In March 2018, the Syrian conflict entered its eighth year with no end in sight. This war has stolen the right to childhood from millions of Syrian children. An entire generation is growing up with the ‘toxic stress’ caused by seven years of bombing, bloodshed and displacement.
In this interview, SOS Children’s Villages psychologist Dr. Teresa Ngigi explains the impact disasters and wars have on children and families, and tells us about the importance of the healing process.
Is there a difference between trauma from natural disaster and trauma caused by mass displacement or conflict?
“When you have continuous disaster – such as war, epidemic, or extreme poverty – children tend to develop resilience that sometimes makes them almost numb to the trauma. This isn’t good but it’s a coping mechanism. Those experiencing disaster for the first time have not previously had the need to create such defence mechanisms.”
How does treatment differ for one-off disasters compared to prolonged emergencies?
“Developmental trauma and continuous trauma create a basis for serious health, mental and relationship problems or learning disabilities – even though externally the individual may appear resilient.
Event trauma – from an earthquake for example – may result in post-traumatic stress disorder (PTSD). The person becomes disorientated. They cannot put their life back together and this interferes with their wellbeing in different ways, including physical and mental health problems.
In both instances, it is important to understand that there’s a difference between treatment and healing. Healing is a long-term process, but treatment can come in the form of medication to address symptoms without necessarily helping the healing process. We need to be able to assess the individual’s situation, identify their needs, create a treatment plan, and then evaluate whether we are able to achieve the appropriate objectives.”
Does toxic stress impact girls & boys differently?
“The way the brain copes and processes toxic stress differs between boys and girls. The insula – the brain region that processes emotions and empathy – is smaller in girls and larger in boys who have experienced toxic stress. The functions controlled by this part of the brain include perception, motor control, self-awareness, cognitive functioning and interpersonal experiences. Girls who experience toxic stress may suffer from a faster than normal ageing of one of the part of the insula which puts them at higher risk of developing PTSD. High levels of stress could also contribute to early puberty in girls.
It’s important to put these findings into consideration when designing healing approaches. Girls may be more susceptible to PTSD than boys, hence they need specific interventions.”
How important is a long-term perspective in treating trauma like you see in Syria?
“Very important! If you start a process with a child who has been traumatized and you leave that process halfway, you are going to worsen the situation for that child.
An assessment is extremely important to establish the needs of the child, as well as to assess whether we have the resources, time, and expertise to start and continue the healing process. Healing trauma is a demanding endeavor, and mental health specialists need to work diligently with a traumatized person to create a solid and reassuring relationship and guide them towards taking their power back.”
The initial phase of a humanitarian response typically involves reaching as many people in need as quickly as possible. Would you say that dealing with deeper mental health issues, especially of children, is more complex?
“Yes, and this is why SOS Children’s Villages works with partner organizations to divide duties and responsibilities. There are organizations better able to address the immediate large-scale needs in a disaster zone. We use our expertise in caring for vulnerable children and helping their families to address their very specialized needs with a long-term perspective.
Through training local social workers and other specialists, SOS Children’s Villages can improve local capacity and strengthen the ability to respond to the needs of children and their families.”
Child Friendly Spaces (CFS) have been a central feature of SOS Children’s Villages’ work in emergency situations. How important are these facilities?
“Child friendly spaces are a central part of our emergency response work. They offer a great environment to deal with trauma because you have caregivers who are trained, a secure and safe place, and an environment where children can express themselves. After trauma it is very important to be able to express yourself. Even without verbalizing experiences, children are involved in drawing, art therapy, singing, dancing and other activities.
It is also important that parents take part in activities so that they can participate in the healing process. Participating with their children is therapeutic for parents. We help address the needs of the parents through the children.”
How do Child Friendly Spaces help in providing ‘normalcy’?
“Child Friendly Spaces offer a place for children to play, talk with other children, learn and tell stories. These activities help the children get in touch with themselves and feel a sense of belonging. When you bring them together, they feel they are a part of a community that is safe and protected.”
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