No Deaths - but a Family in Mourning

After surviving a terrorist attack, the Amar family bears few physical scars. But they are still walking wounded

This is a sad summer for the Amar children. They no longer go out to play on the neighborhood soccer field, they don't go swimming or hang out at the mall. Only seldom do their friends come by for a visit.

Anat Amar and her children - Elad (almost 13), Hagai (9), Noam (8), and Gafnit (3) - were at the Sbarro restaurant in downtown Jerusalem last year when the terrorist bomber struck. Noam sustained burns to his arms and legs, and his mother and brothers escaped unharmed, aside from a few minor scrapes and burns, which healed long ago. But since the bombing, the Amars - a happy, outdoorsy, lively family - have been closeting themselves in the dim rooms of their apartment, living in self-imposed isolation, partly against their will, partly by design.

Last August 9th, they went into the city to buy books and notebooks for the new school year. Elad was going to be starting at a new religious school, and he was excited. Anat Amar recalls with sadness how she gave him a new white kippa to wear that day. It was a nice day. Around lunchtime, with bags of their purchases hanging from Gafnit's stroller, they walked into Sbarro to eat. An older woman offered them her seat. Seconds later, Anat would step over her body to get to the exit.

The explosion hit after Anat asked her son Noam to switch places with her. Noam, who sat down next to the suicide bomber, sustained serious burns that have not yet completely healed. Anat would later feel guilty that he absorbed the brunt of the explosion instead of her. But in those instants, such feelings were far from her mind. She felt the blast of heat, and shouted, "Elad, Elad, where is Gafnit?" At the same time, as if in slow-motion, she saw her little daughter thrown by the shock wave through the restaurant's glass window, a shower of fragments covering her.

Elad did not hear his mother. He was already on his feet, looking for his sister. After finding her crying on the pavement outside, wisps of burnt hair on her head and her face bruised, he brought her to safety in one of the nearby shops. At a time of utter chaos - his brothers had disappeared and his mother was screaming, opening and closing ambulance doors as she searched for the rest of her family - he took charge. There, at Sbarro, Elad Amar left his childhood behind him.

Not yet bar mitzvahed, Elad is a full-fledged adult to his younger siblings. It is he who watches over them when their father is at work as a fireman, spending long stints

outside the home, or while their mother is occupied with the household chores. It has been a long time since Elad has left the house to play with a friend. He is a slightly-built, serious child. A self-conscious smile occasionally flickers across his face. The month after the bombing, he began the new school year in a much more religious school than he had been registered for. "He insisted, I couldn't say no to him," says Anat, apologetically. She was raised in a traditional home, but her husband has become more observant in the past few years, whereupon she began covering her hair.

`Going out is really dangerous'

It seems as if religion has not brought Anat Amar much comfort. In the ambulance on the way to Shaare Zedek Medical Center, after finding out that her two sons, Hagai and Noam, had been taken to Bikur Holim Hospital, Elad began to mumble the Shir Hamaalot psalm, and asked her to say the psalm with him. She pushed him away impatiently. The ancient words did not speak to her.

Elad has seized on religion with all his might. He believes that a miracle occurred, that he was saved thanks to the mitzvoth he observes. In an attempt to find meaning in what happened to him, he recites one by one the signs that prove he was sent by heaven to save his sister. For example that he was not harmed, he says, because of the book of Psalms that was in his wallet. A flash of happiness lights up his eyes when he is asked about the picture on the wall, in which he is seen training in the martial arts. He has been studying ju-jitsu from the age of six, bit in the past year he has not trained at all, because aside from school, he does not leave the house.

"It's all down the drain, and I'm no longer as physically fit as I was," he rails. Later, as one who has accepted his sentence, he says: "I don't argue any more. My mother is afraid for us, and going out is really dangerous." It is hard to be a grown-up when you're really just a child. "It's terrible at home with the siblings, who you always have to give in to," says Elad.

One day, his mother relates, he finally opened up while speaking with the psychologist, and admitted that he was having a hard time, too. "I was hurt here," he says, pointing at his heart. "He cries a lot at night, and by day he tries to be the man of the house," says his mother. A week after the attack, a gala thanksgiving feast was held at the Amar home. "Everyone told my husband that he was given a new family," says Anat. "But the truth is that he was given a damaged family."

While she talks in a subdued voice about her life since the attack, her husband continues to cut the salad for the children's lunch, and doesn't say a word. Aside from the oppressive atmosphere at home, his work as a fireman also exposes him to more than enough bleak scenes at the aftermath of terrorist attacks. But, says his wife, he keeps his pain inside, and speaks fairly little.

Eleven years ago, a small explosive charge concealed atop some gas balloons blew up in the courtyard of their building. Luckily, no one was hurt. Amar is terrified at the possibility of a worse terrorist bombing taking place in her neighborhood, which is not far from East Jerusalem. "I feel that my own territory is not safe," she says. "Even when the Patt Junction bomb went off I felt the windows here reverberating. My flesh became all prickly. I got nauseous and was vomiting. I lost a large part of myself in the [Sbarro] attack, in which the children and I were hurt. I try not to show it at home, but sometimes it's out of my control."

