Giving comfort to the youngest quake survivors

By Dan MacMedan, USA TODAY

Kozue Shimabukuro visits one of her patients, 7-year-old Michael Holloway, in the UCLA Pediatric Intensive Care Unit. She helped out in her native country after the March 11 quake.

EnlargeCloseBy Dan MacMedan, USA TODAY

Kozue Shimabukuro visits one of her patients, 7-year-old Michael Holloway, in the UCLA Pediatric Intensive Care Unit. She helped out in her native country after the March 11 quake.

That's what the traumatized children of Japan need in the wake of a massive earthquake and subsequent tsunami that rocked the country one month ago, pediatric experts say.

Just back from Japan, after three weeks caring for the youngest survivors, critical care pediatrician Kozue Shimabukuro tells the story of a boy she met in Yamada, one of the towns heavily damaged after the catastrophic magnitude-9.0 quake.

"There was nothing wrong with him on the outside," Shimabukuro says of the boy about 8 years old. "He just wanted to be with us."

PHOTOS: Landscape of lossFrom the time she arrived in Yamada on March 21, the child showed up at the medical clinic every day. "Days go by and I realize he was alone," she says.

A native of Okinawa, Shimabukuro has studied and practiced medicine in the United States for the past 15 years and has worked in other disaster-struck countries, including Burma and Thailand.

Initially in Yamada, she says she treated some children for asthma and mild skin infections, but most of the youngsters who survived were fairly healthy. Her greatest concern is for their mental health, she says, because many, like the young boy, appeared to have lost family.

"I kept asking the boy, 'So who are you staying with?' And he wouldn't say anything. He was like the master at folding origami. I asked him, 'Who taught you this?' " He told her that his grandmother used to say that kids nowadays play too many video games.

"He said she told him, 'If you do origami, you'll be smarter.' But I never saw his grandmother," Shimabukuro says. She says after the aftershocks — which were frequent — the boy would grab onto her and ask if he was going to be OK.

The organization Save the Children estimates about 100,000 children are among the displaced population in Japan. That figure is still growing, says Irwin Redlener, president and co-founder of the Children's Health Fund and the director of the National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health. "We have an increasing number of people being evacuated from varying distances from the Fukushima Dai-ichi nuclear power plant," Redlener says. The plant was damaged and is still vulnerable to aftershocks.

He says the displaced children will need water, food, a place to sleep, toys and schooling. Children with chronic health conditions such as asthma and diabetes are especially vulnerable. But equally at risk is their mental health, he says.

"They'll require a lot of support from parents and community, but if parents are themselves stressed and community resources are limited, you've removed critical buffers that protect children under stress," Redlener says.

He says that a well thought out recovery plan that involves getting schools operating again is key — that studies show ongoing disruption to a child's education adds to anxiety and can lead to long term disabilities, such as depression.

The acute phase — stretching from days after the event to about three months — is hardest on children, says Henri Ford, a surgeon at the Children's Hospital Los Angeles.

"The good thing is children are resilient," Ford says. "Get them beyond the acute phase and shower them with hope and they will come out OK in the end."

Wealthy countries tend to recover from disasters faster than poor countries, says Steven Berkowitz, associate professor of clinical psychiatry and director of the Penn Center for Youth and Family Trauma Response and Recovery.

Japan also has a close-knit society with a strong sense of family that Berkowitz says he hopes will help it mend.

"They're more likely to do the kinds of things for kids that need to be done as a society and as a nation," he says.

Shimabukuro says one 7-year-old girl really left a mark on her heart.

"She said since yesterday she can't walk," Shimabukuro says. "She's feeling really weak in the knees. So I checked her and neurologically everything was fine. I told her she is a little bit dehydrated. Nothing is wrong.

"But she kept crying and crying for 30 minutes," Shimabukuro says. "I hugged her. She was sobbing and then she told me, 'I want my daddy to give me a piggyback ride again. I want him to carry me on his back because I can't walk.' "

The child's father had died.

"I felt like I was so useless," Shimbukuro says.

Later, Shimabukuro says, she saw what the best medicine for the child was:

"I saw the grandpa. He carried her on his back."

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