What can we say to children about the Ebola epidemic?

What can we say to children about the Ebola epidemic?


To the teacher

The Ebola epidemic is now so widely publicized in all media channels that teachers must address it in the classroom. When the first Ebola patients arrives in one’s country, when increasing numbers of airports introduce checks on passengers arriving from Africa, fear spread among the public. This also affects children. Children must be taken seriously, facts conveyed, and adults, teachers and parents must meet their thoughts and fantasies about the disease. We provide some thoughts that may be helpful in this regard.

The fear that the disease creates is similar to the fear of swine flu and bird flu. It is however not a respiratory disease and do not spread easily. It is spread by touch. Therefore, it is primarily health professionals working with the sick that are at risk, as well as others who may come in contact with Ebola-infected people during travel. The risk of infection is considered very small, but fear spreads easily. Health officials and the country leaders do their best to spread information about the disease and disease measures, but the fear spreads in the population anyway.

It is the duty of health managers in a country to think about the worst possible. They must use strategic planning based on worst possible outcome in order to plan to stop the epidemic. They need to plan from the fact that the disease is dangerous, even if the risk of infection is low. However, because we are unfamiliar with the handling of such danger, a degree of uncertainty is present, increasing fears of many. The fear will increase if more people become infected, especially if it happens close to where we live. With multiple measures put in place by health authorities, fear increases, because measures signals danger as a kind of "emotional signal".

Some facts about Ebola (source mainly from Norwegian health authorities)
Below are some facts about the disease that can be included in information to children. Increasing age creates a growing need to provide them with detailed information to understand.

• Ebola outbreaks usually occur in remote villages in central and western Africa, near the tropical rainforest.
• Infection of humans occurs probably from infected wild animals (bats, rodents, monkeys). Large bats are believed to be the reservoir for Ebola Virus.
• Transmission between humans occurs through direct contact with blood and other body fluids from diseased or dead people.
• Outbreaks especially affect family members and health care professionals who have been in contact with or treated the sick. Ordinary tourists are little prone to infection.
• Critically ill patients need intensive hospital care with strict infection control procedures. There is no specific treatment or vaccine against the disease. There are several treatments being tested.
• Because Ebola is contagious for health care workers, emergency procedures are very strict and all medical personnel are equipped with protective suits.
• The risk of further Ebola infection in Western countries is considered very low.

Since Ebola is a serious disease with high mortality and we have little experience with the disease in our country, there is some uncertainty with respect to what will happen. On countries’ official websites, updated information about the disease is found.

Many newspapers and news media are filled with information about Ebola, sometimes rather speculative. It is important to remember that children often only see the newspaper’s front pages, and they talk to each other about what they see. Dramatic front pages creates curiosity. We say that every newspaper has a kid’s page, and it is the front page. This they cannot protect themselves against when newspapers are visibly placed in newspaper stands or on coffee tables at home. Even children from the age of seven can read enough to understand that Ebola is fatal, something that is very scary. The pictures in the newspaper and on television of people with protective suits can also be frightening and must be explained to the children. It does not help the kids that newspapers nuances information inside the paper, this information is only read by adults. Children are also active on the internet and watching TV. They take in a lot of information, without necessarily getting adult support to interpret this.

For older children it may be helpful to make them aware that fear sells. That there is a difference between the big headlines and what may be inside the newspaper. Why have we not got headlines that states "LOW risk of infection"? - Something that would actually be true.

Children need adult help to clear away misunderstandings, so that they can understand what is happening. Our aim is to explain about Ebola to children so that they will be safer than much of the information they take in would suggest. It is unfair that children should go around being a lot more scared than we adults are if they do not have to be. For example, it is difficult for children to understand distances. When they hear about many dead in Africa, they do not know how far away it is. They also know little about the differences in health care between countries, or what an emergency is. This must be explained.

We recommend teachers in elementary school to put Ebola on the agenda. Our perspective is calmed and that they can learn something. We recommend that you as a teacher check what your children have heard, so that you can correct possible misconceptions and give them a comprehensible explanation that they can build on. Also, give them hope: tell them that many people across the world work to limit the Ebola disease and that there is work to develop drugs that can cure the disease.

We recommend that two teachers at the school are responsible for following the news in this area and inform the other teachers about the countries plans. It would also be advantageous if the school writes an information letter to parents with specific notice of how the Ebola issue is handled at the school.

