0:00:00.786,0:00:05.970
Worldwide, over 1.5 billion people[br]experience armed conflict.

0:00:06.940,0:00:08.074
In response,

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people are forced to flee their country,

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leaving over 15 million refugees.

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Children,

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without a doubt,

0:00:15.721,0:00:18.811
are the most innocent[br]and vulnerable victims ...

0:00:18.811,0:00:21.502
but not just from the obvious[br]physical dangers,

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but from the often unspoken effects[br]that wars have on their families.

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The experiences of war[br]leave children at a real high risk

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for the development of emotional[br]and behavioral problems.

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Children, as we can only imagine,

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will feel worried, threatened and at risk.

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But there is good news.

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The quality of care that children[br]receive in their families

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can have a more significant[br]affect on their well-being

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than from the actual experiences of war[br]that they have been exposed to.

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So actually,

0:00:53.576,0:00:58.296
children can be protected[br]by warm, secure parenting

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during and after conflict.

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In 2011, I was a first-year PhD student

0:01:05.518,0:01:08.964
in the University of Manchester[br]School of Psychological Sciences.

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Like many of you here,

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I watched the crisis in Syria[br]unfold in front of me on the TV.

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My family is originally from Syria,

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and very early on,

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I lost several family members[br]in really horrifying ways.

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I'd sit and I'd gather with my family[br]and watch the TV.

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We've all seen those scenes:

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bombs destroying buildings,

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chaos, destruction

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and people screaming and running.

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It was always the people screaming[br]and running that really got me the most,

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especially those[br]terrified-looking children.

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I was a mother to two young,[br]typically inquisitive children.

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They were five and six then,

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at an age where they typically asked[br]lots and lots of questions,

0:01:49.966,0:01:53.493
and expected real, convincing answers.

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So, I began to wonder[br]what it might be like

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to parent my children in a war zone[br]and a refugee camp.

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Would my children change?

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Would my daughter's bright,[br]happy eyes lose their shine?

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Would my son's really relaxed and carefree[br]nature become fearful and withdrawn?

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How would I cope?

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Would I change?

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As psychologists and parent trainers,

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we know that arming parents[br]with skills in caring for their children

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can have a huge effect[br]on their well-being,

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and we call this parent training.

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The question I had was,

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could parent training programs[br]be useful for families

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while they were still in war zones[br]or refugee camps?

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Could we reach them[br]with advice or training

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that would help them[br]through these struggles?

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So, I approached my PhD supervisor,

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Professor Rachel Calam,

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with the idea of using my academic skills[br]to make some change in the real world.

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I wasn't quite sure what[br]exactly I wanted to do.

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She listened carefully and patiently,

0:03:00.100,0:03:01.823
and then to my joy she said,

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"If that's what you want to do,

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and it means so much to you,

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then let's do it.

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Let's find ways to see if parent programs

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can be useful for families[br]in these contexts."

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So, for the past five years,

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myself and my colleagues --

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Professor Calam and Dr. Kim Cartwright --

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have been working on ways[br]to support families

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that have experienced[br]war and displacement.

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Now, to know how to help families[br]that have been through conflict

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support their children,

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the first step must obviously be[br]to ask them what they're struggling with,

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right?

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I mean, it seems obvious.

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But it's often those[br]that are the most vulnerable

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that we're trying to support

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that we actually don't ask.

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How many times have we just assumed[br]we know exactly the right thing

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that's going to help someone or something[br]without actually asking them first?

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So, I travelled to refugee camps[br]in Syria and in Turkey,

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and I sat with families,

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and I listened.

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I listened to their parenting challenges,

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I listened to their parenting struggles

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and I listened to their call for help.

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And sometimes that was just paused,

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as all I could do[br]was hold hands with them,

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and just join them in silent[br]crying and prayer.

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They told me about their struggles,

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they told me about the rough,[br]harsh refugee camp conditions

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that made it hard to focus[br]on anything but practical chores

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like collecting clean water.

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They told me how they watched[br]their children withdraw;

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the sadness, depression, anger,

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bed-wetting, thumb-sucking,[br]fear of loud noises,

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fear of nightmares --

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terrifying, terrifying nightmares.

