War and children

1. REFUGEE CHILDREN AND THEIR
VULNERABILITY TOWARDS
PSYCHOLOGICAL IMPLICATIONS
Presented by;
Amal P Suresh
Stephen Thomas
Guided by;
Anithamol Babu

2. INTRODUCTION
Globally, millions of individuals are currently displaced and seek refuge for various
reasons, such as environmental disasters, economic devastation, violation of human
rights, and fear of persecution .
Approximately half of the overall refugee population are children under the age of 18
years .
Unaccompanied and separated children are among the most vulnerable of refugees.
These children migrate alone or are accompanied by someone other than a parent or
legal guardian.
Approximately 111,000 unaccompanied children were reported in 2018, although only
27,600 applied for asylum .
Due to challenges in reaching and assessing this population, these figures are likely to
be an underestimate.

3.  The rights declared under the CRC for refugee and asylum-seeking children are often
violated, resulting in significantly adverse impacts on children’s health and
development, which is already in a fragile and compromised state (Cardoso et al.,
2016).
 Besides, the rights declared under the UNCRC for refugee and asylum-seeking
children are often violated, resulting in significantly adverse impacts on children’s
health and development, which is already in a fragile and compromised state (Bal et
al., 2017)
 However, in reality, this is not the case and many of these children, depending
on where in the world they move to, are denied many of their rights.
 There are five countries in the world that host the most refugees are Pakistan,
Uganda, Sudan, Germany, and Turkey .
This study attempts to answers from various literatures these questions; How the
child development is interrupted and child rights are not attended among
refugee children?

4. HEALTH AND DEVELOPMENT
 Childhood is a period of rapid growth and development in all physical,
mental, spiritual, and social domains (ISSOP, 2018).
 Prolonged exposure to unfavorable conditions—for example, hunger,
limited access to education and health services, low socioeconomic status,
and exposure to violence, war, abuse, and exploitation—has lasting effects
on a child’s ability to thrive (ISSOP, 2018)
 These experiences can be considered as Adverse Childhood Experiences
(ACEs).
 The accumulation of ACEs results in increased negative health outcomes
and can have lasting impacts later in life.

5. PHYSICAL AND MENTAL HEALTH
 The physical health of refugee and asylum-seeking children is negatively affected
by living conditions, malnutrition, lack of clean water sources, and limited access
to medical services (Brough et al., 2003).
 There is an increased prevalence of infectious diseases, and vaccine-preventable
diseases among refugee children.
 Limited resources in refugee camps can result in maladaptive behaviors such as
drug and substance abuse.
 These threats to the protection of children have serious consequences for physical
and mental health, and lead to other problematic repercussions, such as unwanted
pregnancies, sexually transmitted infections, prolonged and/or more serious
maladaptive coping behaviours, increased levels of stress, and physical harm,
including the child or young person’s involvement with gangs or criminal activity
(Cardoso et al., 2016).

6. FACTORS TRIGGERING TO PSYCHOLOGICAL
PROBLEMS
 Refugees are distinctly different from voluntary immigrants because their
migration is involuntary and often prompted by the outbreak of violent wars
(Doll et al., 2009).
 Exposure to potentially traumatic and violent incidents in refugees’ often
unsafe countries of origin is therefore very likely. (Fortin, 2018)
 However, their exposure to violence and unsafe environments occurs
throughout the relocation process, beyond their countries of origin.
 In short, this implies that the unsafe and dangerous conditions that led to
their migration have a significant impact on their mental health.

7. EXPOSURE TO STRESSORS
 Exposures to stress are not limited to the traumatic settings of war and
persecution escaped by refugees.
 Perhaps unexpectedly, resettlement location— i.e. whether a child spent time
in a refugee camp before arrival to a host country— is notably not established
as a source of stress associated with poor mental health outcomes (Georgis
et al., 2014).
 The daily hardships of resettlement and challenges of acculturation often
faced by refugee families resettled in high income nations are powerful
stressors that exert formative influences on refugee children’s mental health
(Gormez et al., 2017).
 School and play opportunities are essential to successful cognitive
development, and prolonged interruption of these activities may contribute to
the development of cognitive delay.