What we can say to children?
What is Ebola?
You may have heard the news, read in the newspapers or on the Internet or heard anyone talk about Ebola. Right now, there is a lot about this in the newspapers and on television. I shall now tell you in a detailed way what this is and why so many people talk about it now. It started in Africa where several people contracted the disease. It can be passed from animals to humans, but we do not know how the first humans were infected. Because the disease is transmitted through contact between people and many people do not know how it spread, many got the disease. The disease spreads only through contact from a diseased to a healthy person, through hand contact or when a healthy person comes in contact with body fluids from the patient. Body fluid is saliva, sweat, blood, vomit, urine (pee), feces (poop). In Africa, it has taken time to teach people that there is a difference between touching and having contact with patients with infectious diseases and to touch, hug or have contact with patients with non-infectious diseases. This can be difficult for us too, if we do not quite know whether a disease is contagious or not. Therefore, we always get advice from doctors who have a good grasp of this. When it comes to Ebola, all people must ensure that they do not touch or have close contact with the sick or the dead without protection. Only with such protection, we can prevent the disease from spreading. Africa is not as well developed regarding hospitals and health care as in our country. Therefore, many who were well were in contact with sick and became ill themselves. Now many countries are working for this to be better, and those who are ill must be in special hospitals and those who care for them must wear protective gear when they have contact with the sick.

It is important to know that everyone will be sick from time to time, but there are only some diseases are so dangerous that we can die from them. Ebola is one such disease. In Western countries, we will keep all Ebola patients that come from Africa in hospitals that have trained to receive and treat Ebola patients, so that others do not get the disease. The bosses of Health in each Western country (those we call health authorities) work to make sure that Ebola will not spread. However, adults can still be troubled or anxious, because with something as new as this disease they are unsure what will happen.

Is Ebola dangerous?
Yes Ebola is dangerous, but only when we are in contact with a sick person. All persons that are going to help the sick know this and will protect themselves. If someone gets sick, then they get a lot of fluid supplied because they can bleed a lot. It is not that everyone that gets the disease die, but many do, and the doctors do not know why some die and others do not. In Africa, thousands have died of the disease, while outside Africa only a few have died. We cannot say that it is not dangerous for those who are treating patients with Ebola in hospitals, because it has happened that they have been infected. But fortunately very, very few. As this has happened, they have become even more cautious and careful to protect themselves.

There is no medicine today, which helps against Ebola. They are working to develop new medicines, but they are not yet completely finished. They have been allowed to use these medicines to see if they can help those who get the disease to recover. However, these medicines take a long time to make, so there are not plenty of them. Researchers are working constantly to make better drugs that are even stronger.

Why are we talking so much about this if the disease will not spread?
When adults are so concerned about this, it is because it is a dangerous disease that we do not want to spread. Although our leaders tell us that this will spread in our country, many are scared. When so much is written about the disease many becomes even more frightened and concerned about what is happening. Because the countries that now have the disease are poor and do not have as good health care as we have, it also discussed how and how much we can help. At the same time, some discuss whether we who live in rich countries could have done more before the disease began to spread, especially spending money on developing medications that might make the sick healthy again. Although those who lead our health care system do not believe that the disease will spread, they must make sure that we are well prepared if that happens.

What can kids do?
The adults are responsible for working with Ebola. The sick are treated at hospitals and therefore you do not need to worry. If your mom or dad work in hospitals or health care, you should know that there are only a few in each hospital who work with those who are sick with Ebola. In addition, those who work with Ebola will be protected by masks and other protective gear to prevent them from falling ill.

But there are some things you still can do:

- You should take care not to spread rumors, to tell things that are not true.
- Be careful not to frighten small children.
- Play as before and do nice things and try to think as little as possible on what is happening.
- Talk with adults and ask them to explain what is happening and what is new, if you think a lot about the disease.

For the preschool teacher

Children are scientists, they hear, see, read and draw their conclusions. They are actually scientists in a new and different way than just a decade ago. The web has become part of everyday life. Recently a grandfather told that his four-year-old grandson asked if he had learned to do a search online. It was part of family life. It is necessary to listen to the older children in kindergarten, what they have "researched" regarding Ebola.

We know that children in kindergarten often have taken in the frightening news from TV and radio, or overheard adult conversations. Often there are also older siblings or friends who talk about the disease and relates this to their younger siblings, often inaccurate and oversimplified. Children pick up that this is frightening, but they lack the qualifications to assess to what extent this affects them.

We recommend that an initiative be taken among the oldest children in kindergarten to check out what they have learned. Ask children about what is in the news so you can correct misconceptions. If children do not show interest in the topic, it is good that you let it go - but you know it only after you have checked out what they think.
The little kids lack the concepts to understand disease; therefore, they can be unnecessarily scared and confused. It may be helpful to think that children need adult explanations to counter unnecessary fear. The small children need to be reassured that you will be there for them and that nothing will happen to mama or papa. Explanations must be simple, concrete and truthful.

