October 26 2016 Trauma expert: ‘There is no one more affected by war than a child’ Training and understanding are vital to protecting children in Syria and other conflict areas International trauma expert Paul Boyle talks about the impact of war on Syrian children and what can be done to help care for them. Paul Boyle is a trauma expert and former regional psychosocial support coordinator and consultant for SOS Children’s Villages in East Africa. He has trained more than 2,000 SOS mothers, aunts and other employees in 17 countries in how to work with traumatised children. He recently visited the SOS Children's Villages emergency programmes in Syria, Lebanon and the Central African Republic to conduct workshops on trauma healing. In the following interview, Mr Boyle talks about his observations and work in Syria. You have worked in many countries for SOS Children’s Villages and in different types of emergencies where children are particularly vulnerable. How does the situation in Syria compare? Many emergency zones in the world are transient – the emergency comes and it will go. However, in Syria there seems to be no end. War trauma is considered one of the worst forms of trauma as the dangers never go away. Children begin to see the abnormal as normal and the normal as abnormal. They grow up in war and conflict, and they may grow up to participate in continuing the war. Syrian children know nothing but war, conflict, death and destruction, so you can imagine how this affects their world view. The Syrian, Iraqi and Afghanistani children who have fled to Europe for protection are also affected by trauma. You can take these children from the war and the trauma. But it is a far more difficult task to take the war and trauma out of their minds, hearts and bodies. What are the tell-tale signs of trauma in children? The cognitive signs include poor verbal skills, memory problems, difficulty in accomplishing tasks, poor attention span, and learning disabilities. Behaviourally, traumatised children may scream or cry excessively, be easily startled, unable to trust others, or make friends. They may fear adults who may remind them of the trauma. Or they may be anxious, fearful, irritable, sad and withdrawn. There may be physiological effects, such as poor appetite or digestive problems. Pain – headaches and stomach aches, insomnia, nightmares, bed wetting, and being clingy are also tell-tale signs. SOS Children’s Villages is providing care and protection for children in Syria and is working in many other countries to help refugees of conflicts. What is the most important advice you can give to someone who is helping these vulnerable children and their families? It is crucial that the caregiver understand the effects trauma has on children as well as on themselves. The way the child thinks, acts and behaves is quite different from a child who is not exposed to war and conflict. Caregivers may see the child being angry, aggressive or violent and they interpret this as the child being bad. However, this is not about a bad child but about a child who is mentally disturbed, emotionally distraught and socially inadequate. My advice is that all caregivers be trained and sensitised to the effects of trauma in children … so they identify if a child is traumatised and seek professional assistance. Describe your impressions of what you saw in Syria? I am very impressed by the work of SOS Children’s Villages in Syria. It is incredible the love and compassion SOS staff show for poor, vulnerable and marginalised people. They look for poor children who are homeless and destitute, and place them in one of the facilities SOS Syria manages in Damascus. They have teams on the ground in Aleppo providing emergency support even though the dangers for staff are high. They focus on the needs of the people and do what they can despite the danger and challenges. What strikes me most is the mental and psychological health of Syrian staff – they are all doing very well. I have rarely witnessed such energy and dynamism, and I am most impressed by the good they do by loving, caring and respecting the children.