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Five years after Maria and one week after Fiona, children in Puerto Rico continue to wait for trauma and toxic stress to be addressed accumulated from the adverse experiences they have lived through. During my visits to the communities, I have heard the trauma first hand, I have witnessed a silence that is a cry for help, I have seen suffering faces, the anguish, the impact of feeling abandoned, like the families without communication in the Valencian neighborhood of Juncos who , having missed a bridge, they are still waiting for a sustainable solution.
I am convinced that complex care should be prioritized urgently children and young people whose mental health is not fully taken into account in the development of the country’s recovery plan. We have almost a generation whose access to their rights to education, health and security, among others, has been violated. In many cases, this can be an impairment that affects not only immediacy, but also their executive skills, memory and its development as a whole.
A six-year-old boy we spoke to in a group intervention these days after the hurricane affected us greatly because all the significant experiences he remembered to share were related to a natural disaster or emergency. He remembered Hurricane Maria, the earthquakes, the COVID-19 pandemic, until the day when there was a lot of dust from the Sahara. Like so many others like him, this child associates his childhood, that stage that is almost always recalled with joy, with traumatic experiences.
Now what awaits our childhood? Lots of challenges. But the good news is that yes, we can do more to strengthen the protective factors that help heal and overcome trauma. In emergencies, it is essential to provide them with urgent access to basic community-based physical health and nutrition services, accompanied by support for families and attention to the details of their felt needs, rather than peripherally perceived needs. The most that our brigades in the south and support in the shelters asked us for was drinking water. water! Something more basic? Not being able to guarantee clean water is an attempt against life and even that was lacking.
It is as important as physical attention ensuring access to sustainable affordable mental health services in communities. You can’t wait for the children affected by the hurricane to call the helpline. Instead, you have to go to where the families and children are to talk to them because they feel paralyzed. Their brains are in survival mode. Five years have been in a kind of “electric shock” from successive traumas from natural, economic and political disasters. We must take care of them now and prevent greater evils.
We need to strengthen ecosystems of services to support children in all communities, with a special focus on contexts of high poverty and violence. If community service centers are not established, there will not be enough financial support to address the systemic problem before us that has been exacerbated by disasters. More is needed!
An urgent coordinated response from all systems is required. Willingness and resources are needed to implement the recommendations that community organizations have been making for years. We need to recognize children as subjects of rights, not as objects of charity. It is important to understand that children’s traumas do not allow them to learn and react at the expected speed. There are young children who have spent their entire lives in a state of emergency in Puerto Rico, and their recovery is not easy.
What should be done? A true country program for children from the earliest age. In the meantime, let’s start with the relaunch of the National Prevention and Family Support Plan, the National Reading Plan and the implementation of so many other upcoming actions. Mental health support should be ongoing, not a month and end effort. As schools and recreational facilities reopen and a sense of safety returns to communities, a country plan should be followed to prioritize children and their families at all times.
Clearly, there is much we can do, but we know that we all need to agree on what we need to do in a fair recovery plan, government, the private sector, academia, communities and non-profits. All together we can make it possible to move in the same direction: a Puerto Rico where children are not left behind, can heal trauma and look again at life with the hope that it should live in every boy and girl on our land.
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