(WOMENSENEWS)A year after Hurricane Katrina drove Michelle Castillo and her family from New
Orleans they are struggling with anxiety, chronic stress and fatigue, as are an estimated 2 million other survivors. Fifth in a series about one woman rebuilding her life.
ORLANDO, Fla. (WOMENSENEWS)--Michelle Castillo makes an effort every single day to exude strength and resilience in front of her traumatized teenage children and ailing father.
Nearly a year has passed since Hurricane Katrina washed them out of their home in New Orleans, forcing them to leave their old city behind. But as she struggles to create a new life for her family in Orlando, Fla., every family member--including Michelle--exhibits symptoms of mental stress and the physical symptoms that can accompany it.
Castillo's 68-year-old father, Allen Wallace, a saxophonist and longtime fixture in the New Orleans music scene, has been checked into the Health Center of Windermere since early July, when he suffered an inflamed prostrate and severe bladder infection. Wallace, a diabetic, has just in the last two weeks begun tentative efforts to feed and clothe himself again.
Doctors told Castillo that the stress of the past year undoubtedly worsened his health.
"I've never seen him so unwilling to even try to do things for himself," says Castillo.
Untreated mental health issues, says Dr. Richard Weisler of Duke University, in Durham, N.C., and the University of North Carolina at Chapel Hill can lead to physical manifestations.
"Disrupted sleep cycles and prolonged stress for survivors can weaken the immune system, all of which can contribute to making existing health issues more severe," Weisler says. "The most susceptible are the young and the elderly."
Health care workers have repeatedly expressed concern about the ability of children and elderly people to bounce back from a disaster like Katrina, which displaced half a million people permanently from the Gulf Coast region.
"For older people adjustments under normal circumstances take longer and when everything that meant comfort and safety is gone, that transition can mean prolonged trauma," believes Dr. Paula Madrid, director of the Resiliency Program at the National Center for Disaster Preparedness at Columbia University in New York. "Children take in whatever they see going on with adults, and if the adults are struggling that will affect the children."
'My Kids Are Not Secure'
"My kids are not secure, they're clingy and scared in a way I've never seen them," says Castillo. "They just can't seem to get a foothold in this place we're trying to call home."
Both children spent the bulk of their summer vacation inside Castillo's rented house watching television, gaining weight and largely refusing to go outside to engage in summer activities. Alexandra, now 13 years old, started high school this past week having made no friends over the last year and dreading the prospect of going back to school; 12-year-old Giovanni has been acting out at home.
"They miss the old neighborhood, their friends, and there's nothing I can seem to do about it," says Castillo, a 42-year-old single mother.
Health care professionals say the emotional damage of disasters tears a broad path through an affected population that disregards variations such as race, gender or economic status and that a mental-health response should be the cornerstone of any recovery assistance plan.
"Mental health isn't just about asking people how they're doing, it is an integral part of the disaster response system," says Southfield, Mich., psychologist Susan Silk, who traveled to Florida after hurricanes Andrew and Katrina to help administer initial psychological care as a volunteer with the Red Cross.
"Everybody needs people to be compassionate and reassuring in such an overwhelmingly frightening situation, to bring a little humanity," says Silk. "That can be through simple acts like a smile, a hug and listening."
Steady Encouragement Needed
Survivors need steady encouragement from those around them, and society in general, to buttress their individual efforts. For 70 percent, those needs are short-term. But between 25 percent and 30 percent are likely to develop anxiety disorders, according to the American Psychological Association, and in the case of Hurricane Katrina, that could be up to 500,000 people.
Women are twice as likely as men to experience longer-term effects, which can include self-destructive behavior such as alcohol or drug abuse, chronic depression and stress-induced physical complaints. In a February survey of Katrina survivors by Columbia University's Mailman School of Public Health, 68 percent of female caregivers reported symptoms of depression and anxiety.
Following less-extreme disasters, survivors benefit from community support as friends and neighbors give money, time and attention that provide people with a crucial sense of accomplishment and belonging.
"Tapping into pre-existing support networks like family, friends, church and schools is central to recovery," says Silk, "but with Katrina everything and everyone was just swept away."
Katrina survivors have had a hard time establishing roots in new communities.
In the first four months after the storm, families had moved an average of 3.5 times and 25 percent of children were not yet settled into schools, according to a Mailman School study released in April.
Despite over $100 billion in recovery efforts and an initial outpouring of generosity from people across the country, thousands of families are still without permanent housing, health care or jobs. Twenty-three percent of displaced Gulf Coast residents remain unemployed.
Resiliency Being Challenged
"People's resiliency is being challenged every day," says Columbia University's Madrid. "And when support from society turns into stigma it is truly horrible for people who have been so battered."
Health care professionals such as Silk believe suffering and emotional trauma will be running high as the Aug. 29 anniversary of the hurricane approaches.
"After a long barrage of recovery issues, many are going to be plagued by sadness, isolation, chronic stress and overwhelming fatigue," says Silk. "There won't be anyone from the affected area who is not feeling grief over what has been lost and how far there is to go."
Castillo certainly identifies. Her nine brothers and sisters are spread out across the southern United States. While Castillo has found some community support in the local Jehovah's Witness church she attends, she still feels terribly alone.
"I wish I had more family or friends here," she says. "Every day I begin knowing that it's going to be a struggle and I just feel as though I'm wrecked, like I can't go on, can't keep doing this all by myself."
The knowledge that her children and father are depending on her, Castillo says, is both empowering and overwhelming.
Castillo says she stopped trying to talk to Alexandra and Giovanni about the storm and how it has changed their lives months ago, feeling that it would be better for the children to look toward the future.
"Course, the future is just as scary as the past," she says. "I'll do everything I can to keep my family afloat, but I can't make anyone any promises . . . I can't put the sadness that makes me feel into words."
Juliette Terzieff is a freelance journalist currently based in Buffalo, N.Y., who has worked for the San Francisco Chronicle, Newsweek, CNN International and the London Sunday Times during time spent in the Balkans, the Middle East and South Asia.
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For more information:
"After Katrina: One Surviving Family's Story":
Kaiser Family Foundation--
"Voices of the Storm: Health Experiences of Low-Income Katrina Survivors"
Columbia University, National Center for Disaster Preparedness
"On the Edge":