Family trauma and economic problems, including domestic violence, the death of relatives or losing access to healthcare, housing and schooling can be more closely related to a child’s mental health than the 2004 tsunami or the civil conflict that ended in May 2009 after two decades of fighting and three failed peace attempts. The government is trying to boost services in the conflict and disaster-affected north and east to help children in distress.

“Significant variance in children’s distress and development is explained by daily stressors caused and exacerbated by, or even unrelated to conflict or natural disaster,” the authors wrote in one study of 400 Sri Lankan youths aged 11 to 20. Little research uses this “ecological perspective” to measure the ongoing and cumulative impact of multiple disasters on children, according to Child Development.

The escape

Kannan*, 9, from the Tamil ethnic group fled with his family during the height of Tamil rebel fighting in 2009 from Kilinochchi in northern Sri Lanka – the rebels’ military base – to the neighbouring province of Mullaitivu.

“I was scared. Blood was everywhere,” he told IRIN. How such children recover from war depends on the extra attention they get, said Mahesian Ganeshan, a child psychiatrist in eastern Sri Lanka. “These children need extremely caring environments within families and outside the family environment to overcome the horrific and traumatic experience.”

Most children in northern and eastern Sri Lanka have lived through either war or the tsunami, or both, according to the UN Children’s Fund (UNICEF), which, with the government, has identified at least 4,000 children, a number of them former child soldiers, needing urgent support. Further assessments should be made to establish how many more children may need extra help, said Mervyn Fletcher, UNICEF’s head of communications in Sri Lanka.

Response

A senior consultant to the government’s child protection authority, Hiranthi Wijemanne, told IRIN: “With the prolonged conflict and the resulting psycho-social distress and trauma compounded by the tsunami, we definitely need more [children’s mental health services]. With the numbers [of affected children] involved, a more community-orientated and public health approach is preferable to the ‘western, individual’ model, which we cannot afford as the needs are great.”

He said the government was hiring more mental health specialists and the University of Colombo psychiatry department and the government planned to implement a community-based programme to train public health officials in working with children.

Jaffna College, a private school for primary and secondary students in northern Sri Lanka, has started admitting students from displaced families on special admission programmes that include extra guidance and counseling. “These [are] children who had seen the death and suffering continuously for months,” the college’s principal, Noel Vimalendran, told IRIN.

UNICEF is helping to train 269 government employees – whose agencies span probation, social services, police forces, women’s development and counselling – in 14 of the north’s 33 administrative regions to improve services to protect children. In addition, the children’s agency will train more than 1,000 community workers in at least 150 agencies in how to reduce children’s risk of accidents from unexploded ordinance (UXOs).

Handicap International, Caritas and Motivation UK are rehabilitating disabled children, while Save the Children UK is helping former child soldiers adapt to life after civil war.

“The most important aspect of all this is the end of a violent environment for children,” said Wijemanne.

IRIN (Integrated Regional Information Networks) is part of the UN Office for the Coordination of Humanitarian Affairs, but its services are editorially independent.