The National Insurance Institute (NII) approved an hour of psychological treatment each week for Anat. "They figured that if the mother could be straightened out, so would the children," she says. "The problem with this establishment is that treatments related to injuries are approved automatically, but I had to demand the psychological treatment for children. It's absurd: the physical wound is healed, but when the spirit is wounded, it is hard to heal. I wasn't willing to let them continue to carry this trauma around with them. I was afraid it would become chronic, and I was right. It's been a year, and the children still haven't straightened out."

Gafnit, whose hair was completely burned off in the bombing, won't let anyone touch her head. Every time she has her hair shampooed or brushed becomes a nightmare for her and the rest of the family. She relentlessly asks her mother to hold her. She wets her bed at night, and has gone back to sleeping in her crib. For a long time after the bombing, the entire family would sleep together at night, on mattresses they put on the parents' bedroom floor. Gafnit and Noam, who have suffered from nightmares all year, still sleep there. "Noam sleeps next to my bed. He has a very hard time falling asleep. A night light, Psalms, reciting the `Shma' prayer - nothing helps. He is afraid. He talks and yells out in his sleep," says Anat.

The games are not the same

Only recently has research into trauma among children, which had been overlooked all these years, begun to step up, partly due to the upsurge in terrorist attacks, which have affected large numbers of children. A study conducted by the New York City Board of Education after last year's Twin Towers attack, found that some 75,000 children - 10.5 percent of all students in grades 4 through 12 - suffered from symptoms of post traumatic stress disorder (PTSD). Fifteen percent of students - about 100,000 - suffered from agoraphobia, fear of public places. They explicitly noted that they are afraid to take public transport.

Tamar Lavi, a doctoral candidate at Tel Aviv University's department of psychology, conducted a wide-ranging study among 1,200 fifteen-year-olds. She found that 30 percent of children living in settlements and 70 percent of Palestinian children suffered from symptoms of PTSD. Young children are considered more immune to traumas, because they naturally filter out hard-to-absorb sights, and because they trust their parents.

An entire family destroyed

Experts feel there is a close connection between the mother's ability to endure, and the recovery of the children. "The younger the child, the more he sees the world through the prism of his parents," says Dr. Esther Galili, director of the Child and Adolescent Psychiatry unit at Hadassah Hospital. "When the mother is in a state of anxiety, and is scared to leave the house, it affects her children."

Naturally, the psychiatric treatment is extended through the family, with the parents' participation. As with all treatment designed for children, it is usually combined with games and painting. A study conducted by Dr. Galili last year surveyed 50 children who were lightly hurt in car accidents. She found that the more that parents developed trauma-related symptoms, the more the children developed the same sort of symptoms.

It is hard to decide what is the cause and what is the result, says Galili, since the parents' anxiety level is also a function of the fact that their children were involved in the traumatic event. A study conducted in hospital oncology departments found that the anxiety level of parents of children with cancer was higher than that of adults who themselves have cancer.

The way children react to a traumatic event is altogether different from that of their parents. "Children are not little adults," says Dr. Galili. "They do not express anguish non-verbally, which can be confusing." They may seem easygoing, laughing and playing with everyone. The signs can be a lot more suggested: the nature of the game changes and becomes less complex, their drawings become monotonic and repetitive. Babies and toddlers develop eating and sleep disorders, and cry more often. Kindergarten and school-age children who have been exposed to trauma will express their distress through fears of abandonment. In school, children are liable to present behavioral problems.

Recognition of the emotional state of children who have not sustained physical injury is hardly automatic. In order to receive funding for her children's psychological treatment, Amar had to go through a series of humiliating medical committees. "On top of all the trauma, you get another slap in the face from the medical committees. They don't have any time for you. In the two or three minutes they give you to talk, you're supposed to present an entire life, and then it's someone else's turn. Come to our house for an hour, and you can see how an entire family has been destroyed."

Beginning this year, through contributions received by Hadassah, every child requiring psychological treatment receives it for free. Not long ago, there was an attempt by telephone to locate 200 children who had been brought to emergency rooms after sustaining injuries in terrorist attacks. About half reported being afraid when taking buses, behavioral problems in school, nightmares and sleep disorders. Only 10 percent had received psychological treatment. Only about half of the victims has applied to the NII for psychological treatment.

The National Insurance Institute eventually recognized the emotional harm sustained by the Amar family. The older children refuse to continue their individual treatment, but the entire family is being seen by a psychologist. "I am extremely apprehensive about their future," says Anat Amar. "Something terrible has happened to them at such an early age. They fight all the time, it wasn't always like this. We were a beautiful family. We don't enjoy being together anymore."