Political interests hamper traumatized children's recovery

Thousands of children traumatized in armed conflicts are now facing hardship in various refugee camps. The social cost that Indonesia will have to pay by neglecting the situation today would be enormous according to psychologist Shinto B. Adelar of the University of Indonesia. The following is an excerpt from her interview with The Jakarta Post recently. Related articles are also run on this page, questioning the society's readiness to deal with the problem.

Question: How ready are we to deal with the problems of children traumatized in communal violence?

Answer: There are facilities and institutions that deal with the problems but they are only recently established. And we need data about how many children need such treatment. There's no such data. We don't know how many traumatized children there are in East Nusa Tenggara, Maluku, Manado (in North Sulawesi), West Kalimantan, Madura and East Java and Aceh.

We have only started. Indonesia has never before faced this situation (where there are countless traumatized children). In the past, there were (victims of) violence, but we could not speak about it as the government was so repressive. So our psychologists and psychiatrists were not trained (to deal with traumatized children). Instead, we had foreign workers from institutions such as Unicef, Christian Children's Fund, Save the Children, World Vision and others.

Now we have the Crisis Center at the University of Indonesia's School of Psychology. There are similar centers at the Sumatra Utara University and Airlangga University. There are numerous non-governmental organizations working in the field but mostly for emergency work such as the provision of food, clean water and sanitation, rather than on traumatized children.

I understand organizations such as Christian Children's Fund also helps find adopted parents for the children while Unicef holds career trainings and there are organizations that extend psychosocial assistance to refugee children. Still we need solid data on how many traumatized children there are from armed conflicts. On the other hand, the Ministry of Health is currently preparing a guideline for doctors at puskesmas (village health centers) near conflict areas to identify and handle post traumatic stress disorder.

Q: So there is help for traumatized children now. What is lacking?

A: We all need to be better coordinated. Physical assistance is not enough for people with psychological problems. Both physical and psychological treatment is needed. The helpers must also understand the social and cultural characteristics of the affected people. This is important so that the assistance given will not be misinterpreted as meddling, the way it was with the UNHCR (in Atambua), and lead to new conflicts.

Also to be considered when we work with displaced people or refugees are the local people where the refugees are sheltered. They are also victimized. They have to sacrifice their land, their food, which is not plenty in the first place and they have to tolerate differences in culture. This is potential for conflict. Therefore, a social psychological approach is needed.

Presently, our approach to treatment of trauma is individualistic but actually how an individual deals with their trauma is influenced by their psychosocial environment. Actually, there are now many people who help traumatized individuals but less attention is given to those suffering from post traumatic stress disorder such as the children in armed conflicts.

Q: Tell us about the Crisis Center at the School of Psychology, University of Indonesia...

A: It was set up shortly after the May 1998 riots to anticipate the number of people traumatized in the unrest. Also because people said there were many women raped then. I said "people said" because actually no one came forward to say they were raped. A Jakarta branch of an association of psychologists received a call from someone, soon after the riots, asking help for ten rape victims, all of them Buddhist. OK. But several days later the association received another call to cancel the request because the rape victims were too afraid to come for help.

The center is part of the School of Psychology and so the person in charge is the dean. Recently (a staff lecturer) Atjuk Parsudi MSc was appointed chairman of the center. The center is staffed by an estimated 100 lecturers, plus about 50 volunteers. So far, we have sent missions to Ambon and to Bengkulu following the earthquake. We are now making preparations to send another mission to Ambon.

Q: How do you treat children traumatized because they were victims or witnesses of violence during armed conflict?

A: Because this involves many children, we work in groups. We employ various techniques, for instance, through play. But what we do in general is reestablish routine for the children (in refugee centers). Before the violence, the children's routine were, for example, going to school or playing with friends. In their new environment in the refugee centers, everything is uncertain--so this becomes a new source of stress. Routine helps restore children's feeling of safety.

So we encourage adults to help children reestablish a routine such as studying or whatever is it they can do together. We also encourage children to express their feelings and their experience of witnessing violence. We help them digest the experience and handle their feelings. If they are insomniac, angry or fearful, we help them understand what's happening inside them.

There are some things that we can overcome, there are other things that are simply beyond our power (to rectify). For instance, we know how certain political interests lead to situations which are not favorable for the children's recovery. The warring parties, for instance, do not want to have peace...Adults who are angry may perpetuate tension in children by spreading hatred.

Q: How long does it take for a traumatized child to heal?

A: It depends on the individual. People who witnessed natural deaths say they still remember them after five years. What about children who witnessed violent deaths? They surely need more time (to heal.) This is not to mention the continued anxieties and fears they experience in refugee camps because there are people there who continue to spread tension--all this affects the children.

I read about someone who witnessed the death of a parent during the communist purge (in the 1960s); he needed 34 years to resolve his inner conflict about the violence. He suffered from insomnia, eating disorder and other problems because he did not get systematic help.

Studies conducted overseas show that when children are deprived, for instance, of food or education in refugee camps, their intellectual development suffers. Their moral development are also stunted and they might nurture morality based on fanaticism.

There are also an increased risks of substance abuse. The children's sexual behavior may also be affected because of loose parental control in refugee camps. Even now some parents in refugee camps in Indonesia are complaining about not being able to control their children.

We have thousands, tens of thousands of children who are facing this prospect. We can imagine the social cost that we have to pay in the future unless we take decisive actions now. Are we going to attend to this now or are we going to wait until this problem explodes? (swe)