The recent terrorist attack on the Army Public School in Peshawar has left an indelible mark on the psyche of the Pakistani nation. One cannot even begin to comprehend what the children must have gone through in those harrowing moments when the terrorists burst into the school premises and opened fire, mercilessly killing more than 140 of them.
Neither can one comprehend the anguish and turmoil their families must be going through now. Needless to say, terrorism and violent acts have become a way of life in Pakistan today and no one is suffering from this more than the children of this country.
What effects do such acts have on children? Are there any long-term consequences of being brought up in such a violent environment? And what can be done to prevent not just a terrible tragedy like that at APS Peshawar but other acts of violence and terrorism that our children are subjected to on a daily basis?
Pakistan has been going through a perpetual state of low- to medium-intensity war for the last couple of decades. And this state of affairs is unlikely to end anytime soon. Many children and young people have been affected personally by terrorism, either by being at the scene of an attack, by knowing someone injured or killed by militants or watching graphic scenes on their television screens.
In several surveys carried out on children who have witnessed violence in conflict areas around the world, almost three quarters of those surveyed reported increased subjective fear of hopelessness. One would find similar rates in Pakistan, if not higher, because terror exposure is not just a one-time event, but has become a way of life in Pakistan.
These high figures have prompted many mental health professionals to ask how children are affected by growing up in the midst of violence, and how these Pakistani children can best be helped to cope.
Trauma in the long term can affect children’s self-esteem.
Many children suffer acute anxiety when in public places. Others may have symptoms such as difficulty in sleeping, poor concentration, irritability, aggression, loss of appetite etc. Post-traumatic stress disorder is a psychiatric condition that can be triggered after experiencing or witnessing a life-threatening event, from military combat to terrorism, natural disasters and personal assaults.
After an event, daily life can be marred by nightmares and flashbacks, difficulty sleeping and emotional withdrawal.
Increasingly, behavioural problems are emerging at schools. With every new terror attack, past traumas are relived and this raises the question of the responsibility of the state not to take it lightly that children are exposed to terror trauma.
In the long term this can affect children’s self-confidence and self-esteem, their relationships and their ability to progress in life.
Understandably, many children feel confused, upset, and anxious. Children ask lots of tough questions, but questions about terrorism or war are some of the hardest to answer. Especially when TV channels provide immediate and graphic details, parents and professionals are in a quandary about how much information to provide.
Parents may have difficulty in explaining terrorism and suicide bombings and why, despite having such a large army and being a nuclear power, we have not been able to solve the problem.
Although difficult, it is important to have an open dialogue with children. This gives parents an opportunity to help their children feel more secure and understand the world and the society in which they live.
According to the American Academy of Child and Adolescent Psychiatry, “adults can help by listening and responding in an honest, consistent, and supportive manner. Most children, even those exposed to trauma, are quite resilient. Like most adults, they can and do get through difficult times and go on with their lives. By creating an open environment where they feel free to ask questions, parents can help them cope and reduce the possibility of emotional difficulties.”
Terrorism and war also provide an opportunity to discuss issues of prejudice, religious intolerance and discrimination. But as some experts point out, “it is easy to look for and assign blame, in part to make a situation understandable and feel it was preventable”.
It is often said that children are the future of a country. If so, then we are seriously compromising our future, as we allow the unabated violence to go on in our communities, our streets, our mosques and now our schools.
The country is awash with weapons, from small firearms to heavy ones, the scary demonstration of which we are subjected to every New Year’s Eve, at the sighting of the Eid moons or any other occasion people deem fit.
It is time we give serious thought to deweaponisation and reducing the general level of violence in the country, which is taking such a heavy toll on the young people of Pakistan.
The writer is a professor of psychiatry.
Published in Dawn January 18th , 2015