Relief Through Reading

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t just 7 years old, Kaylen Brice can vividly recall jumping off the roof of his granny’s home during Hurricane Dorian to avoid drowning inside.

His classmate Makayla Lubin and her mother hid under a table in their home for hours as the massive, slow-moving, Category 5 storm pounded the island. Many of their classmates lost parents or other relatives in the maelstrom. And many still struggle to talk about it.

These children are part of just one class of second grade students at the Central Abaco Primary School in Marsh Harbour. But their drawings recently served as a window into the harrowing experiences of these young children during Dorian, a 185-miles-per-hour storm that ripped through the northern Bahamas in September 2019 with high winds, rain and a 20-foot storm surge. The storm sheared away homes and businesses in the bustling commercial center of the town.

Close to 90 young Bahamian students were learning and drawing about hurricanes in late April as part of a pilot program led by a team of doctors and staff members from the Miller School’s Global Institute for Community Health and Development. The pilot was conceived by Anjali Saxena, M.D., an assistant professor of clinical internal medicine and pediatrics.

In the months after Dorian, she joined a team of University physicians from the Global Institute, and staff from a nonprofit called Direct Relief, that helped the Bahamian government care for patients at a public medical clinic on the island. At the time, Dr. Saxena was struck by the need for counseling and education to help local children process the trauma of living through such a destructive storm.

“As a general pediatrician, I left there feeling very concerned that there was this entire group of kids who were just sitting with these thoughts and nothing to do,” said Dr. Saxena, who is also academic program manager for the Global Institute. “For months after the storm, they had no safe place to learn, play or receive appropriate counseling because of the immense infrastructural damage that had occurred. So, I really wanted to find a way to help them.”

From her own research and experience, Saxena knew how critical schools are to help children recover from disaster. She also recalled how books can help people come to terms with their feelings, and she remembered happily borrowing books from a library van that visited her school when she was a child. From these ideas, Saxena envisioned The Wonderful Floating Library program — a library carried by donated boats. On Great Abaco, where the only public library was destroyed during Dorian, the pilot program aims to try and help these students emotionally process their experiences, while also offering books to help improve on the poor literacy rates. Eventually, the team hopes to expand the program to visit surrounding islands.

“This area endured back-to-back disasters with Hurricane Dorian and then the COVID-19 pandemic, which forced many of these children to be out of school for longer than the rest of the world, moving from place to place, and lacking many of the things that we know are needed for them to have healthy development and growth,” Dr. Saxena said. “We wanted to help increase literacy again and also to provide these students with a place to talk about their experiences with Dorian, as well as how to prepare for the next storm in age-appropriate ways.”

By giving the children a chance to select a new book, and by teaching them about hurricanes and disaster preparedness, the team aspired to help the children gain more resilience before the 2023 hurricane season began on June 1.

“At the Global Institute for Community Health and Development, we remain totally committed to the underserved children of the Bahamas. Our focus is on providing each one of them the opportunity to be healthy, safe, educated, and optimistic about their future,” said Dr. Barth Green, co-director of the Global Institute, professor of neurological surgery and executive dean for global health and community service. “Our team has embraced the Floating Library strategy as a means of providing these children what they deserve — a sense of self confidence and self-esteem, and the knowledge that the world beyond their island homes truly cares about their future.”

To craft the three lessons for the pilot, Dr. Saxena enlisted the guidance of her colleague, Kendra Van Kirk, M.D., a former middle school science teacher, who is now the Miller School’s co-director of the medical educator pathway for the internal medicine and combined internal medicine-pediatrics residency programs.

“We know storms like Dorian are likely to affect the Bahamas again, so we want to help lay the groundwork for these students — to learn basic terminology about hurricanes, to help them better understand what is happening when they see or hear about them on the news. But we also want to create a safe space where they can openly discuss their feelings of fear or sadness as it relates to past storms,” said Dr. Van Kirk, who is also an assistant professor of clinical internal medicine and pediatrics. “We hope that in doing so, they are equipped with the tools to mentally prepare for and cope with another hurricane when it happens.”

