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Children in situations of armed conflict

Children in situations of armed conflict

(See also the thematic guide on Children)

Experiences of children in armed conflict

The experiences and circumstances of children in armed conflict are diverse and cannot be easily generalized. Children may live in areas where they are exposed to and may participate in low-intensity warfare for many years (as in Sri Lanka); they and their families may be displaced suddenly and may lose their possessions and land; they may be separated from or remain with caregivers; they may be abducted by armed groups (as in northern Uganda); they may experience sexual exploitation and torture; and they may witness death, killing, and injury of family members, friends and neighbours. Bombings, and the threat of land mines may be among the experiences that children and their families are confronted with.

In many situations the health of children may be endangered through malnutrition, insufficient food intake, and a lack of access to basic health care. An example that illustrates all of these different aspects is Palestine, where the situation of children has seriously deteriorated since the start of the last intifada in September 2000. A 2002 report by Johns Hopkins University and partners found that children were experiencing severe levels of malnutrition in Gaza and the West Bank (http://www.usaid.gov/wbg/reports/Nutritional_Assessment.pdf). Children and their families are also frequently being prevented from reaching clinics in hospitals during periods of occupation by Israeli troops (Save The Children US 2001a) , and school attendance has dropped as children are either unable to attend school due to road blocks, closures, or military attacks by Israeli troops.

What are the psychological and social effects of these diverse experiences on children? There has been a tendency for psychologists to make blanket statements about vast numbers of 'traumatized' children who have suffered forms of psychological 'damage', and at times it has been claimed that these are irreversible and permanent wounds inflicted on the psyche and spirit of children. There can be no doubt that situations of armed conflict have negative consequences for children's well-being and that they often interfere negatively with children's development. However, such statements are based on particular Western notions of childhood, development, and trauma, which will be discussed in the next section.

There has also at times been a narrow focus on the psychological or mental and emotional effects of armed conflict per se, without a recognition that the social effects of armed conflict have a severe impact on the overall well-being of children. To take the example of Palestine above: it is not only the experiences of attacks and occupation by Israeli troops that affect children, but also the impact of economic stagnation in Gaza and the West Bank, which results in severe malnutrition for children, as well as the dangers and difficulties of gaining access to health care and schooling. It is not possible to separate out the impact of the actual attacks from the social, economic, and political consequences of armed conflict, nor to identify particular events such as deaths or bombing as the only experiences that cause distress and negatively affect children's development.

Websites
Save the Children US 2001a http://www.forcedmigration.org/psychosocial/inventory/pwgcopyright.php?PWGTitle=Palestine:%20The%20education%20of%20children%20at%20risk&PWGDoc=007

Childhood, development, and trauma

Conventional Western perspectives on children and childhood have tended to view children as vulnerable, passive, and dependent, and they should therefore be protected from work, hardship, and misfortune (Boyden 2000) . Western scholars have presented these views of children as 'truths' that apply to children everywhere. Boyden points out, however, that such notions are socially constructed and context-specific and vary across cultures, class, and historical time periods. Great variation exists of how children, their capacities, roles, and needs are viewed in different societies, and the notions of passivity and dependency are not necessarily shared. Children in many societies take care of siblings and work in and outside the household, learning skills and competencies that are valued by the children themselves, as well as by their communities.

Another challenge to Western notions of children as passive and vulnerable is that these perspectives deny children's agencies and resilience (McCallin 2001) . Children are active social agents, who engage with the environment around them and participate in and influence events. The assumption that children are passive recipients to whom negative things happen, as opposed to actors who are resilient and who cope with the difficulties they face, is pervasive in psychological discussions of the effects of armed conflict, and may result in a lack of recognition of children's rights to make decisions about issues that affect their lives. It also has implications for perceptions of the 'psychological damage' done to children in situations of armed conflict: statements about large numbers of traumatized children assume that emotional and mental wounds are inflicted on children, who respond with symptoms of trauma. This 'pathologizes' the experiences of children and ignores their status of subjects, rather than respondents, in situations of adversity. Evidence has clearly shown that the majority of children do not become traumatized or suffer severe long-term psychological problems, but that they cope with their experiences and suffer no long-term psychological consequences (Cairns 1996) . Of course children do experience distress in the form of nightmares or fear, for instance, and a minority of children do react with severe disturbances, but it is wrong to assume that all children are automatically traumatized or permanently damaged.

