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EditorialIsland Voices

Column: Keiki are vulnerable during, after disasters

Robert H. Pantell, M.D., F.A.A.P., is medical director of the Child Advocacy and Protection Center, Kapiolani Medical Center for Women and Children.
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Robert H. Pantell, M.D., F.A.A.P., is medical director of the Child Advocacy and Protection Center, Kapiolani Medical Center for Women and Children.

While April 2020 will always be remembered for the coronavirus epidemic, April of every year is recognized as National Child Abuse Prevention Month.

In 2018, there were nearly 680,000 confirmed cases of child abuse and 1,680 deaths nationwide. In Hawaii, there were nearly 4,800 investigations and 1,235 confirmed cases of child maltreatment.

Sadly, but inevitably, child abuse occurs more frequently during and after disasters. This is also true for domestic violence and elder abuse. Life is full of daily stresses, and we all learn how to adjust. However, when disruption becomes massive, such as with the current COVID-19 pandemic, tempers become short and it is easier to reach a flash point and lash out at others. Consequences are often seen for many months after the initial impact of disasters.

We all know babies cry, but for families with infants, right now it may seem like they cry all the time. It’s important to recognize that this is normal. In fact, until about 5 months of age, most infants cry for hours, peaking in the late afternoon. Rocking and walking with baby in a Snugli may occasionally help. It also doesn’t hurt to let baby cry while safely on her back in a crib while you catch some peace.

If you feel you’ve reached your limit, hand baby over to another household member, or reach out to another family member or friend for help. You can also call the Hawaii Department of Health’s ACCESS Crisis Line at 832-3100; neighbor islands call 1-800-753-6879. The service is free and confidential.

For toddlers or school age children, the American Academy of Pediatrics (AAP) strongly recommends against any form of physical punishment. It seldom works and has many negative consequences. Children and adolescents who are now not in school may feel like they’re on vacation and will need direction to continue learning. Many families do not have access to a computer or internet service, making online learning a challenge. Others have parents who are still working in critical positions and unable to home school.

Reach out to your child’s school or teacher for assistance as there are many tools and resources available for families in these situations. The Hawaii Department of Education is also continuing its meals programs and local announcements should be followed closely.

For adolescents, many may already have a built-in system of support through social networking. If an older child or adolescent has had a cell phone removed as a consequence of misbehavior, this is a good time to consider suspending the sentence till the virus passes. Modifying the sentence for positive actions can also be considered.

However, some may not be connected in this way and social isolation increases the risk for mental health problems and suicide. Extra patience, longer screen times, and family connections are especially important.

HealthyChildren.org is a great website for parents that has many useful tips covering everything from making a new schedule that works during disruptions and ideas for things to do together like cooking meals, watching programs, and playing board games or video games, to planning for when this period of disruption has ended.

Other helpful resources include friends, religious and community organizations, physicians, nurse practitioners and counselors. Keep this in mind if you’re a parent, but also if you know other parents who might be particularly vulnerable or just need a little extra support. Help is available in many places. Please don’t hesitate to ask.

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