Handling the aftermath

Canadian trauma expert Donna Tona is helping survivors of the terrorist attacks to get back on their feet, reports JULIE MIDDLETON.

Imagine this: you're sitting in your skyscraper office when the building begins to shake. A split-second later, the movement intensifies and there's a terrible roar.

The lights go out; loose paper, a flock of crazy bats, start flapping around the room on a sudden, vicious draught.

The emergency sprinklers come on, the acrid smell of smoke reaches your nostrils. People start shouting, screaming, crying.

Groping for the door, you're slipping and sliding, sure that your time is up.

The stairs are packed; people are hysterical; many of them covered in soot. Several have had their clothes melted to their bodies.

You register this but do not stop. Time stands still as you negotiate 50 flights of stairs, bumping into others, stepping and stumbling over them.

The gloomy lobby is a mass of moving, shrieking bodies. Police shout at you to run, run! You sprint like never before.

And then it comes: the hail of debris that flattens everything, including you. Dust covers everything.

Dazed, you get up and stumble in the direction that seems safest. Strong hands eventually pull you into a hotel lobby, where you sink to the floor, stunned and speechless.

Trauma over? For survivors of the attacks that levelled the twin towers of New York's World Trade Center and part of Washington's Pentagon last week, it's just beginning.

And this is the point at which Canadian trauma intervention expert Donna Tona comes in, to prevent casualties of crisis becoming a tribe of permanent walking wounded.

Tona, 42, flies to Baltimore on Monday to work with the city's Workplace Trauma Centre, which is coordinating the counselling of survivors as well as those working with them.

She hasn't yet been briefed, doesn't know if she will be sent to Washington or New York. Either way, she knows what she will be facing.

"There's a thing called survivor guilt," she says down the phone line from her home town, Leduc, in Alberta.

"A lot of what [survivors] are feeling is two-fold: they can't understand why they lived. The second thing, they're glad they did.

"The third thing is they're afraid to tell people they're glad, for fear they could be misconstrued as being happy others died.

"So you can just imagine the tornado that's going on emotionally for them.

"We help them to work through the fact that because you lived, that's all right, you happened to be able to get out. The fact that others died wasn't within your control."

She's not a shrink or a counsellor. Tona is the one hauled in by companies when staff suffer a crisis - whether that's the untimely death of a leader, or an industrial accident.

She has dealt with everything from the impact of bank holdups on staff through to the 1995 attack on Oklahoma City, where Timothy McVeigh's deadly bomb disembowelled the Alfred P. Murrah building and killed 168.

She has developed a widely used post-robbery programme. She waded into the aftermath of floods in Manitoba in 1997, and the severe storm in eastern Canada now known as Ice Storm 98.

Her new assignment could be anything from helping corporations to provide death notifications, to debriefings for groups of employees who have lost comrades, and providing support and assistance for families with small children who have lost relatives. "It could be helping companies look at their own policies and rebuild, or shore them up," she says.

But there are three things she already knows. The first is how survivors are feeling.

"Time stands still until the people who have lost loved ones have the body recovered.

"They're still at ground zero. In their minds they're still watching that building collapse and hoping against hope that someone survived in a pocket. And until they hear otherwise, they hold out that hope."

The second is that graphic television replays of the terror - "watching the horror over and over again" - lead to survivors' "overstimulation".

The third thing is that the start point for healing is always the same: survivors group together and repeat their stories.

"You allow them to describe it any way they want," says Tona, "whether they need to be graphic, or use some foul language.

"Whatever they need to do, you allow them to do it."

She guides, but says that healing starts with hearing other people's stories and how they are coping.

"My role is to facilitate ... They begin to heal and become their own therapist.

"You get in there when it's at its ugliest, and you get out and you refer [victims] to long-term counselling."

She describes intervention "as like triage in a hospital. I'm kind of the paramedic. I get you to the emergency ward, I make sure you're stabilised and that you have the right IV dripping in you and all that sort of stuff, and then I send you up to the surgeon.

"A lot of people get caught up in the abnormal feelings and they spend a tonne of energy trying to get back to the way they were before the incident.

"We come in and try to stop that process, and tell them, no, you can't get back to the way you were, you're a new person now because of this negative experience.

"You're never the same after a critical incident."

Intervention is, of necessity, a short, sharp and intense process.

Tona has offered herself for two and a half weeks, a period that prevents any dependency by those she counsels, or her own burnout.

From her first visit to New Zealand in June, Tona feels that our companies are fairly well prepared for any disaster that might hit.

But all those she spoke to were keen for more information on handling the human aspect of business crisis.

"When people have had the training, they get better faster, the healing is more complete, victims get back to work sooner, and they are productive more quickly," she says.

"You can have all the plans in the world that are going to make you financially stable after a disaster, but if you don't look after your people, and you don't look after their families, and if you don't look after yourself ... the business will never be the same.

"Businesses can't run on the back of traumatised staff."

And the harsh reality is that even if disaster hits a business, business can't stop, says Tona: "People still want your commodity."

But how to prevent the trauma specialist getting traumatised herself?

"Nineteen years of training," says Tona. "When I go to help you, your issues are yours.

"I can't get involved in your issues, I can only guide you. And then when I get home, I have psychologist friends and people in counselling services who I access right away to make sure I'm stable and that I'm OK and that I'm processing it properly."

Although she reacted to news of the New York and Washington attacks like many - "with my mouth hanging open" - she's tried to keep away from television coverage, pushing emotions aside.

"You have to be a person who looks at that and has the stability of mind, who is not terrified ... of how people are going to react. You have to think on your feet and go minute by minute. It's the land of the unknown."

A thwarted ambition to be a police officer brought Tona to crisis intervention.

But while studying police and justice administration at university, she had to choose some volunteer work and picked victim assistance.

"I thought that might be kinda cool, I'll be with the police," says Tona. "And the rest is history."

She later was a civilian manager in the police and the head of victim assistance programmes, and says intervention proves its worth "time and time again".

"I believe that many psychological lives can be saved if the right stuff is done on the frontlines.

"There are too many walking wounded in all of our collective nations. I hate to see that because it's a lot of life and time wasted, and we're not here on this earth all that long."

* Donna Tona, of Trauma Management Training Services, is in New Zealand for a week in November to give two seminars: How to support your staff in times of crisis (November 22 and 23, Wellington) and Interview Profiling (November 16, Auckland). Phone Peter Rudd, project manager at the Institute for International Research, (09) 308-3760, for more information, or check out The Institute for International Research website