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  • Writer's pictureRalph Santora

How to help Syria’s refugee children.

We must invest in their mental health and education — before it's too late.

Injured children are treated at a hospital in the rebel-held Douma district in Eastern Ghouta, Syria, on Feb. 19.

Washington Post

Haunting images of children wounded or killed in war fill global news reports with dispiriting regularity. And while the migration of Syrian refugees has generated controversy across the United States, these images convey a deeper tragedy that governments and humanitarian organizations have yet to properly address: the crippling, long-lasting effects on these young survivors’ psyches.

Combating the refugee crisis today requires confronting the mental, as well as the physical, trauma of war. More than a century ago, the Italian educator Maria Montessori argued for confronting the psychological devastation of children of war with a robust education program. She conceived of an entire organization to provide such a service: the White Cross. While modern medicine has come to recognize the importance of her ideas about how to treat civilians harmed by conflict, humanitarian organizations still lack the funding and resources to implement them.

Efforts to create the White Cross began during World War I. While traveling in France to record the effects of the Great War, children’s author Maude Radford Warren stumbled upon a group of young refugees. They had witnessed both the “Rape of Belgium” — Germany’s premeditated war crimes against Belgian civilians — and the invasion of northern France in the opening months of the war.

Montessori was convinced that by stimulating the children’s senses with reassuringly repetitive exercises in a stable environment, the children could recover their damaged mental faculties. If left untreated, however, their symptoms would only worsen.

In 1917, Montessori worked to create a supranational humanitarian association, which she planned to call the White Cross. This organization was to develop the use of her pedagogy for the benefit of war-traumatized children. The color white was chosen to stand for the nervous system, as distinct from the Red Cross, which represented the blood of wounded soldiers.

White Cross personnel would ideally be trained as both nurses and teachers, making them specialists in mental diseases. Their training would center on “first aid, knowledge of nervous diseases, dietetics for infants and children, isolation, special psychology, domestic science, agriculture, language and a theoretical and practical course in the Montessori Method as specially applied to those children.” The Montessori teacher would, in other words, teach the children to be functional members of society.

This was a groundbreaking approach. Its all-encompassing view of treatment, which included education alongside physical and psychological services, stood in stark opposition to the medical conventions of the time.

But nobody responded to Montessori’s call. For the remainder of the war, she relentlessly advocated the creation of this organization, writing to possible patrons, from social workers and organizers to psychiatrists — including the father of psychoanalysis, Sigmund Freud — and religious leaders such as Pope Benedict XV. They applauded her efforts, but no one provided financial support. The initiatives that did receive governmental and private financing were those that provided exclusively material relief to children.

Since WWI, modern warfare has evolved increasingly to target civilians, as the boundaries between state-organized militaries and small-scale militias have blurred. Warfare in many parts of the world has absorbed all aspects of civilian life, to the degree that today 90 percent of its victims are civilians, according to the United Nations. They are often not merely bystanders, but the victims of targeted violence.

In current conflicts, children account for a considerable proportion of casualties, as schools and hospitals are attacked in violation of all international humanitarian and human rights laws. Some of these children are victims of general assaults against civilians; others are part of calculated genocides. Despite these changes to the nature of warfare, treatment for the victims has not shifted accordingly.

Syria, which is in the throes of a seven-year conflict, is a notable example of this discrepancy. A recently published study, titled “Invisible Wounds” and assembled by the Save the Children Fund, a nongovernmental humanitarian organization, examined Syrian children’s mental health and physical well-being. It describes its subjects in a manner starkly reminiscent of Montessori’s own language, concluding that with the right support, children can be rehabilitated.

Melissa Fleming, a spokeswoman for the United Nations High Commissioner for Refugees, agreed with the importance of these goals. “Refugee children are in danger of becoming a lost generation of uneducated, traumatized, and dangerously frustrated kids. And yet they talk of education as the most important thing in their lives because it helps them focus on a hope rather than hatred, on their futures rather than the nightmares of their past.”

Seven straight years of conflict have devastated Syria and its people. Bombed, starved and neglected, Syrian children experience severe emotional challenges every day. The effect on the children’s cognitive, emotional and physical development may take the form of developmental delays or lifelong impairments. The next generation of Syrians may face severely diminished mental and physical capacity.

Today, organizations such as Save the Children, Doctors Without Borders and Human Rights Watch are responding to reports of serious psychological illness, such as depression, anxiety and psychosis, as well as an increase in self-harm and suicide attempts in the refugee camps surveyed — the very same symptoms and phenomena that Montessori described in children affected by WWI.

Montessori’s ideas are the basis for current best practices in rescue efforts for civilians; although psychological treatment for them has evolved in the past 100 years, her work continues to inspire organizations involved in such care. Nevertheless, countries are accepting fewer refugees, and NGOs are receiving less funding. A century ago, Montessori was denied the financial support she needed to do her work. Can we risk repeating this very same mistake?

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