Violence Leaves Terrible Legacy on Iraqi Children

BAGHDAD, Dec. 21, 2007— -- Children have long been the cruellest victims of war, and the situation in Iraq is no different.

Acute malnutrition among young children here has nearly doubled since the U.S.-led invasion began in 2003, according to UNICEF and other aid agencies.

And while the statistical haze that enshrouds civilian casualties continues, no one is sure how many children have been killed or maimed since the war began.

But while the physical scars of the conflict are all too visible inside Iraq's morgues and hospitals, psychologists and foreign aid organizations, working inside the country, warn that the emotional turmoil experienced by young people here is going largely unmonitored and untreated.

A study published earlier this year by the Association of Iraqi Psychologists estimated that the violence has affected millions of children, raising serious concerns for future generations. The study urged the international community to help establish child psychology units and mental health programs.

"Children in Iraq are seriously suffering, psychologically, with all the insecurity, and with the fear of kidnapping and explosions," the report says. "In some cases, they're found to be suffering extreme stress."

The toll that the war has had on a generation of young children is often hard to quantify, mental health experts say. But examples of just how the violence is playing out are evident in many Baghdad neighborhoods.

A year ago, when sectarian violence in the capital was at its peak, 11-year-old Haider found his father's headless body near the family's home in Sadr City, a violent Shiite-populated area in northeastern Baghdad. He was murdered by Sunni insurgents who terrorized the neighborhood, says Haider's mother, Suham Kadhum.

The killing had a profound effect on Haider, with weeks going by after his father's death, before he'd mix with other neighborhood kids and go to school.

"I can't go to school," Haider told ABC News at the time. "I just can't."

A doctor diagnosed Haider with depression and post-traumatic stress. With help from donations raised after his story was told on ABC, Haider received treatment from a psychologist, and has slowly made progress, according to his mother.

"What we went through was very difficult," she says. "But thank God there was love and tenderness in our family."

Haider is lucky. Most Iraqi families have little money and access to counseling, particularly those trained at dealing with children and war, says Lynne Jones, a child psychiatrist with the International Medical Corps.

Jones, who has worked with children scarred by wars in Bosnia, Africa, and Iraq, says, though the war is producing a generation of deeply scarred young people, there is a lack of professional help available.

"Mental health experts are often in short supply when conflict erupts," she says. "Unfortunately, most governments don't put a high priority on establishing outposts to deal with mental trauma for children."

Generally poor security also forces organizations, like UNICEF, to employ only a small presence in Iraq. Save the Children, another aid organization, closed its operations earlier this year after 15 years in the country. The Iraqi Red Crescent Society has been forced to suspend a program for children suffering from war trauma, because of a lack of funding.

The country's overstretched hospitals are not equipped to cope with psychological trauma, and psychiatric hospitals, which were heavily looted immediately after the war, have abandoned many patients.

Many of the best doctors have either fled the country or been killed. Last year, one of Iraq's most prominent child psychologists, Harith Hassan, was killed as he drove to work. Hassan worked with victims of trauma, and often appeared on Iraqi media. Iraqi newspaper reports suggested that Hassan may have been killed by hard-line militants who were angered by his criticism of the culture of sectarian violence that has gripped the country.

The problems of dealing with Iraq's children of war are compounded by the stigma that psychological and psychiatric care carries in Iraq.

"Many families will not bring their children in for treatment, because they fear they will be considered crazy," says Dr. Jamal Taha, a doctor at Baghdad's al-Yermuk hospital, who has treated dozens of young people since the war began.

Despite the dire environment, studies have shown that children in war zones can be incredibly resilient, says Jones.

"The trauma tails off rapidly once the violence dies down," she says. But, she adds, "a child's continued well-being depends a great deal on the kind of environment in which he or she lives in after that."

Like other experts in the field, Jones says parents and teachers and doctors need to look for the distress signals that children — scarred by war — send out; from nightmares and bedwetting to withdrawal, and violence towards other children, and sometimes their own parents. "A lack of professional help in the long term can be critical," Jones says.

Children are not the only ones suffering from mental stress in Iraq. Of the 2,000 adults interviewed in the Association of Iraqi Psychologists study, which surveyed people in all 18 Iraqi provinces, 92 percent said they feared being killed in an explosion. Some 60 percent of those interviewed said the level of violence had caused them to have panic attacks, which prevented them from going out because they feared they would be the next victims.

"Some people might see this as a normal reaction to violence," says Ala'a al-Sahaddi, vice president of the association. "But if you go deeper, you will discover that there is much more to it. Their minds have been changed, and they are like robots moving in response to explosions, bombs and violence."

An improving security situation in Iraq — including a sharp and sustained drop in all kinds of violence in Baghdad — could spell relief for many Iraqi children, says Diyala University psychology professor Haitham Mohamed.

The U.S. military says the weekly number of attacks have fallen to the lowest level since just before the February 2006 bombing of the Shiite shrine in Samarra, an event commonly used as a benchmark for the country's worst spasm of violence since the American invasion began.

Casualties suffered by Iraqi security forces are down 40 percent since the beginning of the troop reinforcement plan, and civilian fatalities in Baghdad are down 75 percent in recent months, the U.S. military says.

"Even a perception that things are better than they were in the recent pass, will have a good and positive affect, not only on Iraqi children, but also on the population, generally," says Mohamed.