A Physically Injured Survivor in the Aftermath

This guide has been written by members of Disaster Action, who are survivors and bereaved people from disasters. The disasters we have been affected by include the Zeebrugge ferry sinking, King’s Cross underground fire, Lockerbie aircraft bombing, Hillsborough football stadium crush, Marchioness riverboat sinking, Dunblane shootings, Southall and Ladbroke Grove train crashes, the 11th September attacks, the South East Asian Tsunami and the Bali, London 7 July and Sharm El Sheikh bombings and other recent terrorist attacks and transportation disasters.

Our aim is to enable you to understand what may happen after a disaster, giving you the opportunity to maintain some control over events.

The information in this leaflet offers the experience of others that may be useful to you, your family and friends. While it cannot cover every eventuality, given the wide range of possible injury from cuts and bruises to life changing, the leaflet is relevant for those affected by a disaster in the UK and for those returning from overseas. At the end of the leaflet there are some explanations of the centres that may have been set up by the local authority and/or the police following the disaster, which you may not have been aware of or able to visit because of your injuries.

Part One: The immediate aftermath

If many people have been killed or injured in a disaster, the early aftermath is likely to be chaotic and getting information about who has been injured, which hospital you may have been taken to, and what has happened, may have been very difficult for your friends and family.

Your workplace may well be used as a point of contact and your colleagues may find themselves inundated with requests from people seeking information.

Being in hospital

You and your family may have the assistance of a police family liaison officer (FLO) and/or social worker, depending on the circumstances.

Having been through a totally unexpected and traumatic event you may be trying to work out what happened to you and what the sequence of events was. You may also be trying to understand who - if anyone - was responsible for the disaster and why they did what they did. If you wish to do so, you can talk about this with your family and friends and the police.

The medication you may be on could affect your usual personality. You may also find that you experience nightmares and flashbacks – these are not unusual and should pass in time.

When you feel well enough, you may find it useful to talk to other survivors; they will undoubtedly find it helpful to talk to you. Survivors from other disasters have found that talking about what happened with others can be beneficial.

Encourage family and friends to bring some of your clothes and personal possessions in to hospital so that you can return to being ‘you’ as quickly as possible. You will need to learn what hospital routines are and what everyone does.

The scene of the disaster

If the disaster happened in the UK, the police will have taken photographs of the debris after the disaster and you can ask about seeing these if you wish to do so. They may keep the debris for some time while the legal processes are ongoing, and you may also be able to visit this once you are physically able to do so. Others from past disasters have found it helpful to do this, as well as visiting the site, though the most important thing is for you to be able to make these choices for yourself.

Survivor elation and survivor guilt

Many survivors experience elation or guilt. Both feelings are perfectly normal. Survivor elation is a reaction to the realisation that you have overcome an event where the outcome could have been much worse. Some people have found that it can be a powerful aid to recovery. Survivor guilt derives at least in part from feelings that you could have done more to protect those around you and that you survived when others did not.

If you feel you need help in dealing with these feelings, you can access further information and support through your GP and through any dedicated services that may have been set up in the aftermath of the disaster (see Part Two of the leaflet and Useful Contacts). Some survivors have found talking to others who have been similarly affected very helpful.

Funerals and memorial services

If you are in hospital for some time, you may not have been able to attend events held to commemorate those who died. You may even have had to miss funerals for those you were with. It may be helpful to ask family and friends to make a note of who was there and what happened to tell you later.

You could also ask for the funeral to be videoed so that you can see it in your own time (remember to ask permission if you want someone to record the event). It has become increasingly common for audio and video recordings to be made of personal events such as these and many people find it helpful even when they have been able to attend and participate.

What happened to those you were with?

In the early stages after the disaster, if you are conscious and aware of what happened, this may be a deeply anxious time, especially if you got separated from relatives or friends who were with you when the disaster happened.

The police may ask you for personal details about anyone you were with at the disaster scene. A police officer will fill in a form with this information, which will be passed on to the Casualty Bureau (CB). The CB is where the police gather all the information coming from the disaster site (and from outside sources) about who may be involved.

If the police have any news about those you were with, they will let you know, but you should feel free to ask about what is happening.

Personal property

After a disaster items of personal property may have become separated from their owners and later found at or near the site. If they have been recovered, you may have to wait some time for your possessions to be returned to you, or it is possible that they were destroyed. You can ask your FLO, if you have one, about what will happen to the items. You may find the DA leaflet The Return of Personal Property helpful in understanding how property is dealt with.

Dealing with the media

It is likely that information about what happened will become available through social media very quickly after the disaster or even while it is still happening. However, bear in mind that what you learn from all media sources may not give you the amount - or accuracy - of information that you would like to have.

The media may try to approach you, looking for photographs or interviews, even if you are in hospital. It is up to you whether or not to talk to them, but remember that you cannot change your mind later about what you have said. Hospital staff can be helpful in preventing media from accessing you while you are in hospital - if you wish them to do so.

Remember that journalists are in a competitive business. Once you have given information to one, others will want to approach you and may also wish to approach your friends, family, neighbours and work colleagues. You may receive offers to sell your story. You should take advice so that you understand the implications of the contract and the effects that this may have on your personal life before agreeing to anything.

If the media is bothering you or your family, tell the police.

Part Two: The Longer Term

During and following your physical recovery, what you have seen and heard may have an effect upon you. In the future, this may be shown through feelings of anger and sadness, which are an entirely normal reaction to an abnormal (traumatic) event. Coming to terms with a disaster can be difficult even when the physical recovery is complete. In addition, you may have life-changing injuries to contend with. Each person's experience of and feelings about a disaster are unique; some people may experience emotional problems because of it and others may not.

