Journal of Management (JOM) Volume 6, Issue 2, March-April 2019, pp. 121-129, Article ID: JOM_06_02_015 Available online at http://www.iaeme.com/JOM/issues.asp?JType=JOM&VType=6&IType=2 Journal Impact Factor (2019): 5.3165 (Calculated by GISI) www.jifactor.com ISSN Print: 2347-3940 and ISSN Online: 2347-3959 © IAEME Publication PSYCHOLOGICAL IMPACT OF MASSIVE NATURAL DISASTER ON SCHOOL STUDENTS – A SIGNIFICANT BUT UNSEEN ASPECT OF SCHOOL MANAGEMENT IN POST DISASTER SCENARIO – A STUDY FROM RURAL NEPAL. Boby Joseph Thadathil SJ Research scholar, Singhania University, Rajasthan ABSTRACT Aim of this study was to assess the psychological impact of the 2015 Nepal earthquakes on students in rural Nepal. A total of 1001 school students from 19 schools in four of the worst affected districts were included in the study by stratified random sampling. A survey questionnaire was administered in the local language after obtaining necessary permissions and verbal consent. An overwhelming majority of students reported symptoms of post-traumatic stress during the post-earthquake period. 80.9% of students suffered from fear of another earthquake, 73% reported loss of appetite and 78.3% reported loss of sleep, 37.9% of students reported inability to concentrate on studies and 48.7% of students suffered from feeling of constant strain. Loss of sleep, loss of appetite and feeling of constant strain was significantly higher among female students.There was no correlation between inability to concentrate and gender of students. There was significant correlation between loss of family members or friends with inability to concentrate, feeling of constant strain and feeling unhappy or depressed.There was highly significant correlation between injury sustained during earthquake and fear of another earthquake, inability to concentrate and feeling unhappy or depressed. There was highly significant correlation between loss of pets and inability to concentrate, inability to enjoy day-to-day activities, feeling of constant strain and feeling unhappy or depressed. To conclude, psychological impact of natural disasters is often unseen but is of much greater magnitude than physical damage. Keywords: Earthquake;psychological impact; students; rural Nepal Cite this Article: Boby Joseph Thadathil SJ, Psychological Impact of Massive Natural Disaster on School Students – A Significant but Unseen Aspect of School Management in Post Disaster Scenario – A Study from Rural Nepal, International Journal of Management, 10 (2), 2019, pp. 121-129. http://www.iaeme.com/IJM/issues.asp?JType=IJM&VType=10&IType=2 http://www.iaeme.com/JOM/index.asp 121 editor@iaeme.com Boby Joseph Thadathil SJ 1. INTRODUCTION Two earthquakes and multiple aftershocks that struck Nepal in April- May 2015 affected a total of 8308 schools (42% of Nepal’s schools) (Event recap report, 2015Aon), The fact that both the earthquakes occurred on school holidays saved a lot of children’s lives. Even so, children are one of the most vulnerable groups during a natural disaster. Often rural children are hit the worst. Profound sadness for the loss of homes, parents or other family members, fear of future disasters and disruption of schooling have a major psychological impact on young minds. In addition, lack of security and safety in makeshift tents and temporary shelters make them vulnerable to exploitation. Rural children are often expected to bear the additional burden of helping the family earn a living in times of natural disaster and hence drop out of school. (Nepal Children’s Earthquake Recovery Consultation, 2015) Management of educational institutions after the disaster needs a lot of time and space to create a positive environment in education. Management has to deal with the aftermath of destruction, building of temporary shelters, reconstruction of permanent structures, and at the same time keepup the morale of students and teachers. The psychological imprint of a disaster is often of a greater magnitude than the physical damage and the scars left behind may never heal. There is very little literature on the psychological impact of natural disasters on school children from Nepal. 2. AIM OF THE STUDY This study aims to record the psychological impact of the 2015 earthquakes on school children in four of the worst affected districts of rural Nepal. The researcher aims to record the frequency of symptoms of post-traumatic stress and assess its correlation with demographic, sociocultural and other factors. 