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By Tamara Hegyi, 6th September 2021

Instead of living the careless and joyful life of children, some are forced to face with the cruellest side of the world, war.
Children are being recruited by armed forces and are being put in extremely dangerous situations. These children are expected to combat, transport explosives, act as a human shield and carry out suicide attacks. Some of them have not even reached the age of 10.

Children becoming soldiers

Save the Children’s Stop the War on Children report (2020) introduces us an extremely dire situation: “149 million children [are] living in high-intensity conflict zones where more than 1000 battle-related deaths occur in a year” and “between 2005 and 2018, a total of 65 081 children are verified to have been recruited and used by armed forces and groups”.[1]

Children can be more easily exploited and abused and since they are often viewed as expendable, there is no need to dedicate a lot of resources to their recruitment and training. Usually they are more compliant and listen to authorities without questioning their control and command, making the prospect of their recruitment preferable to that of adults.
The majority of the children is abducted or forcibly recruited. Those living close to combat zones and are poor or displaced from their families are the most vulnerable. Other children might volunteer because they either believe that defending their country is their duty or believe that the service is their only chance for survival, hoping that it will provide them with a stable income and food.

Besides fighting children are also put in other positions, such as cooks, guards and messengers. Many of them, mainly girls, are sexually abused.

The situation in Africa

As can be seen in the Stop the War on Children report out of ‘The ten worst conflict-affected countries to be a child’ six can be found in Africa. This is further reflected in the data provided by the report: “In 2018 alone, more than 7 000 children were recruited; most of the verified cases were from Somalia (2 300) and Nigeria (1 947)”.[2]
According to the United Nations in 2020 the number of children recruited and used was:

  • 1 716 in Somalia
  • 788 in the Democratic Republic of the Congo
  • 584 in the Central African Republic
  • 284 in Mali
  • 62 in South Sudan
  • 7 in Nigeria[3]

The UN reports only the verified cases, the actual numbers are expected to be a lot higher.
Most of the children are recruited by opposition and rebel militia groups but some of them are recruited by national police and military forces and by national intelligence agencies.

Children deserve to be happy,
but sometimes life has different plans

Photo by Belle Maluf on Unsplash

Psychological effects

War affects a child’s entire life. During their childhood they live in constant fear and insecurity. They have to cope with food shortage and poverty which are often brought on by wars. They miss out on years of education and many of them will find their parents emotionally unavailable or even killed during their years of formation when they would need a parent’s care and attention the most.[4]
Child soldiers are particularly vulnerable to psychological suffering as a result of these conditions. In their work, The Psychological Impact of Child Soldiering, Elisabeth Schauer and Thomas Elbert write: “Child soldiers are raised in an environment of severe violence, experience it, and subsequently often commit cruelties and atrocities of the worst kind. This repeated exposure to chronic and traumatic stress during development leaves the children with mental and related physical ill-health, notably PTSD and severe personality changes”.[5]

The traumatic events usually include being deprived of food, experiencing physical and sexual assault, being forced to loot property and burn houses and being forced to kill someone.[6]

Post-traumatic stress disorder

Post-traumatic stress disorder is usually caused by experiencing or witnessing stressful and traumatic events. This disorder can have a significant impact on the patient’s life since “someone with PTSD often relives the traumatic event through nightmares and flashbacks, and may experience feelings of isolation, irritability and guilt”.[7]

Ilse Derluyn, an expert in the topic of war-affected children, asked 71 former child soldiers from Uganda to fill in the Impact of event scale which is a “self-report measure that assesses subjective distress caused by traumatic events”[8] and which was revised for post-trauma stress reactions. Her group found that 97% of the participants reported post-traumatic stress reactions of clinical importance.[9]

PTSD can also cause physical symptoms such headaches and stomach aches, but in more severe cases patients can experience chest pains, are more likely to have hypertension and are in a higher risk of cancer.

