1 00:00:10,371 --> 00:00:11,521 Good morning. 2 00:00:12,790 --> 00:00:17,950 Worldwide, over 1.5 billion people experience armed conflict. 3 00:00:19,030 --> 00:00:21,726 In response, people are forced to flee their country, 4 00:00:21,750 --> 00:00:24,870 leaving over 15 million refugees. 5 00:00:25,670 --> 00:00:27,006 Children, without a doubt, 6 00:00:27,030 --> 00:00:29,510 are the most innocent and vulnerable victims ... 7 00:00:30,790 --> 00:00:33,406 but not just from the obvious physical dangers, 8 00:00:33,430 --> 00:00:37,150 but from the often unspoken effects that wars have on their families. 9 00:00:38,430 --> 00:00:41,646 The experiences of war leave children at a real high risk 10 00:00:41,670 --> 00:00:44,589 for the development of emotional and behavioral problems. 11 00:00:46,110 --> 00:00:47,966 Children, as we can only imagine, 12 00:00:47,990 --> 00:00:50,070 will feel worried, threatened and at risk. 13 00:00:50,630 --> 00:00:51,830 But there is good news. 14 00:00:52,470 --> 00:00:56,206 The quality of care that children receive in their families 15 00:00:56,230 --> 00:00:59,686 can have a more significant effect on their well-being 16 00:00:59,710 --> 00:01:03,390 than from the actual experiences of war that they have been exposed to. 17 00:01:04,510 --> 00:01:07,246 So actually, children can be protected 18 00:01:07,270 --> 00:01:11,710 by warm, secure parenting during and after conflict. 19 00:01:13,990 --> 00:01:17,326 In 2011, I was a first-year PhD student 20 00:01:17,350 --> 00:01:20,550 in the University of Manchester School of Psychological Sciences. 21 00:01:21,110 --> 00:01:22,566 Like many of you here, 22 00:01:22,590 --> 00:01:25,590 I watched the crisis in Syria unfold in front of me on the TV. 23 00:01:26,630 --> 00:01:28,926 My family is originally from Syria, 24 00:01:28,950 --> 00:01:30,206 and very early on, 25 00:01:30,230 --> 00:01:32,910 I lost several family members in really horrifying ways. 26 00:01:33,830 --> 00:01:36,510 I'd sit and I'd gather with my family and watch the TV. 27 00:01:37,270 --> 00:01:38,686 We've all seen those scenes: 28 00:01:38,710 --> 00:01:40,766 bombs destroying buildings, 29 00:01:40,790 --> 00:01:42,230 chaos, destruction 30 00:01:43,110 --> 00:01:44,682 and people screaming and running. 31 00:01:45,510 --> 00:01:49,446 It was always the people screaming and running that really got me the most, 32 00:01:49,470 --> 00:01:51,710 especially those terrified-looking children. 33 00:01:53,470 --> 00:01:57,166 I was a mother to two young, typically inquisitive children. 34 00:01:57,190 --> 00:01:58,766 They were five and six then, 35 00:01:58,790 --> 00:02:01,846 at an age where they typically asked lots and lots of questions, 36 00:02:01,870 --> 00:02:03,990 and expected real, convincing answers. 37 00:02:05,190 --> 00:02:07,846 So, I began to wonder what it might be like 38 00:02:07,870 --> 00:02:11,270 to parent my children in a war zone and a refugee camp. 39 00:02:12,240 --> 00:02:13,560 Would my children change? 40 00:02:14,680 --> 00:02:17,880 Would my daughter's bright, happy eyes lose their shine? 41 00:02:18,520 --> 00:02:23,520 Would my son's really relaxed and carefree nature become fearful and withdrawn? 42 00:02:24,800 --> 00:02:26,040 How would I cope? 43 00:02:27,440 --> 00:02:28,640 Would I change? 44 00:02:30,640 --> 00:02:32,856 As psychologists and parent trainers, 45 00:02:32,880 --> 00:02:36,776 we know that arming parents with skills in caring for their children 46 00:02:36,800 --> 00:02:39,360 can have a huge effect on their well-being, 47 00:02:40,200 --> 00:02:42,080 and we call this parent training. 