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Traumatised and broken: the plight of children in conflict zones

“I feel a lot of terror, and now that terror is getting bigger. We started to sleep in the hallway because I’m so afraid… I’m really afraid and fear has spread everywhere. I stay up all night long, I can’t sleep from the sounds of their airstrikes,” a 10-year old-girl shared with Save the Children, a UK-based organisation, during the recent attacks on Gaza in May 2021.

Luma Tarazi, mental health and psychosocial support adviser for Save the Children in the occupied Palestinian territory, said: “Because of overstimulation of the nervous system, their (children’s) bodies cannot calm down. Even if the violence ends, children will not able to relax or sleep – instead, they will remain distressed. We expect that this emotional toll will prevent them from playing, relaxing and focusing in school. Their recovery will take a long time.”

Unfortunately, this is true for thousands of children around the globe. Children who hold the responsibility to shape the future of the world, who need confidence, social skills, education, and love and care to welcome the diversity around them are the most vulnerable souls in such societies.

According to the United Nations Children’s Emergency Fund (UNICEF) more than 1 out 10 children worldwide are affected by armed conflicts and an estimated 246 million children live in areas affected by conflict as reported by United Nations High Commissioner for Refugees (UNCHR).

According to the UN, the 10 worst countries for children in conflict areas include Iraq, Syria, Yemen, Central African Republic, Democratic Republic of Congo, Mali, Nigeria, Somalia and South Sudan.

As stated by Save the Children, “nearly 90% of children in Yemen, 70% of those in Syria, and 60% of Somalia’s children were living near high-intensity conflict in 2017.”

Forced to stay in fear, flee for safety, and facing horrible brutalities on their way to refugee camps cripple the weak minds and bodies. Many are unable to make it while a vast majority of survivors have no basic life needs. 

Food and water

Food and water are among the most important element for survival and the same get scarce the moment armed conflicts take place in any area.

In fact food is used as a war weapon. Attacks are planned on livestock, crops, and food storages first. Scarcity of food leaves children malnourished taking a heavy toll on their physical development.

Children have been reported to suffer from “moderate and severe acute malnutrition, anaemia, and other nutritional deficiencies,” reports the American Academy of Pediatrics, in The Effects of Armed Conflict on Children.

The report also suggested that South Sudanese refugee children living in Ethiopian camps faced “global acute malnutrition rates of 25% to 30% in children six months to five years of age with an acute malnutrition prevalence of 5.7% to 10%.”

More than two decades of war in Afghanistan has devastated the young population. According to UNHCR, only 13% of the population has access to water and sanitation facilities and the malnutrition rate for children under five years of age is 45%-59%.

Nearly 2 million children under five years of age are suffering from acute malnutrition, including 600,000 children with acute malnutrition in Afghanistan as reported by Mohammad Zahir Akbari, a writer at the Daily Outlook Afghanistan.

As stated by UNDP 1.6 million children living with malnutrition (14% of the 2019 child population) in Yemen.

Shelter

The war strategies have changed over time. The basic purpose of armed conflicts is to destabilise a society. Thus, common cities, civilian residing areas are targeted in mass. Nowadays, even hospitals and schools are not considered safe for shelter.

Displacement of people mostly affects children who have to spend their lives in uncertainty without basic needs as food, water, and sanitation. Severe weather and violent war environment arouse the sense of insecurity and fear to its greatest.

“Crowded camps and urban areas are prone to outbreaks of cholera and other communicable diseases,” Connolly MA, Gayer M, Ryan MJ, Salama P, Spiegel P, Heymann DL write in a research paper Communicable diseases in complex emergencies: impact and challenges.

“Lack of immunisation programs, sanitary and living conditions result in outbreaks of vaccine-preventable diseases such as measles, meningitis, and pertussis.”

