Touched by fire: While the physical damage caused by the wildfire exists in plain sight, a deeper, unseen trauma persists

Barbara Weber coughed, cried, spit up blood. She shrieked when her fiancé surprised her with a playful "Boo!" Her pulse raced. Her head buzzed. She panicked if plans changed even the slightest. Ms. Weber's body and mind, like thousands of others, failed her after Fort McMurray's massive wildfire.

The Horse River Wildfire generated roughly 90,000 stories – one for every evacuee. Ms. Weber's starts at an evacuation centre, where she was working. In the middle, she was right behind the highway crash that killed two people after the mass evacuation. She was in a medical shuttle because her breathing was so laboured. The problem lasted months. She was traumatized. The physical and psychological fallout meant she could not return to work.

"It just didn't seem real," she said last week.

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Now, a year after the wildfire, it is possible to get a glimpse of how many of Fort McMurray, Alta.'s 90,000 stories mirror Ms. Weber's experience with physical and mental illness. Data from the Workers' Compensation Board hint at how many people suffered health problems. A University of Alberta study quantifies the breadth of mental illness in and around Fort McMurray. Alberta knows how many millions of dollars it provided for mental-health support specifically tied to the blaze. A survey of non-profit organizations highlights how the fire weakened the workforce.

It is no surprise to find Ms. Weber isn't alone. But only now are statistics – rather than just stories – emerging that show how many people are with her.

Ms. Weber works at FuseSocial, which provides support in emergencies. She was organizing an evacuation centre on May 3, 2016, when she was exposed to smoke that led to her chaotic medical evacuation. Alberta's WCB provided support when she could not return to work.

WCB claims for "psychological injuries" in the Wood Buffalo region more than doubled in May, 2016, compared with the same month a year earlier, according to calculations the agency provided to The Globe and Mail. Further, claims for all injuries more than tripled when comparing May, 2016, to the same month a year prior. Injuries related to poisoning and other toxic effects accounted for 74 per cent of these claims in 2016, compared with only 4 per cent in 2015. The agency used May because it tracks data by when injuries occur, rather than when claims are filed.

"It is a snapshot that tells us there was a significant impact to the individuals working in and around the Fort McMurray area at the time of the wildfire," said Ben Dille, a spokesman for WCB.

WCB does not link claims to specific events such as fires. The agency based its math on addresses belonging to employees and employers. (Major corporations with headquarters far from Fort McMurray, WCB noted, often employ people through subsidiaries with local addresses). As a result, WCB's numbers are reasonable, although imprecise, estimates.

WCB's responsibility is limited to injuries employees incur executing their job requirements. Ms. Weber's job meant she had to work in a traumatic and smoky situation. Folks unable to work because the fire harmed them would not be captured in WCB's figures unless the nature of their jobs exposed them to the fire's dangers.

Ms. Weber panicked on her September wedding day. It wasn't cold feet. Instead, her phone was going off as she was in the midst of a bridal ritual: putting on her dress, doing her hair, applying makeup. Last-minute questions from friends overwhelmed her. She gave her cellphone to a friend to deal with it all. And that type of support – or lack thereof – is the most significant factor in determining how adults respond to trauma.

A University of Alberta survey of 486 adults from the city found more than one in 10 Fort McMurray residents – 12.8 per cent – "likely" suffered post-traumatic stress disorder (PTSD) six months after the fire. Slightly more – 14.8 per cent – "likely" suffered a major depressive disorder (MDD). Some people would fall into both categories.

Dr. Vincent Agyapong, who conducted the study which has not yet been released in full, is an associate clinical professor in the department of psychiatry with the university's faculty of medicine. He works with Alberta Health Services.

He found insurance coverage did not influence the likelihood an adult would suffer from PTSD or MDD. Instead, support from family and friends proved to be the main difference: Adults who said they had "absolutely no support" were about nine and a half times more likely to develop PTSD and 13 times more likely to develop MDD at six months compared with those who said they received "absolute" support.

"This means that things like support from government is good. Support from insurance is good. Support from the Red Cross is good. But the most important factor to preserve people's psychological well-being is support from family and friends," Dr. Agyapong said.

The fire damaged about 2,500 buildings, such as condos, homes and apartments. It hit roughly 90 more structures such as hotels and airport facilities. The financial fallout is still being tallied. Rafat Alam, an economics professor at Edmonton's MacEwan University, estimates direct and indirect costs may reach about $9-billion. This includes the cost of destroyed buildings, lost wages and less-tangible estimates such as environmental damage. Physical and mental-health costs, when calculated in full, will push the figure higher, according to Prof. Alam. Meanwhile, Alberta said it has spent $24-million on mental-health support specifically in response to the fire.

Fort McMurray is now home to about 73,500 people, about 5,000 fewer residents than were reflected in the 2015 census. The outward migration can't solely be attributed to the fire. Companies operating in the oil sands, struggling because of weak energy prices, shed thousands of jobs long before the blaze started. Fort McMurray's mayor estimated it will take about five years for the population to recover to its previous strength. Meanwhile, the city has issued 645 development permits since the fire. Rebuilding activity across the city's neighbourhoods is patchy: efforts in Beacon Hill and Abasand, for example, are busy in comparison to Waterways. Vacant lots, the mayor said, will take years to fill.

Fort McMurray, on Wednesday, will "recognize" the Horse River Wildfire's one-year anniversary. The municipality has planned a day-long gathering, starting at 5 a.m with a community breakfast and sunrise yoga. The day will be "tranquil, welcoming, supportive."

Meanwhile, the lingering effects of trauma on Fort McMurray's workforce are evident: A recent survey of the city's non-profit organizations captured how the combination of the economic downturn and the fire hit the area. FuseSocial surveyed 70 non-profit organizations nine months after the fire. The survey's participants are tied to social services, health, housing, advocacy and a number of other sectors.

About half said they had job openings; collectively, the organizations had 169.5 full-time job vacancies nine months after the fire. School boards reported 38 of these positions.

Twenty-six per cent of the vacancies were because staff did not return to Fort McMurray. Staff lost due to health problems made up another 12 per cent, the survey said. Some employees left because their spouses relocated, some reported "compassion fatigue," others found the pay insufficient. Only 63 per cent of the agencies were operating at full capacity.

Barbara Weber is among those back at work, though her fire story will never end. "This community is living in two times: We're living in the now but we're also still living in the moment when the fire affected us," she said.