1P-SS1-05

LESSONS LEARNED – BHOPAL 1984 AND GUJRAT STATE 2001

Bhave S¹

¹Indian Academy of Pediatrics, Mumbai, India

Background: In 1984 in Bhopal, India, more than 8,000 people were killed when toxic fumes broke away from the storage tanks maintained and used by Union Carbide in the manufacture of pesticides. The Bhopal experience not only demonstrated the need for emergency services with pediatric-sensitive personnel, supplies and facilities; it also emphasized the necessity for understanding the importance of systematically tracking the outcomes of these experiences.

Discussion: Because of lessons learned from the Bhopal disaster, when an earthquake devastated large parts of Gujrat State in Western India on January 26 2001, killing an estimated 30,000 people, immediate actions were taken to help those who required the most urgent attention—the children. Many hospital and primary healthcare centers had collapsed, and most of the district health staff were victims of the earthquake. Despite this, health personnel responded heroically and provided health services from temporary premises in tents, out of vans or out in the open.

Several international organizations coordinated emergency food and aid to provide nutrition to an estimated 298,000 people. Pregnant and lactating women and children under age 5 years of age received micronutrient supplementation including vitamin A, iron and folic acid. Measles vaccine were distributed and syringes for rapid immunization for at least 400,000 children in the "at-most-risk areas", 50,000 auto destruct syringes were provided and vitamin A supplements were given to boost immunity.

UNICEF ascertained that the earthquake affected more than 3 million children under the age of 14. Many children lost everything—family, homes, schools and their sense of security. Children also suffered crushed arms, legs and fingers due to being buried under collapsed buildings. Aside from physical injuries, thousands of children experienced psychological trauma. They became withdrawn, unresponsive, did not play with other children and suffered from nightmares. Assessment is currently under way to identify children who lost both parents. In India, the strong extended family structure and the community-based approach to childcare and protection mean that in most cases, children without parents will be traditionally provided for, but a monitoring system will be needed to ensure that all unaccompanied children are taken into care.

Conclusion: Trauma training to cope with emotional after-effects of disasters is being provided for teachers and health workers to help children cope up with loss and displacement. These trainers will in turn train other teachers, health workers and nongovernmental organizations to identify children with the most severe forms of trauma, refer them to doctors and conduct simple activities, such as drawing and clay modeling, to help children express their feelings and anxiety.