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International Journal of Disaster Risk Reduction 65 (2021) 102520Available online 26 August 20212212-4209/© 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Integrating psychosocial and WASH school interventions to build disaster resilience Emily-Marie Pachecoa,b,*, Iwona Bisagac,d, Rina Suryani Oktarie, Priti Parikhd,f, Helene Joffea,b,** aClinical, Educational and Health Psychology, UCL Division of Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, United Kingdom bEPICentre, Civil, Environmental & Geomatic Engineering, University College London, Gower Street, London, WC1E 6BT, United Kingdom cGeography and Environment, Loughborough University, Loughborough, LE11 3TU, United Kingdom dUCL Engineering for International Development Centre, Bartlett School of Sustainable Construction, University College London, Torrington Place, London, WC1E 7HB, United Kingdom eTsunami & Disaster Mitigation Research Center (TDMRC) and Department of Family Medicine, Faculty of Medicine, Universitas Syiah Kuala, Jl. Tgk. Syech Abdul Rauf, Darussalam, Banda Aceh, 23111, Indonesia fBartlett School of Construction Project Management, UCL Faculty of the Built Environment, 2nd Floor, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom ARTICLE INFO Keywords: Disaster risk reduction Psychosocial Wellbeing WASH Resilience Children ABSTRACT This paper reviews the key disaster risk management (DRM) frameworks used for protecting childrens wellbeing in disaster settings and identifies a lack of consideration for (1) psychosocial and (2) water, sanitation and hy-giene (WASH) needs. It also demonstrates that these two domains are meaningfully linked, as access to adequate WASH provision may protect psychosocial wellbeing and promote community resilience. As support in both domains is vitally important to childrens wellbeing, these gaps warrant immediate attention. Schools are uniquely situated to support these needs as part of disaster risk management and resilience building. Therefore, we consider the ASEAN Common Framework for Comprehensive School Safety (ACFCSS), which is an adaptation of the Comprehensive School Safety Framework (CSS) implemented in schools across the ASEAN region. While the CSS explicitly considers WASH, it only briefly considers psychosocial support; the ACFCCS lacks consider-ation of both domains. We argue revisions of the ACFCSS should prioritise the inclusion of psychosocial and WASH support and consider the role of schools beyond their capacity as educational institutions. We present an adaptation of ACFCSS with an additional framework pillar to guide this revision. Overall, we advocate for an integrated approach to DRM in schools based on an evidence-based, interdisciplinary perspective. We provide a series of evidence-based recommendations for DRM frameworks to consider, especially for those that intend to safeguard the wellbeing of children. 1. Introduction In the wake of disasters, children are among the most vulnerable for developing psychological trauma [14]. Multiple frameworks have been proposed to support the disaster preparedness, response and recovery of children and communities following natural hazard events. However, these frameworks lack emphasis and guidance concerning psychosocial needs and needs pertaining to water, sanitation and hygiene (WASH). This paper examines the importance of integrating psychosocial support and access to WASH services in disaster risk reduction (DRR). DRR is a systematic approach to assessing and reducing risk, with the purpose of minimising vulnerabilities, mitigating the adverse impacts of natural hazards and facilitating sustainable development [5]. The paper gives novel consideration to how WASH and psychosocial support intersect in relation to disasters. We propose that access to psychosocial support and WASH services be included explicitly in existing disaster risk management (DRM) frameworks. DRR and resil-ience in low-/middle-income nations prone to natural hazard events, such as the Association of Southeast Asian Nations (ASEAN) region, would benefit immensely from improved frameworks. It is this regions DRM that this paper addresses in particular, especially concerning the * Corresponding author. University College London, 26 Bedford Way, London, WC1H 0AP, United Kingdom. ** Corresponding author. University College London, 26 Bedford Way, London, WC1H 0AP, United Kingdom. E-mail addresses: e.pacheco@ucl.ac.uk (E.-M. Pacheco), h.joffe@ucl.ac.uk (H. Joffe). Contents lists available at ScienceDirect International Journal of Disaster Risk Reduction journal homepage: www.elsevier.com/locate/ijdrr https://doi.org/10.1016/j.ijdrr.2021.102520 Received 16 April 2021; Received in revised form 18 August 2021; Accepted 19 August 2021
International Journal of Disaster Risk Reduction 65 (2021) 1025202wellbeing of children in seismic hazard zones. The literature identifies schools as vital centres of support for chil-dren and their communities following a hazard event [68]. Resilience building and disaster recovery are facilitated through a system of pro-cesses that exist to buffer the impact of disasters, or improve circum-stances during or afterwards, including short-term responses and long-term planning [9,10]. While there is no cross-disciplinary consensus on what resilience means [11], the Intergovernmental Panel on Climate Change [12] defines resilience as the ability of a social sys-tem to absorb disturbances while retaining the same basic structure and ways of functioning, the capacity for self-organisation and the capacity to adapt to stress and change. Drawing on the SPHERE Handbook for humanitarian response (2018), the International Network for Education in Emergencies (INEE) Strategic Framework 20182023 (2018) [114] and the INEE Minimum Standards in Education [13], we propose an integrated approach to DRR and resilience-building through schools. The goal of this paper is to build on existing frameworks in the ASEAN region, particularly