WAR AND REFUGEESTHE PROBLEM Two soldiers … threw me in a tub which had no water in it. I got up and ran to my mother at the gate. I held my mum and asked her not to allow them to take me. They snatched me away again. I was put against the wall and one of the soldiers kicked me with his knee in my stomach. I screamed. Then they took me behind their compound. There was a coconut tree. They tied my legs with rope and pulled me upside down. While hanging, I was beaten with netted wire about six times. Then they let me down and tied my hands. I was beaten with sticks from the tulip tree.Testimony of Rajah, an 11-year-old Tamil boy, in 1997 to Amnesty International. In 1995, I was abducted and taken captive by the Lords Resistance Army rebels led by Joseph Kony. The rebels took us to Sudan, and on our way I saw many children, who could not walk because their feet were swollen, killed by the rebels. They gave us one boy who was a government soldier to kill and we did kill him. The rebels abducted 30 of us from my village. During training and fighting we had no food to eat or water to drink. We went for days without food. Once in a while we ate boiled sorghum with weed leaves as the sauce. Once, I was forced to drink my own urine and I gave some to my friend who was dying of thirst. I spent two years and nine months in captivity before I escaped. … We were often forced to kill our fellow children as a way of training us. Killing is so painful and traumatizing. We are always haunted by these actions, even after counseling. … The girls who were in rebel captivity feel used and this has often destroyed our self-esteem. In addition to being used as sex slaves, we are required to fight and do all the domestic chores. We were also beaten. Many girls who have had babies, and others who had conceived remain in captivity. Many of us were repeatedly raped and have contracted illnesses such as syphilis; there are also those who have contracted HIV/AIDS…. Bring home the children, still in captivity. … Help us to make the world safe from abduction, rape, torture and murder of children. The rebels trained me to become a soldier. I now want to become a doctor.Testimony of Grace, now in the World Vision Children of War Rehabilitation program, who spoke during a UN Special Session: Beijing +5, Women 2000: Gender Equality, Development and Peace for the 21st Century. War Armed conflicts around the world are shattering the lives of children. No child ever started a war. Yet every time a war breaks out, children, as the most vulnerable members of society, suffer the worst. They are forced to live in fear and to give up their education. Some lose their lives; some lose family members. All lose their innocence. (Global Movement for Children) Throughout the world, children are all too often forced into military service, displaced from their homes, subjected to rape and other violence, witnessed violence against others, and/or forced into refugee camps. War inflicts severe psychological wounds that can scar children for life. Some children may suffer with post-traumatic stress disorder, a psychological wound that interrupts the development process. For children under three years old, severe trauma scars emotionally, but also can permanently change the brain chemistry. The international community has long recognized that children have no place in wars, yet they are still major victims. As a result of war and armed conflicts between 1985 and 1995, more than 2 million children were slaughtered, 6 million were seriously injured or permanently disabled, and 12 million were left homeless, according to a UNICEF report on the State of the Worlds Children. The trauma experienced by children can include: (1) physical injury or death of themselves or a loved one, (2) rape, or other forms of torture, and (3) horrific experiences as a child soldier. 1. Physical Injury Children in war-torn countries are often victims of trauma and violence. UNICEF estimates that between 80 percent and 90 percent of people who die or are injured in conflicts are civilians, and most of them children and their mothers. In the last decade of the 20th century, more than one million children were orphaned or separated from their families because of conflicts. In Sarajevo, about 90 percent of the children had witnessed people being seriously wounded and 41 percent had seen people killed. Seventy-two percent were exposed to the shelling of their homes, and 81 percent reported that they had been in situations where they feared death. In addition, 14 percent of the children thought they might die of the cold. 2. Rape and Other Forms of Torture Rape also is often used as a weapon of war against civilians. In some raids in Rwanda, the militia rapes every adolescent girl who is not killed in the attack, according to UNICEF. In Bosnia, the genocidal intent specifically targeted children. Girls as young as six were gang-raped, and children were used as human shields for protection against gunfire, Dr. A. Husain writes. In Sierra Leone, children have been murdered, mutilated, tortured, beaten, raped and enslaved for sexual purposes, according to Human Rights Watch. The rebel Revolutionary United Front would throw infants and children into burning houses, sever the hands of toddlers and sexually abuse girls as young as eight. 