Saxena, Lemma and the Global Institute’s Director of Strategic Initiatives, Didi Bertrand Farmer, traveled to Marsh Harbour last fall to bring their idea to local schools, educators, and government officials, all of whom had similar concerns about the children in the Abacos. In February, the group partnered with Central Abaco Primary School and Agape Christian School to host their first lesson at the Abaco Beach Resort and Marina, focused on “courage and everyday heroes.” By reading the picture book I Am Amazing and using activity books created and donated by AshBritt Chief Executive Officer Brittany Perkins Castillo, the lesson focused on building self-confidence and resiliency.

Students were asked to express in words or pictures a time when they had to be brave and overcome their fears. Afterward, each child got a mask and cape they could decorate, and the Miller School team explained that heroes too must overcome scary situations to help others.

Students also boarded a boat temporarily donated by the project’s primary donor, Ed Herbst, owner of the Terrible’s franchise chains, as the initial Floating Library, where they could pick a book to take home. Samantha Gonzalez, M.D. ’17, an assistant professor of clinical internal medicine, joined Dr. Saxena on that trip to help plan and execute the first lesson. She also designed the students’ library cards.

On April 26, the team returned to teach the same students about hurricanes. They explained how hurricanes are formed and the wind speeds that comprise each category, and they showed the students how to understand a hurricane forecast map. Joining Dr. Saxena on the second trip was Dr. Van Kirk, along with Jennifer Denike, M.D., an internal medicine resident in the global health track; Katrina Lopez, a double alumna and nurse practitioner; and Jessica Lemma, senior manager of business operations for the Global Institute.

The team plans to return in the next few weeks for the third time, when it will be teaching students about disaster preparedness, with another goal: to arm the children with strategies about how to keep themselves and their family safe during a hurricane. This time, students will get the chance to create an emergency supply kit that they can take home.

“These lessons can empower the kids to feel ready for any situation they know is coming,” Dr. Saxena said. “As parents, we have all had times when our kids come home and challenge us with something they learned at school. I’m hoping they go home and force a conversation that may not have happened otherwise.”

Teachers and school leaders in Great Abaco are grateful for the help. Mary Williams, who teaches second grade at Central Abaco Primary, said that the storm’s extensive damage to the school, as well as the pandemic, forced them to close throughout the past two years, and very few students logged into online learning each day. One of her students had never entered a classroom until this year, and she had to teach him how to hold a pencil.

“This is the first year of normalcy for our school, so there’s a big learning gap between Dorian and the COVID-19 pandemic,” said Williams, who often loses sleep worrying about her students. “I know too well the repercussions of not having an education, so getting them interested and exposed to more books is helpful.”

Jameika McPherson, Central Abaco Primary School’s senior mistress, agreed.

“A lot of these children aren’t exposed to books at home, so I think this is a great initiative and they all can benefit from it,” she said. “Also, in the event that we were to expect another hurricane, now they can relate to things like the categories and all the information they were given today.”

Students who participated in the February program were eager to get a new book and to see Dr. Saxena again in April, and they greeted her and Lemma with hugs. Shazaria Vixama, 8, beamed after receiving her new book, Eudora Space Kid, and eagerly flipped through it.

Nadia Farrington, the students’ third grade teacher at Central Abaco, was glad to see her students enthusiastic about reading. Since the school’s library is still closed, books from the Global Institute have helped add more reading options to her classroom.

“They now have a gravitation toward the Floating Library program, and we are very excited to get some new books that we can add to our classroom library,” she said.

While they were able to use a donated boat for the program in February, Dr. Saxena said the team is still looking for more donated vessels for the Floating Library, so that the program also can reach other surrounding islands. She would also like to scale up the program to reach both older and younger students in Great Abaco. Dr. Green has even broader plans.

“This is a pilot to see if we could extend this program across the Bahamas and globally across our hemisphere but also domestically too,” he said. “Because there’s not a day in the week when there’s not a flood, disaster or mass shooting, we want kids to be strong and resilient, regardless of what’s happening in the world.”

If you are interested in donating a boat, books or supplies, contact the Global Institute by e-mailing globalinstitute@med.miami.edu, or donate to the Global Institute programs. 

UNIVERSITY OF MIAMI MEDICINE

FALL 2023