Literatures Salient to the Experiences of Children Separated from Their Families During Disasters
In disasters (defined as events that overwhelm existing infrastructure to adequately respond), children are at risk of family separations, which are harmful to the health of both children and adult family members (Blake and Stevenson, 2009; Mace et al., 2010; Rodriguez-Llanes et al., 2013). Children separated in their infancy or early childhood are unlikely to be able to recount contact information of family members. Given that every day of a separation matters to a child’s health and well-being, that children— especially young children—might be at risk of kidnapping or exploitation following a disaster, and that disasters are becoming increasingly common, the global community must be prepared to reunify families following a disaster as quickly and as safely as possible, in line with the best interest of the child (Dreby, 2015; Starmer et al., 2010; Whitaker et al., 2005). DNA technologies might provide a powerful tool to reconnect separated families. However, access to DNA technologies should be distributed equitably, and resulting data or reports delivered through a trauma-informed approach that advances children’s and families’ rights in a manner that is both ethical and secure (Barnert et al., 2021). Children develop best in the context of safe, nurturing relationships, especially with caregivers (World Health Organization, 2009). Parents’ impact on their children’s well-being is significant in the earliest years of life, and parental relationships provide a protective shield against childhood traumas, with effects observed across the life course (MacKenzie et al., 2017; Miranda and Legha, 2019). Thus, the separation of families after disasters and subsequent reunification can have significant ramifications, which can be understood within theoretical rights frameworks as well as through empirical evidence.
Theoretical and Legal Frameworks
Existing frameworks from the fields of child development, trauma, and human rights can be applied to help understand children’s experiences with separation after a disaster, underscoring the importance of prompt, safe reunification. Examples include the following:
- John Bowlby and Mary Ainsworth’s attachment theory attests to parents’ quintessential impact on children’s well-being (Ainsworth and Bell, 1970; Bowlby, 1973). The theory posits that in healthy child-parent relationships, children undergo a critical process of attachment to their parents in early years that forms a secure base for children’s lifelong healthy attachments and exploration of the world. When children become separated from their parents, a failure to form healthy attachments—including to re-engage in attachment when reunited (i.e., detachment)—might occur, negatively impacting children’s internal working model of the world, their exploratory behaviors, and their adaptability. Thus, when disasters separate families, the disruption in the process of healthy attachment can have lifelong implications. The disruption of attachment might be especially harmful if sudden and/or unexpected, which frequently occurs in disasters.
- Pauline Boss’s theory of ambiguous loss addresses situations characterized by uncertainty about a family member’s fate or whereabouts (Boss, 1999). Ambiguous loss is defined as a grief that is unclear or indeterminate because the outcome is unknown, resulting in a “tormenting or stressful” loss, intensified by its ambiguity (Boss, 1999). Because children and their family members can experience significant ambiguous loss when separated in disasters, often not knowing if their missing loved one is alive or dead, family separations caused by disasters can be extremely traumatic, underscoring the importance of reunification.
- The life course health development framework, which demonstrates that health trajectories are the product of risk and protective factors operating in genetic, biological, behavioral, social, and economic contexts, addresses how early life experiences have lasting effects on health (Halfon and Hochstein, 2002). Early life experiences of being separated from family due to a disaster can negatively affect lifelong health trajectories.
- As framed by Judith Herman, trauma is an experience that “overwhelms the ordinary human adaptation to life” (Herman, 2015). The experience of family separation can be categorized as a profound trauma that poses a destructive threat to children’s healthy development (Agorastos et al., 2019). The trauma of family separation can be compounded by the trauma of the disaster event itself, and reunifying children with their families is paramount to the steps necessary for healing.
In addition to the theoretical frameworks discussed above, a human rights framework provides both a conceptual and legal lens for understanding children’s rights and experiences in separation after a disaster. Reunifying families separated by disasters upholds fundamental human rights, which is important to underscore because disasters are expected to continue to increase (Chung and Blake, 2014; Starmer et al., 2010). The integrity of the family unit is protected by international human rights and humanitarian law. Articles 8, 9, and 18 of the United Nations (UN) Convention on the Rights of the Child (a treaty which, notably, the United States is the only nation in the UN yet to ratify) address the importance of preventing familial separation and promoting family reunifications, in line with the best interest of the child standard (United Nations General Assembly, 1989). The rights of families also are protected by the UN International Covenant on Civil and Political Rights and on Economic, Social, and Cultural Rights, which maintain the right to the protection of the family unit and the right to the highest attainable standards of physical and mental health, including provision of necessary steps “for the healthy development of the child” (United Nations General Assembly, 1966). Thus, developing and implementing methods to reunify families separated after a disaster is critical to upholding fundamental human rights.
Empirical Evidence on Family Separation
In alignment with the above frameworks, mounting empirical evidence demonstrates the persistent harm of family separation (except when necessary for child safety). Growing evidence demonstrates that separating families, even for a short while, is harmful to children’s health and wellbeing (Shadid and Sidhu, 2021). Children’s responses to family separation include emotional distress, anger, feelings of abandonment and insecurity, attachment difficulties, developmental regression, anxiety, depression, and posttraumatic stress disorder (Lovato et al., 2018; Miller et al., 2018; Wood, 2018). Family separation also negatively affects children’s academic success, peer relationships, and other social outcomes (Gindling and Poggio, 2012; Lovato et al., 2018), and causes negative effects on health and wellbeing that reverberate across the life course (Delgado et al., 2021; Schapiro et al., 2013). The effects on physical health likely occur in large part by triggering toxic stress pathways that could increase the risks of cardiovascular disease, cancer, and premature mortality, among other negative health effects, into adulthood (Bucci et al., 2016; Kalmakis and Chandler, 2015; Krushas and Schwartz, 2022). The examination of life histories of young adults who had been forcibly separated from their families as children during war and underwent reunification decades later indicates that the harm family separation imposes on children’s health is likely to be lifelong (Barnert et al., 2019; Barnert et al., 2015). While these studies are not specific to the context of disasters, given the fundamental nature of the parent-child bond to child development and well-being, it is likely that separations caused by war create a universality of effects as with separations caused by disasters, exacerbated by the trauma from the separation event (Barnert, 2023). Overall, given the demonstrable and likely lifelong harm of family separations to children, multiple expert groups have issued public statements that denounce the separation of families and prioritize the prompt reunification of children with their families (American College of Emergency Physicians, 2019; Disaster Preparedness Advisory Council & Committee On Pediatric Emergency Medicine, 2015; McNutt et al., 2018).