3. The Child Soldier One of the most alarming trends in armed conflict is the participation of children as soldiers, says the United Nations in a report that calls for the eradication of the use of child soldiers. More than 300,000 children below the age of 18 are fighting in armed conflicts today, according to the Global Report on Child Soldiers 2001. While most child soldiers are between 15 and 18 years old, sometimes children as young as seven have been recruited. These children lose the opportunity for normal development and education, and risk physical injury, psychological trauma and death. Most often recruited are boys, although the Liberation Tigers of Tamil Eelam in Sri Lanka is one group that has systematically recruited girls for combat since the mid-1980s. In addition to combat duties, girls are subject to sexual abuse and may be taken as wives by rebel leaders. They also are subject to diseases such as HIV/AIDS, unwanted pregnancies, abortions and deliveries in unsanitary and dangerous conditions. The recruited children may lay explosives and serve as human mine detectors, participate in suicide missions, spy and commit atrocities such as being forced to participate in the torture or execution of their own family members or neighbors. They often are deliberately brutalized so they may become more ruthless soldiers or are given amphetamines, tranquilizers and other drugs to increase their courage and dull their sensitivity to pain. One 14-year-old girl abducted by the Revolutionary United Front in Sierra Leone told of the trauma she experienced: Ive seen people get their hands cut off, a ten-year-old girl raped and die, and so many men and women burned alive . . . So many times I cried inside my heart because I didnt dare cry out loud. In Uganda, the rebel Lords Resistance Army has abducted thousands of children to fight against the government. They tie the children to one another and force them to carry heavy loads of looted goods as they march them off into the bush. Children who protect or resist are killed. Children who cannot keep up or become sick are killed. Children who try to escape are killed. In southern Lebanon, boys as young as 12 have been forced into the South Lebanon Army. When they refuse, flee the region or desert; their families may be expelled. In Cambodia, a UNICEF survey of wounded soldiers found that 20% of them were between ages 10 and 14 when recruited. Currently the 1989 Convention on the Rights of the Child recognizes 15 as the minimum age for compulsory or voluntary recruitment, although an Optional Protocol that would raise the minimum age to 18 is gaining momentum. Many governments, including very industrialized nations, still recruit soldiers under 18. The United States and the United Kingdom both routinely send 17-year-olds into combat. Numerous cases of bullying and humiliation of young recruits, as well as the death of many in training or combat, have been reported in the U.K. Other countries that recruit those under 18 are: Australia, Austria, Bangladesh, Belgium, Bhutan, Bosnia-Herzegovina, Brazil, Burundi, Canada, Chile, Croatia, Cuba, Cyprus, Denmark, El Salvador, Estonia, Finland, Former Yugoslav Republic of Macedonia, France, Germany, Honduras, India, Indonesia, Iran, Iraq, Ireland, Israel, Italy, Japan, Jordan, Laos, Libya, Luxembourg, Mauritania, Mexico, Namibia, Netherlands, New Zealand, Nicaragua, Norway, Pakistan, Peru, Poland, Portugal, Qatar, Republic of Korea, Slovakia, Slovenia, Sudan, Switzerland, Uganda and Yugoslavia. (The Coalition to Stop the Use of Child Soldiers) Refugees and Internally Displaced People Wars and natural disasters, such as earthquakes, floods, hurricanes, and tornadoes, often cause people flee their homes. About 50 million people, half of them children, have been uprooted and 7 million become refugees facing a new life in often-hostile environments. They often must leave with only the clothes they are wearing, and may not have time to say goodbye to those close to them, according to Disaster Training International, family members are lost during the flight, either because they cannot keep up with the others or because they become ill and die. Children may be alone when they arrive at refugee camps and may be abused in their new homes. To make matters worse, medical attention in refugee camps is frequently unavailable. (Between 1994 and 1999, the United Nations requested $13.5 billion in emergency relief funding, much of it for children, but received less than $9 billion.) These children face the challenge of making the transition to a new culture, a new social system and a new language. The most extreme cases are those refugees who have been tortured or who have seen loved