As mentioned in a report published by Save the Children, in 60 years long armed conflicts in Columbia, “of people registered as displaced, 2,279,891 are minors younger than 18 years old… This created a situation for certainty among children “that is at first hostile and unknown, with precarious social, economic and human opportunities; situations that significantly impact the social and emotional development of children”. (CODHES & UNICEF, 2000, pg 46).

Medical facilities

Attacks on medical care centres are a violation of international humanitarian law. However, it is systematically violated in all kinds of armed conflicts.

According to a report from Syrian American Medical Society Foundation (published on October 19, 2018) “Between 2011 and 2017, there were 492 attacks on healthcare in Syria, killing 847 medical personnel. From January to July 2018, another 119 attacks were recorded, mostly affecting East Ghouta, eastern Aleppo, Dara’a, and Idlib.”

In such conditions, very few healthcare workers, doctors, nurses are left to take care of the injured. Again children are the frailest to suffer from war injuries and the rise in causalities among children is higher.

Injuries, disabilities and causalities

“Children, especially those younger than five years of age, bear the highest burden of indirect conflict-related death,” Toole MJ and Waldman RJ repost in their joint research The public health aspects of complex emergencies and refugee situations, Annu Rev Public Health, 1997.

Lower respiratory tract infections, diarrhoea, measles, malaria, and malnutrition are among the leading causes of mortality in children in conflict-affected areas,” states a report by the World Bank, Demographic and Health Consequences of Civil Conflict.

In conflict zones, previously controlled vaccine-prevented diseases have a greater chance of outbreak as an outbreak of polio has been a serious threat to children in Syria in conflict zones.

According to a report by UNDP, in 2019 one child dies every 11 minutes and 54 seconds in Yemen.

Education

Educational infrastructures are targeted in armed conflicts as bombing, aerial fires, and combats on regular basis and most affected of all are school-going children.

According to United Nations High Commissioner for Refugees, Global Education Monitoring Report, Half of the primary school-aged children who are refugees and 75% of adolescent refugees are out of school.

A report by the UN Relief and Works Agency for Palestine Refugees in the Near East stated: “In Gaza, the Israeli-imposed blockade and repeated hostilities have had a devastating impact on Palestine refugee children…during the summer of 2014, six UNRWA school buildings used as designated emergency shelters for IDPs were hit directly or indirectly, causing deaths and/or injuries, and at least 83 school buildings were damaged.

In the occupied West Bank, including East Jerusalem, nearly 50 years of military occupation has hindered the education and development of children and youth – even more so with the upsurge in violence since October 2015.

In Lebanon, Palestine refugee camps have been marked by clashes and UNRWA schools have been physically damaged and exposed to instances where schools were used by armed factions.”

In Afghanistan, as stated in a report by Christian Children’s Fund (2003) “under the Taliban, access to education was limited for girls (enrollment 3%-6%) and also for boys (enrollment 38- 58%) since a ban on women working nearly immobilized the school system.”

Girls and boys are affected differently by armed conflicts as studied by many international organisations.

For example, as reported by UNRWA, “the majority of education-related incidents recorded by UNRWA in 2015 occurred in boys schools…boys school buildings witnessed 23 incidents of evacuations, military incursions or different types of ammunition landing in their premises, in comparison to 13 incidents in girls school buildings. On the other hand, in Syria, anecdotal evidence suggests that girls, more than boys, are prevented by their parents from going to school due to the lack of security, which shows a greater impact of conflict on girls’ ability to access education in the country.”

Indirectly it is ensured in armed conflicts that education which can bring hope, unity and peace among the next generation is hindered and infrastructure to be shattered as much as possible.

10.3 million children without access to schools (36% of school-aged children in 2019) in Yemen have been recorded by UNDP.

Learning disabilities

Children who experience armed conflicts directly or indirectly suffer serious injuries or traumas which may last their whole life if not treated well. As these war zones already lack basic health facilities hope for clinical help is unlikely. Therefore, even in post conflicts times, children find it hard to concentrate in studies.