General advice for conversation with children

Do not wait to see - go to see
As an adult for children you have to actively check out what the child has heard or seen about Ebola if you think he/she is worried by what is happening. News from distant regions may seem close when the media brings them into the living room every day. Remember that all newspapers have a kid’s page - it is the front page. All children who can read get it right in the face from the newspaper rack and from your table. You may have to rethink where you place your newspaper or iPad.

Children need help to understand
Think about how you should formulate yourself when your child has taken in the news about Ebola, possible by headlines with war types. If we cannot protect them from the daily media exposure, we must help them make sense of this news for them to reestablish “a quiet location in the brain”. This applies regardless of where they learnt about it. You may also want to check out how other parents in the neighborhood handles this.

Children need good concepts
Good hooks are words and concepts that allow the child to understand at their level. Providing explanations and assurances can reduce children’s fears and worries. For young children assurances of the type "I am not afraid, Mom or Dad cannot get the disease; Now everyone works to stop others from getting the disease" may be necessary if they are worrying. Older children need you to explain why you feel safe. Check if your kid has questions, and answer them honestly. If you do not have an answer, say so, or say that you will find out and do so. Children build up their experience through questions and often ask the same thing repeatedly to get a better grip on information.

Provide them with the best adult explanations possible
If there are strong emotions, it is harder for kids to save the explanation properly in memory. They need to hear it several times. They become confused if there are large variations from time to time. The explanations should not get worse. Therefore, provide the worst part the first time around, "It is a dangerous disease that we can die from, therefore the sick must be separated from others (healthy), and only those who have equipment on them that protects them against disease can be in contact with them. This will prevent the disease from spreading to others”. Children want and they deserve our best adult version. Tell them that it is very difficult to get the disease in our country and that there is only xx people in our country who have the disease.

Open up conversations to understand and calm your child
A conversation with a child about a serious issue aims to ensure that a child will understand and be calmed by talking about it. To achieve this aim we must make sure that this really happened. When we open up our conversation to talk about the worst, we must explain to the child that we do it for them to gain control over their troublesome thoughts. It is not a goal to evoke strong emotions; it is a measure to curb those already there.

Stick to the facts
Ebola is a rare disease that we have known about for many years. It has only been in Africa and those infected have come from Africa. It is because it has now spread to other countries outside Africa that it is now spoken and written so much about. Scientists believe it has spread from infected bats to humans, but they do not know for sure. Explain that there are differences between countries in Africa and our part of the world - health care is much better here, and we have better ways to ensure that the disease does not spread.

What can they do?
Tell them that there is really nothing they have to do or can do, since they will not meet someone with Ebola. Nevertheless, the occasion can be used to tell them that it is important that they wash their hands when they have been to the toilet, or to cough into their elbow if they have a cold and so forth, because the diseases that are not dangerous, such as influenza and colds, also can be transmitted through body fluids.

Adults can also use the situation to teach children about the body, telling them what happens when we get sick and how the body's various parts interact for us to live. Children that asks about death must receive simple explanations of what happens in the body when we die; that all life functions stop, that one cannot feel pain longer and that the dead cannot come back.

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Clinic for Crisis Psychology (formerly Center for Crisis Psychology) has provided Emergency Preparedness Agreements to municipalities and private companies for more than 30 years. This includes oil companies, offshore supply companies, airline and helicopter companies, banks and other private companies and industrial entities. Clinic for Crisis Psychology offers emergency preparedness agreements allowing both private and public organizations a quick follow-up if the organization should experience a crisis or disaster. This ensures highly qualified support and assistance to managers and employees in case of accidents or other incidents that require psychological assistance.

Selv om krisepsykologi som begrep først har blitt kjent blant folk flest de siste tiår, har kriseintervensjon som arbeidsmetode vært i bruk fra tidlig i forrige århundre. I krigssituasjoner skjønte befal (og helsepersonell) at tidlig hjelp nær fronten til soldater som hadde vært utsatt for store påkjenninger, med forventninger om at det skulle gå bra, gjorde at de klarte seg bedre enn om de ble fraktet vekk fra fronten for å få hjelp langt bak frontlinjene.

Det har vær mye fokus på seksuelle overgripere den siste tiden. Spesielt har det blitt framhevet hvor lite overgriperne skiller seg ut fra andre mennesker, på at de kan være ”hvem som helst” - en hyggelig nabo, en populær trener eller en ansatt i barnehagen. Når overgrepet blir avdekket blir omgivelsene sjokkerte og vantro, de hadde aldri trodd det var mulig. Sjokket rammer i mange tilfeller også overgriperens nærmeste familie.


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