DisasterAction :: When Disaster Strikes :: A Physically Injured Survivor in the Aftermath

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A Physically Injured Survivor in the Aftermath

This guide has been written by members of Disaster Action, all of whom are survivors and bereaved people from disasters. Some of the disasters we have been affected by are the Zeebrugge ferry sinking, King’s Cross underground fire, Lockerbie aircraft bombing, Hillsborough football stadium crush, Marchioness riverboat sinking, Dunblane shootings, Southall and Ladbroke Grove train crashes, the 11 th September attacks, the South East Asian Tsunami and the Bali, London 7 July and Sharm El Sheikh bombings.

The purpose of this leaflet is to offer the experience of others that may be useful to you and to your family and friends. The leaflet cannot cover every eventuality, given the wide spectrum of possible injury from cuts and bruises to life changing. The leaflet is primarily relevant for those affected by a disaster within the UK, but it should still be helpful for those returning from overseas. At the end of the leaflet there is a list of Useful Contacts, and some explanations of the centres that may have been set up by the local authority and/or the police following a disaster, whatever its cause.

Part One: The immediate aftermath

If many people have been killed or injured in a disaster, the early aftermath is likely to be chaotic, and getting information about who has been injured, which hospital you may have been taken to, and what has happened, may be very difficult for your friends and family.

Your workplace may well be used as a point of contact and your colleagues may find themselves inundated with requests from people seeking information. It will be helpful if one person is nominated to deal with enquiries.

Being in hospital

You and your family may have the assistance of a police family liaison officer (FLO) and/or social worker.

Having been through a totally unexpected and traumatic event you may be trying to work out what happened to you and what the sequence of events was. You may also be trying to understand who - if anyone - was responsible for the disaster and why they did what they did. I f you wish to do so, you can talk about this with your family and friends and your FLO.

The medication you may be on may affect your usual personality. You may also find that you experience nightmares and flashbacks – these are not unusual and should pass in time.

When you feel well enough, you may find it useful to talk to other survivors; they will undoubtedly find it helpful to talk to you. Talking about what happened with others may be cathartic.

Encourage family and friends to bring some of your clothes and personal possessions in to hospital so that you can return to being ‘you’ as quickly as possible. You will need to learn what hospital routines are and what everyone does.

The scene of the disaster

The police will have taken photographs of the debris after the disaster and you can ask about seeing these if you wish to do so. The police may keep the debris for some time while the legal processes are ongoing, and you may also be able to visit this once you are physically able to do so. Others from past disasters have found it helpful to do so, as well as visiting the site, though the most important thing is for you to be able to make these choices for yourself.

Survivor elation and survivor guilt

Many survivors experience elation or guilt. Both feelings are perfectly normal. Survivor elation is a reaction to the realisation that you have overcome an event where the outcome could have been much worse. Some people have found that it can be a powerful aid to recovery. Survivor guilt derives at least in part from feelings that you could have done more to protect those around you and that you survived when others did not.

If you feel you need help in dealing with these feelings, you can access further information and support through your GP and through any dedicated services that may have been set up in the aftermath of the disaster (see Part 2 of the leaflet, and Useful Contacts). Some survivors have found talking to others who have been similarly affected very helpful.

Funerals and memorial services

If you are in hospital for some time, you may not have been able to attend events held to commemorate those who died. You may even have had to miss funerals for those you were with. It may be helpful to ask family and friends to record who was there and what happened. Ask for feedback when you are ready for it.

You could also ask for the funeral to be videoed so that you can see it in your own time (remember to ask permission if you want someone to record the event). It has become increasingly common for audio and video recordings to be made of personal events such as these, and many people have found it helpful even when they have been in a position to attend and participate.

What happened to those you were with?

In the early stages after the disaster, if you are conscious and aware of what happened, this will be a deeply anxious time, especially if you got separated from relatives or friends who were with you when the disaster happened.

The police may ask you for personal details about anyone you were with at the disaster scene. A police officer will fill in a form with this information, which will be passed on to the Casualty Bureau (CB) - see page 6.

If the police have any news about those you were with, they will let you know, but you should feel free to ask about what is happening.

Personal property

After a disaster many items of personal property may have become separated from their owners or found at or near to the site. If they have been recovered, you may have to wait some time for your possessions to be returned to you, or it is possible that they were destroyed. You can ask your FLO, if you have one, about what will happen to the items found. You may also find the DA leaflet The Return of Personal Property helpful.

Talking to people who understand

If you would like to talk straight away to those with a similar experience, contact Disaster Action.