Depression and Anxiety

Depression is a mental disorder that is characterized by sadness and hopelessness. People lose interest and pleasure in the things they used to enjoy. Depression can negatively affect someone’s sleep and appetite, patients usually feel tired and have difficulty concentrating.[10][11]
Anxiety, feeling worried or tense, is part of our daily life. It becomes a problem when it affects someone’s everyday life, when the person cannot recover from anxiety and remain anxiety-free when the provoking situation is absent.[12]

Anett Pfeiffer and her group interviewed 72 adults who were abducted in their childhood, 62 of them were former child soldiers from Northern Uganda. Their study concluded that 71% of the interviewees showed symptoms of depression and 60% showed symptoms of anxiety.[13]

A disconcerting data showed by Pfeiffer and her group is that “More than a third of the respondents (36%) fulfil the criteria for all three ascertained mental health disorders [PTSD, depression and anxiety] simultaneously”.[14]

Dissociation

Childhood trauma is one of the major causes of dissociation. Since most of the time child soldiers cannot physically escape their captivity, their mind finds a different way to escape.
During dissociation people feel disconnected from the world around them and even from themselves. They can forget about certain time periods and feel uncertain about who they are. In case of injuries they might not feel pain at all.[15]

The proper diagnosis of dissociation is difficult because children act very differently while dissociating. Some of them look as if they were daydreaming while others appear frozen. According to Elisabeth Schauer and Thomas Elbert children can also experience auditory command hallucinations. “It is not uncommon for severely traumatized children to hear voices commanding them to harm themselves or others, which is a dangerous, unpredictable condition. Consequently, such adolescents can be erroneously misdiagnosed as suffering from a primary psychotic disorder, such as schizophrenia.”[16]

Dissociation can also happen later in a former child soldier’s life as a response to a triggering experience, if the traumatic event has not been dealt with or processed.

Aggressiveness, Anti-social and disruptive behaviour

Being part of an armed group hinders a child’s moral development. During childhood people learn the norms and values of their societies, but child soldiers are expected to loot property, fight and kill. As a result, many former child soldiers solve their conflicts with violence and manifest anti-social and disruptive behaviour.

People with antisocial personality disorder are deceitful and manipulative. They can be impulsive or reckless and they do not care for other people’s feelings. They may take part in criminal activity without feeling guilt.[17][18]
Those diagnosed with disruptive behaviour disorder have difficulty controlling their actions. They are often viewed as uncooperative and defiant, usually they react to authority figures with indifference or hostility. Their actions can range from arguing and not following rules to being aggressive, stealing and destroying property.[19]
Both disorders are on a spectrum.

Being forced to fight and being subject to the manipulation of adults do not allow children to develop decent social skills.
In their study Carol Magambo and Ronald Lett explain that even though war-affected children sympathized with victims of violence, to solve their conflicts they still resolved to violence as they were unaware of non-violent alternatives.[20]

Alcohol and drug abuse

Armed forces often give drugs to child soldiers. This way the children become more energetic, do not feel fear and are less aware of danger, all of which makes them more useful in battle. In its publication, Wounded Childhood: the use of child soldiers in armed conflict in Central Africa, the International Labour Office describes what these children are forced to consume: “Besides cigarettes, they are also given cannabis and other drugs made of a mixture of coffee, gunpowder, herbs and papaya leaves”.[21] Based on their data from Congo the ILO found that child soldiers are almost 4 times more likely to consume alcohol and 5 times more likely to consume hashish on an occasional or regular basis than those children who have never been recruited.[22]

However, alcohol and drug abuse can also develop later in a child soldier’s life, after the service has long since been behind them. Former child soldiers turn to alcohol and drugs to escape their current situation – be it unemployment or mental illness – brought on by the past.

The reality of former child soldiers

Mental health is often more complicated than it seems. Former child soldiers do not have to cope with only one mental illness, but usually with a combination of them. Those former child soldiers that suffer from PTSD will likely suffer from depression and anxiety. Increased stress levels and the consumption of alcohol and drugs increase the chance of experiencing dissociation.
In addition, former child soldiers routinely have to face with social stigma. Some might say that they deserve rehabilitation but others think that they should be in prison. Girls and young women who were victims of sexual assault are also likely to be stigmatized.

Some children are missing

Photo by Hennie Stander on Unsplash

Besides mental health problems and social stigma, former child soldiers also have to deal with their lack of education and the limited opportunities to get an education.
Apart from the problem of children not learning the basics of mathematics and literature, by missing out on education former child soldiers are put in a vulnerable situation. These children are deprived of the chance to develop adequate social skills and because of their lack of education they will likely struggle to find jobs and escape the poverty trap, making them exposed to further exploitation by armed forces.
In addition, in conflict-affected areas getting an education is a dream for many children. Those that manage to attend school usually receive an education of poor quality. Conflict-affected areas, such as South Sudan, often do not have appropriate schooling facilities, face a shortage of decent textbooks and have teachers who are not properly trained.[23]
Another problem is that children are too afraid to go to school – just like their parents are scared to let them attend lessons – as schools are often the target of attacks and many children gets abducted and then recruited by armed forces on their way to school. As a result, children and former child soldiers are forced to get an education in bigger cities, meaning that they once again get displaced from their families, making them once again vulnerable to recruitment by armed groups.