ones tortured and/or killed. The mental health consequences of torture often last far longer than the physical consequences and require specific treatment. There are, however, many refugees who suffer from mental health consequences of their past experiences and traumas, even if they didnt experience torture, per se. They have been forced to leave their homes and, often, to live in refugee camps for many years before being resettled in another country, if ever. If they are among the fortunate ones to be resettled in another country, they often arrive there without language skills and little to no knowledge of the culture they are entering. They must strive to become self-sufficient in a short time by finding employment, getting their children into school, and finding an appropriate home. And they must learn language and culture at the same time. Mental health is often not put as a high priority in the midst of these logistical adjustments but, in time, the past experiences of refugees may well start to inhibit their integration and adjustment into their new communities. It is important that services be provided to help prevent serious mental health problems and to handle them if they do arise. WAR AND REFUGEES: STRATEGIES FOR SUCCESSFUL INTERVENTIONS Around the globe, there are many efforts aimed at reducing trauma and violence toward children in armed conflict or displaced by natural disasters or war. Most are based upon the Convention on the Rights of the Child. Highlights are provided below. World Vision: This organization works with national governments to address these concerns along four avenues including: 1. Humanitarian assistance to children during and after conflict, 2. Child-focused community-development work that addresses causes of war, 3. Peace building and reconciliation activities, and 4. Advocacy to improve public policies that affect children. The United Nations Machel Report: This document calls for a global campaign to demobilize all child soldiers and to eradicate the use of children under the age of 18 years in the armed forces. It also calls for all future peace agreements to include specific measures pertaining to the demobilization and reintegration of child soldiers and for governments to standardize recruitment procedures for armed forces and to prosecute violators. Finally, the report illustrates how the recruitment of children can be minimized when communities and parents know the law. U.N./UNICEF collaboration on female soldiers: The U.N. Department for Disarmament Affairs, the U.N. Development Fund for Women, UNICEF, the Office of the U.N. High Commissioner for Human Rights and the Division for the Advancement of Women are collaborating on issues of gender and disarmament and are paying particular attention to the plight of female child soldiers. Prohibition of mines: Advocacy by governments and other organizations has led to the adoption of a Convention prohibiting anti-personnel mines. ILO Convention 182: This convention prohibits the forced recruitment of children for armed conflict. The Rome Statute of the International Criminal Court: This statute recognizes as war crimes the drafting of child soldiers and crimes of rape, sexual slavery and enforced prostitution. Peace Accords: Advocacy has brought the plight of children affected by conflicts to the attention of the worlds decision-makers. Efforts to address war-affected childrens problems have been specified in peace accords in Burundi, Northern Ireland and Sierra Leone. In addition, Child Protection Advisers have been deployed as part of U.N. peacekeeping missions in the Democratic Republic of Congo and Sierra Leone. MENTAL HEALTH INTERVENTIONS Education and psychological services during war: Mental health professionals attempt to intervene with educational and psychological services during war, even though these efforts represent major challenges. In East Timor, the U.N. Transition Administration and NGOs developed child-friendly spaces in the midst of conflict. Other models include the National Commission for Children in Sierra Leone and Children as Zones of Peace in Sri Lanka. Play as treatment: Not all children who endure war atrocities suffer from long-term mental health problems. Syed Arshad Husains research article, in the Psychiatric Times, reported that children are very resilient and have the ability for magic thinking. He discovered that making a game of the violence and personalities of guns helped to transform the fear of boys in Sarajevo who had constantly heard the sounds of artillery. Play is another strength, and programs that incorporate play have been quite popular for Bosnian teachers and mental health care professionals. In the United States, play has also been used to aid in the recovery of children who observed planes hitting the World Trade Center. A program devised by the Childrens Movement for Creative Education effectively used first-person essays, paintings, drawings and meditation, as well as discussions where youngsters can voice fears