Developmental psychologists have sometimes presented a universal notion of child development that is based on the idea that all children pass through specific developmental stages in which they need to negotiate specific tasks, for instance the development of trust, self-confidence, or certain age-specific competencies. This approach assumes that children need certain conditions for optimal development and that the lack of these conditions will impede or delay their development. This linear, generalized model has been challenged by scholars who view development as a dynamic and evolving process during which multiple forces interact to shape a child's physical, emotional, social, and cognitive maturation (Ahearn et al. 1999) . The notion of conditions for optimal development also operates as a Western standard of ideal conditions for children's development against which other conditions are unfavourably compared, a problematic concept (Burman 1994) . Again, these criticisms of developmental psychology do not imply that developmental psychology has no role to play in discussions of the effects of armed conflict on children, and the significance of child development will be discussed in the next section. It is, however, important to understand that a purely needs-focused approach, based on Western understandings of what these needs are, is contested.

Websites
Boyden 2000 http://www.lse.ac.uk/collections/DESTIN/pdf/WP05.PDF
McCallin 2001 http://earlybird.qeh.ox.ac.uk/rfgexp/rsp_tre/student/children/toc.htm

Child development and child rights

The two dominant approaches to understanding the situation of children affected by armed conflict and providing assistance to them have been oriented around child development and child rights. These two approaches are not necessarily in conflict with one another, and complement each other even as they place different emphasis on various aspects of children's situation.

The child development approach emphasizes the age- and stage-related developmental needs, vulnerabilities, and capacities that must be addressed in order to further healthy and holistic development in children (Ahearn et al. 1999) . The aim is to minimize risks and prevent further harm while reinforcing protective factors that facilitate children's physical and psychosocial well-being. Cultural influences and contextual factors such as patterns of socialization, education, and care can have a profound influence on a child's developing attitudes, values, and beliefs, and should be considered when adopting a developmental approach. For example, while it is clear that babies and toddlers depend on adults for their physical survival, the way in which attention, care, and nurture are given to them may vary within different social and cultural contexts. While participating in cultural and social activities is also a developmental need of children, the way in which this happens will be diverse. The main aim is to allow children to reach their fullest potential in a holistic manner.

The rights-based approach focuses on the fact that children have not only needs, but also the right to have these needs met, as well as other rights such as survival rights, protection rights, and participation rights. The Convention on the Rights of the Child (CRC), which was launched in 1989 and widely ratified by governments around the world, and the African Charter on the Rights and Welfare of the Child (1990) set international norms for the recognition and observance of children's rights. The three key principles of the CRC are (1) the best interests of the child must be observed; (2) non-discrimination is to assure that all children have the right to be treated equally; and (3) children must have the right to participation. This last principle is important for a number of reasons: first, it acknowledges that children are individuals with thoughts and feelings; second, it emphasizes the right of children to have their views not just heard but also taken into account when decisions are made; and third, it recognizes that children are participating members of their communities (McCallin 2001) .

Both child development and child rights approaches place primary importance on the protection of children from violations, maltreatment, injury, and exploitation. Both approaches also emphasize the provision of services to children, for instance the right to food and health care, the right to education, and the right to enjoy social security. The rights approach places additional importance on the right to participation.

Websites
Convention on the Rights of the Child http://www.unicef.org/crc/crc.htm
McCallin 2001 http://earlybird.qeh.ox.ac.uk/rfgexp/rsp_tre/student/children/toc.htm

Some key issues in the provision of psychosocial assistance

Focus on children and focus on families

Over the past years, attention in psychosocial work has shifted from providing assistance to children directly to working with families. The family has the most significant influence on a child's development and is the child's greatest resource (Action for the Rights of the Child 2002). The physical and emotional well-being of caregivers (defined as individuals involved in providing care to children, including parents, siblings, grandparents, relatives, or neighbours) is important for the well-being of children, and this recognition has led to more programmes for caregivers. Strengthening the capacities of parents, families, and communities better to assess and respond to the abilities and needs of their own children is perhaps the most effective and sustainable means of achieving positive, long-term developmental impact for children.

Websites
Action for the Rights of the Child 2002 http://www.unhcr.org/cgi-bin/texis/vtx/home/+DwwBmVeoNxpwwwwnwwwwwwwhFqA72ZR0gRfZNtFqrpGdBnqBAFqA72ZR0gRfZNcFqmE2gDzmxwwwwwww/opendoc.pdf

Separation

Research has shown that keeping children with parents or caregivers during emergencies usually provides children with the emotional support they need, and reduces the negative impact of the events and the risk of developing severe reactions of distress (Richman 1993) . This has led to a general principle in humanitarian work that aims to keep children together with their caregivers where this does not directly endanger the lives of the children, and to reunite children who become separated from their caregivers as quickly as possible in the post-emergency phase (Uppard et al. 1998) . Institutionalization of orphans and children who cannot easily be united with their families is usually only undertaken when no possibilities exist for finding fostering places or peer groups that can fulfil the role usually filled by other caregivers.

