WUNRN
More Must Be Done
to Protect Children in Armed Conflict - UN Special Representative
Despite global acceptance of existing human rights legislation dealing with children’s rights, 250,000 child soldiers remain involved in more than 30 conflicts around the world today. This contradiction was highlighted by the Special Representative of the Secretary-General for Children and Armed Conflict, Radhika Coomaraswamy, in her report to the 12th session of the Human Rights Council in Geneva. She exposed the “shocking reality that in far too many situations of armed conflict children are routinely brutalised and their most fundamental rights contravened.” The Special Representative acknowledged significant progress in efforts to better protect the rights of children entangled in armed conflict. The Security Council passed a landmark resolution on children and armed conflict this year. Resolution 1882 expands the protection framework for children by allowing for the “naming and shaming” of those responsible for grave human rights violations, among other provisions....... She told the Council that the changing nature of conflict around the world takes a greater toll on children and other civilians who are increasingly on the front lines: people have become deliberate targets of terror attacks in public spaces and the “collateral damage” of attacks on combatants. Children are also detained as part of counter-terrorism measures because they’re suspected of being associated with “terrorist” groups. In some instances, sexual violence on boys and girls continues to be used as a weapon of war and is a grave breach of international humanitarian and human rights laws. “Sexual violence has been used as a premeditated tactic of war designed to humiliate or exterminate a population or to force displacement. For children, the physical and mental consequences are devastating, with far-reaching negative effects on sustainable peace and security”, said Coomaraswamy........ |
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GIRLS AND BOYS GONE TO WAR:
Gender and Mental Health of Child Soldiers
By Laura Janneck
March 2009
As wars rage on in dozens of corners of the globe, the use of children as soldiers and servants to militias and armies has become a common practice. The plight of these children and their communities has started to gain some attention in the West, but typically the image that comes to mind has been that of boy soldiers; skinny pre-teens with AK-47’s strapped to their backs. These stereotypes miss the reality that many of the children abducted and recruited into these roles—both combat and non-combat—are girls6.
The nature of armed conflicts is changing, with wars being fought more often by non-state actors that do not recognize international humanitarian law, including those protecting against the use of children in fighting forces1, the most specific of which is the Optional Protocol to the Convention on the Rights of the Child, which has been ratified by 120 states7. Other legal documents include the Paris Principles8, UN Security Council Resolution 16129, and the Rome Statute of the International Criminal Court, article 210.
The first Global Report on Child Soldiers in 2001 reported that over 500,000 children had been forcefully conscripted into armed groups11. There is a growing body of literature on the mental health challenges facing these children, and increasingly attention is paid to both males and females. However, while gender is often considered as a variable, in-depth consideration of sex and gender differences is uncommon. To clarify, “sex” refers to biological characteristics that enable sexual reproduction, and is generally assigned in relation to secondary sex characteristics, gonads, or sex characteristics4. “Gender,” on the other hand, refers to social and culture-bound constructions of the roles, behaviors, and relations between and among men, women, boys and girls4. Both sex and gender affect these children’s exposure to different forms of trauma, their utilization of mental health services, and their overall health outcomes.
Recognizing
the need
In a study of 266 former child soldiers in Sierra Leone, where 12% of child soldiers were females, Bentacourt (2008) found that boys and girls experienced similar levels of exposure to most kinds of violence, including having injured or killed a loved one, having injured or killed a stranger, being threatened, chased, forced to take drugs, stabbed or shot, detained or arrested, and being exposed to looting of homes. Girls experienced significantly higher rates of sexual violence than boys, and were prone to unwanted pregnancy1.
Another study in Sierra Leone highlighted gender differences in the utilization of available services. Burman and McKay (2007) estimated that 48, 216 child soldiers were involved in the fighting forces, including 12,056 girls (25%). Of the children who underwent formal demobilization, disarmament, and reintegration (DDR), only 8% were girls3. DDR was developed by the United Nations as part of their peacekeeping efforts, and are aimed at transitioning former combatants to peacetime roles in post-conflict societies12. Many girls avoided the DDR programs in Sierra Leone because they did not want people to know they had been associated with fighting forces, for fear of the stigma and difficulty in finding a husband, and for fear of sexual violence from males in the programs3.