0:04:34.999,0:04:38.861
These families had been through[br]what we had been watching on the TV.

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The mothers,

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almost half of them were now[br]widows of war,

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or didn't even know if their husbands[br]were dead or alive,

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described how they felt[br]they were coping so badly.

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They watched their children change,

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and they had no idea how to help them.

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They didn't know how to answer[br]their children's questions.

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What I found incredibly astonishing,

0:04:59.524,0:05:01.081
and so motivational

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was that these families were[br]so motivated to support their children.

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Despite all these challenges they faced,

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they were trying to help their children.

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They were making attempts at seeking[br]support from NGO workers,

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from refugee camp teachers,

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professional medics,

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other parents.

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One mother I met had only been[br]in a camp for four days,

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and had already made two attempts

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at seeking support for[br]her eight-year-old daughter

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who was having terrifying nightmares.

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But sadly, these attempts[br]are almost always useless.

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Refugee camp doctors,

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when available,

0:05:36.042,0:05:37.743
are almost always too busy,

0:05:37.743,0:05:41.887
or don't have the knowledge or the time[br]for basic parenting supports.

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Refugee camp teachers and other parents[br]are just like them --

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part of new refugee community[br]who's struggling with new needs.

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So, then we began to think.

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How could we help these families?

0:05:57.471,0:06:01.594
The families were struggling with things[br]much bigger than they could cope with.

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The Syrian crisis made it clear how[br]incredibly impossible it would be

0:06:05.912,0:06:08.116
to reach families on an individual level.

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How else could we help them?

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How would we reach families[br]at a population level,

0:06:14.693,0:06:17.314
and low costs

0:06:17.314,0:06:20.163
in these terrifying, terrifying times?

0:06:21.026,0:06:23.749
After hours of speaking to NGO workers,

0:06:23.749,0:06:26.374
one suggested a fantastic innovative idea

0:06:26.374,0:06:31.086
of distributing parenting information[br]leaflets via bread wrappers --

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bread wrappers that were being delivered[br]to famlies in a conflict zone in Syria

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by humanitarian workers.

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So, that's what we did.

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The bread wrappers haven't changed[br]at all in their appearance,

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except for the addition[br]of two pieces of paper.

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One was a parenting information leaflet[br]that had basic advice and information

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that normalized to the parent[br]what they might be experiencing,

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and what their child[br]might be experiencing.

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And information on how they could[br]support themselves and their children,

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such as information like spending[br]time talking to your child,

0:07:03.505,0:07:05.716
showing them more affection,

0:07:05.716,0:07:07.769
being more patient with your child,

0:07:07.769,0:07:09.255
talking to your children.

0:07:09.508,0:07:12.231
The other piece of paper[br]was a feedback questionnaire,

0:07:12.231,0:07:14.100
and of course, there was a pen.

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Is this simply leaflet distribution,

0:07:18.028,0:07:21.785
or is this actually a possible means[br]of delivering psychological first aid

0:07:21.785,0:07:24.754
that provides warm, secure,[br]loving parenting?

0:07:24.754,0:07:28.673
We managed to distribute 3,000[br]of these in just one week.

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What was incredible was we had[br]a 60 percent response rate.

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60 percent of the 3,0000[br]families responded.

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I don't know how many[br]researchers we have here today,

0:07:40.778,0:07:43.307
but that kind of response[br]rate is fantastic.

0:07:43.307,0:07:46.490
To have that in Manchester[br]would be a huge achievement,

0:07:46.490,0:07:49.241
let alone in a conflict zone in Syria --

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really highlighting how important[br]these kinds of messages were to families.

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I remember how excited and eager we were[br]for the return of the questionnaires.

0:07:59.395,0:08:01.930
The families had left[br]hundreds of messages --

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most incredibly positive and encouraging.

0:08:04.316,0:08:06.030
But my favorite has got to be,

0:08:06.030,0:08:09.512
"Thank you for not forgetting[br]about us and our children."

0:08:10.422,0:08:12.463
This really illustrates[br]the potential means

0:08:12.463,0:08:15.468
of the delivery of psychological[br]first aid to families,

0:08:15.468,0:08:17.516
and the return of feedback, too.