48 00:02:42,680 --> 00:02:44,616 The question I had was, 49 00:02:44,640 --> 00:02:48,376 could parent training programs be useful for families 50 00:02:48,400 --> 00:02:51,416 while they were still in war zones or refugee camps? 51 00:02:51,440 --> 00:02:54,016 Could we reach them with advice or training 52 00:02:54,040 --> 00:02:56,160 that would help them through these struggles? 53 00:02:57,800 --> 00:03:00,536 So I approached my PhD supervisor, 54 00:03:00,560 --> 00:03:02,056 Professor Rachel Calam, 55 00:03:02,080 --> 00:03:06,360 with the idea of using my academic skills to make some change in the real world. 56 00:03:06,720 --> 00:03:08,959 I wasn't quite sure what exactly I wanted to do. 57 00:03:09,970 --> 00:03:11,826 She listened carefully and patiently, 58 00:03:11,850 --> 00:03:13,426 and then to my joy she said, 59 00:03:13,450 --> 00:03:16,306 "If that's what you want to do, and it means so much to you, 60 00:03:16,330 --> 00:03:17,586 then let's do it. 61 00:03:17,610 --> 00:03:20,586 Let's find ways to see if parent programs 62 00:03:20,610 --> 00:03:22,970 can be useful for families in these contexts." 63 00:03:23,890 --> 00:03:26,786 So for the past five years, myself and my colleagues -- 64 00:03:26,810 --> 00:03:29,466 Prof. Calam and Dr. Kim Cartwright -- 65 00:03:29,490 --> 00:03:31,706 have been working on ways to support families 66 00:03:31,730 --> 00:03:33,930 that have experienced war and displacement. 67 00:03:35,570 --> 00:03:38,986 Now, to know how to help families that have been through conflict 68 00:03:39,010 --> 00:03:40,426 support their children, 69 00:03:40,450 --> 00:03:44,266 the first step must obviously be to ask them what they're struggling with, 70 00:03:44,290 --> 00:03:45,506 right? 71 00:03:45,530 --> 00:03:46,906 I mean, it seems obvious. 72 00:03:46,930 --> 00:03:49,306 But it's often those that are the most vulnerable, 73 00:03:49,330 --> 00:03:50,746 that we're trying to support, 74 00:03:50,770 --> 00:03:52,106 that we actually don't ask. 75 00:03:52,130 --> 00:03:55,306 How many times have we just assumed we know exactly the right thing 76 00:03:55,330 --> 00:03:58,970 that's going to help someone or something without actually asking them first? 77 00:03:59,410 --> 00:04:03,066 So I traveled to refugee camps in Syria and in Turkey, 78 00:04:03,090 --> 00:04:05,450 and I sat with families, and I listened. 79 00:04:06,250 --> 00:04:08,986 I listened to their parenting challenges, 80 00:04:09,010 --> 00:04:11,266 I listened to their parenting struggles 81 00:04:11,290 --> 00:04:13,506 and I listened to their call for help. 82 00:04:13,530 --> 00:04:15,546 And sometimes that was just paused, 83 00:04:15,570 --> 00:04:17,626 as all I could do was hold hands with them 84 00:04:17,650 --> 00:04:19,850 and just join them in silent crying and prayer. 85 00:04:20,610 --> 00:04:23,026 They told me about their struggles, 86 00:04:23,050 --> 00:04:27,176 they told me about the rough, harsh refugee camp conditions 87 00:04:27,200 --> 00:04:30,415 that made it hard to focus on anything but practical chores 88 00:04:30,439 --> 00:04:32,240 like collecting clean water. 89 00:04:32,960 --> 00:04:35,520 They told me how they watched their children withdraw; 90 00:04:36,280 --> 00:04:39,456 the sadness, depression, anger, 91 00:04:39,480 --> 00:04:42,656 bed-wetting, thumb-sucking, fear of loud noises, 92 00:04:42,680 --> 00:04:44,536 fear of nightmares -- 93 00:04:44,560 --> 00:04:46,280 terrifying, terrifying nightmares. 