Reintegration

The majority of former child soldiers stay in their country and start a new life there, only a small fraction of them manage to make their way to Europe. It is estimated that around 150 former child soldiers arrive in Germany every year.[24]
Therefore, rehabilitation and reintegration mainly take place in the most conflict-affected countries in the world.

The reintegration of former child soldiers is very important for both the children and their communities. Reintegration programmes enable children to have a healthy and successful life after their time spent in war and ensure that the communities can live without armed conflicts, maintaining peace.[25]
The reintegration is a difficult and long process. For instance, in South Sudan the UNICEF implemented a three-year long reintegration programme for former child soldiers during which time children receive everything they need for starting over.[26] For a successful reintegration psychosocial support, education and vocational trainings are indispensable, otherwise children might decide to return to the armed forces. Instead of feeling lost and as an outsider, they decide to go back to a well-known environment, the armed group they could hardly escape from.

The recruitment and use of children by armed forces or armed groups is one of the six grave violations against children in times of war, as it was identified by the United Nations Security Council.[27][28] Many organizations, such as UNICEF, Save the Children and World Vision, are trying to stop this practice and help the reintegration of former child soldiers because no child should be subject to this kind of suffering.

Please note that this article mentions only the most common mental health problems child soldiers experience; the list is not exhaustive.

[1][2] https://www.savethechildren.org/content/dam/usa/reports/emergency-response/gender-matters-swoc-report.pdf
[3] https://www.un.org/ga/search/view_doc.asp?symbol=S/2021/437&Lang=E&Area=UNDOC
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2080482/
[5][6] Martz, E. (Ed.). (2010). Trauma rehabilitation after war and conflict: Community and individual perspectives. Springer Science + Business Media. https://doi.org/10.1007/978-1-4419-5722-1
[7] https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/overview/
[8] https://www.ptsd.va.gov/professional/assessment/adult-sr/ies-r.asp
[9] Derluyn, I., Broekaert, E., Schuyten, G., & Temmerman, E. D. (2004). Post-traumatic stress in former Ugandan child soldiers. The Lancet, 363(9412), 861–863. doi:10.1016/s0140-6736(04)1573
[10] https://www.who.int/health-topics/depression#tab=tab_1
[11] https://www.nhs.uk/mental-health/conditions/clinical-depression/overview/
[12] https://oxfordmedicine.com/view/10.1093/9780195173642.001.0001/med-9780195173642-chapter-10
[13][14] Pfeiffer, A., & Elbert, T. (2011). PTSD, depression and anxiety among former abductees in Northern Uganda. Conflict and Health, 5(1), 14. doi:10.1186/1752-1505-5-14
[15] https://www.nhs.uk/mental-health/conditions/dissociative-disorders/
[16] Martz, E. (Ed.). (2010). Trauma rehabilitation after war and conflict: Community and individual perspectives. Springer Science + Business Media. https://doi.org/10.1007/978-1-4419-5722-1
[17] https://www.nhs.uk/mental-health/conditions/antisocial-personality-disorder/
[18] https://www.health.harvard.edu/a_to_z/antisocial-personality-disorder-a-to-z
[19] https://www.nationwidechildrens.org/conditions/disruptive-behavior-disorders
[20] Magambo, C., & Lett, R. (2004). Post-traumatic stress in former Ugandan child soldiers. The Lancet, 363(9421), 1647–1648. doi:10.1016/s0140-6736(04)1621
[21][22] http://www.ilo.org/employment/Whatwedo/Publications/WCMS_116566/lang–en/index.htm
[23] https://theconversation.com/why-its-hard-to-get-south-sudans-former-child-soldiers-back-to-school-95445
[24] https://tbinternet.ohchr.org/Treaties/CRC/Shared%20Documents/DEU/INT_CRC_NGO_DEU_15810_E.pdf
[25] https://childrenandarmedconflict.un.org/wp-content/uploads/2018/09/Reintergration-brochure-layout.pdf
[26] https://www.unicef.org/southsudan/stolen-childhoods
[27] https://www.unicef.org/stories/children-under-attack-six-grave-violations-against-children-times-war
[28] http://unscr.com/en/resolutions/doc/1612