Children and adolescents are one of the very vulnerable groups in any disaster situation. Not only did around 10,000 children die in the tsunami in Sri Lanka, but the survivors experienced a number of symptoms. Children and adolescents were often not allowed to grieve, as information on their parents' and family members' deaths were withheld from them in order to protect them. Fear of recurrence and separation anxiety was related to school refusal. In addition, displacement and within-country migration led to increased demands and pressure on extended family and in some cases led to child sexual abuse. In this paper, lessons from observation of the aftermath of the disaster are described. For health care professionals as well as for lay volunteers, some factors have to be contextualized within the cultural context.