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Just imagine replicating this[br]using other means

0:08:20.153,0:08:22.595
such as baby milk distribution,

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or female hygeine kits,

0:08:24.709,0:08:26.502
or even food baskets.

0:08:28.205,0:08:30.052
But let's bring this closer to home,

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because the refugee crisis

0:08:31.305,0:08:34.494
is one that is having an effect[br]on every single one of us.

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We're bombarded with images daily[br]of statistics and of photos,

0:08:39.462,0:08:41.082
and that's not surprising,

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because by last month,

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over one million refugees[br]had reached Europe.

0:08:45.436,0:08:46.808
One million.

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Refugees are joining our communities,

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they're becoming our neighbors,

0:08:52.004,0:08:54.912
their children are attending[br]our children's schools.

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So, we've adapted the leaflet to meet[br]the needs of European refugees,

0:08:59.869,0:09:02.420
and we have them online,[br]open-access,

0:09:02.420,0:09:04.747
in areas with a really high[br]refugee influx.

0:09:04.747,0:09:05.750
For example,

0:09:05.750,0:09:08.309
the Swedish healthcare[br]uploaded it onto their website,

0:09:08.309,0:09:09.980
and within the first 45 minutes,

0:09:09.980,0:09:13.668
it was downloaded 343 times --

0:09:13.668,0:09:17.341
really highlighting how important it is[br]for volunteers, practitioners

0:09:17.341,0:09:18.338
and other parents

0:09:18.338,0:09:21.801
to have open-access,[br]psychological first-aid messages.

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In 2013, I was sitting on the cold,[br]hard floor of a refugee camp tent

0:09:29.759,0:09:31.224
with mothers sitting around me

0:09:31.224,0:09:33.246
as I was conducting a focus group.

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Across from me stood an elederly lady

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with what seemed to be[br]a 13-year-old girl lying beside her,

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with her head on her elderly lady's knees.

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The girl stayed quiet[br]throughout the focus group,

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not talking at all,

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with her knees curled up[br]against her chest.

0:09:49.235,0:09:50.917
Towards the end of the focus group,

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and as I was thanking[br]the mothers for their time,

0:09:54.037,0:09:57.002
the elderly lady looked at me[br]while pointing at the young girl,

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and said to me,

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"Can you help us with...?"

0:10:00.438,0:10:02.754
Not quite sure what she expected me to do,

0:10:02.754,0:10:04.577
I looked at the young girl and smiled,

0:10:04.577,0:10:05.935
and in Arabic I said,

0:10:05.935,0:10:07.250
"Salaam Alaikum."

0:10:07.250,0:10:09.760
(Arabic) "What's your name?"

0:10:09.978,0:10:12.852
She looked at me really[br]confused and unengaged,

0:10:12.852,0:10:13.709
but then said,

0:10:13.709,0:10:14.991
"Halul."

0:10:15.198,0:10:19.577
Halul is the pet's name for[br]the Arabic female name, Hala,

0:10:19.577,0:10:22.827
and is only really used to refer[br]to really young girls.

0:10:23.693,0:10:27.573
At that point I realized that actually[br]Hala was probably much older than 13.

0:10:28.026,0:10:32.662
It turns out Hala was a 25-year-old[br]mother to three young children.

0:10:33.215,0:10:37.060
Hala had been a confident, bright,[br]bubbly, loving, caring mother

0:10:37.060,0:10:38.492
to her children,

0:10:38.492,0:10:40.457
but the war had changed all of that.

0:10:41.313,0:10:45.651
She had lived through bombs[br]being dropped in her town;

0:10:45.651,0:10:48.297
she had lived through explosions.

0:10:48.588,0:10:51.044
When fighter jets were flying[br]around their building,

0:10:51.044,0:10:52.039
dropping bombs,

0:10:52.039,0:10:53.597
her children would be screaming,

0:10:53.597,0:10:55.041
terrified from the noise.

0:10:55.041,0:10:58.389
Hala would frantically grab pillows[br]and cover her children's ears

0:10:58.389,0:10:59.824
to block out the noise,

0:10:59.824,0:11:01.864
all the while screaming herself.

