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DAMAGED: Boko Haram’s violence inflicts emotional injury on children, and it is life-long

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In places where bridges had been blown away, alternative routes have appeared. Where houses were destroyed, improvised shelters accommodate internally displaced persons.

But children caught up in the Boko Haram's 10-year-old insurgency suffer damage not so easily repaired. They are now struggling with distressing memories and ongoing adversities – resulting in an upsurge of psychological trauma.
Aisha Abdulmumin, age 12, roused from a nightmare, trembling and crying, and darted to an adjacent room where Blessing Solomon, 11, was sleeping. In that moment, Aisha held Blessing tightly to her body, her heart racing as she sobbed.

They live in face-to-face shanties at Angwa Chaba, a rundown area of Yola, the capital of Adamawa State in north-eastern Nigeria.

Sitting on the pavement at the back of a building in Yola Central Development Secretariat where Hope and Rural Aid Foundation is having a training session on how to make soap and body cream, the girls tell The ICIR that Aisha's slain parents had come to her in a dream wearing a blood stained white garment. As they recount their horrific ordeals, younger children swarm all over the venue of the training meant for displaced children and women.

Since Aisha witnessed Boko Haram kill her parents at Bama in Borno State in 2014, she habitually has panic attacks that keep her agitated for hours. When she started having the episodes, the woman she lives with would beat her as she woke up in terror and screamed. She later learned to run out of the house to her friend.

But her friend is not out of the danger either. "My mother fed me in my sleep," Blessing says. "I woke up screaming but my sister held me on the bed." Blessing, living with her elder teenage sister, lost both parents when the insurgents overran her village at Gombi in Adamawa State. She has not seen her three other siblings since that attack.

Without psychosocial help, the girls have been forced to develop their own ways to cope with the anguish. They cuddle and pray. "I ask Allah to help us," Aisha says, drawing a retreating veil that reveals her cornrow braid to her forehead. "I pray to Jesus to deliver us" adds Blessing, appearing a little taller than Aisha in her white gown.
Aisha and Blessing play at Yola Central Development Secretariat
While the girls seem to have persevered, mental health experts suggest that they may have an illness that needs urgent attention.

"It's an illness that is making them have nightmares," Taiwo Lateef Sheikh, a neuro-psychiatrist and former medical director/CEO of Federal Neuropsychiatric Hospital, Kaduna, tells The ICIR after learning of the girls' condition.

"The children have suffered an illness as a result of the catastrophic and severe experiences they had, and also as a result of deprivation they're presently going through. It's because of that they're having nightmares, seeing their dead parents in dreams," says Sheik, who is also a professor at the Department of Psychiatry, Ahmadu Bello University, Zaria.

The girls' struggle resembles today's experience for millions of children whose life trajectories have been altered by the insurgency. But despite the number of children and caregivers in need of psychosocial support and life skills activities in 2018, only about one-thirds were reached, according to the last November's humanitarian situation update from UN Office for the Coordination of Humanitarian Affairs (OCHA).

Following renewed attacks by Boko Haram, displacement has increased, leaving more than 2 million girls, boys and caregivers in need of psychosocial support, according to Unicef, the UN children's agency.

As violence defines the affected children's world, aid workers say the war has inflicted enormous psychological damage.

"We have asked children in their classroom to draw what they are thinking, and seen a child drawing a pistol because that is what they used in killing his parents," says Elizabeth Maiyaki, child protection and case management supervisor with Plan International, who has been providing psychosocial services for unaccompanied and separated children.

The traumatised children show other signs of suffering. "They don't eat well. They don't talk. They're shy. They're lonely. Very aggressive. Easily angered. They don't associate or come in the midst of people. Sometimes, they could be stubborn. They easily fight among themselves," Maiyaki says.

Boko Haram's decade of insurrection to enthrone an Islamic caliphate in north-eastern Nigeria has resulted in accumulated tragedies: tens of thousands of people killed, about 2 million displaced, more than 7 million in dire need of life-saving aid, about 120 children used for suicide bomb attacks, mass abduction and rape of girls, and nearly 400,000 children with severe acute malnutrition.

But the cost of the insurgency goes beyond the loss of lives and displacement of people, experts say. Millions of children have seen their childhood maimed and their future puts at risk.
Home evokes paralysing memories
In Michika – 238km, or about six hours drive on dirt roads, from Yola – Albert Ishaku, 11, grasps a blanket and wails. "This blanket reminds me of my dad," he tells The ICIR.

In 2014 when Bokka in Michika fell to Boko Haram, Ishaku's family joined other villagers fleeing towards a route through mountain that surrounds the village. But Boko Haram captured his father before they could reach the foot of the mountain. With his palm straightened across his stomach, he demonstrates how a Boko Haram fighter jab his father with a broken bottle. His father bled to death.

