Silent Suffering: The Psychosocial Impact of War, HIV, and Other High-risk Situations on Girls and Boys in West and Central Africa

This 64-page report is the product of a 5-country study by Plan International and Family Health International (FHI) to examine some of West Africa's most vulnerable children. Researchers interviewed more than 1,000 adolescents in Cameroon, Burkina Faso, Sierra Leone, Liberia, and Togo with the aim of assessing the mental health and psychological needs of the children, some but not all of whom had experienced conflict, trafficking, or the loss of a parent.

The study found that children - both those who had experienced conflict, trafficking, or loss and those who had not - experienced high levels of domestic, sexual, and community violence. The authors suggest this may be due to a culture of violence left in the wake of conflict during which both children and adults experienced high rates of trauma. Although the authors point to many factors that help children cope with violence, they advocate for a wide range of interventions to address this issue, including greater community involvement, increased attention from community radio stations, and the creation of safe spaces.

Children interviewed detailed traumatic events such as the loss of parents to HIV as in Cameroon, surviving instances of ethnic cleansing in Burkina Faso, growing up without parental support in post-war Sierra Leone, involvement in Liberian fighting forces, and instances of trafficking in Togo. However, both these children and peers who did not experience these types of trauma experienced high levels of violence - most often, abuse at the hands of caregivers who may also have survived traumatic events. This abuse included physical, mental, and emotional abuse. According to the report, children most likely to employ successful coping strategies in the face of abuse had higher self-esteem, felt more in control, and reported a sense of belonging and a connection to community values. They were also more likely to have solid relationships with caregivers and peers, participated in traditional rituals, and reported that their basic needs were met in terms of food, clothing, and shelter.

The report concludes with several communication-related recommendations. The authors argue that child protection programmes need to be better tailored to meet community needs and practices, and they suggest that churches and traditional groups may be able to help transmit these messages with the help of community radio stations. They state that community radio stations need to be more involved in transmitting messages to affected populations in the language they speak and with content adapted to local realities. They also argue that parents and caregivers need emotional support to cope with their own traumas before they can undergo necessary training regarding children's rights and developmental needs. Finally, the report suggests that communities strive to create safe spaces for children that encourage them to participate in games, group discussions, and role-playing games. Staffed by social workers and volunteers, these centres may be able to identify vulnerable children early.

The report also points out that children subjected to violence in their homes - or, in particular, circumstances like trafficking - are among the most marginalised and invisible groups in society, with limited access to public services or the opportunity to influence public decision-making. The use of a rights-based approach to development that focuses, among other things, on working with the most marginalised populations, needs to be strengthened in West and Central Africa. The authors also state that more research is necessary to understand the degree and types of mental health impairments sustained by children and their caregivers in Africa and to explore further community strategies to address the needs of vulnerable children. Knowledge also needs to be built up on the psychosocial and medical needs of boys who have suffered from sexual violence, an issue that many people consider taboo and are hesitant to talk about. The authors conclude by recommending greater strengthening of peacebuilding and reconciliation efforts at the community level to enable victims and perpetrators to reach out to each other and to learn to solve conflicts without violence. In addition, sustainable peace and non-violent conflict resolution should become a priority in the sponsorship work of local organisations.