Bellevue Responds, First to Disaster, then its Aftermath

Within 40 minutes of the attack on the World Trade Center, Bellevue Hospital Center stood ready for more than a thousand victims. The Pediatric Emergency Center was turned into a triage unit anticipating overflow from the adult ER. Waiting Child Life staff focused on organizing volunteer blood donors, who stood on long lines for hours, until collection supplies were exhausted.

Tragically, Bellevue's great skills and resources were of limited use. In the days following the attacks, only 310 victims were brought to the Emergency Center, but thousands of family members turned to Bellevue for news of their lost loved ones. And every day since September 11th Bellevue has treated many indirect victims: emotionally traumatized children.

Social Work, Child Life and other staff worked long hours, helping distraught people pour over the short lists of patients and helping them with their shock and grief. Child Life and Development staff established a streamlined assessment process in the Pediatric Resource Center to allow immediate referrals to counseling. Senior staff circulated through the many clinics to speak with parents about their children's recent changes in behavior, normal responses to anxiety, stress and trauma, and ways for parents to help their children cope.

Staff immediately stocked every waiting room and playroom with rescue vehicles. As chilling as it sounds, reenactment of a traumatic event through dramatic play is a therapeutic measure proven to help overcome the dreadful psychological impact.

Child Life staff worked closely with the Department of Pediatrics to develop written materials for parents and adolescents. Flyers were specially drafted for use by people with limited literacy skills. These flyers have been translated into Spanish, Chinese and Bengali and distributed in the communities we serve.

Many Bellevue care-givers were suffering personal losses and emotional upheaval while providing support to patients and families. To help those care-givers, staff organized counseling sessions for Bellevue employees.

Staff remain ready to respond to needs however events unfold.

Children send messages to Bellevue's children

Children everywhere have reached out to Bellevue with letters and drawings. This German 4-year-old expressed his sadness with tears, a common theme. Other frequently seen images in drawings are of a child and mother, an image of comfort, and of flaming buildings, perhaps attempts to master terrifying fears and memories.

What We Expect in the Uncertain Months Ahead

In the wake of the World Trade Center tragedy, the psychic toll on children is immense and the need for help is urgent. Many children witnessed the attack or were vividly exposed to it through television and adult conversation. Within our primary geographic area, many children lost relatives or know classmates who did.

We see increased signs of panic, anxiety, depression, stress and behavior disturbances in our children. Delayed grief and trauma reactions often surface weeks or months later.

Illnesses related to environment such as asthma will worsen. Conditions exacerbated by tension - diabetes, obesity, emotional disturbance, child abuse and neglect - are expected to rise in seriousness and frequency. And we know children already suffering from abuse are more vulnerable to the terrifying images and nightmares associated with violence.

Fortunately, services to address these problems are in place at Bellevue. We must insure they remain and broaden.

Support in Jeopardy

The flood of donations to relief efforts reaffirms Americans' generosity to worthy causes that touch our hearts. Children of Bellevue programs are eligible for some relief funding and we have applied for support, but the dispersal of relief funds may be long delayed.

The economic downturn also affects our contributors. New Yorkers without work or worried about job security are not able to readily give. Corporate gifts will be diluted by the combination of generous donations to relief funds and the restrictions of general market conditions.

City and state budgets are shrinking. Mayor Giuliani has called for a $1 billion reduction of the city budget alone. At the same time, significant federal funding for Bellevue's outpatient pediatric services is scheduled to be redirected at year's end.

Despite this daunting picture, Bellevue Hospital, the Child Life Department and Children of Bellevue are fully committed to meeting all needs of our children, from basic medical care to trauma recovery.

Child Life specialists continue to assess youngsters and families for signs of distress, counsel where appropriate, and to refer to Child Psychiatry any family who needs immediate services. Individual, group and family counseling programs will begin as early as possible.

Children with chronic illness, such as asthma, diabetes and HIV, and those vulnerable to violence will be closely monitored and receive special intervention as needed.

Our task is to help New York's most vulnerable children come to grips with their experiences, rebuild their sense of security and rekindle their hopes for the future. We hope you will join us in this work.

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