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Invisible Wounds: The impact of six years of war on the mental health of Syrian children – Save the Children

March 22, 2017

IT IS not too late to prevent irreversible harm to Syrian children from the conflict in their country, a new report from Save the Children says. But Syria is at a “tipping point” and their chances of recover­ing from the extreme stress are, dwindling by the day.

The report is believed to be the largest study of its kind on the mental health of children living in Syria during the war. The charity and its partners managed to speak with more than 450 children and adults between December and February.

It warns that many chil­dren are in a state of “toxic stress” — the response to experiencing “strong, frequent or prolonged ad­versity without adequate adult sup­port”. It was evident in reports of increases in bed-wetting, self-harm, suicide attempts, and aggressive or withdrawn behaviour.

At least three million Syrian children below the age of six know nothing but war. By far the’ biggest source of fear identified was bomb­ing, shelling, and “the overwhelm­ing feeling of being unsafe”.

A psychosocial counsellor quoted in the report describes how some children lost the ability to speak, so that they continually screamed.

One child, aged 12, had taken his own life after being told that his father, killed by a car bomb, was a martyr. Another young boy re­peated the same phrase three times, shouting louder each time: “I hate the aeroplane because it killed my dad.”

Several children spoke of wanting to take revenge for the violence inflicted on them and their family.

“After six years of war we are at a tipping point, after which the im­pact on children’s forrgative years and childhood development may be so great that the damage could be permanent and irreversible,” writes Dr Marcia Brophy, one of the char­ity’s senior advisers on mental health.

“The risk of a broken generation, lost to trauma and extreme stress, has never been greater.”

Yet the report finds “glimmers of hope” in the resilience of the chil­dren and their hopes for a better future: “That many children are still showing a range of emotions and have not yet become desensitised to the violence that surrounds them, and are still actively seeking out support from their family and social networks, suggests that we are not yet past the point of no return’

Among the recommendations are calls for donors to fund mental-health and psycho-social program­ming, and an end to attacks on schools. Before the outbreak of the war, almost all children were en­rolled; today almost one third are no longer in school.

Save the Children partners report that the vast areas of Eastern Ghouta and Dara’a, where about 1.4 million people live, are served by just two professional psychiatrists. The charity’s centres offering psycho-social support have waiting lists. They offer treatment, including drawing, drama, and music, to help children process and communicate feelings.


For the past six years, children in Syria have been bombed and starved. They have seen  their friends and families die before their eyes or buried under the rubble of their homes. They have watched their schools and hospitals destroyed, been denied food, medicine and vital aid, and been torn apart from their families and friends as they flee the fighting. Every year that the war goes on plumbs new, previously unimaginable depths of violence against children, and violations of international law by all sides

Millions of children in Syria are living in daily fear – of airstrikes and bombs that  destroy their homes, killing children and their loved ones; of no longer being able to go to school; of wondering where the next meal will come from; and of being separated from their families.

“I always feel angry, all the time.” Aboud, 12–14, Idlib

“I’m afraidof going to school because a plane will bomb us.” Rihab, 8–11, rural Aleppo

“I would be confused if I didn’t hear or see airstrikes, because they happen so often.” Ala’a, 12–14, Eastern Ghouta

“I get really sad if I cannot get education and I cannot build a future.” Haya, 15–17, rural Aleppo

“I feel sad when we have a (public) holiday but my parents are not here because I have already lost them, and I am alone because everyone is dying.”  Zeinah, 15–17, rural Aleppo

“I’m angry because my neighbour’s child is in hospital because he got blown up and is hurt.” Khaled, 12–14, Idlib

“My son wakes up afraid in the middle of the night. He wakes up screaming. This is how children have been affected. He has bad dreams and wakes up crying and sometimes runs out onto the street. He has nightmares because of the war and air bombardment. Because of fear. A child was slaughtered in front of him, so he started to dream that someone is coming to slaughter him. When a child witnesses a beheading, how could he not get afraid?”Firas, father of Saeed

“The children are psychologically crushed and tired. When we do activities like singing with them, they don’t respond at all. They don’t laugh like they would normally. They draw images of children being butchered in the war, or tanks, or the siege and the lack of food.”

We receive many children who are increasingly aggressive as they’re surrounded by fighting and violence. We’ve found that this can be reversed by getting them involved in activities at the centre. We run a choir where they get to join in with other children, singing specially written songs about forgiveness and non-violence. At first, they often find it silly and difficult, but eventually they love it. Drawing also helps them to communicate their feelings. Lots of them enjoy dancing sessions – usually to traditional songs, but sometimes they choose to dance to more modern music like rap. Day by day their behaviour gets better and  they feel less aggression. It takes time – not just a couple of days or weeks – but eventually we see most children’s behaviour change for the better.”Anas,

“They often take drugs to forget the current situation they’re living in, in order to feel better.” Rasha, a teacher in southern Syria

“When there are no centres for psychological support, no education projects or health services, young men and women become more vulnerable to issues like drug abuse of hashish or opium.” Tamara, an aid worker in Idlib

“The children ask a lot about death, and they want to know the details about death. About five to six months ago, a child who was 12 years old committed suicide. We never had something like this before, even for older people. His dad was killed in a car bomb. They tried to explain to the child that now your dad is a martyr and he is going to paradise, so the child thought that if he died he would see his dad. He hunghimself with a scarf.” Sharif, psychosocial worker,  southern Syria

“We don’t see the result of this conflict right now. We’re going to see the results and consequences in the coming years. We’re going to see a generation that’s uneducated or barely educated. A generation that’s emotionally destroyed. We need a generation that will build the new Syria.”

The report is online here

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