BY MOHAMMAD ZAID
Nearly a quarter of the world’s children are estimated to live in countries where armed conflict or natural disasters have occurred.
Following Russia’s invasion of Ukraine, children in the country are dealing with the devastating effects of living in a war zone, including the constant threat of shelling, shooting, and losing loved ones, as well as the worry about food, clean drinking water, and healthcare, as well as the disruption of their normal routines and structures.
The mental health consequences of this war are likely to last for many years.
In the aftermath of war, the most common mental health disorders are posttraumatic stress disorder (PTSD) and depression, which affects both adults and children. While it’s difficult to estimate the prevalence of these disorders, most studies have found significantly higher levels of disturbance when compared to control populations. For example, anxiety levels in newly arrived refugee children have ranged from 49 percent to 69 percent in previous studies, with prevalence rising dramatically if at least one parent has been tortured or if families have been separated.
Even a single traumatic event can cause PTSD in children, but repeated or prolonged trauma increases the risk. PTSD can manifest itself in a variety of ways, including intense fear, helplessness, anger, sadness, horror, or denial. They may also experience physical symptoms such as headaches and stomachaches, exhibit more abrupt and extreme emotional reactions, and have difficulty falling or staying asleep. Children who have been exposed to trauma on a regular basis may develop a form of emotional numbing to help them cope with the pain and trauma. This is referred to as dissociation.
Children as young as three years old can develop depression, which manifests itself in feelings of sadness or hopelessness, as well as a lack of interest in previously enjoyed activities. Their sleeping habits and energy levels may change, and some may even harm themselves.
The support a child receives from their caregivers will have a significant impact on their mental health. However, normal attachments are frequently disrupted during times of war, making this difficult. Some children may lose their caregivers, be separated from them as some family members flee and others remain to fight or discover that their caregivers are too depressed, anxious, or preoccupied with protecting and sustaining the family to be fully emotionally available.
The adverse effects of war trauma on children are not limited to specific mental health diagnoses, but also include a wide range of developmental outcomes that adversely affect relationships, school performance, and overall life satisfaction. The fact that violent conflict frequently destroys or severely damages schools and educational systems exacerbates the problem. Without the structure that schools provide, children will rely on the adults in their lives to provide it; we’ve seen videos of Ukrainian children in underground bunkers where adults facilitate lessons and set aside time for designated playtimes.
It isn’t just their loved ones and routines children may be separated from. Many people will be forced to flee their homes on short notice, leaving behind their most prized possessions, such as an ‘attachment object,’ which is typically a favorite blanket or soft toy. When children need to feel safe, they frequently reach for these items. However, many children are left without these items during wartime, when they are forced to flee and need them more than ever.
Many Ukrainian children will be forced to leave their homes, as well as their country. Displaced children, particularly refugees, are more likely to suffer from psychological problems. They are also exposed to additional risk factors and may be subjected to various forms of exploitation.Some studies mentioned that children are particularly vulnerable to a buildup of stressors; in fact, there is substantial evidence for a dose-response relationship between the number of stressors children face and their mental health outcomes. Three main sources of stress for child refugees:
Many may have witnessed or experienced violence, torture, and the loss of family and friends in their homelands.
Traveling to a safe country can be a stressful experience. Separation from parents may occur in refugee children, either by accident or as a precautionary measure.
The final stage of seeking refuge in another country can be particularly challenging, as many people must prove their asylum claims while also attempting to integrate into a new society. To emphasize the problems, this period is increasingly being referred to as a period of “secondary trauma.” A refugee child will need to adjust to a new school and find a peer group once they arrive. Children may be forced to assume adult roles too soon, such as serving as a vital language link to the outside world.
Refugee children suffer from both the effects of fleeing a war zone and the effects of adjusting to a new culture. These stressors also have an impact on their families, which hurts them. The longer a war lasts, the worse it becomes for children.
Longitudinal studies, in which children are examined at various points throughout their lives, show that these mental health issues tend to persist over time, while also increasing susceptibility to other psychological issues.
Adolescents who have been exposed to war on a regular basis or who have developed PTSD as a result of war events have been found to have significantly higher rates of substance abuse. Children who have witnessed war and conflict are more likely to develop depression and anxiety later in life. The prolonged activation of stress hormones in early childhood, in particular, can reduce neural connections in learning and reasoning areas of the brain, affecting children’s ability to perform later in life. The conflict has a huge social cost for future generations in this way.
Children must be quickly integrated into the educational and healthcare systems of the countries where they have sought asylum. They will require emotional and psychological support from cross-cultural teams who can work with children in schools and their families on a long-term basis. A variety of treatments, including individual, family, group, and school-based interventions, are required. Schools are in a unique position to aid in their integration by serving as an anchor for educational, social, and emotional development, as well as an important link between children, their parents, and the local community.
Children are involved in conflicts in other parts of the world as well like in Syria, Yemen, and Afghanistan.
After more than a decade of conflict in Syria, UNICEF claims that every child there has been affected by the war’s massive physical devastation, which has resulted in violence, displacement, severed family ties, and a lack of access to essential services.
Since the conflict began, nearly 13,000 children have been killed or injured. Meanwhile, 6.5 million children require humanitarian assistance due to a severe economic crisis, mass displacement, widespread public service infrastructure destruction, and the COVID-19 pandemic.
In Syria, for many children, war is the only thing they have ever known, and the constant threat of violence and hunger has had a significant impact on their mental health. The war has also caused one of the most serious educational crises in recent memory Schools can help children cope with trauma by providing opportunities for them to interact with peers, develop as competent members of society, and receive consistent social support. On the other hand, Syria’s educational facilities are overburdened, and many schools are unable to function because they have been destroyed or damaged, or because they are being used to house displaced families or for military purposes. More than three million Syrian children were out of school by March 2022.
In Yemen, children are also suffering as a result of what can only be described as a humanitarian catastrophe. Since the war began, at least 10,200 children have been killed or maimed, thousands have been recruited to fight, and two million people have been internally displaced. Access to education and health services has also been disrupted as a result of the damage and closure of schools and hospitals, making them even more vulnerable. Yemen’s most pressing problem is hunger. It should come as no surprise that children who are chronically hungry and malnourished are more likely to experience stress, anxiety, depression, or even schizophrenia.
Afghanistan’s children have repeatedly witnessed or experienced poverty, malnutrition, violence, and death. A large number of Afghan children suffer from depression and anxiety, but they lack access to critical support services. As per the report by Save the Children in 2019, two-thirds of parents surveyed in parts of Afghanistan said their children were afraid of explosions, kidnappings, or other forms of extreme violence on their way to and from school. War begins for political reasons, but it quickly loses its humanity.
Mohammad Zaid is a Research Scholar in Government Medical College and Hospital, Chandigarh