Returning to
the community
Gender differences in the perceptions of returning child soldiers can have a profound effect on the ability of these children to reintegrate into their communities. In a qualitative study in Sierra Leone, communities expressed fear of the returned female child soldiers, and reacted with ridicule and provocation of the girls3. The girls often avoided talking to other former child soldiers for fear of being interpreted as a threat3. These community perceptions may apply to both girls and boys, yet with girls being more marginalized in general, they are more susceptible to the social ostracism stemming from these fears.
Girls face heightened discrimination due to the community perception of sexual promiscuity associated with militia forces1 and because their sexual experiences are antithetical to traditional community norms3. These perceptions point to the growing global recognition of the sexual exploitation of child soldiers, female and male13, 14. While both boys and girls may be victims of sexual exploitation, sexual activity in the fighting forces violates the gender norms much more prominently for girls than for boys3. For example, in Sierra Leonean society, virginity is expected for girls to be married, and girls who become pregnant during their time with the fighting forces cannot hide their sexual experience3. It is difficult for the communities of these child mothers to conceptualize their place in society3.
Girl soldiers also face different social challenges than boy soldiers upon return to their communities. Often, they have missed the opportunity to come of age in ways appropriate to their cultures, and have thus not been socialized into their communities as young women in the usual ways6. They lack basic survival necessities such as health care and occupational skills6. Because girl mothers often have difficulty finding someone to care for their children, they cannot easily find the opportunity to attend skill training programs that can help them become more economically viable3. Some turn to transactional sex for economic support3.
Interventions
and gender
Considering the extremely traumatizing experiences of child soldiers, high levels of psychological effects can be expected. There is a growing recognition of the need for effective, individualized, and long-term rehabilitation services for these children, but current levels of provision remain dismal1. The United Nations has, in the past decade, updated its peacekeeping strategy from demobilization, disarmament, reintegration (DDR) to include rehabilitation (DDRR)5. Rehabilitation components often focus on formal education or vocational training, and often pay little attention to mental health needs15. These programs begin to take into account some issues for former child soldiers, but these services must also include attention to gender differences in experiences, manifestations of trauma, and interaction with mental health services.
There are very few published studies of interventions targeting former child soldiers that focus on mental health outcomes. The most relevant study found was a randomized controlled trial of 317 adolescents from two camps in northern Uganda, a region that has seen ongoing armed conflict16 since the early 1980s2. This study was not specifically directed at former child soldiers, but rather to children generally affected by war; however, 42% of the participants did report a history of abduction into one of the rebel groups, the Lord’s Resistance Army2. The study found that girls in an interpersonal group intervention improved significantly on the depression score, and boys in that group improved, but not to a statistically significant degree2. The authors hypothesized that boys may be less willing to talk, especially in group settings, and thus would be less involved in the interventions2. Also, gender differences in co-morbidities may have influenced the effectiveness of the intervention; for example, boys had higher rates of substance use and post-traumatic symptoms and previous studies had found that interpersonal interventions do not work as well on individuals with both depression and anxiety disorders2. This study highlights the importance of considering gender from the start in future studies on effective interventions for improving metal health outcomes in these highly traumatized children.
Implications
for further research, policy, and program development
Despite the recognition of the need for the second R in DDRR, official strategies for incorporating rehabilitation into on-the-ground efforts have been slow in coming5, due to a combination of a knowledge gap in the components of effective programs, lack of commitment and support from donor organizations, and competing priorities in post-conflict situations. From international bodies such as the United Nations to local NGOs delivering these interventions, policies should be adopted that incorporate the provision of appropriate and effective interventions aimed at improving mental health outcomes into the overall strategies of relief and peacekeeping. Within these policies, explicit recognition of sex and gender influences on mental health outcomes should be provided. Policies should also include mandates for consideration of these factors in the design, implementation, and evaluation of interventions.
On the programmatic level, professionals in post-conflict settings often do not have the tools to assess the gender-specific behaviors and psychological undercurrents of the children after disarmament5. This calls for the development of appropriate and effective tools that can be used by health professionals to assess their patients. All workers that engage with these children and their communities should have formal training including basic mental health concepts and techniques5. Special consideration should be made to girls that have become pregnant or have children from their time with the fighting forces. Female former child soldiers may need to be actively sought out because of their greater reluctance to utilize DDRR services. Separate services for males and females may help to alleviate their fears of sexual violence and exploitation from male program participants. Girls should also be given particular assistance in utilizing educational and skill-building opportunities so that they can support themselves financially, especially if their ostracism makes them more independent of family and male partners.
