Health and wellness
Trainer’s Corner: August 2012
By Ed Brouwer
By Ed Brouwer
This is Part 3 of a four-part series on surviving PTSD. Read Part 1; read Part 2; read Part 4. This series is intended to provide information. It is not to be used to diagnose or as a cure of any kind. If you or someone you know is thought to be suffering from post-traumatic stress disorder (PTSD), seek professional help immediately.
Emergency-service workers respond to floods, earthquakes and airline crashes where the death tolls and property destruction can be overwhelming.
|Responding to natural disasters is a key trigger for post-traumatic stress disorder. Photo by Mitchell Brown
The Canadian Disaster Database contains detailed disaster information on more than 900 natural, technological and conflict events (excluding war) that have happened since 1900 at home or abroad and that have directly affected Canadians.
The CDD tracks “significant disaster events” that conform to the Emergency Management Framework for Canada definition of a disaster and meet one or more of the following criteria:
- 10 or more people killed
- 100 or more people affected, injured, infected, evacuated or homeless
- an appeal for national/international assistance
- historical significance
- significant damage/interruption of normal processes such that the community affected cannot recover on its own
The database describes where and when a disaster occurred, reports the number of injuries, evacuations and fatalities, and gives a rough estimate of costs.
Listed among the top Canadian disasters are:
- 1775 – Newfoundland hurricane, 30-foot waves, more than 4,000 lives lost
- 1825 – The great Miramichi fire, 16,000 square kilometres burned, 160 lives lost
- 1873 – Nova Scotia hurricane, 900 destroyed buildings, 100 lives lost
- 1885 – The great Labrador gale, 190 kilometre-per-hour (km/h) winds, 300 lives lost
- 1903 – Frank rockslide in the Northwest Territories, 60 people killed
- 1912 – Regina cyclone, 28 lives lost, 2,500 homes lost
- 1913 – Great Lakes storm, 145 km/h winds, 250 lives lost
- 1929 – Grand Banks earthquake, 28 lives lost, 10,000 people lost their homes
- 1954 – Hurricane Hazel in southern Ontario, 216 millimetres of rain, 150 km/h winds, 81 lives lost, $1 billion in damages
The aftermath of most of these disasters had one thing in common: the presence of emergency first responders.
Disasters can cause severe psychological disturbance not only for the victims, but also for the first-responding emergency workers. There is a growing need for disaster-response chaplains, not necessarily to support the victims but to aid and watch over the well-being of the first responders.
Certainly the reaction to a disaster depends, to a degree, on the severity and duration of the event. Vulnerability factors in individual responders also play a part.
On a personal note, 2003 will go down in history as the year British Columbia burned. Not only was our fire crew among the first to respond on Aug. 16, but also we were the last crew released from the Okanagan Mountain Park fire on Sept. 24.
During our battle with the fire dragon, our families were twice forced to leave their homes. We were trapped twice by extreme fire behavior, once needing to be heli-lifted out. We were numb with exhaustion, sleep deprived, weary and mentally and physically spent. We were on the edge emotionally to the point that when someone held up a “God bless the firefighters” sign we broke into tears. We had not personally lost anything, but the sheer duration of this wildland urban interface fire caused us to take each loss personally.
You can’t fight the fire dragon for more than 30 days and not get emotionally hooked. A number of firefighters narrowly escaped death when they became trapped by flames and smoke in subdivisions while attempting to protect Kelowna from a rank-six wildfire. We were told that as a result of this overwhelmingly emotional event, a few of them quit fire fighting altogether.
According to researcher Margaret Gibbs and others in Disasters, A Psychological Perspective, first responders and disaster workers are at particular risk for post-traumatic stress disorder (PTSD) and other negative emotional consequences of disaster.
Disaster workers often spend more time at incidents than others, cleaning up or digging out, as crews did after 9-11. In that situation, feelings of helplessness and lack of control were prevalent as workers searched for but were unable to find identifiable bodies.
Psychologists have many theories about what causes the disorders such as PTSD, depression and anxiety, but little is conclusive in terms of what it is exactly about a disaster that leads to emotional damage.
In addition to the life-threatening and job-related stresses firefighters encounter in their professional lives, researchers have noted that many cope with personal and family issues from children with special needs to the death of a loved one, to aging or invalid family members, terminal illness, divorce, and the demands of raising a family.