94 00:04:47,320 --> 00:04:51,000 These families had been through what we had been watching on the TV. 95 00:04:51,600 --> 00:04:52,816 The mothers -- 96 00:04:52,840 --> 00:04:55,016 almost half of them were now widows of war, 97 00:04:55,040 --> 00:04:57,816 or didn't even know if their husbands were dead or alive -- 98 00:04:57,840 --> 00:05:00,520 described how they felt they were coping so badly. 99 00:05:01,840 --> 00:05:05,896 They watched their children change and they had no idea how to help them. 100 00:05:05,920 --> 00:05:08,880 They didn't know how to answer their children's questions. 101 00:05:09,750 --> 00:05:13,086 What I found incredibly astonishing and so motivational 102 00:05:13,110 --> 00:05:18,006 was that these families were so motivated to support their children. 103 00:05:18,030 --> 00:05:20,446 Despite all these challenges they faced, 104 00:05:20,470 --> 00:05:22,726 they were trying to help their children. 105 00:05:22,750 --> 00:05:26,366 They were making attempts at seeking support from NGO workers, 106 00:05:26,390 --> 00:05:28,286 from refugee camp teachers, 107 00:05:28,310 --> 00:05:29,526 professional medics, 108 00:05:29,550 --> 00:05:30,750 other parents. 109 00:05:31,350 --> 00:05:34,566 One mother I met had only been in a camp for four days, 110 00:05:34,590 --> 00:05:36,206 and had already made two attempts 111 00:05:36,230 --> 00:05:38,646 at seeking support for her eight-year-old daughter 112 00:05:38,670 --> 00:05:40,710 who was having terrifying nightmares. 113 00:05:42,310 --> 00:05:45,230 But sadly, these attempts are almost always useless. 114 00:05:45,990 --> 00:05:48,046 Refugee camp doctors, when available, 115 00:05:48,070 --> 00:05:49,846 are almost always too busy, 116 00:05:49,870 --> 00:05:53,950 or don't have the knowledge or the time for basic parenting supports. 117 00:05:54,670 --> 00:05:57,790 Refugee camp teachers and other parents are just like them -- 118 00:05:58,430 --> 00:06:01,910 part of a new refugee community who's struggling with new needs. 119 00:06:02,490 --> 00:06:04,690 So then we began to think. 120 00:06:05,250 --> 00:06:07,610 How could we help these families? 121 00:06:08,730 --> 00:06:12,866 The families were struggling with things much bigger than they could cope with. 122 00:06:12,890 --> 00:06:14,586 The Syrian crisis made it clear 123 00:06:14,610 --> 00:06:19,906 how incredibly impossible it would be to reach families on an individual level. 124 00:06:19,930 --> 00:06:21,906 How else could we help them? 125 00:06:21,930 --> 00:06:25,866 How would we reach families at a population level 126 00:06:25,890 --> 00:06:27,450 and low costs 127 00:06:28,110 --> 00:06:30,830 in these terrifying, terrifying times? 128 00:06:31,870 --> 00:06:34,446 After hours of speaking to NGO workers, 129 00:06:34,470 --> 00:06:36,926 one suggested a fantastic innovative idea 130 00:06:36,950 --> 00:06:41,966 of distributing parenting information leaflets via bread wrappers -- 131 00:06:41,990 --> 00:06:46,326 bread wrappers that were being delivered to families in a conflict zone in Syria 132 00:06:46,350 --> 00:06:47,990 by humanitarian workers. 133 00:06:48,350 --> 00:06:49,966 So that's what we did. 134 00:06:49,990 --> 00:06:52,966 The bread wrappers haven't changed at all in their appearance, 135 00:06:52,990 --> 00:06:55,190 except for the addition of two pieces of paper. 136 00:06:55,790 --> 00:07:00,686 One was a parenting information leaflet that had basic advice and information 137 00:07:00,710 --> 00:07:04,126 that normalized to the parent what they might be experiencing, 138 00:07:04,150 --> 00:07:06,166 and what their child might be experiencing. 