Studies investigating the effects of natural disasters on children in Turkey started with the 1992 Erzincan earthquake and the 1995 Dinar earthquake (Karabulut & Bekler, 2019). Cognitive and verbal expression abilities are not sufficiently developed in children. Children cannot express their thoughts and feelings like adults, but this does not mean that they are not affected by natural disasters. Children and adolescents are the most vulnerable and vulnerable individuals in the age groups affected by natural disasters.
In a study covering the three-month period after the 17 August 1999 earthquake, a higher rate of anxiety disorder was found in pediatric patients who applied to the pediatric psychiatry outpatient clinic for the first time compared to the previous year. It was observed that the diagnosis was made (Berkem & Bildik, 2001). It is estimated that one of the main reasons for this anxiety is the thought that the earthquake will be repeated. Especially in the first month of symptoms, it can be observed in children who experience the earthquake one-to-one, that the earthquake constantly comes to their minds or re-experiences the moment of the earthquake. Avoidance or ignoring can also be seen in order to prevent the events that come to mind. Situations such as intense emotional approaches, anxiety, fear, helplessness, and horror can be experienced. On the other hand, the biggest symptom in children who did not experience the earthquake directly is the anxiety brought about by the thought of uncertainty. In his thoughts about the future, his worry and fear of what will happen to himself and his family greatly affect his daily life. Sleep quality and feeding routine tend to deteriorate due to this concern. Children's sense of security is shaken. In this case, they may want to get away from home or may not want to leave home by being more attached than they are to home.
Separation anxiety is an important situation especially for preschool children. Children's fear of separation from their parents after a disaster increases considerably from normal levels. Not wanting to sleep alone at night, not being able to leave his favorite toy are situations that arise with separation anxiety. Symptoms such as feeding problems, problems with falling asleep, nightmares, bedwetting, sensitivity to loud sounds, speech difficulties, and inability to be alone can be observed in this age group after a disaster (İşmen, 2016). These symptoms occur with regression, which is one of the ego's defense mechanisms.
It is a high probability to observe similar symptoms in school-age children. The most basic element that distinguishes it from the preschool age is that they are more aware of the realism of events. School-age children can more clearly articulate the reasons for their fear and anxiety. Situations such as agitating behaviors, increased attention problems, undiagnosed pain complaints and decreased school success may occur (Nakajima, 2012). Again, in this period, children who experience awareness may try to suppress their feelings in order not to upset their parents (İşmen, 2016). The emotions they suppressed again emerge with the symptoms of regression. Situations such as fear of the dark, not wanting to sleep alone, having nightmares, and bedwetting may also occur.
Children may react differently to earthquakes. While behavioral changes can be observed immediately after an earthquake, problematic behaviors can be exhibited after weeks or months of pretending nothing has happened (Erkan, 2010). Earthquake is a threat and our brain puts forward several responses to deal with this threat. The fight or flight response is a situation created by the threat (Nakajima, 2012). We can fight, we can run, or we can freeze without both. It is a state of freezing when the body slows down the heartbeat, the movements become difficult, and it is in a calm position. A frostbitten child should not be forced to speak. A safe environment should be created for the child to talk. In addition, children who ignore the earthquake and never speak can be observed. There may be denial, and this is a certain normal reaction. Not asking any questions about the events, ignoring the turmoil and sadness around are reactions to denial. However, it is necessary to understand the difference between the freezing response and the denial response and to act accordingly. While the freezing reaction is generally a physiological slowdown, the denial reaction is the unresponsiveness to the event.
Turkey On February 6, 2023, the earthquake of 7.7 and 7.6 magnitudes in Kahramanmaraş's Pazarcık and Elbistan districts was the most destructive in recent years. experienced the earthquake. Children were also directly or indirectly affected by this great natural disaster. Parents are always role models for children and in this process, they be a true role model for them. It has been observed that some of the parents reflect the worries and emotions they experience to their children because they are unsuccessful in their coping strategies (Canel & Balcı, 2018). Children try to understand their parents' experiences and internalize them. In this case, it is understood that even if children try to keep them away from the psychological consequences of the trauma, it turns out that they internalize their parents' stress (Bradfield, 2013). If parents can create a place where they can express their feelings and thoughts without making it chaotic in the environment they live in, children can start to notice a safe place to talk. Open and honest communication stating that it is normal to experience anxiety and strain, that they share the same feeling together, but that they will overcome it, can help children understand that their own emotions are also normal. Explaining these difficult symptoms to children after the earthquake is a healthy way of communication. It has been seen in the studies that the primary task of the parents in this process is to ensure that the child understands that this situation in his mind is not a problem, but as the adaptation of our mind and body in order to adapt to a new situation. Also, acute grief reactions can vary according to the trauma or loss they are exposed to (Özgentürk-Ayaksız, 2004). One-month post-disaster responses are stress responses. It is a period when the body and mind are trying to heal themselves. These are normal responses that happen in the process. These symptoms are expected to decrease gradually as of approximately the second week. Professional support is extremely important in cases lasting more than two weeks and in severe conditions (Nakajima, 2012).
In studies conducted with children in Turkey for post-traumatic stress disorder (PTSD), the rates for diagnoses 6 months after the earthquake are %, respectively. 73.5 and 71% (Bulut, 2009). If situations such as anger, fear and anxiety, startle and alertness, in which re-experiencing, bodily symptoms, intense thoughts and emotions begin, do not begin to decrease after two weeks, the child's work life
Earthquake disaster affects children as well as adults. One of the important steps in the difficult process should be to enable children to express themselves. Children express themselves through play. It is through play that he can internalize and deal with what he has experienced and seen. It can be good to play games, increase physical contact, talk with them. It will be good for children to tell them about this process and to make them understand that their feelings are normal. It is necessary to know that every child can react differently. It is necessary to act according to the reactions of the children and to carry out the process by considering the severity of the symptoms. It is very important to get professional support for symptoms that do not decrease in severity at the end of the period recommended by experts, for mental disorders that may occur in the future.
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