8. TRAUMAS
 Refugees from conflict zones often continue to experience trauma from
persecution, imprisonment, torture and resettlement for a long time (Bal et al.,
2014).
 The most common mental health issue for refugees is post-traumatic stress
disorder and related symptoms of depression, anxiety, inattention, sleeping
difficulties, nightmares, and survival guilt.
 When refugee children resettle to a host country, which is most often in a place
that is not of their choosing, they must adapt to a new place and language under
uncertain circumstances and with uncertain futures (Brough et al., 2016).
 Re-establishing a home and identity, while trying to juggle the tasks of daily living,
is yet another significant challenge that the refugee must undertake (Cardoso et
al., 2016).
 Early studies showed that post-migration stress contributed to the poor mental
health of refugees.
 Pre- and post-migration stress may differentially predict specific kinds of
symptoms and distress in both children and adults.

9. TRAUMA IN DIFFERENT AGE GROUPS
 Birth to five years. Young children have difficulty explaining their trauma, but
display their trauma by clinging to their mothers, trembling and uncalled for crying.
They may also show their trauma through play and inappropriate behaviors.
 Six to 11 years. Children at this age may become anxious, depressed, angry,
unable to concentrate or socialize with peers, and may refuse to go to school.
 Adolescents. Adolescents trauma shows in school difficulties, eating disorders,
alcohol abuse, teenage pregnancy, thoughts about suicide, or general ‘acting out.’
 Adults. They may startle easily, show the fight-or-flight response or a heightened
sense of awareness, and suffer from nightmares, emotional detachment from
oneself and others, and distorted emotions and perceptions.

10. POSSIBLE SOCIAL WORK INTERVENTIONS
 Group-based interventions grounded in cultural competency and
spirituality could more effectively provide support to refugees (Mollica
2006).
 Continue to support a culture of research and evaluation in
resettlement agencies and programs (Betancourt et al. 2002).
 Providing mental health interventions without assessing physical
appearance of refugees and understand the importance of providing
interventions at an early stage (NASW, 2017).
 Continue to develop new therapeutic approaches for working with
refugee children, and build upon promising practice-based research
on the effectiveness of trauma-focused cognitive behavioral
approaches, and therapy (NASW, 2016).
 Developing community partnerships that foster mutual trust and
provide access to resources to support refugee children (Bal et al.,
2014)

11. CONCLUSION
 For a child refugee, their vulnerability towards psychological problems begins at
their mother nation.
The end number of challenges they might face during their migration will likely to be
a factor to trigger their inner vulnerable self, which will make them prone to
psychological problems like Anxiety, Panic, Post traumatic stress disorder etc.
 These refugee children have often experienced severe distresses during all periods
of their migration, mainly in their pre-migratory stage where they might have
witnessed extreme violence, some unfortunately a subject to watch their own family
being affected by the violence and distress.
 While in migration, uncertainty of their future, several screening tests, security
checks, administrative hurdles may become a lot more than what a child can
handle, especially in a state where they are displaced.

12. REFERENCES (SOME)
 Maria Vargas Claudia (2007). War Trauma in Refugees.
 Perry B.D (1999) Effects of Traumatic events on Children. Inter disciplinary Education
series, 2(3)
 Nielsen Maj, et al. (2019) Risk of Childhood Psychiatric disorder in children of refugee
Parents with post-traumatic stress disorder: a nationwide, register based cohort study.
 American Psychiatric Association. (2010). The American Journal of Psychiatry.
 Ellis, B. H., Miller, A. B., Baldwin, H., & Abdi, S. (2011). New directions in refugee youth
mental health services: Overcoming barriers to engagement. Journal of Child &
Adolescent Trauma, 4, 69-85. doi: https://doi.org/10.1080/19361521.2011.545047
 Evers, S., Van der Brug, M., Van Wesel, F., & Kbrabbendam, L. (2016). Mending the
levee: How supernaturally anchored conceptions of the person impact on trauma
perception and healing among children (cases from Madagascar and Nepal). Children &
Society, 30, 423-433. doi: https://doi.org/10.1111/chso.12153
 Fazel, M., Doll, H., & Stein, A. (2009). A school-based mental health intervention for
refugee children: An exploratory study. Clinical Child Psychology and Psychiatry, 14(2),
297-309. doi: https://doi.org/10.1177/1359104508100128 F
 ortin, J. (2018, July 4). ‘Access to literacy’ is not a constitutional right, Judge in Detroit
rules. New York Times (p. A11). Retreived from
https://www.nytimes.com/2018/07/04/education/detroit-public-schoolseducation.html