|Refugee Emergencies. A Community-Based Approach (UNHCR, 1996, 142 p.)|
|Part Two. Refugees at Risk|
REFUGEES AT RISK
"...we were doing well (until) the war started. All of a sudden everything changed, there were too many people dying. A lot of families were trying to escape, but we held on till the last minute. I decided it was time to move when my father and uncle were killed. We left one night and left everything we owned behind, and just fled for our lives. I have ten children, and luckily all of them were home that night... We walked for weeks, walking all night and hiding during the day." *
* Source: Case studies reported in K. Hancock, "Refugee Women and Children in Somalia, their social and psychological needs", UNICEF, Mogadiscio, 1988. (Also passages quoted on pages 62, 68 and 80.)
All children have special physical, psychological and social needs that must be met for them to grow and develop normally. For this reason refugee children are particularly vulnerable in an emergency and should be among the first to receive protection and assistance.
The needs of refugee children should be identified and documented as early as possible by qualified and experienced child welfare personnel. A regular review should be carried out to ensure that their requirements are being met. If practicable, assessment should be made on an individual basis, as the age, personality, health, family and cultural background will effect a particular child's needs and the identification of appropriate solutions. The opinion of a child on his/her own needs should be obtained and given weight in keeping with the child's maturity and judgement. In large refugee populations, where individual assessment is not possible, such methods as surveys, meetings and interviews with children and key informants can be used.
Community-based Approach: If special, separate assistance activities for children are required, these should be carried out with the full participation of their families and communities, rather than addressing children in isolation. The effectiveness of assessment and responses can be significantly increased if the refugee community itself is actively involved.
Emphasis on Psycho-social Aspects of Child Development: Most relief agencies working with refugees have, until recently, focused on the physical survival of the refugee child by reducing infant mortality. This has had top priority in UNHCR emergency assistance practice for a number of years through its supplementary and intensive feeding programmes. However, it is becoming more and more apparent that physical survival is not enough in order for the refugee child to grow up and become a responsible member of society. The psycho-social aspects of child development must also be included in assistance programmes for refugee children.
A child's mental health is directly affected by the level of well-being of the family and community. Apart from the harm which may be caused to normal development by the disruption and insecurity inherent in refugee situations, additional problems may arise when children suffer or witness violence, abuse, torture or the loss of family members. In this respect unaccompanied children are particularly at risk.
Access to Services: Refugee children generally should have access to the same or similar mental health services as nationals. Moreover those who suffer mental disorders or extreme mental distress as a result of their experiences, or their situation as refugees, are entitled to benefit from mental health services and treatment, even where such services may not be available to nationals.
Preventive Measures: Not only treatment should be available but measures that help prevent mental health problems should also be adopted. In general, this will include action to pursue durable solutions and to re-establish normal family and community life. Such community-oriented measures can have important benefits at the family level, as well as enabling children to develop and learn cultural values in a normal fashion. A child's mental health and psycho-social development is to a large extent dependent upon the restoration of daily routines and activities and the resumption of educational, recreational and cultural activities.
Trauma: Because of the possible damaging effects of trauma, refugee children should be systematically screened (through schools, clinics or feeding centres) to identify those at high risk from mental health or other psycho-social developmental problems. Some children will require specialized services or treatment.
Community-Based Treatment. Treatment services should be planned and provided in a culturally appropriate manner with the involvement of the refugee community and qualified personnel. In some situations, traditional healers have proven effective in treating mental disorders among refugee children. Unless it is necessary to prevent abuse or neglect, a child should not be separated from his family and community for treatment.
Services that address such special difficulties as trauma related to witnessing or being a victim of torture, violence or sexual assault require the involvement of a qualified mental health professional with a background in working with children. Preferably such a professional would be of the same ethnic background as the refugees or at least have good cross-cultural skills. His/her role could be either to provide treatment directly or to guide and support members of the family or community to do so.
Every child has a right to education.
Although priorities in the emergency phase may mean that the full elaboration and implementation of an education programme is not possible, the setting up educational activities will make a significant contribution to the well-being of the whole community. Teachers and other educated refugees should be identified and encouraged to participate. Even with inadequate supplies, establishing the discipline of schooling through regular classes and organized activities for the children is important. Simply gathering the children together for a set period each day and keeping them occupied is a valuable first step.
The choice of curriculum is debatable. In practice it is considered advisable to continue with a curriculum which is familiar to both the pupils and their teachers. This will help to bridge any gaps and, by re-establishing familiar patterns, palliate to some extent feelings of being uprooted. At a later stage, when the situation is more settled, children may be introduced to the language and curriculum of the country of asylum.
Games, sports, play and other recreational activities are important for the psycho-social well-being of the children as well as for their recovery from trauma. The opportunity to play is extremely important: playing is a basic activity which gives the child the possibility to process negative experiences and begin to come to terms with them.
Teacher training, should include the psycho-social aspects of the education process. Teachers must have an understanding of the effects of trauma (e.g. disturbed behaviour, psychosomatic problems, learning difficulties) and be able to plan therapeutic activities (e.g. structured games, drama, drawing, peace education) to help the children work through their experiences.
Emotional and Psychological Needs of Children
· Emotional security and stability.
· Individual and sustained care of at least one adult, preferably someone of a similar linguistic and cultural background.
· Continuity in existing relationships with other adults and children.
· Continuity in societal relationships, education, cultural and religious practices.
· Specific help to overcome particular, individual problems.
· Unaccompanied children, in particular, need environments which provide as many stabilizing factors as possible and minimize possibilities for additional stress. Continuity of community and cultural ties is all the more important in the absence of family.
· The stable nurturing care of an adult is especially Important for infants and young children.
Are families supported in making their own decisions, controlling their lives and disciplining children?
Are there any (opportunities for) special activities to meet social needs of children?
Are there culturally appropriate facilities to identify and assist traumatized children?
Is there adequate support for mothers to fulfill their mothering role (stimulation) for apathetic babies/children and mothers?
What kind of challenges do refugee children face in everyday life in terms of stimulation or danger?
What is being done to improve the psycho-social environment of refugee children - a) schooling, b) organized play activities, c) support for families in special need?
Have teachers or other educated refugees been identified/recruited?
Are learning activities organized for children on a regular basis?