3. LITERATURE REVIEW Psychosocial impacts of a natural disaster are wide ranging and pervasive across all societal barriers. More persons are harmed psychologically than physically (Shultz et al, 2013) The psychological footprint of the disaster is larger than the medical footprint and worse still, it is often ignored. Eventhough many people in the disaster zone escape physical harm, they will suffer from distress, anxiety, stress reactions, fear and sometimes bereavement and grief. Those who sustain physical injuries will also have an added psychological burden of injury related mental stress and increased chance of developing post-traumatic stress disorder(PTSD) (Zatzick, 2007). In natural disasters resulting in major casualty, the entire community will go through prolonged grief with many of the survivors often having to deal with the loss of multiple close relatives and friends.Hazard characteristics that determine the severity, duration and extent of psychological reactions have been studied. Shultzet al (2007) postulated the disaster characteristics which include 1) absolute magnitude or intensity 2) duration of exposure to hazards 3) frequency of the episodes 4) proximity to the geographical epicentre of destruction and 5) scope and scale of destruction which includes the area impacted and the number of people affected by the disaster. For a confirmed diagnosis of PTSD, the student must have experienced a trauma which is perceived as a threat to oneself or others and must experience distress (horror, helplessness and fear). Symptoms for PTSD in children included re-experiencing, numbing and avoidance, symptoms of hyperarousal like irritability, sleeplessness and not participating in activities previously enjoyed. PTSD is a frequent disorder in populations exposed to trauma and is classified as an anxiety disorder with 3 symptoms- re-experiencing, avoidance and hyperarousal, all three of which should be present for one month after the disaster and should http://www.iaeme.com/JOM/index.asp 122 editor@iaeme.com Psychological Impact of Massive Natural Disaster on School Students – A Significant but Unseen Aspect of School Management in Post Disaster Scenario – A Study from Rural Nepal result in impaired functioning.(Shultz 2013) . The prevalence of PTSD in direct victims of natural disasters reported in literature is 30-40% (Shultz, 2013) In a study by Math SB et al (2008) following tsunami in Andaman and Nicobar islands, it was found that only few of the survivors had psychological disturbances. The most common were adjustment disorder, depression, PTSD and panic disorder in descending order.The factors increasing resilience were family systems, religious faith and culture. In the tribal community, joint families were common and this was important in reducing psychiatric morbidity among children. Even the children who lost their parents were cared for by the clan. Religious and family rituals helped the children to deal with their grief. They found that only a minority of the survivors required individual intervention. Others were fine with community based interventions. Cultural differences may have a significant role in the psychological impact of a disaster on a community/ individual. Kar et al (2007) stated that manifestation of PTSD may vary according to cultural differences in susceptibility to stress, support networks and coping strategies. Goenjian et al (1995) found that there are differences in psychiatric morbidity following natural disasters in communities in developing countries and those in the United States. Psychological first aid is skills that can be taught to the students by the school staff so that they can deal with the traumatic event. Interagency Standing Committee guidelines list the components of first aid, including protecting survivors from further harm, identifying and providing support for the most distressed, re-establishing social supports, returning to familiar routines, facilitating communication between students, parents and agencies involved in disaster.LPC (Listen- protect- connect) is an evidence informed model which is a form of psychological first aid focusing on children. LPC uses teachers, parents and primary care providers to give basic psychological support. It is a version of psychological first aid designed to reduce initial stress following a disaster and helps the student to return to school and resume learning. (Kataoka et al, 2012) 4. MATERIALS AND METHODS This study was done after obtaining permission from the district educational officer, school management committee and headmasters of the schools. A total of 19 rural schools were selected from 4 of the worst affected districts in Nepal, namely Gorkha, Sindhupalchowk, Kavre and Dholakha. In each school,students from Class seven to Class twelve were randomly included in the study. Total number of respondents included 1001 students. A structured survey questionnaire was used for data collection. The questions were prepared based on the objectives of the study and translated to the local Nepali dialects. The researcher was present during administration of the questionnaire and explained the theme, the purpose and the objectives of the study to the participants.Verbal consent was sought and all those who did not wish to participate were excluded from the study. The researcher stayed with the participants from the start to finish, in order toattend to any questions or clarifications.All the participants were assuredof anonymity and that the information requested was used for the purpose of this research only. Data was collected in February- March 2017. 