks or life vests made for adult-sized faces and bodies. Children also require different formulations and doses of medicine than adults, not only because of their smaller size, but also because some medications have different effects in children.
Unlike adults, children are still developing their cognitive skills and ability to process emotions, especially in response to a traumatic event. When children are exposed to circumstances beyond the usual scope of human experience (such as a terrorist attack, natural disaster or acts of violence), they may have difficulty coping and develop a range of symptoms, including depression, anxiety, or, if deaths are involved, bereavement. Disasters are rarely isolated, and often initiate a cascade of secondary stresses and losses. This protracted period of time may be especially significant for a child; a year is a long time for an adult, but for a 2-year-old, it’s half his life. While sometimes harder to detect, children’s emotional and mental health needs cannot be overlooked in disaster planning.
For all of these reasons, children need our help. There are steps families can and should take— like taking time to prepare a disaster readiness kit with non-perishable food, water, medications and batteries; understanding what kinds of natural disasters might happen in your region and how to react; and developing a plan for reunification if you and your child are not together when disaster strikes. Talking to children is important. Children can cope more effectively with a disaster when they feel they understand what is happening and what they can do to help protect themselves, family, and friends. One of the most important things parents can do to reassure their children is to talk to them about what parents, schools and communities are doing to be ready and to have the right things in place in the event of any type of disaster. Learn more about ways you can prepare with resources from the American Academy of Pediatrics (AAP) at www.aap.org/disasters.
There are also steps the federal government is taking to make sure children are protected:
- The Centers for Disease Control and Prevention (CDC), under the leadership of Thomas R. Frieden, MD, MPH, plays a key role in preparing the nation for all types of public health threats, whether nuclear, biological, chemical or natural. When a disaster occurs, CDC supports local and state public health departments to help save lives and reduce suffering. CDC also plays a pivotal role conducting research on infectious diseases and identifying and tracking epidemics. The AAP is partnering with the CDC on a variety of preparedness initiatives, including supporting children and youth with special health care needs. As part of this effort, we are working to make sure that children at high risk for influenza complications receive the seasonal influenza vaccine as soon as it is available, and to treat them early and aggressively if they develop influenza-like illness.
- The Federal Emergency Management Agency (FEMA) is also helping lead preparedness and recovery efforts. Under the leadership of Administrator W. Craig Fugate, FEMA’s Children’s Working Group has made significant strides toward meeting children’s needs. This month, please join AAP and become a member of the National Preparedness Coalition at http://ready.gov and learn more about what your family, your child’s school and your local community can do to be prepared for an emergency.
- As we speak, Congress is working to finalize key legislation, the Pandemic and All-Hazards Preparedness Act (PAHPA) Reauthorization, which would renew and strengthen the nation’s public health and medical preparedness and response for emergencies, including several new and vital provisions for children. Among those advances for children that have been championed by the AAP are provisions that will:
- Create a National Advisory Committee on Children and Disasters, which brings together governmental and non-governmental experts to provide guidance and recommendations on our nation’s medical and public health preparedness for children before, during and after a disaster or public health emergency.
- Improve the development and stockpiling of medical countermeasures for children;
- Ensure that public health preparedness programs address the unique needs of children;
- Prioritize children’s needs within the federal government’s disaster preparedness and response efforts; and
- Increase pediatric subject matter expertise throughout all national disaster planning and response efforts.
During National Preparedness Month, let us all take a moment—parents, pediatricians and the federal government alike—to refocus our awareness and renew our commitment to improving the lives of children affected by disasters. No step is too small to take, and no time is better than now.