Listen to this

practice

Young children in complex emergencies

Kirk Felsman

The war acquires comparatively little significance for children so long as it only threatens their lives, disturbs their comfort or cuts their food rations. It becomes enormously significant the moment it breaks up family life and uproots the first emotional attachments of the child within the family group.

- Freud A and Burlingham D ¹

Anna Freud and Dorothy Burlingham’s early work in English war nurseries with children separated from their parents during World War II broke new ground: their observations focused on the nature of children's attachments, on social and emotional development and the dynamics of group care. Decades later, relief and development workers, often preoccupied with children's material needs, have rediscovered the concerns that Freud and Burlingham held as primary. Yet, a significant historical difference must be acknowledged. Most of the children in the care of Freud and Burlingham had been intentionally evacuated from London and the whereabouts of parents was well known, with some visiting regularly. In contrast, the scale and scope of displacement in today’s complex emergencies are staggering. Children and adolescents invariably account for over 50 per cent of any population displaced by emergencies and when armed conflict and civil strife are causal factors, that percentage tends to be even higher. The protracted nature of these conflicts (Afghanistan, Angola, Somalia, Sudan, and so on) and the deliberate targeting of the civilian population and infrastructure, dramatically increase the associated risks for children, especially those who are young and separated from family and community.

Not making matters worse

A child temporarily or permanently deprived of his or her family environment ... shall be entitled to special protection and assistance.²

Through a developmental lens, the articles of the United Nations' Convention on the Rights of Children (CRC) are intended to ensure for all children the necessary conditions for normal, healthy development. Operationalising the articles of the CRC in the context of an emergency, however, presents a formidable challenge to professional practitioners and policy makers alike.

In July of 1994, I was part of a team sent to Rwanda and across the border to Goma (then Zaire), to undertake a situation analysis of children and adolescents affected by the genocide and the massive displacement that followed. That experience was followed by sustained periods of time in Rwanda through 1995 and included repeated visits to the many and diverse care centres that were established to attend to the needs of separated children. One of my strongest impressions from that work was the number of very young children in residential care and the extent to which their broad developmental needs received, at best, marginal attention. Massive dislocation tears the fabric of society, undermines local institutions and disrupts the less visible but no less important network of human relationships and informal associations that traditionally care for children in communities. Experiences of loss and separation are high-risk factors for young children and in the context of chronic poverty, often set in motion the accumulation of further insults and injury. It is a simple fact that separated or unaccompanied children (children who are separated from both parents and who are not being cared for by an adult who, by law or custom, is responsible to do so) are at higher risk of neglect, abuse and exploitation than peers who retain some traditional network of support.

Documentation, tracing and family reunification
Young children's attachment to a primary caregiver is readily observable. Classic descriptions note that most children will seek them out for play or for comfort when distressed; that children are less distressed in unfamiliar situations if they are with them; and that they soothe distressed children more easily than do other people. Because young children's bonds and attachments to caregivers and family members are more important to their immediate welfare and are far more fragile than attachments that exist between adults, emergency situations require that priority he given to preventing family separation.

Active tracing efforts are critical for preserving primary attachments. Given the limits of their ability to provide accurate information on their situation, registration and documentation efforts are most complicated with young children. Searching out and thoroughly documenting information from anyone who knows the child becomes an urgent, critical task.

More passive approaches to tracing, such as sending messages and waiting for a response can be important to long-term reunification efforts, but sole reliance on such methods can not meet the “best interests” test with regard to young children. Active, rapid tracing is also essential because displaced populations are often subject to repeated dislocation, potentially placing guardians and children farther away from each other or beyond the geographic scope of more passive tracing methods. Priority must also be given to keeping sibling groups together, not simply for the sake of information but because siblings can help to nurture and care for each other.

The issues of evacuation and adoption are most acute in emergencies and have special bearing on the situation of very young children. From earlier experiences such as the 1975 Vietnam “Babylift”, to the more recent examples of young children from the Former Republic of Yugoslavia in Germany or Rwandan children in Italy and France, the processes involved with return and social reintegration are complicated, long-term and not without substantial developmental risks. International standards on evacuation and adoption in emergencies have been established but are not well known or uniformly applied.^3,4,5,6

Interim care for displaced children
It is generally accepted that the placement of separated children into residential centres should be a last resort^5,6 Within these institutions, emphasis should he placed on establishing a sense of normalcy, addressing children's social and psychological needs, and fostering family-like bonds ^7,8 In Rwanda, the different origins of the institutions and their varied support structures generated strikingly different approaches to childcare. These help illustrate some of the central dilemmas involved in responding to young children in emergencies.

In general, the more children are appropriately involved in their own care, the better. Having older children provide care and support for younger children tends to be culturally appropriate and can enhance a sense of competence, build self-esteem and reinforce pro-social behaviour. The importance of providing continuity of adult caregivers in children's institutions cannot be overestimated.

The term “interim care” implies a temporary situation. Yet all too often, children's stay in residential settings becomes protracted. Even when children are successfully reunited with extended families or placed in substitute families, their best interests are not always assured. The children of receiving families may experience a genuine drop in their standard of living, sharing scarce attention, space, food and clothing with new arrivals. Resentments and open conflicts may arise, especially if the reunified child is provided with special support or privileges (waived school fees, books, extra clothing, and so on).