5. FINDINGS AND DISCUSSION The respondents were from the worst hit districts in Nepal (See table 1). Totally 29.1% of students interviewed lost a friend/ family member in the earthquake. 94.3% of children interviewed in Kavre, 99.5% in Sindhupalchowk, 97.0% in Dolakha and 93.6% in Gorkha reported that their homes had been damaged by the earthquake. 34.3% of children interviewed were injured during the quake ranging from 34.1% in Kavre to 45.6% in http://www.iaeme.com/JOM/index.asp 123 editor@iaeme.com Boby Joseph Thadathil SJ Sindhupalchowk. 31.8% of children lost their pets/ domestic animals in the quake. The earthquake happened on a Saturday, an official and school holiday, 61.7% children were at home when the disaster struck, 7.5% at the market and 15.8% in the fields, 14.6% were at other places. Only 0.4% of students were in schools at the time of the disaster. These findings indicate the severity of the damage wreaked by the quake and that an overwhelming majority of the students interviewed have suffered in some way or the other as a result of the quake. Table 1: Demographic characteristics of the sample Students Districts Kavre Sindhupalchowk Dolakha Gorkha Total N Age of students 991 Range 23 Frequency 247 218 269 265 999 Minimum Maximum 7 30 Mean 15.35 Percent 24.7 21.8 26.9 26.5 100.0 Std. Deviation 1.635 The majorityof the students interviewed in the current study were between 11-15 years (54%) and 16-20 years (44.6%). Although there were few adult students enrolled in the schools. 57.6% of the students interviewed were female and 42.4% were male. 72.5% of students interviewed came from families whose main source of income was agriculture. The most commonly reported immediate reaction to the earthquake was shock in 42.9% and fear in 32.9%. 12.4% reported to have cried, 4.3% screamed and 7.6% started running after the quake. 93.7% of the children reported that they discussed their feelings about the earthquake with someone. 38.5% of children discussed it with parents, 41.6% with friends and neighbours, 12.5% with teachers and 7.4% with siblings. In a study by Yilmaz et al, a high proportion of school students have discussed disaster-related issues with their friends. Furthermore,in their study, about 75% of students reported to have discussed disaster-related issues at home with their parents. In the current study only 38.5% of students discussed their feelings regarding the disaster with their parents. 80.9% of students reported to have fears about another earthquake. 73% suffered from loss of appetite after the earthquake, 78.3% reported loss of sleep. 37.9% said they could not concentrate on studies after the quake. 48.7% of students felt they were constantly under strain after the earthquake. 57.4% said they could not enjoy their day to day life after the quake. 64.8% of students reported feeling unhappy and depressed after the disaster. 48.1% said they could not feel happy. 76.9% thought that the disaster would badly affect their future. 82.6% felt their life was coming back to normal in the 22 months following the earthquake. These figures show a high frequency of psychological symptoms suggestive of PTSD among the students. However a definite diagnosis of PTSD would require more thorough psychiatric evaluation for the presence or absence of diagnostic criteria (given below), which is beyond the scope of this study. There has been no published study on PTSD in Nepali children after the earthquake. The findings in the current study also indicate the need for training teachers, parents, non-teaching staff and community members in giving emotional and psychological support to the children. Correlation of Stress Symptoms with Age in Students: There was no significant correlation of age of students and fear of another quake (p value 0.07). There was no significant correlation between loss of appetite and age of students. (p value 0.15) or loss of sleep and age of students (p value 0.89).Feeling of constant strain had significant correlation with age. 52.2% of students in the 16-20 age group reported constant strain as opposed to 45.7% in the 11-15 http://www.iaeme.com/JOM/index.asp 124 editor@iaeme.com Psychological Impact of Massive Natural Disaster on School Students – A Significant but Unseen Aspect of School Management in Post Disaster Scenario – A Study from Rural Nepal age group. (p value 0.03). There was significant correlation between inability to concentrate and age of the student. Inability to concentrate was significantly higher in 16-20 age group when compared to 11-15 age group. (p value0.001) The age groups at the extremes had very little students. There was significant correlation between enjoying day-to-day activities and age of the student.