ACEH CHILDREN MENTAL HEALTH AFTER THE TSUNAMI Assessment of mental health/ psychosocial well-being of children and impact of UNICEF psychosocial intervention in Children Centres in NAD

Since the tsunami hit Aceh, UNICEF became the leading Agency on Child Protection, launching one of its largest humanitarian operations, dedicating special attention to children’s psychosocial support. The present exploratory research is the first mental health assessment of Aceh Province children. A stratified random sample of 243 children was evaluated in early 2007, two years after the 2004 earthquake and tsunami tragedy and after the long conflict ended in 2005. Half of the children ben- efited of psychosocial intervention in the UNICEF Children Centres, half of the children never benefited of any psychosocial intervention. An assessment of the cognitive and social competence, as well as a psychi- atric diagnosis was conducted using internationally validated and/ or cross cultural instruments. An assessment of the post-traumatic memory and nar- rative competence was also effectuated, in order to add further qualitative elements to the children’s profile. The study reveals that in most cases the monitored population presents a low socio-economic condition and a significant under-nourishment status: 53% of the examined children are moderately or severely undernourished. Moreover, 28% of them have lost a parent or both and 79% have been evacuated for some months mainly consequent on the tsunami. None of the children have been seriously affected by the conflict exposure and at least half of them have suffered a low-dose exposure. The subjects have been much more exposed to the natural disaster than to the civil war. The current work results show a spread risk of cognitive impoverishment of the whole investigated population, throughout the transition from child- hood to adolescence. The cognitive competence is inversely associated to the under-nourishment level. The burden of present psychopathology is 18% (using DSM-IV criteria), PTSD is the most frequent diagnosis. In 77% cases, PTSD onset is associ- ated to the tsunami exposure dose. In general, a present psychopathology is associated to higher trauma dose, to parents’ post-traumatic distress rate and to the child’s poorer general health status. Disordered children also show to be still facing a greater number of difficulties and worries. The memory of the tsunami is present in the mind of the children as a shared and collective recollection, but it doesn’t show marked subjective features. The UNICEF children are better tellers, likely in relation to the psychosocial intervention they benefited from. The results suggest the necessity of comprehensive interventions addressed to prevent the impact of poverty and trauma exposure on the children psy- chological development. In this framework, the data seem to suggest the protective role played by UNICEF Child Protection psychosocial inter- vention.