0:11:02.240,0:11:03.905
When they reached the refugee camp,

0:11:03.905,0:11:07.346
and she knew they were finally[br]in some kind of safety,

0:11:07.346,0:11:10.968
she completely withdrew to acting[br]like her old childhood self.

0:11:11.282,0:11:14.844
She completely rejected her family --

0:11:14.844,0:11:16.903
her children, her husband.

0:11:17.413,0:11:19.979
Hala simply could no longer cope.

0:11:20.791,0:11:23.709
This is a parenting struggle[br]with a really tough ending,

0:11:23.709,0:11:25.664
but sadly, it's not uncommon.

0:11:25.664,0:11:28.535
Those who experience armed[br]conflict and displacement

0:11:28.535,0:11:31.426
will face serious emotional stuggles.

0:11:31.823,0:11:34.326
And that's something we can all relate to.

0:11:34.999,0:11:38.883
If you have been through[br]a devastating time in your life,

0:11:38.883,0:11:43.746
if you have lost someone or something[br]you really care about,

0:11:43.746,0:11:46.264
how would you continue to cope?

0:11:46.846,0:11:50.512
Could you still be able to care[br]for yourself and for your family?

0:11:51.608,0:11:55.028
Given that the first years[br]of a child's life are crucial

0:11:55.028,0:11:58.304
for healthy physical[br]and emotional development,

0:11:58.304,0:12:03.183
and that 1.5 billion people[br]are experiencing armed conflict --

0:12:03.183,0:12:05.954
many of whom are now[br]joining our communities --

0:12:05.954,0:12:07.893
we cannot afford to turn a blind eye

0:12:07.893,0:12:11.470
to the needs of those who[br]are experiencing war and displacement.

0:12:13.069,0:12:18.090
We must prioritize these family needs[br]to those who are internally displaced,

0:12:18.090,0:12:20.797
and those are are refugees worldwide.

0:12:21.316,0:12:26.289
These needs must be prioritized[br]by NGO workers, policy makers,

0:12:26.289,0:12:30.679
the WHO, the UNHCR[br]and every single one of us

0:12:30.679,0:12:34.343
in whatever capacity it is[br]that we function in our society.

0:12:35.900,0:12:41.084
When we begin to recognize[br]the individual faces of the conflict,

0:12:41.084,0:12:45.626
when we begin to notice those intricate[br]emotions on their faces,

0:12:45.626,0:12:48.053
we begin to see them as humans, too.

0:12:48.256,0:12:51.084
We begin to see the needs[br]of these families,

0:12:51.084,0:12:53.550
and these are the real human needs.

0:12:54.047,0:12:56.860
When these family needs are prioritized,

0:12:56.860,0:13:00.164
interventions for children[br]in humanitarian settings

0:13:00.164,0:13:05.177
will prioritize and recognize the primary[br]role of the family in supporting children.

0:13:05.944,0:13:08.714
Family mental health will be[br]shouting loud and clear

0:13:08.714,0:13:10.937
in global, international agenda.

0:13:11.298,0:13:15.007
And children will be less likely[br]to enter social service systems

0:13:15.007,0:13:16.659
in resettlement countries

0:13:16.659,0:13:19.684
because their families would[br]have had support earlier on.

0:13:20.667,0:13:23.467
And we will be more open-minded,

0:13:23.467,0:13:24.498
more welcoming,

0:13:24.498,0:13:25.503
more caring

0:13:25.503,0:13:28.821
and more trusting to those who[br]are joining our communities.

0:13:30.097,0:13:32.435
We need to stop wars.

0:13:33.018,0:13:37.620
We need to build a world where children[br]can dream of planes dropping gifts,

0:13:37.620,0:13:39.181
and not bombs.

0:13:39.607,0:13:43.496
Until we stop armed conflicts[br]raging throughout the world,

0:13:43.496,0:13:46.252
families will continue to be displaced,

0:13:46.252,0:13:47.888
leaving children vulnerable.

0:13:48.303,0:13:51.455
But by improving parenting[br]and caregiver support,

0:13:51.455,0:13:56.541
it may be possible to weaken the links[br]between war and psychological difficulties

0:13:56.541,0:13:58.347
in children and their families.

0:13:59.010,0:14:00.247
Thank you.

0:14:00.247,0:14:01.485
(Applause)