News

Clear and present danger? By the time you read this, it may have already happened - not war on Iraq, although that is likely this month - but a terrorist attack in one of our major cities. Recent alerts, at Heathrow for instance, may be government propaganda or they may be based on hard facts.

Either way, they pose the question - what role should social services play in the aftermath of a major disaster?

In The Guardian, last week, Anne Eyre, a trauma specialist, wrote of the lessons learned from the "decade of disasters" in the 1980s, among them, the Zeebrugge ferry capsize, the King's Cross fire and the Clapham rail disaster. Many of the bereaved and survivors then felt a "lack of understanding and effective support". More recently, after the Twin Towers and the Bali bomb, long-term support for relatives and those who survived proved patchy in the UK.

Rose Murray, who chairs the UK Emergency Planning Society's human aspects group, says it is unrealistic to expect social workers to plan and train for an event that may never happen when they are already over-stretched. Still, after the Clapham rail crash, social services in Hampshire established a network of trained "major incident report teams".

In Trauma and Recovery From Domestic Abuse to Political Terror, psychiatrist Judith Lewis Herman gives an analysis of the aftermath for many of those who face overwhelming and unexpected danger. Survivors, she says, find themselves caught between extremes of amnesia and reliving the trauma, exacerbating a sense of unpredictability and helplessness. For some this can be long lasting. A Dutch study of people taken hostage found that, six to nine years after the incident, one-third still had intrusive symptoms.

She writes the "threat of annihilation" may pursue the survivor long after the danger has passed, breaching the attachments of family and friendships and shattering "the construction of the self." This is a process of disintegration that often goes undetected.

Herman believes there are three stages to recovery: the establishment of safety; the right to mourn; a reconnection with ordinary life.

It seems beyond belief that we, in the UK, might endure a devastating attack. Yet a trip on the London Underground easily demonstrates our vulnerability. The pressing question is how prepared will social services be the morning after to offer the kind of help that counts?