Much still needs to be done to understand and improve the suffering of former child soldiers, boys and girls. By raising awareness and supporting research, policy, and programming efforts in this field, meaningful impacts may be achieved for those who have lived through some of the most atrocious scenes in the history of humankind.
Laura Janneck is a medical student at Case Western Reserve University School of Medicine and the outgoing AMSA Global Health Education Coordinator. She is currently a master of public health candidate at the Harvard School of Public Health where she is studying humanitarian assistance and health in complex emergencies. She can be contacted for questions or comments at laura.janneck@gmail.com.
Want to learn more about child soldiers?
- Coalition to Stop the Use of Child Soldiers, available at http://www.child-soldiers.org
- The Invisible Children is a film about the plight of child soldiers and night commuters in Northern Uganda. The official website is http://www.invisiblechildren.com/
References:
1 Betancourt TS. Child
soldiers: reintegration, pathways to recovery, and reflections from the field.
J Dev Behav Pediatr. 2008 Apr;29(2):138-41. http://www.ncbi.nlm.nih.gov/pubmed/18408537
2 Bolton P, Bass J, Betancourt T, Speelman L, Onyango G, Clougherty KF, Neugebauer R, Murray L, Verdeli H. Interventions for depression symptoms among adolescent survivors of war and displacement in northern Uganda: a randomized controlled trial. JAMA. 2007 Aug 1;298(5):519-27. http://www.ncbi.nlm.nih.gov/pubmed/17666672
3 Burman ME, McKay S. Marginalization of girl mothers during reintegration from armed groups in Sierra Leone. Int Nurs Rev. 2007 Dec;54(4):316-23. http://www.ncbi.nlm.nih.gov/pubmed/17958659
4 Krieger N. Genders, sexes, and health: what are the connections--and why does it matter? Int J Epidemiol. 2003 Aug;32(4):652-7. http://ije.oxfordjournals.org/cgi/content/full/32/4/652
5 Medeiros E. Integrating mental health into post-conflict rehabilitation: the case of Sierra Leonean and Liberian "child soldiers". J Health Psychol. 2007 May; 12(3):498-504. http://www.ncbi.nlm.nih.gov/pubmed/17439999
6 Roberts K. The plight of girl soldiers. Am J Nurs. 2005 Feb;105(2):102-3. http://www.ncbi.nlm.nih.gov/pubmed/15674073
7 UNHCHR (2002). Optional Protocol of the UN Convention of the Rights of the Child on the Involvement of Children in Armed Conflict. Retrieved February 21, 2009, from http://www.unhchr.ch/html/menu2/6/protocolchild.htm
8 UNICEF (2007). The Paris Principles: Principles and Guidelines on Children Associated with Armed Forces or Armed Groups. Retrieved February 21, 2009 from http://www.unicef.org/emerg/files/ParisPrinciples310107English.pdf.
9 United Nations (2005). Security Council Resolution 1612. Retrieved February 21, 2009, from http://www.securitycouncilreport.org/atf/cf/%7B65BFCF9B-6D27-4E9C-8CD3-CF6E4FF96FF9%7D/CAC%20SRES%201612.pdf
10 United Nations (1998). Rome statute of the International Criminal Court. Retrieved February 21, 2009, from http://untreaty.un.org/cod/icc/statute/romefra.htm
11 CSUCS. Child soldiers-global report. Accessed February 21, 2009 from http://www.child-soldiers.org/library/global-reports
12 United Nations (2006). Integrated Disarmament, Demobilization, and Reintegration Standards. Accessed February 21, 2009, from http://www.unddr.org/index.php.
13 Alfredson, L. Sexual exploitation of child soldiers: an exploration and analysis of global dimensions and trends. Accessed February 21, 2009, from http://www.reliefweb.int/rw/lib.nsf/db900sid/LGEL-5RPBPA/$file/csusc-exploit.pdf?openelement
14 Price, S. Use of girl soldiers condemned. BBC News. Accessed February 21, 2009, from http://news.bbc.co.uk/2/hi/africa/3531641.stm
15 United Nations (2008). UNDP Liberia Programmes. Acessed February 21, 2009, from http://www.lr.undp.org/ddrr.htm
16 Southwick, K. North Ugandan Conflict, Forgotten But Still Deadly. YaleGlobal, 9 March 2005. http://yaleglobal.yale.edu/display.article?id=5398
Downloaded from http://www.globalpulsejournal.com/2009_janneck_laura_girls_boys_war.html
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