An estimated 300,000 children in more than 80 countries are participating in armed conflict--carrying guns, fighting, serving as spies, porters and cooks, and being used as soldier "wives," according to a report released in June by the London-based International Coalition to Stop the Use of Child Soldiers.

The report recounts grisly stories of children watching their homes burn, seeing their parents being killed, fleeing from gunfire, being forced into serving in an army or joining to avoid starvation, laying and clearing land mines, and fighting on the front lines.

According to relief agencies, in today's era of combat, 85 to 95 percent of those harmed or killed by modern armed conflict are civilians. Of those, about 50 percent are children.

Concern for these children is growing worldwide: One of the key issues at this month's U.N. General Assembly special session on children will be the impact of war on those under age 18. At the session, APA's six representatives will team up with other organizations to ensure children's psychological concerns are part of the agenda, says Corann Okorodudu, PhD, one of the representatives.

"We will work with governments to ensure that what comes out of the special session will really be a major mobilization to help these children in the years ahead," explains Okorodudu.

War's impact

Most people have only recently started to realize that war affects children in many ways, says University of Ulster psychology professor Ed Cairns, PhD. In addition to witnessing fighting and bloodshed, children are faced with a host of other challenges, including:

  • The loss of basic resources. Armed conflict destroys the basic necessities of life: schools, health care, adequate shelter, water and food. That makes it difficult for communities to give children an environment that fosters healthy cognitive and social development.

  • Disrupted family relationships. Many children have family members who are kidnapped or killed while fighting--and others are taken from their families and forced to join armies. Others are separated from parents while fleeing conflict. The loss of the family places a considerable stress on children, especially since the biggest mediating factor in how they cope is a solid family relationship, say psychologists.

"When parents are emotionally affected by war, that alters their ability to care for their children properly," explains Mike Wessells, PhD, a Randolph-Macon College psychology professor with extensive experience in war zones. "War stresses increase family violence, creating a pattern that then gets passed on when the children become parents."

  • Stigma and discrimination. Children associated with armies are often stigmatized because of their participation in the war. Meanwhile, hostile environments prohibit some ethnic-minority children from attending schools and parents from earning money to provide for their children.

"Discrimination and attack can lead to the construction of an identity of themselves as victims," explains Wessells. "And that can become a warrant for future acts of violence to make sure that no one can ever do that to them again."

  • A pessimistic outlook. "One of the greatest effects I see on a day-to-day basis is a loss of hope," says Wessells. "Once young people feel hopeless, they really do give up. They don't take the steps that might build a constructive future."

Wessells, who works half-time with the Christian Children's Fund, explains that in many refugee camps, children grow up feeling as if they've lost everything and can't do anything to make things better for themselves. In other regions, children's war experiences can give them a cynical view of adults and society, says James Garbarino, PhD, co-director of Cornell University's Family Life Development Center and author of a book about how American gang warfare has similar effects.

  • Normalization of violence. Many children, exposed to horrible acts of violence during key developmental years, come to accept violent acts as a normal part of life. "This is putting young people at risk for continuing cycles of violence," explains Wessells. "Violence is the way they will use to discipline their children or deal with a conflict with their spouse."

The invisible girls

While attention to children in armed conflict has increased, girls' experiences and needs are just beginning to be noticed, says psychologist Susan McKay, PhD, a University of Wyoming professor and former Div. 48 president. In many places, "children are low on the totem pole, but girl children are even lower," she explains. "Nobody will talk about them. So girls, up until very recently, have been invisible."

There's little information about the impact of being associated with a fighting force on the rest of girls' lives. For example, does the stigma of having a soldier's baby prevent girls from returning to their families or to schools? To fill that research gap, McKay and a colleague are conducting a five-year study of girls associated with fighting forces in several regions. In Uganda, for example, some girls are having children who are being raised to be part of the fighting forces.

"They may have never experienced normal life in the community," McKay says. "They may never learn what it's like to be a girl. Their gender development can be totally skewed."

Initial research by McKay shows that while girls fight and serve other functions, often they are used for sex or to bear children. That puts them at great risk of experiencing sexual violence, contracting sexually transmitted diseases and developing other health problems.

Growing needs, few psychologists

APA's U.N. representatives are hopeful this month's special session will result in new, significant action to reduce war's impact on children. But even if significant progress is made on the policy level, a distressing fact remains: There aren't enough well-trained psychologists to meet the demand of relief agencies.

"Every NGO [nongovernmental organization] struggles mightily to find people to advocate for policies and to deal directly with children's psychosocial needs," says Barbara Smith, PhD, who manages the International Rescue Committee's 28 overseas assistance programs. She emphasizes that a thorough understanding of how to provide culturally appropriate services is essential.

There's also a need for psychologists to advocate for policies that support children affected by armed conflict, and to help NGOs deliver other services--such as providing food, water and health care--in sensitive ways, adds Smith.

Kathleen Kostelny, PhD, a senior research associate at the Erikson Institute for Advanced Study in Child Development, gives the following example: With the best of intentions, a relief agency pulls a truck into a refugee camp and throws bags of rice into the crowd. A better approach, she says, would be one that builds community participation, perhaps asking the refugees to distribute the rice. While refugees do need food and water, they also need to feel like they have control over their lives, Kostelny explains.

"Sometimes damage can be done when you're not sensitive--even though the agenda is to help," she explains. "Psychologists can help NGOs raise the level of psychological awareness."

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