139 00:07:06,190 --> 00:07:10,006 And information on how they could support themselves and their children, 140 00:07:10,030 --> 00:07:14,246 such as information like spending time talking to your child, 141 00:07:14,270 --> 00:07:16,366 showing them more affection, 142 00:07:16,390 --> 00:07:18,446 being more patient with your child, 143 00:07:18,470 --> 00:07:20,286 talking to your children. 144 00:07:20,310 --> 00:07:22,886 The other piece of paper was a feedback questionnaire, 145 00:07:22,910 --> 00:07:24,510 and of course, there was a pen. 146 00:07:26,050 --> 00:07:29,546 So is this simply leaflet distribution, 147 00:07:29,570 --> 00:07:33,386 or is this actually a possible means of delivering psychological first aid 148 00:07:33,410 --> 00:07:36,466 that provides warm, secure, loving parenting? 149 00:07:36,490 --> 00:07:40,570 We managed to distribute 3,000 of these in just one week. 150 00:07:42,050 --> 00:07:45,706 What was incredible was we had a 60 percent response rate. 151 00:07:45,730 --> 00:07:49,946 60 percent of the 3,000 families responded. 152 00:07:49,970 --> 00:07:52,466 I don't know how many researchers we have here today, 153 00:07:52,490 --> 00:07:54,826 but that kind of response rate is fantastic. 154 00:07:54,850 --> 00:07:58,106 To have that in Manchester would be a huge achievement, 155 00:07:58,130 --> 00:08:00,826 let alone in a conflict zone in Syria -- 156 00:08:00,850 --> 00:08:04,570 really highlighting how important these kinds of messages were to families. 157 00:08:05,190 --> 00:08:09,046 I remember how excited and eager we were for the return of the questionnaires. 158 00:08:09,070 --> 00:08:11,566 The families had left hundreds of messages -- 159 00:08:11,590 --> 00:08:13,966 most incredibly positive and encouraging. 160 00:08:13,990 --> 00:08:15,726 But my favorite has got to be, 161 00:08:15,750 --> 00:08:18,750 "Thank you for not forgetting about us and our children." 162 00:08:20,190 --> 00:08:22,246 This really illustrates the potential means 163 00:08:22,270 --> 00:08:25,046 of the delivery of psychological first aid to families, 164 00:08:25,070 --> 00:08:27,166 and the return of feedback, too. 165 00:08:27,190 --> 00:08:29,686 Just imagine replicating this using other means 166 00:08:29,710 --> 00:08:34,286 such as baby milk distribution, or female hygiene kits, 167 00:08:34,310 --> 00:08:35,590 or even food baskets. 168 00:08:35,861 --> 00:08:37,576 But let's bring this closer to home, 169 00:08:37,600 --> 00:08:38,896 because the refugee crisis 170 00:08:38,920 --> 00:08:42,336 is one that is having an effect on every single one of us. 171 00:08:42,360 --> 00:08:46,975 We're bombarded with images daily of statistics and of photos, 172 00:08:46,999 --> 00:08:48,576 and that's not surprising, 173 00:08:48,600 --> 00:08:49,855 because by last month, 174 00:08:49,879 --> 00:08:52,976 over one million refugees had reached Europe. 175 00:08:53,000 --> 00:08:54,200 One million. 176 00:08:54,800 --> 00:08:57,936 Refugees are joining our communities, 177 00:08:57,960 --> 00:08:59,456 they're becoming our neighbors, 178 00:08:59,480 --> 00:09:01,960 their children are attending our children's schools. 179 00:09:03,120 --> 00:09:06,680 So we've adapted the leaflet to meet the needs of European refugees, 180 00:09:07,440 --> 00:09:09,776 and we have them online, open-access, 181 00:09:09,800 --> 00:09:12,426 in areas with a really high refugee influx. 