Shyness in the informal education system where students of different age groups are set together, anxiety and stress to cope up with the missed years and most of all the loss of their homes, families, friends and witnessing the atrocities of bombing and combats leave permanent marks on their mind which shatter their learning abilities in different ways.

Lack of concentration, depression, fear and insecurity hinder their performance.

Still many children across the globe are miraculously striving for the best.

As reported in one UNRWA report: School on the frontline, “In the Ein El Hilweh camp in Lebanon, a school principal introduced me to a 13-year-old Palestine refugee girl from Syria. On her flight to Lebanon, she had lost her father and a brother and yet was the highest performing pupil in the school. To me, she illustrates how deeply Palestinians value learning and developing skills, often against all odds, and how they seek to rebuild after so much has been lost. I see her and others like her helping their shattered communities recover after the conflict is brought to an end.”

(Statement of UNRWA Commissioner-General Pierre Krähenbühl at the high-level ministerial meeting on the financial sustainability of UNRWA in New York, 26 September 2015)

Mental health

A child’ first and best academy is family. Children who live a healthy life with their families build confidence, high self-esteem, learn problem-solving and tolerance.

Unfortunately, war-affected children, many of whom are parent-less, living in refugee camps suffer from fear and insecurity, stress and anxiety, aggression and revenge, trauma and depression.

As reported by UNRWA: Schools on the front-line, “In Gaza, as a result of the 2014 hostilities, Palestine refugee children suffered from bed-wetting, shaking at night, clinging to parents, nightmares and increased levels of aggression. At the time, UNICEF estimated that 373,000 children in Gaza were reported as in need of psychosocial support.”

Mohammad Zahir Akbari, a writer of the Daily Outlook Afghanistan, writes as “One-third of children in Afghanistan have experienced psychological distress related to the loss of family and the constant risk of death or injury due to conflict and attacks on schools.”

An event stated in a report by Save the Children shows the psychological impact on one innocent child as: “Ali was playing outside his home in Aden (Yemen) with his friends… when his best friend Saif* joined them and was holding an unexploded anti-aircraft bullet.

Ali says “He started to hit the bullet on a concrete wall and then suddenly there was a big spark of fire on the wall and it blew up.” Saif and another boy were killed and six children, including Ali were injured.

Ali suffered severe injuries to his chest and shoulders, requiring two operations to remove shrapnel from his body. His mother told Save the Children that since the accident, he wakes up in the night crying, sobbing and screaming “All my friends died! Where are they?”

The psychological impacts are horrible. A sample study by Save the Children organisation says: “150 children attending Save the Children Child-Friendly Spaces or participating in our mine risk education sessions in Aden and Lahj governorates (Yemen), 70% were assessed to have symptoms associated with distress and trauma including anxiety, low self-esteem, feelings of sadness, lack of concentration and low problem-solving skills.”

The horrible sufferings leave a pronounced effect on children which onward affect academic progress. Thus, a vicious circle is created for the next generation.

Child abuse

According to Amnesty International “Girl children, and at times boys, have suffered rape and sexual assault. They have been abducted by local warring commanders, either for their sexual purposes or to be sold into prostitution in Afghanistan”.

As stated by a report of UNDP “The war (In Yemen) has resulted in increased rates of gender-based violence and child marriage.”

Countries around the globe are spending billions of dollars each year on their military budget and many even more than their average GDP. Education and health sector through the most important are neglected in the tides of war.

The question is where does this thread lead to…an entangled next generation? The message of aggression, cruelty and bloodshed as the only solution to manmade conflicts is penetrating deep into the minds of young ones who lose their innocence within three to five years of their life.

These atrocities cannot go on forever, many international and local organisations try to reach the survivors in the war zones and much is done, however, this is an issue to be addressed at the government level.

*Saif is not the original name of Ali’s friend. The name has been changed due to privacy.

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