Child Psychosocial support
in emergencies (war)
Introduction
Whenever there is a crisis, the heavy toll rests upon
the vulnerable – women and children. Children are normally exposed to all forms
of emotional torture and violence as a result of witnessing the horrific acts
that are associated with war. Such acts include witnessing the shooting and
killing of human beings and even fellow children, witnessing the killing of their
family members as was the case in DRC. Far from that, children are at times a
target by the militants and end up being exposed to sexual violence, some are
used as child soldiers, or carry military equipment, denial of the basic needs or
used as human shield as the case with the Hamas in Middle East which is one the
gravest act against the right to life and development of children. Such acts
have a negative impact on a child’s normal functioning in terms of behaviour
and relating with other people as well as self. Therefore psychosocial care and
support in emergencies is an integral component in the rehabilitation of
communities and in restoring children’s normal and healthy development.
In relation to children, psychosocial refers to a
complex of interventions to address a child’s social, cognitive and emotional
stability “broken” as a result of war. The package should analyse a child’s feelings,
thoughts, perceptions and the interplay of all these with their social environment.
Emphasis should be placed on repair of the social environment, the family, the community
and the child while of course minding the principal of the Best interest of a
child.
Psychosocial support interventions should aim at; -
restoring normal “order”, protecting a child’s mental health, support family
bonds, and engaging children in the whole process.
Though principally all children are vulnerable during
war in one way or another, the most at risk are children including adolescents
without adult caretakers, children with health conditions like
disabilities, children belonging to marginalized
ethnic groups, Unaccompanied and separated minors, children who are exposed to war and its consequences(rape,
miming, child soldieries, witnessing deaths)
Of importance however, is to first make an assessment
of all the different vulnerabilities that children may be exposed to like psychosocial
stress or cases of severe mental health breakdown. Most often, such children are
those exposed to the killings, or whose parents were killed and have no
caretaker, children abandoned / neglected.
If there is a psychosocial expert it’s essential to identify children with:
depression, anxiety disorder, Post traumatic stress disorders (PSTD), and other
associated behavioural disorders.
However during implementation observe the core
principals as laid out in the IASC- Guidelines on mental health and psychosocial
support in emergency settings: Promote buman rights and equity, maximize community
participation, , do not harm ,use the available resources, integrate support
systems, and offer support to different groups.
Psychological disorders/ stress: caution should be to identify
children who may have suffered different psychological disorders/ stress as a
result of war and address the problems immediately. Though children do not
suffer severer mental health problems as adults, if their problems are not addressed
immediately, it may impact on their mental health wellbeing. In particular,
research has documented the many ways in which exposure to war-related
traumatic events contributes to subsequent mental health distress, and in some
cases, longer-term psychopathology in children and adolescents. For example a
study in northern Uganda revealed that children suffered mental illness and stress
and in particular anxiety disorders, Post traumatic stress disorder in war
affected children. (Kinzie et al 1986). Counselling, and psychological interventions
should be enhanced and support offered to children and families. Empowering families
to offer psychological support makes children coping and resiliency faster.
Education : during emergencies , despite the disruption
of order, wherever the children are gathered be it in the camp or community residence,
maintaining formal and informal education activities provide a safe and stable
environment and restores a sense of hope and normally which plays a big part in
a child’s coping mechanisms. The education activities however should make
children security a priority and especially those that are utmost risk. Through
interaction with peers, the sense of security and belonging to a large
community restores hope and certainty of the future. Though it may be difficult
to get teachers in such situations, it should be noted that training community
members to act as teachers during emergencies helps a great deal. It should be noted that the education described
here is not the structured one but education that tailored to suit the
situation. Such education schedules should be flexible and short but exciting
with lots of children participation. Use of structured activities such as games,
song, dance and drama that use locally available materials should be encouraged. Such play and drama should demonstrate a
content that portrays and teaches children rights, safety during emergencies,
prevention and sensitization of children about different modes of exploitation
that they made be exposed to and how to avoid them or react when faced with
such a situation.
Family support: it’s imperative to always involve a child’s
family at any given intervention or make sure that the family is aware of what
is going on. Often families are insecure when children are targeted and may
hinder their involvement in any intervention if not oriented on how the
intervention will benefit the child. Most
child programs should be channelled through the family because when the family
is able to meet the social needs, the children are the main beneficiaries. Such
family targeted interventions are one of the best indirect interventions that
aim to guarantee the well-being of a child.
Family support can be in form of promotion of livelihoods like
agriculture, skills training for project management and enterprise development,
grants for business start-up, sensitization on children rights, involvement of
the family in the psychosocial interventions. As you may note, the intervention
range from psychological care, economic support, self-reliance, social integration
and community development.
Community: the larger community should not be ignored
while designing psychosocial support intervention. This is because some of the
activities involve a larger community than individual or even a family. For example
play activities may require a communal playground and access to that playground
necessitates approval of village chiefs and leaders. Hence interventions should
look at a bigger picture other than the family. The indirect support to the
community to address child mental health problems hinges on acceptability of
the interventions by the religious leaders, community leaders, cultural leaders,
and the local associations. The community
should take ownership of some of the interventions. After training community
members on counselling and psychosocial support, it’s imperative to let the
trained persons take control of that service because it enhances program ownership
and acceptability and members participate in own programs other than being mere
recipients.
Recreation and Play: Play is the core work of children
and a rock in restoring psychosocial development in children. Play makes
children feel safe and it creates a sense of return to normalcy and belonging
into a larger community of children. The kind of play however should promote sharing,
togetherness, relaxation, happiness; enhance identity and the process of learning.
Use of traditional songs, drama and play instils a sense of stability and continuation
of community life. Such should promote
communication, awareness about their rights, cooperation, cultural and social integration.
During displacement where children may be detached from their caregivers, still
play and drama should be able to instil a sense of security and make them understand
that life goes on and that there is a future despite the commotions.
.
Further reading
IASC – Mental health and
psychosocial support in emergencies
SPHERE –Humanitarian
Charter and Minimum Standards in Disaster Response
Author
Mr. Deogratias Tibanyendera
Child Protection specialist
MPH -fellow (UK) , MA Child Psychology(Child
Mental Health) -IHMH-India, BA(SS) -Makerere University -Kampala Uganda
……………………………………………………………………………………
Skype: deotiba1
Linkedin: http://www.linkedin.com/pub/tibanyendera-deogratias/3a/672/584/
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