Richman (1993) points out that the emotional well-being of children will remain reasonably intact when the caregivers with whom the children remain offer a stable presence and have not themselves become severely distressed, anxious, or depressed. If it is the case that the caregiver is anxious and distressed for long periods of time the child's emotional well-being may deteriorate rapidly.

Establishing a sense of normalcy and predictability

It has generally been accepted that one of the important issues for the psychosocial well-being of children is how quickly and how well a sense of normalcy and predictability can be established in the lives and daily routines of children (UNHCR 1994) . Establishing educational and leisure activities such as sports, as well as the continuation of religious and cultural activities, are seen as important means of providing this normalcy. It has recently been questioned whether the idea of 'going back to what was before' is always appropriate or desirable, given that communities may have spent considerable time before the present emergency living in situations that were unpredictable and marked by intermittent episodes of violence. In addition, elements of what may be sustaining the conflict in a certain area may be part of the previous normalcy, and it may be that communities wish to change those factors and engage their children in different activities. However, these considerations of what type of 'normalcy' the lives of children should be returned to does not detract from the idea that structured activities are beneficial for children, as they provide children with some predictability and routines that may otherwise be absent following displacement and severe disruption to their communities.

Websites
UNHCR 1994 http://www.unhcr.org/cgi-bin/texis/vtx/home/+TwwBmetFMl_wwwwrwwwwwwwhFqA72ZR0gRfZNtFqrpGdBnqBAFqA72ZR0gRfZNcFqOt1omncoDn5aqrocmGnDaWKK6Dzmxwwwwwww1FqhRl200/opendoc.pdf

Education

The early provision of educational activities is seen as vital to the psychosocial well-being of children (Action for the Rights of the Child 2002). Not only do schools provide a daily structure, purpose, and meaning for children, but they may also lead to children gaining greater insight into understanding the events that have occurred. In addition, teachers who have been made aware of possible problems and difficulties that may occur with the children may be in a position to identify particularly distressed children so as to monitor their progress.

Voices of criticism of the importance accorded to education in the form of schooling have been growing. Parents may see school as irrelevant for their children, as no jobs are available upon graduation, and they may see vocational training as more important. In many countries schools are inadequate, and the regimentation and bureaucratization in schools is contrary to the ways in which children live and learn in traditional communities (Desjarlais et al. 1995) . Corporal punishment and the authoritarian relationships of teachers with their pupils may make experiences of schooling a source of distress for children. Blanket statements about the psychosocial benefits of schooling need to be made with caution.

Websites
Action for the Rights of the Child 2002 http://www.unhcr.org/cgi-bin/texis/vtx/home/+DwwBmVeoNxpwwwwnwwwwwwwhFqA72ZR0gRfZNtFqrpGdBnqBAFqA72ZR0gRfZNcFqmE2gDzmxwwwwwww/opendoc.pdf

Importance of play

The notion that play is an important part of children's lives which promotes their overall well-being is central to many psychosocial programmes. Tolfree (1996) discusses the reasons for this. Children's play often reflects the experiences they have undergone, for example attacks or bombings, and may serve as an expression of feelings as well as a way of integrating difficult experiences. In this sense, play can be seen as having 'natural healing properties'. Play can also serve as a barometer of children's well-being: the absence of play among children can be taken as an indication that something is wrong. Many programmes thus concentrate on providing opportunities for children to play, meet together, and socialize with one another (Tolfree 1996) .

Adolescents

A recent report by the Women's Commission for Refugee Women and Children, entitled Untapped Potential, draws attention to the fact that adolescents are subsumed under the category of children, but are usually overlooked in programming, as resources are directed towards younger children who are perhaps perceived as more worthy recipients of aid. Not only are the needs of adolescents overlooked, but their strengths and their potential as constructive contributors to societies also remain unrecognized. Adolescents are affected by armed conflict in particular ways that expose them to increased risks such as recruitment into armed groups, sexual abuse, the contraction of sexually transmitted diseases, and economic exploitation. They may assume adult responsibilities such as heading households, yet are frequently not accorded decision-making powers in communities. Adolescents may thus be faced with particular problems and may have specific psychosocial issues that they want to address. In a participatory research study with young people in Kosovo (Lowicki 2001) , adolescents identified psychosocial problems as their second most important concern, superseded only by security concerns. The loss of family and friends, and uncertainly about the future and feelings of hopelessness were mentioned as issues with which they needed help.

