After surviving the conflict, the trauma of Syrian children endures

Many of the millions of children displaced and in refugee camps are exhibiting signs of post-traumatic stress disorder and need long-term treatment

Children wade through floodwaters in Bekaa Valley, Lebanon. Joseph Eid / AFP

In a community centre for refugees in Lebanon, we sat in a giant circle, counsellors mingling with children, the oldest of whom could not have been more than 13 or 14 years old. All the children were from Syria and they were being encouraged to tell stories about the horrors they witnessed during the war.

It was part of a programme to help them cope with the devastation of the conflict. Two siblings from Quneitra, a brother and sister, had lost their mother during the war after she fell sick and could not access medicine or treatment. Their father had lost his leg after being hit by a shell while scouring the streets for a balm to ease his wife's pain.

The children blamed themselves for their mother’s death, saying their parents had delayed leaving the town, fearing for their safety on the journey. The pair clung on to each other, inconsolable and heartbroken.

The memory of those two siblings haunts me still. I also remember Shahd, the little girl who took my notebook at a refugee camp in the Bekaa Valley and in it, drew her family fleeing across a bridge while a helicopter loomed overhead. Or I picture again the children and their mothers standing in a circle, holding hands, as they were taught to process the traumatic memories of the war with drama, art therapy and song. It begs the question: what will become of them when the guns and bombs fall silent and some sort of normality descends?

According to Unicef, which yesterday launched a worldwide awareness campaign called Children Under Attack, there are 2.5 million Syrian refugee children and 2.6 million internally displaced. From being used as human shields to rape, forced marriage and violence, the staggering atrocities committed against children continue to stack up. Unicef emergency programmes manager Manuel Fontaine says it is getting worse: "Children living in conflict zones around the world have continued to suffer through extreme levels of violence over the past 12 months and the world has continued to fail them".

The Syrian children I met had survived the bombardment of their homes, the death of friends and loved ones, the threat of being maimed, and the miserable conditions of refugee camps.

As I have seen in the course of reporting from the region over the last few years, women and children from the Middle East's war-torn regions face an under-reported mental health crisis, whose consequences will be dire if left untreated.

Many children suffer from the classic symptoms we associate with post-traumatic stress disorder, or PTSD, ranging from nightmares and flashbacks to bed-wetting. When the immediate danger and threat to safety is long gone, there is an assumption from the outside world that life will return to normal. For those in the conflict zone or who have been directly affected by it, however, the prolonged misery of living in displacement, and the myriad methods of humiliation and discrimination visited upon them, give rise to an even more protracted form of suffering, a complex range of emotions and psychological scars that are tougher to treat and come to terms with.

One child I met in a Palestinian refugee camp in Beirut had regressed back to needing to be fed; another in the Bekaa Valley in Lebanon had progressively lost her ability to walk.

Many are forced to simply live with the trauma. Those who do not often lose the will to live. A 2014 survey by Save the Children found that 40 per cent of Syrian teenagers who fled the war contemplated suicide. According to International Medical Corps figures from 2015, there are thousands of mental health patients among the refugee community. Three-quarters of those in Jordan have severe emotional disorders while in Turkey, 40 per cent of patients suffered from bouts of epilepsy. In Lebanon and Turkey, one in six refugees suffer from psychotic disorders.

Aid workers say the conditions in refugee camps, where there is little privacy and jobs and money are scarce, are exacerbating such conditions. Domestic violence is also rife.

Most women find it difficult to talk about such episodes, although they sometimes do in counselling sessions. I met a woman who was 13 when she was married off at the start of the war and now has two children. Her husband’s beatings were followed by her hitting her own daughter. Both she and her daughter were essentially still children and the young mother thought she had to compete with her own child for attention, gifts and outings.

It is still difficult to draw attention to these matters and to overcome the stigma of seeking help. There is, naturally, more focus on dealing with immediate humanitarian crises than the longer-term and less tangible issue of helping those traumatised by war, but who have escaped physical danger. There remains a stigma associated with being treated by a psychologist or psychiatrist in the Arab world, and that is when they are available – yet there is only one psychiatrist dealing with the tens of thousands of refugees in Zaatari camp in Jordan.

The positive news is that a little help goes a long way. Many young boys, girls and women are learning to cope with different kinds of therapy when they are available. Some – but not enough – are attending counselling sessions, meeting other mothers who have endured domestic violence, or going to community centres to share their grief with other children who have lost carers. Child brides are learning about their rights, volunteering in those centres and spending time with women from similar backgrounds. Many have taken on the responsibility of acting as heads of households in refugee communities and are learning to speak up.

Yet much more remains to be done. Syria’s children have already endured too much, forced to be adults before their time. They will need extensive mental health services to ensure they are fully equipped to survive the legacy of the terrible violence they endured.