A common feature of any post-conflict situation is the presence of various psychological problems ranging from demoralisation to severe trauma. These tend to be most prevalent in societies engaged in or recovering from war, and often have the greatest impact on children. The need for urgent psychological reconstruction has been recognised by a number of international agencies which have developed special rehabilitation programmes in a number of regions scarred by war.
4.1 Demoralisation, Lack of Confidence, Nostalgia
In the confusion and deprivation which often characterise post-crisis situations, it is not uncommon for those affected to experience lack of confidence, low morale and - frequently - nostalgia for the past. There is a need to alleviate this kind of despair which is often greatest among the war-disabled, as the task force from HOPE '87 discovered in its efforts to re-integrate the disabled in Bosnia30 [ST 2]. However, other groups within the community are not immune to such feelings, as UNICEF has recognised in its proposals to support the development of a new Life Skills Education Programme and its incorporation into the general Armenian curriculum.31
30
HOPE '87, 'HOPE for Sarajevo', in co-operation with UNESCO, 1994, p.3.
31 This teaching package is being developed to teach survival strategies in the Armenian setting (United Nations Consolidated Inter-Agency Appeal for the Caucasus, Armenia. Vol II, March 1995, p.57).
The re-establishment of morale and restoration of confidence is an arduous process which often creates a feeling of nostalgia for past practices and lifestyles as, for example, in many former socialist countries where teachers and pupils continue to find the implementation of new policies, practices and teaching and learning styles with which they are unfamiliar particularly difficult to cope with.
One example of efforts to rebuild confidence and reorient victims of crisis can be found in Kakuma in the Sudan where 12,000 unaccompanied boys share water pumps, food and other facilities with 30,000 other refugees, mostly of Sudanese origin. Here they cook and clean for themselves and many even attend both church and school for they believe that by learning English in school their future is made much brighter.32
32
Jennifer Parmelee. 'The Lost Boys'. Humanitarian Monitor. No. 2, February 1995, p.7.
4.2 Stress, Anxiety and Depression
The uncertainty, insecurity and instability which follow periods of crisis inevitably result in stress, anxiety and depression, conditions which often lead to physical illness. According to one doctor in the UN-run clinic in the Balata refugee camp, children are the victims of stress-related diseases from a very early age. Such diseases include diabetes, cardiovascular complaints, irritable bowel syndrome, hypertension and bronchial infections.33 Attempts to address this reality, which is not restricted to the West Bank, have been witnessed in Armenia where with the assistance of UNICEF a Paediatric Rehabilitation Centre has been established.34
33
TES, 8.3.1991.
34 The Centre will train medical personnel and carers in regional hospitals throughout the country. UNICEF will provide the necessary technical assistance, teaching materials and medical supplies (United Nations Consolidated Inter-Agency Appeal for the Caucasus, Armenia, Vol. II, March 1995, p. 63).
4.3 Trauma
There is a widespread need for special rehabilitation programmes designed to assist children traumatised by crisis, especially following violence or the loss of a family member as a result of war. There are numerous examples, to which we will come below, of programmes which have been implemented in an effort both to identify and treat trauma sufferers. Before examining individual examples it is important to recognise that:
· psychological reconstruction, especially in the case of trauma, is a long-term process
· long-term commitment from aid agencies is imperative35
· trauma represents a serious obstacle where educational processes in schools are concerned
· psychological support for teachers is particularly important
· regular schooling is important in the establishment of the secure, caring environment deemed by psychologists and experienced relief workers to be the most effective means of relieving psychological repercussions for child victims36
35Jeff Drumtra, 'Rwandari Refugees: Updated Findings and Recommendations', UNHCR. 25.10.95, p.14.36 A. Foster, 'From Emergency to Empowerment: The Role of Education for Refugee Communities' (Information from the Internet), 1995.
UNICEF, for instance, has designed and implemented Trauma Recovery Programmes for people from a number of regions including Rwanda, Chechnya, Angola, Iraq, Lebanon, Liberia, Mozambique, the former Yugoslavia and the Caucasus. The objectives of these programmes, as outlined by UNICEF which defines trauma therapy as 'an urgently needed form of psychological first aid',37 are:
· to assess the impact of war on children
· to train teachers and parents to recognise the symptoms of distress [ST 3]
· to help children express their trauma in art, writing and drama [ST 4]
37UNICEF (Information from the Internet), 1995.
One horrifying problem which needs to be addressed, especially in the cases of Rwanda and Liberia, is the phenomenon of child soldiers, or children who have taken part in atrocities. According to a United Nations survey one in three children who were interviewed admitted to seeing children kill other children during the Civil War.38 In Liberia it is estimated that some 15,000 children are armed and used to fighting.39 A 'Children's Assistance Programme' in Monrovia is helping to rehabilitate children caught up in the killing of the Civil War [ST 5].
38
Sudarsan Raghavan, 'Rwanda's Child Machete Killers'. Sunday Times. 7.4.96.
39 Philip Jacobsen, 'Babes in Arms', Sunday Times. 31.3.96.
