Four years ago a young woman brought her baby to Susan Mwangi of AMREF’s Kenya Disaster and Bomb Unit. The mother was worried because her child seemed abnormally scared by loud noises. Susan, who trained as a nurse and midwife, reassured her that this was normal for babies and sent her on her way. Shortly afterwards another of Susan’s patients remarked that her baby cried and clung to her all the time. Susan reassured this mother too and thought nothing more of it. But when the third mother came to her with concerns about her baby’s nervous disposition, Susan began to wonder if there was more to this than coincidence.
There was one common circumstance linking the babies. Susan ran a program of follow up care for 1,402 Kenyans who had been wounded by terrorists in the 1998 Nairobi bomb blast at the U.S. Embassy. Over a four-year period the Disaster and Bomb Unit coordinated the physical and psychological recovery of these survivors through a rehabilitation program that began in July 1999. The anxious mothers who had come to see Susan were all part of this group. Significantly, they had all been pregnant at the time of the bombing.
Typically, physical rehabilitation involved reconstructive surgery, hearing aids for those deafened by the blast, and fitting prosthetic eyes and limbs. The smoke and flying particles of cement and glass had caused extensive eye damage: over 200 people were prescribed glasses for damaged eyesight. The victims suffered extensively from trauma as well. They were counseled for post-traumatic stress, which commonly manifested itself through stress-related symptoms such as peptic ulcers, hypertension, panic attacks and hormone imbalances.
“If we hadn’t been there for them, none of these people would have received good quality care. Two thirds of the victims were manual laborers or had semi-skilled jobs. They were in no position to pay for medical treatment. In assisting the survivors, the program eased the psychological pain of the entire nation,” said Susan.
“Our concern and care instilled a positive attitude amongst the survivors that speeded up their recovery. We held discussion groups where they learned how to cope with and better understand their disabilities. They began to understand why they experienced continual stress. Our culture is not open to counseling so it was an important breakthrough.”
While the mothers had been treated for their own injuries and trauma, no one had thought to consider the effect of the bomb blast on the fetuses in their wombs. Thirty-seven of the bomb blast victims were pregnant at the time of the attack. -The African Medical and Research Foundation
A psychologist and a psychiatrist monitored the post-traumatic stress levels of both the children and their mothers to see if the mothers’ stress levels had a direct effect on their children. They measured three areas of stress manifestation in the mothers: re-experiencing the bomb blast, anxiety and avoidance of talking about the attack. The children were monitored for stress through behavior such as hyperactivity, potential for creativity, their attention spans and social or antisocial behavior. At the same time, a control study was conducted with a similar age group of children born to non-traumatized mothers.
Results showed that stress levels of the mothers were declining slowly with time. However, their children had very high levels of hyperactivity and depression and corresponding challenges in creativity, attention span and social behavior compared to those in the control group.
The tests imply that in-utero stress induced by war, domestic violence or disasters can adversely affect the fetus by impairing psychological development.
“A traumatic experience triggers adrenalin that throws you into a survival state of fight or flight. The physical effect is to cut short the blood supply to the womb,” explained Susan. “Our findings reinforce a theory that a pregnant mother’s emotional experiences can be passed on to the child she is carrying.”