182 00:09:12,450 --> 00:09:15,666 For example, the Swedish healthcare uploaded it onto their website, 183 00:09:15,690 --> 00:09:17,386 and within the first 45 minutes, 184 00:09:17,410 --> 00:09:19,727 it was downloaded 343 times -- 185 00:09:20,490 --> 00:09:22,386 really highlighting how important it is 186 00:09:22,410 --> 00:09:24,946 for volunteers, practitioners and other parents 187 00:09:24,970 --> 00:09:27,890 to have open-access, psychological first-aid messages. 188 00:09:30,290 --> 00:09:36,466 In 2013, I was sitting on the cold, hard floor of a refugee camp tent 189 00:09:36,490 --> 00:09:39,570 with mothers sitting around me as I was conducting a focus group. 190 00:09:40,480 --> 00:09:42,776 Across from me stood an elderly lady 191 00:09:42,800 --> 00:09:46,256 with what seemed to be a 13-year-old girl lying beside her, 192 00:09:46,280 --> 00:09:48,560 with her head on the elderly lady's knees. 193 00:09:49,120 --> 00:09:51,896 The girl stayed quiet throughout the focus group, 194 00:09:51,920 --> 00:09:53,216 not talking at all, 195 00:09:53,240 --> 00:09:55,360 with her knees curled up against her chest. 196 00:09:56,080 --> 00:09:57,776 Towards the end of the focus group, 197 00:09:57,800 --> 00:10:00,776 and as I was thanking the mothers for their time, 198 00:10:00,800 --> 00:10:03,776 the elderly lady looked at me while pointing at the young girl, 199 00:10:03,800 --> 00:10:06,200 and said to me, "Can you help us with...?" 200 00:10:07,120 --> 00:10:09,496 Not quite sure what she expected me to do, 201 00:10:09,520 --> 00:10:11,376 I looked at the young girl and smiled, 202 00:10:11,400 --> 00:10:12,776 and in Arabic I said, 203 00:10:12,800 --> 00:10:14,816 "Salaam alaikum. Shu-ismak?" 204 00:10:14,840 --> 00:10:16,040 "What's your name?" 205 00:10:16,760 --> 00:10:19,496 She looked at me really confused and unengaged, 206 00:10:19,520 --> 00:10:21,120 but then said, "Halul." 207 00:10:21,880 --> 00:10:26,416 Halul is the pet's name for the Arabic female name, Hala, 208 00:10:26,440 --> 00:10:29,320 and is only really used to refer to really young girls. 209 00:10:30,360 --> 00:10:34,000 At that point I realized that actually Hala was probably much older than 13. 210 00:10:34,840 --> 00:10:39,120 It turns out Hala was a 25-year-old mother to three young children. 211 00:10:39,960 --> 00:10:43,936 Hala had been a confident, bright, bubbly, loving, caring mother 212 00:10:43,960 --> 00:10:45,176 to her children, 213 00:10:45,200 --> 00:10:47,160 but the war had changed all of that. 214 00:10:48,040 --> 00:10:52,416 She had lived through bombs being dropped in her town; 215 00:10:52,440 --> 00:10:54,880 she had lived through explosions. 216 00:10:55,480 --> 00:10:57,936 When fighter jets were flying around their building, 217 00:10:57,960 --> 00:10:59,176 dropping bombs, 218 00:10:59,200 --> 00:11:01,936 her children would be screaming, terrified from the noise. 219 00:11:01,960 --> 00:11:05,056 Hala would frantically grab pillows and cover her children's ears 220 00:11:05,080 --> 00:11:06,456 to block out the noise, 221 00:11:06,480 --> 00:11:08,040 all the while screaming herself. 222 00:11:09,070 --> 00:11:10,766 When they reached the refugee camp 223 00:11:10,790 --> 00:11:14,006 and she knew they were finally in some kind of safety, 224 00:11:14,030 --> 00:11:17,430 she completely withdrew to acting like her old childhood self. 225 00:11:18,070 --> 00:11:20,150 She completely rejected her family -- 226 00:11:21,470 --> 00:11:23,430 her children, her husband. 227 00:11:24,190 --> 00:11:26,310 Hala simply could no longer cope. 228 00:11:27,590 --> 00:11:30,486 This is a parenting struggle with a really tough ending, 229 00:11:30,510 --> 00:11:32,326 but sadly, it's not uncommon. 