Leaving the corpse behind, Ishaku crossed the mountain with his mother and sister. From there, they continued running through bushes until they got a lift to Yola. When Nigerian armed forces recaptured his village, his mother brought them back to the village and remarried, leaving him and the younger sister with his aged grandmother. His sister later died after complaining of acute fever.

"I touch blanket; I cry," Albert says. When his father was alive, he used to slide under the bedspread, stretch his arm across his father's wide chest and fall asleep during the harmattan cold. Now, when he feels cold and brings cover upon himself, his father's image flashes through his mind and takes hold of him.

To relieve his stress, Ishaku goes to a child-friendly space in the village, built six months earlier by Plan International to help returning children overcome their traumatic experiences. He is among the first set of children to rush inside as the facility opens after school hours. He pulls off his flip-flop on the sand and jumps on the mats laid across the hall. He grabs Logo bricks but gets frustrated with his skills. He moves to jumping rope outside the hall and eventually settles for playing football with the other boys.
Albert Ishaku, wearing jersey 11, jumps rope outside the child friendly space
"The most traumatized are the ones who witnessed their parents slaughtered with knives," says Olivia Shenge, case worker in charge of the child-friendly space. "These people killed their parents and left the children there. Some slept with the corpses for days until others picked them up," Shenge says.

"It is not easy to lose parents that way," she continues. "So the images are still there. Some couldn't mingle with others. Some are not even interested in going back to school again."

Depending on the severity, Shenge says, it takes between three and four months for each child to be healed of trauma through the play activities and storytelling. She refers cases she cannot handle to other organisations because her facility does not offer medical services.
Children play inside the child friendly space
While play activities distract the children, current adversities like hunger and neglect seem to be common triggers of distressful memories, bringing back thoughts about the loss of their parents.

Joy Tizhe, 12, who heads a household of five, tells The ICIR that she often brings three younger siblings to the child friendly space because hunger makes them cry for their mother.

Their pregnant mother fell and died when they were running away from the Boko Haram's attacks. Their father later brought them back but subsequently disappeared. They have been living with an aged and sick woman in the village.

To eat food, Tizhe says, they volunteer to harvest crops from people's farms in return for leftovers.

As more people return home, aid workers tell The ICIR that lack of funds prevents adequate scaling up of psychosocial services in the liberated communities. Only few communities are covered, leaving others who need help unattended to. Even those who get some help find that interventions by NGOs are short-lived and often subject to availability of funds.
Go home, the sentiment grows
During the heydays of Boko Haram between 2013 and 2014, insurgents overran vast swathes of Nigeria's territory across three states – Adamawa, Borno and Yobe. Big towns like Mubi in Adamawa, where the state's university is located, fell to Boko Haram.

Starting from 2015, the Nigeria armed forces made substantial gains recapturing these areas. In turn, plenty of people once displaced have returned home. In Mubi, a strategic border town with Cameroun, streetlights are lit at night and university students move around.

From Mubi to Michika, about 2 hours by car, normal civilian activities have picked up. In Michika on one recent day, five men stand in front of roasted pork seller's shop, waiting for their orders to be cut into pieces and peppered. Young girls hawk cooked rice and beans. Traders open shops and music blares. Further down the villages, three passengers alight from a motorcycle. Villagers stand to watch aid workers passing by in vans and jeeps.

But reminders of the atrocities of Boko Haram lie in plain sight around the villages: houses with collapsed roofs, electric poles without wires and an absence of mobile phone network signals.

Police mount road blocks, asking questions. Where are you coming from? Where are you going to? They let motorists pass one at a time.

With this security, displaced people in Yola have been asked to go back home. Those who remain in camps have since been denied humanitarian aid by government and NGOs.
Children at Malkohi camp
At Malkohi camp in Yola South, about 30 minutes' drive from where Aisha and Blessing live, a group of children sit on the sand, preparing a morning faux meal with a mixture of sand and water because they have lost the play materials they once had.

Around the camp, children play a dangerous game by gathering on the sand, sculpting guns with clay and pretending to be shooting themselves. They dig holes in the ground, lay sachet water inside as landmines and feign having been killed by the bombs.

The camp's leaders tell The ICIR that the children once had better opportunities to play. The Unicef's child friendly space in the camp was stuffed with toys and Lego blocks in 2015, but the tent has been damaged. Youths used the carcass of the structure to make shade where tens of mobile phone are charged with power from a small generator.

Elsewhere in the camp that shelters 1,329 people, United Nations Population Fund's (UNFPA) women and girls' friendly centre that once had television and draft, remained unused and a new building built by UNHCR, the UN refugee agency, to handle for complaints has remained locked ever since it was built.

"Nothing for the children," says Fatima Hassan, women's leader in the camp who came from Askira in Borno State. "No playground where they can keep themselves busy, no balanced diet, no good clothing, no free education," she adds.
Top left of the picture is the damaged child friendly space at the camp
The majority of people in the camp came from southern Borno where they believe that Boko Haram still holds sway. They say Adamawa State's government had stopped giving them aid because they are not from the state and the National Emergency Management Agency rations food items like rice and soya beans to each family once a month.

