Interview: Jonathan Wilson, humanitarian
On emergent properties of childhood trauma, community harm reduction and why natural disasters don't exist
“History will judge us by the difference we make in the everyday lives of children.” —Nelson Mandela
Few of us devote our lives to such noble work as helping children heal from trauma. It is a task that not only ransoms the most innocent among us, but secures that part of the future of our society that they will build.
Fewer people still become experts in the area of providing care for children who have suffered trauma from disasters, conflict or poverty. It can be harrowing work, but that is exactly what Jonathan Wilson does as director of OpSAFE International.
In this interview, we talk about his life, methods for reducing trauma symptoms in children, emergent properties of trauma and why he thinks natural disasters don’t exist.
DV: Tell us about yourself.
JW: I have done humanitarian work in Asia for the last 35 years and am currently finishing a PhD program studying holistic child development, or how best to help children in some of the most challenging situations in the world. My wife, Rie Wilson, who is a licensed psychologist in Japan, and I first developed the OperationSAFE early intervention for children after community-wide trauma in response to the Sichuan earthquake in China in 2008. After that we used it extensively here in Japan following the 2011 triple earthquake, tsunami, nuclear disaster. Since then we have taken it to eleven countries, most recently Ukraine and surrounding nations hosting war refugees.
DV: What kinds of methods can help reduce trauma symptoms in children who are exposed to political violence?
JW: One of the areas of my research is looking at how mass trauma differs between disasters related to physical events such as floods or earthquakes and those that are more directly caused by other human beings. I think that it is important that we make the distinction that there is really no such thing as a “natural” disaster but rather inadequate foresight and preparation in regards to existing hazards.
So, in a very real way, all disasters are “political” and so too are the responses made to those disasters. One thing that I am always concerned about are ‘secondary’ disasters—governments that refuse international aid, neighboring countries that exploit the situation for their advantage, regions in a country that receive less aid because of political reasons, and of course the ongoing neglect of the poor and marginalized.
I think that it is important that we make the distinction that there is really no such thing as a “natural” disaster but rather inadequate foresight and preparation in regards to existing hazards. So, in a very real way, all disasters are “political” and so too are the responses made to those disasters.
Not surprisingly we found that children exposed to war trauma have higher levels of post-traumatic stress symptoms than those who survived other disasters, but what is surprising was that they also were more responsive to the OperationSAFE intervention. In a nutshell, OpSAFE International trains local communities to provide psychological first-aid specifically for children using a day-camp model where children experience through story, crafts, games, songs, snacks, and calming exercises that they are safe.
The curriculum emphasizes that children are safe, heard, can have hope, are survivors, and are loved, but the structure of the camp is just as important as displaced children establish friendship with a small group of peers, trust with local volunteers in the community, and connections with ongoing regional support.
DV: What regions of the world are currently the most concerning with regard to children in trauma?
JW: I have spent most of my life working to help children in Asia, so the most obvious response is to say that children in the developing world, in poverty, in nations with unstable political structures, and those prone to ongoing war and violence are most at risk. However, as we have all seen recently, there really is nowhere on earth that is immune to mass trauma, whether it is a global pandemic that orphaned hundreds of thousands of children worldwide, fires and other climate-change amplified hazards that overwhelm planned responses, or the continuation of territorial conflict in Europe. Mass-trauma is a public health crisis of huge proportion that needs to be addressed as such.
DV: Are there any emergent properties that make mass trauma in children more than the sum of individual traumas?
JW: This is a great question. There has been a greater awareness of the effects of what has been called “adverse childhood experiences” (ACEs). These are typically individual traumas such as neglect, abuse, or exploitation that cumulatively have the potential to greatly affect the child’s development and lead to psychopathology and even physical disease and early death. Mass trauma events add to the cumulative load of these adverse experiences.
The reality of most at-risk children is that their abuse, neglect, or exploitation is largely hidden or overlooked. But when crises affect the entire community, breaking down the structures these abuses are hidden within, it becomes possible to identify which children are most affected.
When we respond to a disaster, we expect to see roughly 80% or more of the children show resilience as they are supported by their families, community, and a lifetime of nurtured coping skills. These children have had relatively few ACEs and have been successful in overcoming what adversity they have faced. Up to 20% struggle initially but show good progress as they are reassured, rebuild connections and are supported by the community.
Unfortunately, we have also learned that there is always a small percentage that continue to struggle. Some of these are because of extreme exposure during the mass trauma itself, but many have needed to be rescued from abusive situations that existed before the crisis revealed it.
DV: Where has OpSAFE seen the most success or had the most impact in local communities, and what was key to achieving those successes?
JW: From our assessment data collected at the beginning and end of the intervention, we have seen that the intervention is effective across a broad range of crises—disasters, conflicts, refugees, internal displacement—and also in a great number of socio-cultural settings including urban, rural, and tribal in various nations. The keys to the success of this intervention are 1) Local implementation, 2) Scalability, and 3) Sustainability. In each response we partner with local NGO’s that are able to equip communities to provide the intervention for children. These partners understand the language, culture, and political environment that shape the response.
Because mass trauma affects all of the children in a community to one degree or another it is essential that the intervention can scale to meet all of the needs. This is why local communities are equipped and empowered to meet the needs of their own children and not outsiders coming in.
Finally, the intervention is sustainable in that once the community is equipped they are able to duplicate the intervention with their own resources in response to future crises without outside funding. So far, the OperationSAFE intervention has been used with over 50,000 children. Many of these children have been in the Philippines where we have been able to implement these three keys well. Currently, there has been great success in Ukraine and Poland where again the three keys have resulted in a cascade of camps as children endure the ongoing crisis.
DV: We cannot wave a wand and improve economies, so what have you found to be the most effective solutions to address the problem of children in poverty that small organizations or individual people can apply to help make a difference?
JW: Poverty is one of those ‘political’ factors that exacerbates trauma. In Mongolia, we ran a series of OperationSAFE camps despite there not being a disaster or violent conflict. Yet the children were coming from broken homes where substance abuse was prevalent, in neighborhoods with high rates of violence. What we found was that in many ways, this situation mimicked a mass trauma crisis and the intervention produced positive results in the children.
I mentioned before that mass trauma should be considered a public health problem. What I mean is that instead of coming at it as an individual medical problem to be diagnosed and treated, we need to determine the underlying causes and work to prevent them. Of course this means large-scale initiatives like disaster risk reduction, poverty reduction, and peace-building, but it also means encouraging communities to support and protect children, to rebuild community as the ecology in which children develop.
A child whose resilience and coping is compromised by living in poverty is at much greater risk than other children. But at the same time their local community is their greatest resource. We seek to empower that local community by giving them an evidence-based intervention that can be implemented by trained volunteers. In the process, we raise awareness of trauma across the community and equip them to respond in future crises.
DV: What other issues are pressing or overlooked that I neglected to raise?
JW: When I started doing this work, there was very little trauma care specifically designed for children. Children were given a stuffed animal as comfort or activities to distract them, with little attention paid to their developmental needs and sensitivities.
Most crisis psychosocial work was done with adults with children being an afterthought. Because children are still developing, they are actually the most vulnerable members of society to trauma, which can dramatically alter their future well-being. Because of their vulnerability and the rising number of disasters and conflicts, the specific care of children in mass-trauma must be prioritized.