Dealing with the media

The media may try to approach you, looking for photographs or interviews, even while you are in hospital. It is up to you whether or not to talk to them, but remember that you cannot change your mind later about what you have said. Hospital staff can be helpful in preventing media from accessing you while you are in hospital - if you wish them to do so.

Remember that journalists are in a competitive business. Once you have given information to one, others will want to approach you and may also wish to approach your friends, family, neighbours and work colleagues. You may receive offers to sell your story. You should take advice so that you understand the implications of the contract and the effects that this may have on your personal life before agreeing to anything.

Part Two: The Longer Term

During and following your physical recovery, what you have seen and heard may have a great effect upon you. In the future, this may manifest itself in feelings of anger and temporary melancholy and would be an entirely normal stage of reacting to an abnormal (traumatic) event. Coming to terms with a disaster can be difficult even when the physical recovery is complete. In addition, you may have life-changing injuries to contend with. Each person's experience of and feelings about a disaster are unique; some people may experience emotional problems because of it and others may not.

An important milestone is when you can finally go home from hospital. There may be a mixture of excitement and apprehension about this event. You may find that this is a difficult period for you, something your family and friends may not understand. This is not uncommon. At times like this it may help to talk to people, whether family, health professional or people who have gone through a similar experience.

This section of the leaflet is not a definitive guide to everything that may have to be taken into account, but is intended to cover a range of the issues that may be relevant depending on your circumstances.

Assistance from your GP and local health service

Your ongoing needs should have been assessed by the hospital prior to your discharge. If you require continuing care, this will normally be through your local GP. Because of the nature of your injuries you may also continue to attend hospital services as an outpatient. Your GP will receive a letter from the hospital on your discharge concerning your condition.

Dealing with your employer

You may have to give up the job you were doing before the disaster happened, or you may find that your priorities have changed and you wish to do something completely different. The best option will be for you to be enabled to make your own decisions about your future.

Benefits and back to work schemes

The Department for Work and Pensions is responsible for a range of benefits and services for people of working age, providing financial help and support. On the DWP website you can access information on these services and what help may be available for you (see Useful Contacts below).

Driving

You may no longer be able to drive, depending on your condition once you get home, or will need to use a specially adapted vehicle. Information on any condition that you have to notify them about is available from the DVLA (Driver and Vehicle Licensing Agency) website. See Useful Contacts below.

Legal/Insurance claims

It is likely to be helpful for you to have the services of a solicitor who is experienced in dealing with issues arising from disasters. Please see Disaster Action leaflet Legal Representationafter a Disaster for more information on this subject and relevant useful contacts.

Disaster trust funds

Depending on the circumstances of the disaster and whether it happens in the UK or overseas, a disaster trust fund may be set up by the relevant local authority or the British Red Cross Society. You may be eligible to make a claim on this fund, contacts details for which will be publicised through the media.

Adaptations to your home

If you need improvements and adaptations to your home to help you continue to live independently there, you can ask the social services department of your local council to do an assessment of your home. Information on what may be available and how to access this help can be found on the directgov website (see Useful Contacts below).

Criminal Injuries Compensation Scheme

This provides for victims of crime to receive some compensation for their injuries, physical or psychological, or, in the case of the bereaved, the death of their loved one. The scheme is supposed to be simple enough to use without the help of a solicitor, but in many cases it might be advisable to seek advice regardless. (See DA leaflet Legal Representation after a Disaster.)

This scheme is not open to those affected by a disaster overseas, but in the case of a terrorist incident abroad, financial assistance may be available through a fund that has been set up and is managed on behalf of the UK government by the British Red Cross.

How might you be affected psychologically?

You may have a number of different reactions, such as loss of appetite or sleepless nights. You might find it difficult to concentrate. You might have anxiety attacks. You may find it hard to relate to your family or friends who have not shared your experience. And you may keep re-living the disaster or have vivid flashbacks. If you have been recovering from serious physical injuries, these reactions may still occur while you are in hospital or when you are discharged. They may happen whether or not someone has been physically injured.

It is important to understand that these reactions are not abnormal in themselves. If such reactions and feeling persist or disturb you, then you may find it beneficial to seek help. There's nothing wrong with knowing that you need help and trying to find that help.

Where to find help

A telephone helpline may have been set up by the local authority to offer guidance to those who need help. Depending on the circumstances of the disaster, the helpline may remain open for some considerable time after the event, so when you are discharged from hospital you may still find it a source of information and ongoing support. You or your family should be able to get the number from your police contact or social services.