(p value 0.01) Inability to enjoy day-to-day activities was significant in the 1620 age group. There was no significant correlation between age of the student and self- reported feeling of depression or unhappiness (p value 0.94). There is no significant difference in the number of respondents feeling reasonably happy between the different age groups. (p value 0.44) Correlation of Gender of Student with Symptoms of Post- Traumatic Stress:Fear of another earthquake was significantly different between the gender (p value 0.001) See table 2. There was significant difference in the loss of appetite experienced after the quake, i.e., significantly higher in female students (p value 0.005) See table 1.Loss of sleep was significantly higher in female students (p value 0.001). See table 1. There was significant correlation between gender and feeling of constant strain which was significantly higher among females. (p value =0.005). See table 2. Table 2: Correlation of stress symptoms with gender Fear of another earthquake No Yes Total Loss of appetite No Yes Total Loss of sleep No Yes Constant strain No Yes Male Female 114 310 424 Male 134 290 424 Male 118 306 424 Male 239 184 76 497 573 Female 135 438 573 Female 98 475 573 Female 273 302 190 807 997 269 728 997 216 781 997 512 486 There was no correlation between ability to concentrate and gender of the students. (p value0.42). There was no significant correlation between ability to enjoy day-to-day activities (p value0.48), feeling unhappy or depressed (p value 0.94) and feeling reasonably happy (p value0.36) and gender of thestudent. Correlation of Family Income with Symptoms of Stress in Students:There was no significant difference between the different income groups and the fear of another earthquake. There was no significant correlation between family income and loss of appetite (p value 0.73), loss of sleep (p value .61), feeling of constant strain (p value0.40), ability to enjoy normal dayto-day activities(p value0.13), unhappiness/ depressed feeling (pvalue=0.22) and feeling happy ( p value0.11) http://www.iaeme.com/JOM/index.asp 125 editor@iaeme.com Boby Joseph Thadathil SJ Correlation of Symptoms of Stress with Loss of Family Members/ Friends/ Neighbors There was a significant difference in the self-reported ability to concentrate on studies between those who had experienced loss of family member/ friend / neighbor and those who had not. See table 3. There was significant correlation between feeling of constant strain and loss of family member/ friend/ neighbor. (p value 0.04 ). See table 2. There was a significant correlation between feeling unhappy or depressed and loss of family members or friends or neighbors (p value 0.002). See table 3. There was no significant correlation between either fear about another earthquake(p value0.12), loss of appetite (p value 0.18) or loss of sleep(0.11)or ability to enjoy daily activities (p value0.66) with loss of family /neighbors/friends. Table 3: Correlation of loss of family member/ friend or neighbor with ability to concentrate, feeling of constant strain and feeling unhappy or depressed Ability to concentrate Not able to concentrate Able to concentrate Total Feeling of constant strain No strain Feeling of constant strain Total No loss 228 463 691 Loss of family /friend 141 147 288 Total 369 610 979 No loss Loss of family / friend Total 373 133 506 326 155 481 699 987 Feeling unhappy No loss Not feeling unhappy Feeling unhappy Total 263 427 690 288 Loss of family member/friends 79 207 286 342 634 976 Correlation of Symptoms of Stress in Students with Damage to One’s Own House There was significant correlation between feeling of constant strain with loss or damage to one’s own house (p value0.035). There was no significant correlation between loss or damage to one’s own house versus fear of another earthquake (p value 0.15), loss of appetite(p value=0.24), loss of sleep(p value0.08), ability to concentrate(p value0.25), ability to enjoy normal day-to-day activities(p value0.52), feeling unhappy(p value0.14) and feeling reasonably happy(p value0.19). Correlation of symptoms of stress in students with injuryduring the earthquake There was significant correlation between injury sustained during the earthquake and fear of another quake (p value<0.001) See table 3.There was significant correlation between ability to concentrate and injury sustained during the earthquake.(p value0.001). See table 4. There was significant correlation between feeling unhappy or depressed and injury sustained during the quake (p value 0.009). See table 4. http://www.iaeme.com/JOM/index.asp 126 editor@iaeme.com Psychological Impact of Massive Natural Disaster on School Students – A Significant but Unseen Aspect of School Management in Post Disaster Scenario – A Study from Rural Nepal Table 4: Correlation of stress symptoms with injury sustained during the earthquake. Fear of another earthquake No fear Fear of another earthquake Total Ability to concentrate Not able Able Total Feeling unhappy Not unhappy Feeling unhappy Total No injury Injury sustained Total 144 44 188 504 296 800 648 No injury 214 428 642 No injury 245 394 639 340 Injury sustained 157 181 338 Injury sustained 101 237 338 988 371 609 980 346 631 977 There was no significant correlation between injury sustained and loss of appetite (p value 0.07),loss of sleep (p value 0.21), enjoying daily activities(p value 0.08) and feeling reasonably happy (p value 0.59) Correlation between symptoms of stress in students to loss of domestic Animals or petsThere was