When most people think of child soldiers, they don't picture girls. But in conflicts in Africa and around the world, girls-some as young as six or seven and many who are grade school age or in their early teens-are also being forced into armies and rebel forces. They cook, clean, haul gear and sometimes fight. They are usually raped repeatedly and often end up bearing their captors' children, according to the United Nations, the Coalition to Stop the Use of Child Soldiers and other humanitarian agencies.

In fact, the United Nations estimates 250,000 children are currently involved in militias, rebel forces and other armed groups. It is unclear how many of these children are girls, says psychologist Susan McKay, PhD, former president of APA's Div. 48 (Society for the Study of Peace, Conflict and Violence: Peace Psychology) and a women's studies professor at the University of Wyoming, who has been studying women and armed conflict since the 1980s and more recently has been studying girl soldiers in the field; she's spoken to more than 100 of them.

"Even within a country where girls have been in armed groups in substantial numbers-such as Sierra Leone, Angola and Uganda-the phenomenon is very much hidden," says McKay.

She credits anthropologist Carolyn Nordstrom, PhD, of Notre Dame University with being the first researcher to really shine light on the involvement of girls. And she credits fellow Div. 48 past president and child soldier researcher Michael Wessells, PhD, with piquing her interest in the topic.

"I moved in this direction because all the talk about child soldiers was about boys," McKay says. "Girls were thought not to be present or very minimally involved.

"A major turning point was when I watched a video taken at a rehab center in Uganda that had been opened to help returning soldiers from the Lord's Resistance Army [the major anti-government rebel force]. Fifty-five minutes of the video was about the boys, and the last five minutes showed a few girls smiling and seemingly happily rocking their babies."

Disturbing to McKay was that most of their babies had been conceived by rape, yet the girls were presented as happy mothers not needing any of the attention given the returning boys. As it turns out, when the fighting ends, these girls may be excluded and viewed with suspicion and fear in their homes and communities. They are usually left out of the formal disarmament, demobilization and reintegration (DDR) process-sometimes inadvertently, but also purposely. In DDR, the government and nongovernmental agencies collect small arms and other weaponry from combatants, formally discharge participants from the army or group, determine children's needs and reintegrate them into the community be reuniting them with family and giving then education or training.

McKay and Wessells, along with Irish psychologist Angela Veale, PhD, have embarked on a research project that is trying to stop the exclusion of girls from DDR. In October, they met in Bellagio, Italy, with psychology and other practitioners from local NGOs in Northern Uganda, Sierra Leone and Liberia to develop plans to reintegrate today's girl warriors.

Life during wartime

There have probably always been young female soldiers-after all, Joan of Arc, born in 1412, was a girl. But until the last five or six years, girls at war were unacknowledged internationally and neglected in their own countries, notes McKay. In a worldwide study of girls and women in conflict between 1990 and 2003-detailed in the book, "Where are the Girls?" published in 2004 by the Canadian Organization the International Centre for Human Rights and Democratic Development-McKay found that girls were part of government, militia, paramilitary and armed opposition forces in 55 countries and engaged in armed conflict in 38 of those countries. In 27 of the countries, the girls were abducted into the forces. Even in countries where the girls chose to join the conflict, like boys, they usually did so as a way to meet their basic needs such as food and shelter. "Often they have no idea what is in store for them or may see no other choices for survival," notes McKay.

In addition to performing domestic tasks and serving as sexual slaves, many of the girls get pregnant and may be forced to abort. Or, says McKay, their children may be left by the road or killed. Girls also frequently die during pregnancy or childbirth.

Their situation is dire: Many contract AIDS or other sexually transmitted diseases, die from wounds or poor living conditions, contract tuberculosis or other communicable diseases and suffer permanent physical damage from a variety of injuries. Psychologically, the trauma they experience-including torture and atrocities they may have been forced to commit against family or neighbors-takes a huge toll, says McKay.

Cast aside

Once they leave the forces, the girls often face a precariously uncertain future, particularly if they have children. They are feared because of the violence they have been forced to participate in and shunned because they have had sexual intercourse out of wedlock and have children with their captors, to whom they may even still have some attachment.

They are usually stigmatized, as are their children, says McKay. "Their families and communities may reject them or make their continued presence in the community untenable."

Returning girls are also targets of violence and harassment, says Wessells, who has talked to many former girl soldiers in Africa through his work with the Christian Children's Fund. They are often referred to as "rebel girls" or, in some West African countries, "prostitutes," he adds.

Even in countries where girls are less stigmatized, they face huge challenges in trying to reintegrate, says South African psychologist Vivi Stavrou, who worked with girl soldiers in Angola. This conflict raged for 40 years, so in many cases, the girls were taken young and have little memory of who they were before abduction. Even if they do have such memories, they many not have any family left, says Stavrou. Without any community connections, many of these girls and their children live in extreme poverty.

Wessells and McKay agree that lack of a place to go and the most basic resources is a problem for survivors in places such as Uganda and Sierra Leone as well.

"Girls, and I think especially girl mothers, may trade sex for food or money so that they can survive," says McKay. "Mostly, these girls try to survive while keeping their presence within the community quiet," she continues. "They do not want to stand out, which also hinders the ability to locate them and provide assistance."

It takes a village

An essential part of the McKay and Wessell's reintegration plan for these girls is to ask communities for their assistance and give them the chance to address their concerns about the returning girls. For instance, in Uganda, says Wessels, people may fear that the girls have picked up bad spirits through their experiences. If the communities can perform cleansing ceremonies with the girls-perhaps invoking a sacred spirit, burning herbs or conducting a ritual cleansing-the girls may be accepted back into society.

"'Now they can eat off the same plate as us,' is how they put it," says Wessells. Such steps can bring huge psychosocial gains, he continues. Although it doesn't cure everything, it may allow the girls to get married or participate in other aspects of daily community life.

In addition to working with local healers, the teams will seek religious leaders and village elders, who can teach the girls how to be mothers, Wessells explains.

The religious leaders, he adds, can provide moral guidance, "which can be very useful because the girls have come from environments where they had to do terrible things, and their sense of right and wrong is distorted."

Each reintegration team-one each in Northern Uganda, Sierra Leone and Liberia-will design and implement programs based on local customs and girls' needs. The project has received funding for one year from the Oak Foundation, an international group of philanthropic and charitable organizations that focus on issues such as human rights, abuse, conservation and social justice, that is based in Geneva, but it may go on for up to three years depending on how quickly they make progress, says McKay. Work will begin in January, and in September all the teams will meet in Uganda to assess progress. The evaluation criteria will be developed in cooperation with the girls, says McKay, but overall the project is looking for indicators of improved livelihood, health and educational opportunities for the girls and their children in their home communities. "We're trying not only to make a tangible difference with these girls, but to identify effective practices that can be replicated in other settings," says Wessells.