230 00:11:32,350 --> 00:11:35,326 Those who experience armed conflict and displacement 231 00:11:35,350 --> 00:11:37,950 will face serious emotional struggles. 232 00:11:38,610 --> 00:11:40,650 And that's something we can all relate to. 233 00:11:41,810 --> 00:11:44,810 If you have been through a devastating time in your life, 234 00:11:45,490 --> 00:11:49,130 if you have lost someone or something you really care about, 235 00:11:50,290 --> 00:11:52,370 how would you continue to cope? 236 00:11:53,570 --> 00:11:56,690 Could you still be able to care for yourself and for your family? 237 00:11:58,370 --> 00:12:01,506 Given that the first years of a child's life are crucial 238 00:12:01,530 --> 00:12:04,786 for healthy physical and emotional development, 239 00:12:04,810 --> 00:12:09,786 and that 1.5 billion people are experiencing armed conflict -- 240 00:12:09,810 --> 00:12:12,506 many of whom are now joining our communities -- 241 00:12:12,530 --> 00:12:14,426 we cannot afford to turn a blind eye 242 00:12:14,450 --> 00:12:17,706 to the needs of those who are experiencing war and displacement. 243 00:12:17,730 --> 00:12:20,186 We must prioritize these families' needs -- 244 00:12:20,210 --> 00:12:25,050 both those who are internally displaced, and those who are refugees worldwide. 245 00:12:26,010 --> 00:12:31,026 These needs must be prioritized by NGO workers, policy makers, 246 00:12:31,050 --> 00:12:35,346 the WHO, the UNHCR and every single one of us 247 00:12:35,370 --> 00:12:38,770 in whatever capacity it is that we function in our society. 248 00:12:38,980 --> 00:12:44,156 When we begin to recognize the individual faces of the conflict, 249 00:12:44,180 --> 00:12:48,676 when we begin to notice those intricate emotions on their faces, 250 00:12:48,700 --> 00:12:50,580 we begin to see them as humans, too. 251 00:12:51,250 --> 00:12:54,065 We begin to see the needs of these families, 252 00:12:54,089 --> 00:12:55,769 and these are the real human needs. 253 00:12:57,160 --> 00:12:59,856 When these family needs are prioritized, 254 00:12:59,880 --> 00:13:03,176 interventions for children in humanitarian settings 255 00:13:03,200 --> 00:13:08,480 will prioritize and recognize the primary role of the family in supporting children. 256 00:13:09,160 --> 00:13:11,736 Family mental health will be shouting loud and clear 257 00:13:11,760 --> 00:13:13,520 in global, international agenda. 258 00:13:14,400 --> 00:13:18,096 And children will be less likely to enter social service systems 259 00:13:18,120 --> 00:13:19,696 in resettlement countries 260 00:13:19,720 --> 00:13:22,400 because their families would have had support earlier on. 261 00:13:23,840 --> 00:13:26,576 And we will be more open-minded, 262 00:13:26,600 --> 00:13:28,416 more welcoming, more caring 263 00:13:28,440 --> 00:13:31,920 and more trusting to those who are joining our communities. 264 00:13:33,120 --> 00:13:35,320 We need to stop wars. 265 00:13:36,040 --> 00:13:40,696 We need to build a world where children can dream of planes dropping gifts, 266 00:13:40,720 --> 00:13:41,960 and not bombs. 267 00:13:42,640 --> 00:13:46,696 Until we stop armed conflicts raging throughout the world, 268 00:13:46,720 --> 00:13:49,416 families will continue to be displaced, 269 00:13:49,440 --> 00:13:50,800 leaving children vulnerable. 270 00:13:51,400 --> 00:13:54,456 But by improving parenting and caregiver support, 271 00:13:54,480 --> 00:13:59,736 it may be possible to weaken the links between war and psychological difficulties 272 00:13:59,760 --> 00:14:01,680 in children and their families. 273 00:14:02,160 --> 00:14:03,376 Thank you. 274 00:14:03,400 --> 00:14:06,779 (Applause)