significant correlation between inability to concentrate and loss of pets or domestic animals in the quake. (p value0.001). There was significant correlation between feeling of constant strain and loss of pets and domestic animals during the quake. (p value 0.001). There was significant correlation between ability to enjoy daily activities and loss of domestic animals or pets (P value 0.007). There was significant correlation between feeling unhappy or depressed and loss of pets or domestic animals during the earthquake (p value 0.001). There was no correlation between loss of pets or domestic animals and fear of another earthquake (p value 0.08), loss of appetite(p value0.165) and loss of sleep (p value0.49). Although there was significant difference in the ability to concentrate in studies between the groups with different family incomes (p value 0.02), there was no linear correlation of the ability to concentrate with the amount of family income. 40% of students from families with annual income of less than one lakh had difficulty concentrating in their studies compared to 27% in 1-3 lakhs, 36% in 3-5 lakhs and 28.6% in > 5 lakhs categories. 81.4% of all children interviewed reported an average family income of less than a lakh. In a study of post-earthquake behaviour by Ak (2014)from Marmara, Turkey, 12.2% of the students were injured and 11.3% lost a relative or family member. The students were between 6-12 years of age and their major concerns were about harm to family, collapse of building, and death in that order.Ak (2014) concluded that symptoms of PTSD commonly seen in girls include nightmares about disaster, fear of sudden noises, fear of staying indoors, reluctance to go to school and sleep difficulties. Boys showed PTSD symptoms like difficulty in communicating with others and difficulty in understanding lessons. 61% of children were frightened when they remembered the earthquake and 36% thought of death when they remembered the disaster. Ak (2014)found that a majority of children were hopeful of a better future with their family and friends. He found that 268 of 400 reported having fear of another earthquake and 298 of 400 had sleep disturbances. In the current study from Nepal, 78.3% of students interviewed reported that they experienced loss of sleep in the days after the earthquake and 80.9% of students reported that they experienced fear about another earthquake in the future. http://www.iaeme.com/JOM/index.asp 127 editor@iaeme.com Boby Joseph Thadathil SJ In a separate study from Nepal on the psychological impacts of the 2015 earthquake in adults, anxiety and depression were more common in illiterate people, people who had suffered loss of house or property and those who had had an initial fear of earthquake. (Sharma D, 2017). Women had a slightly higher risk of PTSD than men in their study but the difference was not statistically significant. Their study included subjects from 15- 30 years age and did not specifically study children. In a study from New Zealand, the major concern of the respondents aged 9-10 years after the earthquake was about loss of family and fear of being trapped. (King, 2013). Most children expressed fear about earthquakes, but recorded feeling more positive after having learned safe behaviours and coping strategies for earthquakes and having the knowledge that their families are prepared for an earthquake. Ronan et al (2003) stated that fear in parents leads to increasing fear reported by children. King (2012) and Mooney et al (2017) also found that children tried to engage in activities and happy thoughts to distract themselves from worry and fear of an earthquake. Conclusions:The study aimed to record the psychological impact of the 2015 earthquakes on school students in the four worst affected districts of rural Nepal. 29.1% of students interviewed lost a family member of friend during the 2015 earthquake, 34.3% of students were injured, 96% experienced damage to their own houses and 31.8% lost their pets or domestic animals.The most commonly reported immediate reaction to earthquake among students is shock(42.9%) and next common was fear (32.8%). An overwhelming majority of students reported symptoms of post-traumatic stress during the post-earthquake period. This included fear of another earthquake in 80.9%, loss of appetite in 73%, loss of sleep in 78.3%, inability to concentrate in 37.9% of and feeling of constant strain in 48.7%. Significant associations were found between frequency of certain stress symptoms and age, gender, loss of family members, loss of pets and injury acquired during the earthquakes.It is the first study of its kind from rural Nepal and the numbers of students interviewed adds to the robustness of the study. 6. LIMITATIONS OF THE STUDY The findings are all reported by students themselves and from their memory of the disaster. A clinical psychological assessment of huge numbers of students are beyond the scope of the study REFERENCE [1] [2] [3] [4] [5] [6] [7] Aon B (2015). 2015 Nepal earthquake event recap report. 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