The invisible scars of war: How the Syrian crisis affects refugee children

A Syrian refugee girl looks from a tent at the Domiz refugee camp in the northern Iraqi province of Dohuk. The number of Syrian children forced to flee their devastated homeland reached 1 million on August 23, 2013. (REUTERS/Thaier al-Sudani)

As the civil war in Syria escalates, thousands of children are settling into refugee camps – some with families, others without – carrying with them the psychological burdens that come with being displaced from their homes and witnessing the horrors of war.

According to the latest figures from the United Nations, approximately 2 million Syrian refugees are seeking asylum in the neighboring countries of Iraq, Jordan and Lebanon – and half of those refugees are children.  In Iraq, eight new camps have emerged within the last 2 1/2 weeks, and in Jordan, the refugee camps house populations of more than 100,000 people each.

As the children pour across the Syrian borders, aid workers report that signs of trauma are becoming more evident – a problem that overcrowded refugee camps are scrambling to keep up with, as they struggle to supply the steadily growing stream of people with even basic hygiene and water needs.

“The children who come now, they’re in a much worse situation than those who came before, because they’ve been witnessing atrocities for a much longer time.  They’ve witnessed killings, butcherings, living under shells,” Ea Akasha, the regional psychosocial coordinator for the Red Cross and the Red Crescent in the Middle East and North Africa, said. “The children can tell you, ‘This is the sound of an incoming shell.’  They’ve been living in this tense situation of fear and anxiety for a long time.”

Traumatized children, lasting effects

Exposure to long-term violence can inflict considerable damage on a child’s mental health and psychological development, according to Dr. Rona M. Fields, former president of the D.C. Psychological Association and a licensed clinical psychologist who specializes in studying children affected by violence and war.

“In children in Syria, they can’t count on parents protecting them, even when they try to, because the parents are killed in front of their eyes. And they don’t have protection from other institutions, because those are falling apart,” Fields told FoxNews.com.

With displacement also comes the disruption of schooling, which can inflict further emotional damage, since schools are typically safe place for many children.

In addition to education, Fields said there are several other components necessary for a child’s healthy psychological development, including a sense of self-esteem, exposure to compassion and a feeling that they belong to a community.

“These are all the basic kinds of needs that children have in order to grow up feeling capable of dealing with anything that comes along,” Fields said.

Without the presence of these factors in their lives, children are often unable to cope with their feelings of grief.  According to Fields, this emotional confusion often gets expressed as anger, which subsequently fuels trends of transgenerational violence within communities.

“The risks are that you’re going to breed a generation of teenagers who want to fight and kill the other,” Fields said, “who believe there is no justice in the world, who believe they’re alone in their misery and they’re vulnerable to predatory attacks by others and that there isn’t anyone around who cares.”

Furthermore, continued exposure to violence can cause post-traumatic stress disorder – a condition difficult to treat in adults, and even harder to manage in children.

“The trauma comes in from what you see and what you know about the violence against your identity, or the direct experience of losing a parent, losing your home,” Fields said. “Realities, all of this, that escalate into post-traumatic stress, and that is not easily treated.”

Repairing the psychological damage of war

With so many Syrian children having witnessed atrocities that most people will never see in their lifetimes, organizations like UNICEF and the Red Cross, Red Crescent are working to provide refugee children and their families with the necessities they will need to begin to move on from what they’ve experienced, and start rebuilding their lives.

“Certainly all the basic services are critical in the first days and weeks,” Murthy said.  “Water and sanitation are the focus right now, so everyone has access to those critical services.”

According to Akasha, it is also critical to provide children with a sense of security.

“We want to reassure them, ‘Now you’re out of danger; now you can relax,’” Akasha told FoxNews.com.  “This is to make their nervous system that was in a state of hyper-arousal come into a state of calm, where they can cope with reality.”

In an attempt to counteract this fear and anxiety, the Red Cross and Red Crescent are working hard to help reestablish children’s daily routines – an endeavor that begins with sending them back to school.  Due to the war, many displaced Syrian children have been out of school for the past two years.  Returning to classes often helps children experience less anxiety, because they feel as though their lives are getting back to normal, according to Akasha.

However, schools in Iraq, Jordan and Lebanon are packed, many having already taken in refugee children from Palestine.   The United Nations estimates that with so many children fleeing Syria at such rapid rates, Syrian refugees will make up half of the children in these nations’ schools by the end of the year.

“The problem is that with these camps, they don’t have enough schools,” Akasha said. “The camps are so big that mothers can’t accompany them to school.  The women and the children get lost … so we’re trying to make it better.”

Since schooling isn’t always a steady option for children, one of the most important undertakings for the Red Cross and UNICEF is getting children to play again.

“It is really vital that we provide a safe area in the camp for children to participate in recreational activities like drawing, singing and playing sports – basically so they can just be children,” Murthy said. “These types of activities gradually help them recover from the trauma they’ve experienced.”

The Red Cross and Red Crescent provide various play kits to volunteers in Lebanon, Iraq and Jordan, who are then deployed to specific areas in the refugee camps to help organize children into group activities.  Akasha said it’s important for these activities to occur at the same time and in the same location every day, so that children can get a sense of routine, especially if they aren’t going to school.

While these recreational activities help to establish regularity, Akasha said play time is also a critical period for healing.

“There’s much more to it than play,” Akasha said. “Children have to really process what has happened to them.  They’ll talk to the volunteers and tell them what is happening in their lives.  And the volunteers start talking to the children about what has happened and listen to them, offering them psychological first aid. We don’t do it in an intrusive way; it’s just about listening and being there for them.”

According to both Akasha and Murthy, volunteers from both the Red Cross and UNICEF are highly dedicated to helping Syrian children reclaim their lives and get a proper education.  Since the beginning of the Syrian conflict, 22 Red Cross and Red Crescent volunteers have lost their lives in the line of duty.  But these organizations continue to work with the child refugees, in order to prevent an entire generation from missing out on the help and education they deserve.

“It’s always one of the most encouraging things when you step into a school and hear the laughter and noise of children,” Murthy said. “If you sit in the classroom, they’re so excited and happy to be there and you see … how receptive they are to shooting up their hands, wanting to answer questions. And you really understand the absolute critical importance of education and providing that to these kids.”

To learn more or to donate, visit UNICEF and the International Federation of Red Cross and Red Crescent Societies.