Nicaragua quake survivors get new homes - 40 years after disaster (The Christian Science Monitor)

Managua, Nicaragua; and Mexico City – When Guillermo Martin Treminio's house crumbled in the 1972 earthquake that leveled Nicaragua's capital, killing 10,000 people and destroying 50,000 buildings and homes, he had nowhere to go. So he moved his family into a crumbling apartment building in downtown Managua that the wealthy had abandoned.

Mr. Treminio's refugeelike living conditions, which he had once hoped would be temporary, became home for almost 40 years. "We had lost hope," he recalls.

But now he has finally moved his family into permanent housing, thanks to a government program to relocate 103 families who also squatted in the skeletal remains of four abandoned high-rises known as "the ruins." It's one of the last efforts of cleanup after the devastating quake.

"The so-called squatter settlements in the ruins are nothing more than earthquake refugees who never got a place to live after the quake," says Nicaraguan historian Roberto Sanchez Ramirez.

Their four-decade-long plight may be extreme, but it highlights a reality in the wake of large-scale disaster, both natural and human-caused. Though critics often fault governments and aid organizations for the slow pace of reconstruction, months and even years may pass before the displaced regain a solid sense of home.

IN PICTURES: Rebuilding after an earthquake

In Haiti, a year and a half after its devastating earthquake, permanent housing reconstruction has not even begun. Even after the 2004 Indian Ocean tsunami, the aftermath of which is seen as a model for reconstruction, it took four years for families to find permanent homes. Five years after hurricane Katrina in the United States, thousands remained in temporary housing.

"Very-large-scale disasters, especially those that have occurred in the developing world, have very long recovery periods," says Irwin Redlener, a physician and director of the National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health in New York. "The temporary housing might become permanent, or very longstanding."

That is certainly the case in many parts of historical downtown Managua – a crossroads of fault lines that has been left in weed-grown partial abandonment since the 1972 quake. In total, 541 city blocks in Managua were destroyed or irreparably damaged and had to be leveled afterward.

The majority of middle- and upper-class citizens fled, joining an exodus of 250,000, more than half the population of the city. But those living in shantytowns had no place to go, so they forged lives for themselves among the devastation, waiting for government help. "We thought we were going to die there. We never thought we would be moved out," says Erminia Pineda, a longtime resident of the apartment buildings, where as many as 45 people would live on a floor built to house only four or five and which was governed by its own set of laws and social norms. Each floor had its own hierarchy of power, based on seniority and economic clout within the buildings. Residents took care of their own security, organizing into vigilance groups to watch over one another's belongings. Walls often fell down. Rain came through cracks. Each time the ground shook, residents worried the buildings would come down.

Temporary living is fraught with vulnerabilities, says Lilianne Fan, an independent consultant on humanitarian policy and postcrisis reconstruction who has worked in Haiti and Indonesia. Those displaced often face problems with sanitation, little access to education and health care, and limited security. The psychological pressures of not having permanence can also take a toll.

The challenges of postdisaster reconstruction are many. Among them: removing rubble, planning settlements, securing funding, procuring materials, and training builders. While aid organizations sweep into disaster zones, the degree to which they can participate in large-scale reconstruction is limited. When a disaster occurs in a developing country without a strong government, reconstruction takes even longer.

IN PICTURES: Rebuilding after an earthquake

"There are some misperceptions about what the private or voluntary sector can do," says Mr. Redlener. "The larger the disaster, the more necessary it is to have the government as the principal driver of recovery."

Those in Nicaragua blame previous governments for ignoring their plight. "The neoliberal governments [from 1990 to 2006] promised us homes, but it was all a lie," says Treminio.

But now that is changing. In early April, 30 military trucks rolled up in front of the ruins to evacuate the 700 people living there, moving them to a new neighborhood of cement-block homes about six miles away.

While some squatters resisted the move, arguing that the housing settlement was too far removed from Managua's main marketplace, many are glad to get out of the dilapidated buildings, which city officials have deemed a "deathtrap." The buildings were leveled in May.

Starting anew is a challenge for some. "It's harder here, but you can't have everything," Ms. Pineda says in her new neighborhood. "New beginnings are hard everywhere, but we have a house, we have a roof, and we have water. And that's what's important."

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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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