Your doctor can refer you to a counsellor or therapist to talk about how you feel, but if he or she has had no training in disasters, they may be unsure how best to help you. There are a few clinics that specialise in helping those affected by disasters. Ask your doctor what is available locally, or speak to DA.

Some people will not want or feel the need to talk to anyone outside the family and friends, although for others it may be essential. There is nothing wrong with knowing that you need help and trying to find it.

Getting together with others

A number of people may have been affected by the same disaster and perhaps now or in the future, you might wish to talk to and/or meet some of them. Survivors from other disasters have found it beneficial to share their common experience. The authorities, and Disaster Action, may be able to help you to get in touch with others. You can also read Setting up a Survivor and/or Family Support Group, and Setting up an E-Forum Discussion Group, which you will also find on Disaster Action's website.

Useful Contacts

Some or all of the organisations listed below may be helpful to you, depending on the circumstances of the disaster:

BACP (British Association for Counselling and Psychotherapy)
Will give list of counselling organisations and practitioners in your area, their specialisation and fees (some do not charge). Send a self-addressed, stamped envelope to: 1 Regent Place, Rugby, Warwickshire. CD21 2PF.
Office: 01455 883300
Information on counsellors: 01455 883316
www.bacp.co.uk

British Red Cross Society (BRCS)
Telephone: 0844 871 11 11
www.redcross.org.uk
The BRCS responds to emergencies from major incidents to evacuations, floods and fires.

Criminal Injuries Compensation Authority (CICA)
Freephone 0800 3583601
https://www.cica.gov.uk

Cruse - Bereavement Care
Offers counselling, advice and the chance to meet other bereaved people throughout the UK.

Offers counselling, advice and opportunities to meet bereaved people throughout the UK.

Department for Culture, Media and Sport (Humanitarian Assistance in Emergencies Unit - HAEU)
The HAU has responsibility within Government for coordinating support in the UK to those affected by major disasters. If you are having difficulty accessing support services or have questions about help that may be available, write to the HAU, DCMS, 2-4 Cockspur Street, London SW1Y 5DH, email hau@culture.gsi.gov.uk or call 0207-211-6200.

Directgov
http://www.direct.gov.uk/en/DisabledPeople/HomeAndHousingOptions/YourHome/DG_4000634

South London and Maudsley NHS Foundation Trust (Traumatic Stress service)
Provides a clinical service for people suffering from PTSD.
Telephone: 0203 228 6000.
www.slam.nhs.uk

National Institute for Health and Clinical Excellence (NICE)
NICE publishes guidance for the treatment of disorders and conditions on the NHS. One of these guidelines relates to post traumatic stress disorder (PTSD). You can access information on the PTSD guideline at http://www.nice.org.uk/guidance/CG26/publicinfo/pdf/English

Samaritans
Provides confidential, non-judgemental emotional support 24 hours a day for people who are experiencing feelings of distress or despair.
National helpline: 08457 909090.
www.samaritans.org.uk

Traumatic Stress Clinic
Telephone: 020 7530 3666.
Specialists in Post Traumatic Stress Disorder (PTSD). Provides assessment and therapy for those who have been affected by traumatic events such as disasters.

UK Trauma Group
The UK Trauma Group is a managed clinical network of UK Traumatic Stress Services. Their website provides access to a selection of material for the general public and for health professionals about post traumatic stress reactions.
http://www.uktrauma.org.uk/

Victim Support
Offers practical help and advice and emotional support to victims and their families following crime. (Monday-Friday 9.00am - 5.30pm).
Telephone: 0845 303 0900.
www.victimsupport.org.uk

Offers practical help and advice and emotional support to victims and their families following crime.

Local Authority and Police Reception Centres
You may find it helpful to have some information on some of the activities the police and local authorities may have carried out following the disaster.

Casualty Bureau (CB)
The CB is the centre where the police gather all the information coming from the disaster site (and from outside sources) about who may be involved.

Survivor Reception Centre (SRC)
The police set up an SRC as soon as possible after a disaster happens (depending on the nature of the disaster, there may be more than one SRC.) Survivors who were not physically injured may be interviewed here by the police to identify those involved and to find out what they saw and heard. This will help the police find out what happened.

Humanitarian Assistance Centre (HAC)
After some disasters, the local authority, police and other agencies involved in the aftermath may set up a HAC. This will be the focal point for information and assistance for families, survivors and others directly affected by the disaster.

Disaster Action would like to thank all those who contributed to the writing of this leaflet.