"Now, it is only Unicef that still gives educational materials to the students here," Hassan says.

Added to the official neglect, the three civilian teachers who used to assist in teaching children in the camp stopped coming because their salaries were not paid. The camp's school, an abandoned public school, has been left for soldiers who now teach the pupils under the Nigerian Army's Education Quick Impact Project.

"Most of the children have never been to school before they came here," says Tafarki Yakubu, a staff sergeant who is one of the military instructors. He says that when children arrived the camp in 2014, many were afraid of soldiers and did not want to come close to them.

All that has changed, Yakubu says, as the school now has 431 pupils from primary 1 to 5. Last year, 65 of the children passed out of the camp's school, but only 13 were able to go on to the nearest secondary school at Jibson Jalo Military Cantonment. The rest did not have money to continue their education.

Outside the camp, at the displaced persons' settlement, children play gun fight with sticks
Dissatisfied with the government's treatment, many displaced persons left to found a thriving community about 2km from the camp. They have makeshift homes made of sticks and roofed with UNHCR-branded tarpaulin.

"We here outnumber those in the camp," Musa Teller, secretary of the remote settlement tells The ICIR. Many of the inhabitants originally came from Gwoza in Borno where the insurgents once had their caliphate's headquarters.

Now at their settlement, children hang sticks on their shoulders, which they use for a made-up gun battle, pretending to kill each other.
What will their future look like?
Evidence from neuroscience suggests that there are no socioeconomic disparities in brain function at birth but children growing up in adversity will have poorer brain development than children who get good care.

Because human brain develops at an extraordinary rate in the early years of life, early exposure to violence or adversity leads to what Charles Nelson, professor of paediatrics at Harvard Medical School, describes as "noise in the brain" whereby the brain fails to form proper neural connections, but rather becomes crowded with frightful memories and a sensitivity to perceived threats that crowds out development of capacities needed to succeed in a peaceful environment.

Experts in adverse childhood experience suggest that this distorted development not only manifests in mental illnesses in adulthood but also comes with non-communicable diseases.

"Most people intuitively understand that there's a connection between trauma in childhood and risky behaviour like drinking too much, eating poorly, and smoking in adulthood," wrote Nadine Burke Harris in The Deepest Well, Healing the Long-term Effects of Childhood Adversity, published 2018. "But what most people don't recognise is that there is a connection between early life adversity and well-known killers like heart disease and cancer."

In his doctoral dissertation at Walden University, Paul Adebayo Adepelumi studied eight children who were affected by the Boko Haram's violence and found that all had symptoms of mental health disorders, which did not lead to permanent mental health illnesses.

Sheik, not referring to the study, suggests that Nigeria may still be dealing with problems resulting from the insurgency for the next 50 years because the affected children will be dealing with the repercussions of trauma they were exposed to when they were small.

But there is hope. "The solution starts from understanding the problem," says Sheik, who is a faculty at Harvard Program in Refugee Trauma, Global Mental Health at the Harvard Medical School. And that understanding by government and everyone would mean seeing the problem beyond fighting or treating the physically injured but also addressing the mental health challenges arising from the insurgency.

Sheik says that failure to address the problem will spell doom for Nigeria because "the children will not grow into normal adults." He says victims of childhood trauma can grow into adults with psychiatric illnesses, personality disorders, antisocial personalities, drug addiction, criminal tendencies, aggression and insensitivity.

Aisha and Blessing share their traumatic experiences
Already, Aisha and Blessing's experiences have shaped their ambitions. "I want to be a soldier to kill those who killed my parents," Aisha says with her face saddened. Blessing, on the other hand, wishes to be a policewoman because she knows a policeman who has money and enough food in his house.

Whatever their career ambitions, aid workers warn that they may never achieve them because they do not go to school. Displaced children in Yola were once educated under the Education Crisis Response but that programme stopped in 2017.

Galaxy Dwana, founder of Hope and Rural Aid Foundation, tells The ICIR that "We used to run 14 centres but the funding stopped." When the programme closed, displaced children were supposed to return to their liberated communities or be integrated into formal schools in Yola. But the planning never accounted for thousands of unaccompanied children like Aisha and Blessing whose parents were killed.

Rather than close all the centres because of fund, the NGO still keeps three open where Aisha and Blessing often stroll in to learn literacy and numeracy as well as skill acquisitions like soap-making.

But teaching the children has not been an easy job. "They're difficult to control," says Magga Bamanga, education officer with the NGO who doubles as Aisha and Blessing's teacher. "We give them biscuits to make them come to class."

When Aisha and Blessing newly arrived Yola, people were magnanimous in offering foods and clothes; but the teacher say they have not seen such kindness for a while.

"I miss my papa," Aisha says, tears running down her cheeks. "He bought biscuits for me. My aunty doesn't buy anything for me."

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