and feelings, according to The Wall Street Journal. The six-week program also fostered harmony and community, helping to allay fears that students would retaliate against their Muslim peers. The expressive arts are valuable tools in the healing process: dance/movement therapy, theater, story telling, music, art and drawing, and the special cultural arts of countries have met with extraordinary success when talking may be too painful Building Bridges: This Canadian program is a compilation of best practices gleaned from children, parents, educators and mental health professionals and implemented successfully in six Toronto schools. Metropolitan Toronto has children from more than 50 countries registered among its student population, many with troubled refugee backgrounds. Program designers crafted activities to be an extension of things teachers already do and tried to address needs of stressed children such as to have friends, speak English, do well in school and feel safe. Buddy Teams try to bridge cultural differences. Art is Inside Me, Stories in the Classroom and Games We Like to Play allow self-expression and promote self-esteem. The Change Exchange helps children learn to talk together and solve problems without aggression. The program has been adapted for use in schools in Croatia, Bosnia and Albania. (UNHCR) Grassroots social work: Many refugee children can heal from trauma if they can address their stresses in a social therapeutic environment, according to WHO. Trained grassroots social workers can create such environments. In fact, grassroots organizations of young adults, such as one composed primarily of students from Croatia and Bosnia-Herzegovina called Suncokret, have been making some strides in helping refugee children. The group, which started in 1991, worked in many refugee camps throughout Croatia and Bosnia with activities centered on children, but also involving mothers, grandparents and other important adults in the childs social environment. At the end of 1992, more than 80 Croatian and Bosnian young people were involved in the organization of activities for more than 4,000 children. It was later accepted as a partner by UNHCR and as a Croatian NGO. Immigration and Refugee Services of America (IRSA): One of the main voluntary agencies resettling refugees in the United States, IRSA has a National Alliance for Multicultural Mental Health that provides educational programs and trainings tailored to the needs of refugee community leaders, resettlement and employment workers, health advocates and practitioners, ESL teachers and school counselors, immigration legal service staff, police officers, and many more. Topics covered in trainings include refugee mental health, integrating mental health into resettlement, specific refugee groups, cultural competency training, refugee orientation and training, therapeutic models, clinical work with refugees, interpreter training, trauma and survivors of torture, caring for the caregivers, establishing a continuum of care, communal approaches, and others. An annual refugee mental health conference is organized and newsletters and best practice guides are available for free download from their website: www.refugeesusa.org. The United States Committee on Refugees (USCR) is also part of IRSA. USCR defends the rights of all uprooted people regardless of their nationality, race, religion, ideology, or social group. Their activities and findings are available at: www.refugees.org. Red Cross: The Red Cross and similar relief agencies provide medications, vaccines, clean water, food and other essentials to victims of war, natural disasters and to refugee camps. Once initial needs are met, infant care, education, recreation and psychosocial supports are often provided. The International Committee of the Red Cross has also made tremendous strides in reuniting families separated due to war or natural disasters. In the Federal Republic of Yugoslavia (Kosovo), for example, Child Connect used a satellite and wireless Internet Network for this purpose. Save the Children: Together with the UN High Commissioner for Refugees, Save the Children has launched the Separated Children in Europe Statement of Good Practice. This program aims to establish a common policy and commitment to giving these children back their basic rights to a decent childhood, adolescence and a future. This is one of many international programs and information sources produced by Save the Children. In 2001 Save the Children produced a global report to address the UN Special Session on Children in New York City. Children’s Rights: A Second Chance looks at the impact that local, national and international policies and practices have had on children over the last decade and outlines what needs to be done to improve the world for children and provides advice and a practical framework for world leaders to follow. To review report, go to www.savethechildren.net/stc/publicsite/newstc/resources.html
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