The hidden health trauma of child soldiers

Abstract

There are times when the measured language of a scientific paper is almost too cool for its subject. The Research Letter on p 861 of this week's Lancet describes how a group of Belgian academics attempted to assess the trauma of 301 children who had been abducted and forced to become soldiers in the Lord's Resistance Army in northern Uganda. The bare facts are these: 52% of children were seriously beaten; 77% saw another person being killed; 39% killed another person; 39% abducted other children; and 35% of girls were sexually abused. Of 71 children who agreed to complete a questionnaire to assess post-traumatic stress disorder, 69 had clinically significant symptoms. Losing a mother, as 26 of these children had, was especially important in determining the severity of their reaction.Yet, in one way, these children are fortunate, since they were in contact with a rehabilitation centre. Rehabilitation into their communities is very hard for child soldiers, but it is essential if they are to have any future. These children may have no family to return to, suffer terrible guilt for what they have done, and will have lost out on education. According to Susan McKay and Dyan Mazurana in their recent book “Where Are The Girls?” for the Canadian human rights' organisation, Rights & Democracy, girl soldiers are particularly vulnerable because “armed conflict and militarism intensify sexism through extreme violence perpetrated by boys and men against girls and women, especially sexual violence”. Girls are stigmatised after having been raped and often have children by their abductors.Human Rights Watch estimates there are now around 300000 child soldiers worldwide in both government and non-governmental forces. A study by Jo Becker for Human Rights Watch World Report 2004 notes that “commanders see children as cheap, compliant, and effective fighters”. The reasons why children become soldiers are complex and varied. Many are forced into participation after being abducted; in Uganda, to avoid being abducted, thousands of children have become “night commuters”, walking back and forth each night between their rural homes and safety in the cities. Others join voluntarily to seek revenge after witnessing atrocities to their families, some join to try to protect their families, and some join as a means of survival when family and other social structures have collapsed. But, however they became soldiers, most want something better. In an assessment of children in Liberia, where there is a fragile peace, nearly all expressed a desire for a better future and said that education was the way that they could make something of their lives.What is the international community doing to give these children a future? The UN has held a yearly debate on the subject since 1998, and has issued successively stronger condemnations of the use of child soldiers, including publishing lists of those parties, both governmental and non-governmental, that do so. As yet the Security Council has failed to take any concrete action against any party on the list, and judging from the summing up by Olara Otunnu, Special Representative of the Secretary-General for Children and Armed Conflict in the January, 2004, UN Security Council debate, action is as far away as ever. Although Otunnu said that it was his “hope that it would be the occasion for the Council to act”, his requests were for parties to prepare action plans of intentions and to update the Council “within a reasonable time”.That children are being recruited into armies is surely just one sign that their society is dissolving. One hopeful indication is that the first case to be prosecuted by the International Criminal Court will be against leaders of the Lord's Resistance Army (although, ironically, the Ugandan Government, which lodged the complaint, is on the UN's list of those who recruit child soldiers). It is not enough for the UN to say that parties should draw up action plans. The leaders of the UN and its constituent nations should already be intervening in the most vigorous ways possible in conflicts where children are used in war. For example, could UN peacekeeping forces have a part to play as mediators?The rebuilding of societies after wars must be an urgent priority so that these children can be rehabilitated, educated, and have a secure future. For the rest of the world to look the other way while each night children hide from warlords is a terrible indictment of 21st century priorities. There are times when the measured language of a scientific paper is almost too cool for its subject. The Research Letter on p 861 of this week's Lancet describes how a group of Belgian academics attempted to assess the trauma of 301 children who had been abducted and forced to become soldiers in the Lord's Resistance Army in northern Uganda. The bare facts are these: 52% of children were seriously beaten; 77% saw another person being killed; 39% killed another person; 39% abducted other children; and 35% of girls were sexually abused. Of 71 children who agreed to complete a questionnaire to assess post-traumatic stress disorder, 69 had clinically significant symptoms. Losing a mother, as 26 of these children had, was especially important in determining the severity of their reaction. Yet, in one way, these children are fortunate, since they were in contact with a rehabilitation centre. Rehabilitation into their communities is very hard for child soldiers, but it is essential if they are to have any future. These children may have no family to return to, suffer terrible guilt for what they have done, and will have lost out on education. According to Susan McKay and Dyan Mazurana in their recent book “Where Are The Girls?” for the Canadian human rights' organisation, Rights & Democracy, girl soldiers are particularly vulnerable because “armed conflict and militarism intensify sexism through extreme violence perpetrated by boys and men against girls and women, especially sexual violence”. Girls are stigmatised after having been raped and often have children by their abductors. Human Rights Watch estimates there are now around 300000 child soldiers worldwide in both government and non-governmental forces. A study by Jo Becker for Human Rights Watch World Report 2004 notes that “commanders see children as cheap, compliant, and effective fighters”. The reasons why children become soldiers are complex and varied. Many are forced into participation after being abducted; in Uganda, to avoid being abducted, thousands of children have become “night commuters”, walking back and forth each night between their rural homes and safety in the cities. Others join voluntarily to seek revenge after witnessing atrocities to their families, some join to try to protect their families, and some join as a means of survival when family and other social structures have collapsed. But, however they became soldiers, most want something better. In an assessment of children in Liberia, where there is a fragile peace, nearly all expressed a desire for a better future and said that education was the way that they could make something of their lives. What is the international community doing to give these children a future? The UN has held a yearly debate on the subject since 1998, and has issued successively stronger condemnations of the use of child soldiers, including publishing lists of those parties, both governmental and non-governmental, that do so. As yet the Security Council has failed to take any concrete action against any party on the list, and judging from the summing up by Olara Otunnu, Special Representative of the Secretary-General for Children and Armed Conflict in the January, 2004, UN Security Council debate, action is as far away as ever. Although Otunnu said that it was his “hope that it would be the occasion for the Council to act”, his requests were for parties to prepare action plans of intentions and to update the Council “within a reasonable time”. That children are being recruited into armies is surely just one sign that their society is dissolving. One hopeful indication is that the first case to be prosecuted by the International Criminal Court will be against leaders of the Lord's Resistance Army (although, ironically, the Ugandan Government, which lodged the complaint, is on the UN's list of those who recruit child soldiers). It is not enough for the UN to say that parties should draw up action plans. The leaders of the UN and its constituent nations should already be intervening in the most vigorous ways possible in conflicts where children are used in war. For example, could UN peacekeeping forces have a part to play as mediators? The rebuilding of societies after wars must be an urgent priority so that these children can be rehabilitated, educated, and have a secure future. For the rest of the world to look the other way while each night children hide from warlords is a terrible indictment of 21st century priorities.