The miracle on board flight 771

In a Libyan hospital bed, a little Dutch boy called Ruben van Assouw is said by doctors to be "recovering well" after surgery for multiple fractures in his legs. Considering the nine-year-old was on an Airbus that hit the ground with such force that smouldering shards of metal were thrown half-a-mile from the point of impact, he is – to use a well-worn phrase – lucky to be alive.

Or perhaps "lucky" is the wrong word here. The boy is in pain, in a hospital in a strange country more from than 1,000 miles from home, tended by medical staff who do not speak a word of his language, nor he of theirs. The only way he could give them a clue to his identity was by repeating: "Holland, Holland!" Even if the arrival of an aunt and uncle at his bedside after two lonely days cheered him up, no one will be smiling as the visitors break the news that his parents are dead.

We love stories of survival and astounding good fortune. The tale of someone who was on the Titanic and lived to tell the tale is so much more cheering and engrossing than the grief of the loved ones of the thousands who drowned.

It is cheering that a child can survive an impact like that of Flight 771 outside Tripoli airport early on Wednesday, which destroyed the Airbus A330, killing all the other 103 people on board. When the boy leaves hospital, hopefully with no lasting external injuries, they will want to celebrate to welcome him back to his home town of Tilburg.

But at this stage nobody knows what the long-term psychological effects will be on a child who has been through so terrifying an experience and suffered so traumatic a loss. It is likely that Ruben van Assouw will be living with the emotional aftermath of Wednesday's catastrophe well into his adult life.

He joins a list of more than a dozen known examples of sole survivors from air disasters. Sometimes, for freak reasons that defy satisfactory explanation, one person emerges from the wreckage of a crashed aircraft when everyone else on board is dead. Often, that person is a child.

Bahia Bakari, a 12-year-old girl from Paris, had world fame thrust upon her after a Yemeni airbus crashed into the Indian Ocean on 30 June 2009, killing all the other 152 passengers. Thrown into the sea without a life jacket, and barely able to swim, with a broken collarbone and burns to her knees, she was adrift for 13 hours, most of it in pitch darkness, clinging to the wreckage, until a rescue ship arrived. Her mother died in that crash, but she lived to dictate her story to a journalist, which was published in French as Moi Bahia, la miraculée.

Another extraordinary story of survival is that of 12-year-old Francesca Lewis, from Santa Barbara, California, who was in a light aircraft with her best friend from school, her friend's father, and the pilot, when it crashed into a volcano in Panama, in freezing fog. Weather conditions were so bad that it took rescuers two days just to find the wreck. They found three people dead, but Francesca was strapped in her seat, upside down, dressed only in shorts and a T-shirt, hungry but unhurt. Luggage tumbling around her had protected her from the cold.

In 1987, a plane crashed soon after take off in Detroit, killing 158 people, including all the passengers except a four-year-old girl, who suffered serious burns but survived. In 1997, a Russian plane used by a Vietnamese airline crashed in neighbouring Cambodia, all but one of those on board. The survivor was a one-year-old boy. In 2003, a two-year-old was pulled alive from the wreckage of a Sudanese airbus in which the other 115 passengers were killed. These cases suggest that children have a higher chance of survival because of their size. Their heads and legs are not protruding from their chairs, vulnerable to flying wreckage. In 2007, a three-year-old girl survived a crash in a light aircraft in British Columbia because she was strapped to a child's seat.

Or if they fall to the ground, their relative lightness gives children a better chance of having their fallen broken by trees or vegetation. In 1995 a nine-year-old girl, Erika Delgado, was the only survivor of a mid-air explosion on board a flight over Colombia. She landed in a mound of weed in a swamp. There have also been examples of adults emerging alive from plane crashes – only to find that when the physical injuries have healed, the emotional scars remain. Survivors' guilt is a well-known phenomenon, as those who come out alive wonder whether they should have done something for those who died, or whether indeed they deserve to have survived at all.

One famous sufferer was Waylon Jennings, the guitarist in Buddy Holly's backing band, who gave up his seat to another musician on the plane in which Holly was killed. He is reputed to have suffered guilt feelings for years.

Another phenomenon is the euphoria that can follow a near-death experience, which was skilfully examined in the 1993 Hollywood movie, Fearless, in which Jeff Bridges starred as a man terrified of flying who survives a crash, and loses all fear, becoming addicted to putting his life at risk, putting a strain on everyone around him.

The American author, Norman Ollestad, was 11 when he came through a story similar to Francesca Lewis's. He was in a light aircraft with his father, his father's girlfriend, and a pilot, when it crashed into a mountain in bad weather, at 3,700 feet. The two male adults died on impact. The woman and the child crawled out onto the icy mountain and tried to descend, but she fell to her death.

He survived to write a best-selling account of his experience, and of the psychological trauma that afflicted him for a year afterwards. "I wanted to insulate myself from the world, which seemed more chaotic and abrasive than I recalled. I was unable to tolerate any negativity. Everything – people arguing or suffering, even an old woman using a cane – felt overwhelmingly gloomy. I spent most of my waking hours trying to force sweet thoughts into my head. I slept with the lights on," he wrote.

Ollerstadt was a resilient boy who had been brought up to love outdoor adventure, and was lifted out of despondency when he rediscovered the excitement of surfing. It is to be hoped that at some time not too far into the future something will enter Ruben van Assouw's life that will enable to get over the day when he lost his mother and father.