March 30 2018 Healing Trauma in Times of War and Disaster SOS Children’s Villages psychologist, Dr. Teresa Ngigi, explains the impact war and disaster has on children and their families, and the importance of the healing process. In March 2018, the Syrian conflict will enter its eighth year with no end in sight. This war has stolen the right to a childhood from millions of children in Syria. An entire generation of Syrian children is growing up with the “toxic stress” caused by seven years of bombing, bloodshed and displacement. In the interview below SOS Children’s Villages psychologist, Dr. Teresa Ngigi, explains the impact disasters and wars have on children and their families, and the importance of the healing process. Is there a difference between the trauma resulting from a natural disaster and that caused by mass displacement or conflict? When you have a situation where there is continuous disaster happening – it can be war, epidemic, or extreme poverty – children tend to develop resilience that sometimes make them almost numb to the trauma. That is not good but it is a coping mechanism. Those experiencing disaster for the first time have not had the need to create defense mechanisms. How does the treatment differ for one-off disasters compared to prolonged emergencies? Developmental trauma and continuous trauma create a basis for many serious problems – for example, health, mental and relationship problems, or learning disabilities. Even though, externally the individual may appear very resilient. Event trauma – trauma from an earthquake for example – may result in post-traumatic stress disorder. The disaster has disoriented the person in such a way that they have flashbacks or they are susceptible to whatever might happen. They cannot put their life back together and this interferes with their daily life in different ways, including having health problems, mental problems, among others. In both instances, it is important to understand that there is a difference between treatment and healing. Healing is a long-term process, but treatment can come in the form of medication that addresses the symptoms without necessarily helping the healing process. We need to be able to assess the individual’s situation, identify the needs of the person, create a treatment plan, and then evaluate whether we are able to achieve the objectives set out in the plan. How important is a long-term perspective in treating trauma like you see in Syria and other conflict areas where SOS Children’s Villages works? It is 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. That is why an assessment is extremely important - to establish what kind of needs the child or adult has, and do we have the resources, the time, and the expertise to start the healing process and consistently continue it. Healing trauma is a demanding endeavor, but mental health specialists need to diligently work with the traumatized person, create a solid and reassuring relationship with them, 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 you can. Would you say that dealing with the deeper mental health issues, especially of children, is far more complex and requires more focus and attention? This is why SOS Children’s Villages works with partner organizations to divide duties and responsibilities. There are organizations that are better able to address the immediate large-scale needs in a disaster zone. SOS Children’s Villages uses our expertise in caring for vulnerable children and helping their families to address their very specialized needs with a long-term perspective. What is SOS Children’s Villages doing to address the mental health needs of children in Syria? Through training local social workers and other specialists, we improve local capacity and strengthen their ability to respond to the needs of children and their families. The Child Friendly Space (CFS) has been a central feature of SOS Children’s Villages’ work in many emergency situations. How important are these facilities? Child friendly spaces are a very central part of our emergency response work at SOS Children’s Villages. They offer a great environment to deal with trauma because you have caregivers who are trained, a secure and safe place, and you have an environment where children can express themselves in different ways. 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 that help them express themselves. It is also important that the parents take part in activities at the CFS so that they themselves 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. SOS Children’s Villages has worked in Syria for more than 30 years, providing care for vulnerable children. The first SOS Village in Damascus has been operating since 1981. Currently in Damascus, we provide care for 400 children and young adults and support 340 vulnerable families. The Aleppo village, which opened in 1998, was evacuated in 2012 and all the children were transferred to Damascus. In response to the growing humanitarian crisis, SOS Children’s Villages launched an emergency relief program in 2012 to help internally displaced people in Aleppo, Damascus and Tartous. SOS staff has provided child-friendly spaces, interim care, medical referrals, educational support and humanitarian assistance throughout much of Syria’s civil war. Emergency teams also assist Syrian refugees in Lebanon and Europe.