SCARRED
 

SCARRED

The conflict in Syria has taken an acute physical and psychological toll on refugee children. They have witnessed unspeakable horror, which they struggle to forget. Bombs and missiles have destroyed their homes, communities and schools. Friends and family members were killed, sometimes before their own eyes.

In Tyre, Lebanon, two UNHCR registration assistants, Tatiana Nassar and Therese Sarkis, invite children to draw during registration interviews. Children as young as four or five have drawn graphic images of rockets, guns, blood and houses that have been destroyed. Others have alluded to their desire to go home, writing statements such as “I love Syria” alongside their drawings.

A child's scars
UNHCR

Four-year-old Shahad has lived through a terrible ordeal in her short life, including a bomb attack, life-threatening injury and flight into exile.

Physically injured

Children of all ages, from babies to teenagers, have suffered severe physical trauma and injury from sniper fire, rockets, missiles and falling debris. According to UNHCR data, in the first six months of 2013, 741 Syrian refugee children received hospital treatment for physical trauma and other injuries incurred in Syria or Lebanon including burns, bullet wounds and broken bones.

In Za'atari refugee camp, Jordan, doctors had 1,379 consultations with children for weapon or war-related injuries between 20 October 2012 and 25 October 2013. The majority, 58 per cent, were for boys.

Caught in the crossfire
UNHCR/G.Beals

Soundos, 9, was struck in the head by machine gun fire in June 2011. She and her family now live in a tent in Za’atari refugee camp. The bullet remains lodged in her head, as removing it would be too risky.

A war they cannot forget

While some Syrian refugee children have escaped serious physical injury, few have avoided the psychological repercussions that come from living in the midst of a war.

In interviews with 81 refugee children in Jordan and Lebanon, 22 children, or parents speaking on their behalf, said they continued to be deeply distressed by violence they witnessed in Syria.

Sheeraz Mukhaimer, a community-based case manager with the International Medical Corps (IMC) in Irbid, Jordan, has worked with more than 90 Syrian refugee children over the past nine months. She has met a number of children who have not only seen their family members killed before their eyes, but have then helped to move and bury their bodies—a horrific experience which is not easy to leave behind.

The two UNHCR registration assistants, Therese Sarkis and Tatiana Nassar, in Tyre, Lebanon, each typically register between seven and 12 families a day. Both have backgrounds in psychology and see at least one or two children every day they can identify with acute distress or depression.

According to Sarkis, some girls and boys have memorized the sounds of war. Children have described to her how they used to hide together under the bed when they heard a missile close by. Even girls as young as three years old recognize the sound of a gun, missile or bomb.

Drawing death
UNHCR/S.Baldwin

This picture was drawn by a nine-year-old boy while his family were registering as refugees at Tyre registration centre, Lebanon. The bus that he and his family took to flee their home in Syria was stopped and robbed by armed men. To the right of the bus, the boy has written the word ‘death.’

Distress

According to parents, the war in Syria has had a lasting impact on their children, including trouble sleeping, horrifying flashbacks, bed-wetting and even speech problems. A 16-year-old boy from Homs, now living in Amman, had trouble sleeping when he first arrived in Jordan. He found the absence of gunfire—which was a constant backdrop in Homs—unsettling. He was worried it would start again.

A father from Aleppo who now lives in Tyre, in southern Lebanon, said the effects of war had caused his sons—aged three, seven and nine—to become bed-wetters. This is a common symptom among distressed children in conflict situations. His second son, Hani, who was toilet trained long ago, was unable to control his urination even during the day.

A six-year-old boy, now living in Lebanon’s Bekaa Valley, developed a stutter after surviving bombings close to his home in Jobar, Damascus. The mother of a two-year-old girl in Mount Lebanon said that whenever her daughter hears a plane, she runs inside crying with her hands covering her ears.

Another mother, in Beirut, said her seven-year-old son was so severely affected that he imagines that his father, who was killed in the war, is still alive.

Firas

Firas, 17, fled Syria alone owing to his parents’ fears for his safety, and now lives in Irbid, Jordan. He had always dreamed of owning a shop and a house and being self-sufficient. Now, he says, “the exact opposite has happened.”

Before he escaped Syria, Firas saw a bullet strike his sister’s head while they were in a car. He also heard stories of young girls being raped, including his neighbour’s daughter, and about men being tied up and tortured in the village next to his. The women were raped and burned. Afterwards, he saw the devastation first-hand when he and his friends buried the women’s bodies.

Now, in addition to reliving those atrocities he worries constantly about what will happen to his family back in Syria.

Withdrawal

Staff from UNHCR and partner organizations said that some displaced children in Jordan and Lebanon have become hyperactive or aggressive, while others have turned unusually quiet and shy. Parents said that constant crying is common.

In an IMC/UNICEF assessment in Jordan’s Za’atari camp, 71 per cent of 255 adolescents said ‘withdrawal’ from everyday life was one of their main coping mechanisms.2

According to Sheeraz Mukhaimer, with IMC in Irbid, Jordan, the distress often weakens children’s ability to interact with others. Mukhaimer said this can prevent children from wanting to go to school, participate in recreational activities, or in extreme cases even leave the house.

The most important support network for psychologically affected children is usually in the home. Yet Syrian refugee parents and caregivers, struggling with their own scars, can find it difficult to support their own children emotionally.

Abdel-Menhen, a 25-year-old refugee outreach worker in southern Lebanon, said that when he knocks at some families’ doors to offer support or monitor their well-being, they are so haunted by their past experiences that instead of answering, they hide.

According to IMC and UNHCR staff, children living in small or overcrowded homes often overhear their parents talking about their experiences in Syria, the losses they have suffered and the stresses they feel being displaced.

Many families regularly tune into television channels featuring disturbing footage from Syria. This can cause children to relive horrifying events, increasing their own sense of anxiety.

Haunted by the war
UNHCR/O. Laban-Mattei

These children live in a tiny apartment in the suburbs of Amman. The television is one of the only sources of entertainment. With family still inside Syria, the parents often follow Syrian channels that show graphic images of violence, destruction and death.

Supporting distressed children

During the first nine months of 2013, UN agencies and partners provided psychosocial support to 96,368 children in Jordan and 159,585 in Lebanon.3 This can take many forms, such as counselling and follow-up for individual children and their families provided by UNHCR case managers; psychosocial support in schools from teachers who have received specific training; and recreational activities and more specialized psychosocial support provided by UNICEF and partners at child- and adolescent-friendly spaces. Children also receive psychosocial support through NGOs and community centres, as well as at UNHCR registration centres.

In Jordan's Za'atari camp, 304 children, 162 boys and 142 girls were treated for post-traumatic stress disorder or severe emotional disorders between 20 October 2012 and 25 October 2013. But beyond the emergency services provided by humanitarian organizations, there is a serious gap in the availability of state-run mental health services in both Jordan and Lebanon. There are no specialized child psychiatrists working with refugee children in Jordan, and only some 30 psychiatrists country-wide in Lebanon.

There can be no keener revelation of a society's soul than the way in which it treats its children.

~ Nelson Mandela ~

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2 IMC and UNICEF, IMC Jordan Mental Health/Psychosocial and Child Protection for Syrian refugee adolescents in Za’atari July 2013 Report, Jordan, p.10.
3 See Jordan – RRP5 Update (Protection Sector), September 2013 and Lebanon – RRP5 Update (Child Protection), September 2013.

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Syrian Refugee Children

Every day, the conflict in Syria is forcing thousands of Syrian children to flee their country.

Every day, the conflict in Syria is forcing thousands of Syrian children to flee their country.