The Foreign Service Journal, July/August 2018

40 JULY-AUGUST 2018 | THE FOREIGN SERVICE JOURNAL was on the radio trying to find his dad. At that moment we realized the children were already aware of the event. We needed to get back to her house as quickly as possible, but the main roads were being shut down. Fortunately, Steven knew a back way. We continued to monitor the radio in search of familiar voices. We knew that Sally’s husband would be working closely with my husband, the regional security officer [Paul Peterson]. Neither voice was detected during the hourlong ride back to her house, and anxiety was beginning to build. When we finally arrived back at the compound, our children were playing, the sky was blue and it was a beautiful day. At first glance, everything seemed right with the world. Spouses gathered in the living room of one home, and every- one placed their radios in the center of the coffee table, continu- ing to listen for familiar voices. The TV was tuned to CNN, which was broadcasting the aftermath of the horrific event. Hours went by, and some were relieved to hear their loved ones’ voices, while others remained numb. I decided to return home with my children and try to remain calm, keeping things as normal as possible until I learned one way or another the fate of my husband. I was angry because he had not reached out to let me know if he was safe, but I reminded myself that he was working. This is what he was trained to do, and he works best under pressure. Stopping to call me would have been a selfish act, especially given the number of casualties. The bombing occurred at 10:30 a.m. It was after midnight before I knew my husband was alive. When I opened the door for him, I discovered a man I barely knew. He was covered in black soot from head to toe. We clung to one another for what seemed like hours. As he showered and changed into clean clothes, I made sandwiches and coffee for him to carry back to the site as he returned to work. With our children safely tucked in their beds, all I could do was cry and pray for his safe return after the loss of so many. I later learned that everyone in the line to cash a check that morning had died. Why I changed my mind at the last minute I will never know. Over the next week, I volunteered to sort and categorize personal items found at the blast site. Shortly after, I accepted a position as the co-community liaison officer. I felt strongly that it was within my ability to contribute to the rebirth of the embassy and community morale. My advice for such a time is to keep the event alive by remem- bering and honoring those who were lost, the victims as well as the survivors. Everyone has a story. Be compassionate. Listen and offer assistance and a shoulder to cry on. Be a friend. The “Ripple Effect” of Trauma Sam Thielman FS Regional Medical Officer/Psychiatrist I was deeply involved in the private practice of psychiatry in Asheville, North Carolina, on Aug. 7, 1998. I remember hearing the news stories about the bombing on television; but frankly, I did not pay much attention to them. To me, at that moment, the East Africa bombings were just another world tragedy reported on ABC nightly news. The impact on me only began four or five months later when, during my interview for a job with the State Department as a regional medical officer/psychiatrist, I won- dered why so many of the questions had to do with how I would handle the psychological aftermath of an embassy bombing. In disaster psychiatry, there is a lot of discussion of the “ripple effect” of a traumatic event, and my family and I were certainly affected by this rippling. My first trip to Nairobi in my new capacity as RMO/P was in the latter part of 1999, some 16 months after the bombing. When I arrived, I was not only new to Nairobi, but to Africa, to overseas living and to the culture of the Department of State. I quickly learned that I was only one of many new people in such a position. In my role as the embassy mental health provider, I soon became aware that my work was exposing my wife and children to a community that was bereaved and angry. There were many who were cynical about the disaster response and about Washington’s efforts to help. We were in an environ- ment that seemed continuously dangerous. My family resented me at times for having taken them from the beauty and safety of the mountains of North Carolina to this situation of comparative deprivation and threat. I also became aware of the power of vicarious traumatiza- tion— the phenomenon in which people who hear stories of disaster over and over are themselves psychologically affected by the disaster. Many were skeptical about claims of psychological distress by those at the mission who, though in Nairobi during the bombing, were not at the embassy itself when the bomb exploded. But exposure to the dead bodies of friends, stories of death and destruction and pressure from all quarters to keep going took a serious toll on everybody. Vicarious traumatiza- tion was known to the disaster response communities in 1999, but was not yet recognized as a cause of PTSD by the American Psychiatric Association. This led to a lot of unnecessary instances of “blaming the victim.” The embassy community at the time of our arrival was com- prised of a mixture of survivors and of those who had come to help rebuild. Both groups were hurting. I was struck by the fact that