An important milestone is when you can finally go home from hospital. There may be a mixture of excitement and apprehension about this event. You may find that this is a difficult period for you, something your family and friends may not understand. This is not uncommon. It may help to talk to people, whether family, health professionals or people who have gone through a similar experience.

This section of the leaflet is not a guide to everything that may have to be taken into account, but is intended to cover a range of the issues that may be relevant depending on your circumstances.

Assistance from your GP and local health service

Your ongoing needs should have been assessed by the hospital prior to your discharge. If you require continuing care, this will normally be through your local GP. Because of the nature of your injuries you may also continue to attend hospital services as an outpatient. Your GP will receive a letter from the hospital on your discharge concerning your condition.

Dealing with your employer

You may have to give up the job you were doing before the disaster happened, or you may find that your priorities have changed and you wish to do something completely different. The best option will be for you to make your own decisions about your future in consultation with others who can help.

Benefits and back to work schemes

The Department for Work and Pensions is responsible for a range of benefits and services for people of working age, providing financial help and support. On the DWP website you can access information on these services and what help may be available for you (see Useful Contacts below). Driving

You may no longer be able to drive, depending on your condition once you get home, or will need to use a specially adapted vehicle. Information on any condition that you have to notify them about is available from the DVLA (Driver and Vehicle Licensing Agency) website. See Useful Contacts below.

Legal/insurance claims

It is likely to be helpful for you to have the services of a solicitor who is experienced in dealing with issues arising from disasters. Please see Disaster Action leaflet Legal Representation after a Disaster for more information on this subject and some useful contacts.

Disaster trust funds

Depending on the circumstances of the disaster and whether it happens in the UK or overseas, a disaster trust fund may be set up by the relevant local authority or the British Red Cross. You may be eligible to make a claim on this fund, contacts details for which will be publicised through the media.

Adaptations to your home

If you need improvements and adaptations to your home to help you continue to live independently there, you can ask the social services department of your local council to do an assessment of your home. Information on what may be available and how to access this and other help can be found on the Gov.uk website (see Useful Contacts below).

Criminal Injuries Compensation Scheme

This provides for victims of crime to receive some compensation for their injuries, or in the case of the bereaved the death of their loved one. The scheme is supposed to be simple enough to use without the help of a solicitor, but it might still be advisable to seek advice and help in making and progressing your application.

If you were ordinarily resident in the UK and you were injured outside the UK in a terrorist attack, you may be able to claim under the Victims of Overseas Terrorism Compensation Scheme.

How might you be affected psychologically?

You may have a number of different reactions, such as loss of appetite or sleepless nights. You might find it difficult to concentrate. You might have anxiety attacks. You may find it hard to relate to family or friends who have not shared your experience. And you may keep re-living the disaster or have vivid flashbacks. If you have been recovering from serious physical injuries, these reactions may still occur while you are in hospital or when you are discharged. They may happen whether or not someone has been physically injured.

It is important to understand that these reactions are not abnormal in themselves. If such reactions and feeling persist or disturb you, then you may find it beneficial to seek help. There's nothing wrong with knowing that you need help and trying to find that help.

Where to find help

A telephone helpline may have been set up by the local authority to offer guidance to those who need help. Depending on the circumstances of the disaster, the helpline may remain open for some considerable time after the event, so when you are discharged from hospital it may still be a source of information and ongoing support. You or your family should be able to get the number from your police contact or social services.

Your GP can refer you to a counsellor or therapist to talk about how you feel, but if he or she has had no training in disasters, they may be unsure how best to help you. There are a few clinics that specialise in helping those affected by disasters. Ask your doctor what is available locally, or speak to DA.

Some people will not want or feel the need to talk to anyone outside the family and friends and for others it may be essential. There is nothing wrong with knowing that you need help and trying to find it.

Getting together with others

A number of people may have been affected by the same disaster and perhaps now or in the future, you might wish to talk to and/or meet some of them. Survivors from other disasters have found it beneficial to share their common experience. The authorities, and Disaster Action, may be able to help you to get in touch with others. You can also read Setting up a Survivor and/or Family Support Group, and Setting up an E-Forum Discussion Group, which you will also find on Disaster Action's website.

Local Authority and Police Reception Centres

You may find it helpful to have some information on some of the activities the police and local authorities may have carried out following the disaster.

Casualty Bureau

The Casualty Bureau is the centre where the police gather all the information regarding missing persons, casualties and survivors. It will also assess information coming from the disaster site, hospitals and other sources about who may be involved. It will seek to establish the number and identity of those involved in the incident. However, depending on the circumstances it is not likely to be able to provide information on an individual’s involvement for some time. In serious cases the police will also normally speak to the family concerned in person. The purpose of this may be to take more details from the family and friends or provide sensitive information.

Family and Friends Reception Centre

A Family and Friends Reception Centre for those concerned about anyone who may have been caught up in the disaster is likely to be set up by the police and local authority. This will provide a place where people can attend to discuss their concerns with the authorities. It should be noted that it is not likely to have a telephone facility. Relevant Information from here is also passed on to the CB to assist in identifying who is involved.

Survivor Reception Centre

The police and local authority may set up an SRC as soon as practicable after a disaster; depending on the nature of the disaster, there may be more than one Survivor Reception Centre. Survivors who are assessed as not physically injured may be interviewed here by the police to identify those involved and to find out what they saw and heard. This will help the police find out what happened.

Humanitarian Assistance Centre

After some disasters, the local authority, police and other agencies involved in the aftermath may set up a Humanitarian Assistance Centre. This will be the focal point for information and assistance for families, survivors and others directly affected by the disaster and could include virtual support through a dedicated website.

Disaster Action would like to thank all those who contributed to the writing of this leaflet.