the ASEAN Common Framework for Comprehensive School Safety [14,112] to explicitly include the psychosocial and WASH gaps in the ACFCSS impact childrens experiences before, during and after disasters. This broadening of scope may result in better school preparedness practices and improved child and hence community resilience. This paper begins by providing a literature review exploring the psychosocial impact of disasters on the wellbeing of children and com-munities, the role of WASH in DRM and its links to psychosocial resil-ience. A review of core DRM frameworks is then presented; this section specifically considers which components should inform the revision of the ACFCSS, which is presently composed of three pillars that do not explicitly include psychosocial interventions or WASH access. Based on this review, the paper then discusses the implications of such revisions for the ACFCSS. A practical solution for moving towards a more inte-grated approach is presented by proposing an adapted version of the ACFCSS with an additional pillar. The paper concludes by exploring the implications of this additional pillar and offering recommendations for future research and applications of the adapted framework. 2. Literature review 2.1.Psychosocial impact of disasters on children and psychosocial interventions There is a significant body of knowledge demonstrating the effects of disasters on children. Common mental health problems associated with disasters are anxiety, depression and post-traumatic stress disorder (PTSD; [15,16], though there is currently no exact programme or tool for improving psychosocial or mental health preparedness regarding disasters [17]. Studies on disaster preparedness and post-disaster re-covery often lack adequate consideration of psychological wellbeing and its impact as these domains are often oversimplified (or entirely omitted) in DRM frameworks [16]. Thus, there is a need to design and establish a plan to help communities prepare and cope with emotional issues when facing disaster events [18]; see also [19]. Though some research has explored mental distress in children and youth in relation to disaster recovery (e.g. Refs. [2022], little is known about the long-term mental health impacts of disasters [15]. This section considers the psy-chosocial and mental health impact of disasters on children, where ‘psychosocial wellbeingrefers to the connection between individual psychological aspects (thoughts, emotions and behaviours) and collec-tive social aspects (relationships, traditions and culture) that are central to positive human functioning but which are often disrupted by trau-matic events [23]. Recent empirical studies emphasise the need for psychosocial sup-port in disaster recovery and preparedness strategies. Murphy et al. [24] found a large proportion of survivors from eight humanitarian in-terventions identified mental health as an essential component of indi-vidual and collective resilience, and reported psychosocial support as the most valued component of disaster response in a quarter of the sites. Post-disaster studies report that unmitigated psychological disturbances can cause severe consequences in the daily lives of children, especially as children facing disasters often experience extreme changes in their mood, behaviour, development, memory and decision-making [2,16]. Disasters also have the potential to exacerbate existing or underlying mental health issues across the family unit, which can accentuate the vulnerability of children and introduce potential for neglect [25]. The literature documents specific examples of the problems this can cause in hazard-affected communities, such as increases in domestic violence post-disaster [26]. The use of psychosocial interventions for children experiencing trauma in this context has been examined in several studies. Two recent meta-analyses by Brown et al. [27] and Newman et al. [28] found that mental health interventions were significantly more effective than nat-ural recovery in minimising PTSD symptoms, and identified a series of variables that may moderate the effectiveness of the interventions: in-dividual vs group, intervention setting, providerslevel of training, parental involvement, age and length of therapy. These reviews emphasise the need for the intervention to occur as soon as possible after the disaster to protect childrens psychosocial wellbeing. They also emphasise that informal, group-based interventions are as effective as formalised approaches (e.g., Cognitive Behaviour Therapy, Eye Move-ment Desensitization and Reprocessing), which is important to note as resources are often scarce post-disaster, and group interventions can be facilitated with several children at once by a single, trained individual (see Ref. [29]. List of frequent acronyms and abbreviations AADMERASEAN Agreement on Disaster Management and Emergency Response (Guide) ACFCSS ASEAN Common Framework for Comprehensive School Safety (Framework) ASEAN Association of Southeast Asian Nations BBB Build Back Better (Framework/Guide) CSS Comprehensive School Safety (Framework) DRM Disaster Risk Management DRR Disaster Risk Reduction GADRRRESGlobal Alliance for Disaster Risk Reduction and Resilience in the Education Sector GFDRR Global Facility for Disaster Reduction and Recovery GPSS Global Program for Safer Schools (Framework) INEE International Network for Education in Emergencies INEE MS INEE Minimum Standards in Education (Framework) PTSD Post-traumatic stress disorder SDG(s) Sustainable Development Goal(s) WASH Water, Sanitation and Hygiene WISS Worldwide Initiative for Safer Schools (Framework) Other Acronyms and Abbreviations CBT Cognitive-behavioural therapy CBTS Community-Based Total Sanitation EDMR Eye movement desensitization and reprocessing JMP Joint Monitoring Program JSPADM III ASEAN-UN Joint Strategic Plan of Action on Disaster Management (Guide) KIDNET Narrative exposure therapy for children E.-M. 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