In addition, according to a piece in the Minnesota Fire Chief newsletter back in 1981, “The dangers of the job create anxiety in the firefighter’s family.” Many emergency-service workers feel that their loved ones and friends do not understand the magnitude of their duties or the emotional strain they must endure daily.
Ten years later, in 1991, The International Association of Fire Chiefs’ Foundation noted that firefighters “want to protect loved ones from what happened” on the job.
Other researchers have noted that firefighters’ spouses must cope with the constant stress, sacrifice and frustration of living with the worry that their husbands or wives are “constantly walking into the jaws of danger.”
The least the Canadian fire service should do is provide PTSD awareness education for spouses or parents of firefighters.
Even with the constant exposure to life-threatening situations and the multitude of mentally and emotionally challenging emergency calls, most firefighters are reluctant to discuss the death, carnage and human suffering they witness on the job with their families and friends. However, the signs are there if one knows what to look for.
What about the thousands of firefighters who have succumbed to cancers caused by toxic fumes inhaled during prolonged battles with the modern-day fire dragon? Let’s look at two examples, the Horticultural Technologies fire in Kitchener, Ont., in 1987 and the Plastimet fire in Hamilton, Ont., in 1997.
It didn’t take long before the firefighters who attended the Horticultural Technologies fire on March 6, 1987, started to die. Twenty-five years later, the Kitchener Fire Department is still burying its dead from that fire.
In May 1989, Dave Ferrede, age 32, went on sick leave and was subsequently diagnosed with primary liver cancer. He was dead a month later. Then, Capt. John Edward Stahley was diagnosed with primary liver cancer. He died in July 1990 at age 54. During the summer of 1989, Sgt. Lloyd MacKillop of the Waterloo Regional Police Service, who had been the supervising police officer at the fire, developed cancer. He died in May 1990 at age 48. Firefighter John Divo, who was also the local union president, was diagnosed with terminal cancer in his lungs and spine. He died in April 1990 at age 46. Around the same time, firefighter Henry Lecreux was diagnosed with Parkinson’s disease. He died in February 1993 at age 52. Parkinson’s disease has been linked to chronic exposure to a number of chemicals. The following spring, William Misselbrook, who was the day-shift platoon chief at the fire died of liver cancer. He was 64. Several other firefighters who attended the blaze have skin cancers, prostate cancer, Parkinson’s disease and many other health problems. Twenty three of the 69 firefighters called to the blaze have either cancer or Parkinson’s disease.
At the Plastimet recycling plant fire, polyurethane foam and about 400 tonnes of derelict auto parts, left behind by a scrap-metal firm, began to burn. About 225 firefighters struggled to control the blaze for the next four days. The air was thick with toxins, benzene, vinyl chloride and dioxin. In the following weeks, almost 100 Hamilton firefighters complained of infected eyes, skin rashes, and respiratory and gastrointestinal disorders.
How do we deal with the massive wave of stress that flows from major incidents like these? How many firefighters died just after retirement from complications they incurred on the fire ground 10 to 20 years prior?
The reason we call PTSD the silent killer is that many emergency responders are not disabled by these types of experiences until 10 to 15 years later. These traumas are like heavy chains that survivors drag with them through life.
What type of stress loads did their 10 years of suffering and the mountain of medical bills place on their families? How much stress was added by the fact that there was no real recognition of their sacrifices and no financial compensation, no retirement days to go fishing, no weekends with the grandkids or great grandkids?
How many of these brave men and women were honoured with a line-of-duty-death ceremony? How many died without any form of recognition worthy of their sacrifice? I believe the number is staggering.
What’s the bottom line? No matter how strong or well trained we are, everyone is susceptible to PTSD. If you know someone who may be suffering from PTSD, reach out and give as much support and understanding as possible. Lead him or her to trained professionals and do not assume that time will heal emotional wounds. Buried traumas can come back to haunt healthy people.
We are too often hindered by our history and tradition. It is high time that those who have the power to effect change in the area of PTSD in the Canadian fire service do so. It is only reasonable to protect our greatest resource – our firefighters. Until next time, please stay safe out there.
*Read Part 4 of Surviving PTSD series
Ed Brouwer is the chief instructor for Canwest Fire in Osoyoos, B.C., and Greenwood Fire and Rescue. The 21-year veteran of the fire service is also a fire warden with the B.C. Ministry of Forests, a Wildland Urban Interface fire suppression instructor/evaluator and a fire-service chaplain. Contact Ed at firstname.lastname@example.org