Children placed in extended or substitute families are not free from neglect or potential abuse. Indeed, they are at increased risk of being marginalised, both emotionally and materially, and of being exploited for their labour. A process of monitoring that relies on resources that are external to the community (for example, agency social worker, government caseworker, and so on) will seldom provide adequate protection. Promoting a reliance on local associations, religious groups and community networks may be a more effective strategy – to identify viable placements for unaccompanied children and ensure steady monitoring of their conditions. Government child welfare officers or agency community workers can play important roles in such a community system, including the provision of training supervision, as referral sources, and to help intervene in cases of exploitation or abuse. The need to support the development of clear policies and minimum standards of care is of fundamental concern.

A note on play
In the immediate period following the 1994 genocide, Rwandan institutions had frequent contact with international relief agencies, something that influenced the interpretation of what constituted “aid”. A strong pattern emerged in our initial discussions with the leadership and staff of almost all the centres we visited, one that started with and tended to stay focused on material concerns. The question seemed to he, “what are you offering to provide and when?” Along with immediate concerns over food items, clothing, soap, bed frames, mattresses, and so on, the request for manufactured toys was on most lists. The social, emotional and cognitive needs of young children were seldom given high priority in those early conversations, nor were the critical issues of providing support and help with problem solving for the staff who were meant to be directly engaged with the children. Many of the staff had sought the orphanages for their own shelter. Also, administrators offered little acknowledgement of just how demanding and exhausting, physically and emotionally, sustained interaction with young children can be, even in the best of circumstances.

Entering Rwandan centres, especially as a visitor, it was not unusual to be approached by young and curious children. Many of them are prone to clinging behaviour and making intense demands for individual attention and this can prove quite stressful for those who have spent little time with vulnerable young children. On these visits, we often found ourselves emphasising the need for organised activities, noting that while there was no easy recipe or checklist to be followed, it was possible to engage young children in play with whatever was on hand. In one situation, we picked up clear plastic water bottles that had been discarded, put in small pebbles to make shakers and took sticks anddiscarded tin cans to make drums. Quite readily, with a small group of children, we were all producing a rhythm and laughing out loud “part of which may have been directed towards what some felt was our foolishness.

While walking outside another centre and being followed by a group of children, we stopped at a sand pile and began to collect interesting bits of junk, broken bricks and pieces of cardboard. With not a word said, a few of the children quickly joined in. Over the next half-hour, we created with the children a network of roads and houses from the cardboard and bricks and were driving cars (the small objects) in various patterns around roadways ploughed in the sand.

All of this developed without any exchange in Kinyarwanda or English. Much of the activity was imitative and occurred as parallel play, and children engaged in similar activity next to each other but with little direct interaction. But there were still many poignant moments of communication, whether through facial expression, laughs, or making ever louder noises of moving cars and trucks.

The above example does not account for knowing who, in a given culture, has the permission to be most openly playful with young children; nor was it informed by an appreciation of what traditional games, music, songs or activities might have been most appropriate. Observations that note a lack of play or the seeming inability of children to engage in meaningful play are suggestive of developmental problems.

During these visits, however, it seemed especially important to demonstrate that Western, manufactured toys should not be a priority concern. The vast majority of pre-school age children everywhere can engage in symbolic play with whatever is available: a tin can becomes a bowl or a house just as readily as a stick becomes a boat or plane. Small empty tin cans lend themselves to the pleasure of repetitive scooping and pouring.

In this work, we found comments suggesting that children were “just playing” the most difficult to overlook. It is important to acknowledge that children are active agents in their own development while, at the same time, knowing that simply leaving young children on their own is no pathway to development. Creating opportunities for children to practise emerging competencies is terribly important, be it imitating social roles or the basic tasks of building sensory-motor coordination. It is true “there is no development without play”. Vygotsky’s zone of proximal development–⁹ refers to that area between the child's actual, achieved development and what the same children can accomplish with informed assistance. Fundamentally, it is about the role of caretakers, teachers and more capable peers, and about their capacity to appreciate the importance of play and provide children with appropriate pathways to stretch and expand it. Young children readily intuit, judge and respond to the genuineness of those who would engage them.

Extreme conditions provide us with a special lens through which to view children's strength and resiliency. There are few rewards that surpass experiencing young children's pleasure and sheer glee when fully engaged in play.

References
1. Freud A and Burlingham D, War and Children; (1943) Medical War Books, New York.
2. Convention on the Rights of The Child; (1989) UN General Assembly, New York.
3. Evacuation of Children from Conflict Areas: Considerations and Guidelines; (1992) UNHCR & UNICEF, Geneva.
4. lOM/FOM on Adoption of Refugee Children; (1995) UNHCR, Geneva.
5. Ressler F, Boothby N and Steinbock D, “Unaccompanied Children: Care and Protection” in Wars, Natural Disasters and Refugee Movements; (1988) Oxford University Press, New York.
6. Tolfree David, Roofs and Roots: The Care of Separated Children in the Developing World; (1995) Arena, Aldershot.
7. Felsman J K, Social and Psychological Aspects of Emergency Settlement: International Emergency Settlements; (1996) InterWorks, University of Wisconsin, pp. 1-17
8. Promoting Psychosocial Well-being Among Children Affected by Armed Conflict and Displacement: Principles and Approaches; (1996) International Save the Children Alliance, Geneva.
9. Vygotsky LS, Mind in Society (1978) Harvard University Press, Cambridge, Massachusetts.

This article was first published in Early Childhood Matters No.89 and was reprinted in Child and Youth Care Vol.16 No.9.