Websites
Lowicki 2001 http://www.womenscommission.org/pdf/yu_adol.pdf
Women's Commission for Refugee Women and Children, Untapped Potential http://www.womenscommission.org/pdf/adol2.pdf

Especially vulnerable groups of children?

There has been a tendency to identify specific groups of children as being especially vulnerable, for example orphans or disabled children. While such groups may need particular forms of assistance, such as economic help, it has been debated whether identifying such children as especially vulnerable is useful or beneficial. Boyden (1994) suggests that focusing on 'spectacular groups of children' such as soldiers or children on the street often occurs at the expense of the larger child populations affected by conflict. In addition, the experiences of children are not fixed and categorical; they may move in and out of categories and definitions.

Approaches to intervention

Four broad approaches to psychosocial programmes with children can be identified.

Clinical approaches

These approaches are based on a recovery or rehabilitation model that assumes that some form of psychological damage has been done to a child. Common interventions may include individual or small-group counselling and talk therapy in which children are asked to draw, act out, or talk about the distressing experiences. Rehabilitation with former under-age soldiers or with child survivors of land mine accidents are typical examples of this, as are programmes focusing on children with severe behaviour problems, depression, or anxiety. Clinical programmes usually work with small numbers of children and require a certain level of training in psychological theory and practice.

Preventative approaches

These approaches are usually orientated towards people in the community who work with children directly, for instance parents and other caregivers, teachers, health workers, religious leaders, or other social service providers. Training programmes may be instituted that provide information about the needs of children in general and about possible reactions that children may have to experiences of war, and how the adults can respond to these. These programmes are usually large-scale and are based on the assumption that if caregivers understand and respond to the needs of children, more serious reactions of distress will be prevented. Peace education, life skills training, and youth leadership programmes may also form part of such programmes.

Community-based approaches

These approaches are orientated towards strengthening community relationships and networks through community mobilization around issues that affect the entire population. This indirect and long-term approach is based on the belief that a shared community vision and involvement in projects that reduce the dependency on outside resources will lead to an overall improved environment for children to live and participate in

Local cultural approaches

These approaches are based on the notion that communities have their own resources and strategies for helping children deal with difficulties and problems. Reynolds (1996) , for instance, found that children troubled by events of the war of independence in Zimbabwe were taken to traditional healers. Churches, diviners, and communal ceremonies and rituals may be other ways in which people help their children to cope. Political commitment may be a further source of strength for dealing with the effects of armed conflict. The role of 'outsiders' to a community may thus be to help facilitate these activities, rather than to try and institute others.

* * *

The process of developing and implementing interventions has to involve the community itself. The provision of services to children is frequently a point on which community members can agree despite other differences and the development of a programme can be a unifying factor. The communities and the children need to define what priorities for improving the well-being of children exist, and should be consulted on acceptable methods for achieving this.

Key readings on children and armed conflict:
Action for the Rights of the Child (ARC), A Rights Based Training and Capacity Building Initiative. Geneva: UNHCR/Save the Children/UNICEF. http://www.unhcr.org/cgi-bin/texis/vtx/home/+DwwBmVeoNxpwwwwnwwwwwwwhFqA72ZR0gRfZNtFqrpGdBnqBAFqA72ZR0gRfZNcFqmE2gDzmxwwwwwww/opendoc.pdf
Apfel, R. and Simon, B. (eds), Minefields in their Hearts: The Mental Health of Children in War and Communal Violence. New Haven: Yale University Press, 1996b.
Tefferi, H., Psychosocial Needs of Children in Armed Conflict and Displacement. A Module for Training Teachers and Caregivers. Stockholm: Radda Barnen, 1999.
Tolfree, D., Restoring Playfulness. Different Approaches to Assisting Children who are Psychologically Affected by War or Displacement. Stockholm: Radda Barnen, 1996.
UN Study on the Impact of Armed Conflict on Children (the Machel Study) http://www.unicef.org/graca/
Women's Commission on Refugee Women and Children, Untapped Potential: Adolescents Affected by Armed Conflict. A Review of Programs and Policies. New York: Women's Commission on Refugee Women and Children, 2000. http://www.womenscommission.org/pdf/adol2.pdf
Last updated Aug 17, 2011