1 00:00:00,786 --> 00:00:05,970 Worldwide, over 1.5 billion people experience armed conflict. 2 00:00:06,940 --> 00:00:08,074 In response, 3 00:00:08,074 --> 00:00:10,004 people are forced to flee their country, 4 00:00:10,004 --> 00:00:13,005 leaving over 15 million refugees. 5 00:00:13,720 --> 00:00:14,721 Children, 6 00:00:14,721 --> 00:00:15,721 without a doubt, 7 00:00:15,721 --> 00:00:18,811 are the most innocent and vulnerable victims ... 8 00:00:18,811 --> 00:00:21,502 but not just from the obvious physical dangers, 9 00:00:21,502 --> 00:00:25,600 but from the often unspoken effects that wars have on their families. 10 00:00:26,563 --> 00:00:29,797 The experiences of war leave children at a real high risk 11 00:00:29,797 --> 00:00:32,948 for the development of emotional and behavioral problems. 12 00:00:34,104 --> 00:00:36,096 Children, as we can only imagine, 13 00:00:36,096 --> 00:00:38,821 will feel worried, threatened and at risk. 14 00:00:38,821 --> 00:00:40,545 But there is good news. 15 00:00:40,545 --> 00:00:44,396 The quality of care that children receive in their families 16 00:00:44,396 --> 00:00:47,916 can have a more significant affect on their well-being 17 00:00:47,916 --> 00:00:51,800 than from the actual experiences of war that they have been exposed to. 18 00:00:52,582 --> 00:00:53,576 So actually, 19 00:00:53,576 --> 00:00:58,296 children can be protected by warm, secure parenting 20 00:00:58,296 --> 00:01:00,255 during and after conflict. 21 00:01:02,157 --> 00:01:05,518 In 2011, I was a first-year PhD student 22 00:01:05,518 --> 00:01:08,964 in the University of Manchester School of Psychological Sciences. 23 00:01:09,303 --> 00:01:10,809 Like many of you here, 24 00:01:10,809 --> 00:01:14,061 I watched the crisis in Syria unfold in front of me on the TV. 25 00:01:14,728 --> 00:01:17,139 My family is originally from Syria, 26 00:01:17,139 --> 00:01:18,142 and very early on, 27 00:01:18,142 --> 00:01:21,236 I lost several family members in really horrifying ways. 28 00:01:21,961 --> 00:01:25,480 I'd sit and I'd gather with my family and watch the TV. 29 00:01:25,480 --> 00:01:27,106 We've all seen those scenes: 30 00:01:27,106 --> 00:01:28,848 bombs destroying buildings, 31 00:01:28,848 --> 00:01:31,246 chaos, destruction 32 00:01:31,246 --> 00:01:33,390 and people screaming and running. 33 00:01:33,640 --> 00:01:37,740 It was always the people screaming and running that really got me the most, 34 00:01:37,740 --> 00:01:40,431 especially those terrified-looking children. 35 00:01:41,617 --> 00:01:45,383 I was a mother to two young, typically inquisitive children. 36 00:01:45,383 --> 00:01:46,962 They were five and six then, 37 00:01:46,962 --> 00:01:49,966 at an age where they typically asked lots and lots of questions, 38 00:01:49,966 --> 00:01:53,493 and expected real, convincing answers. 39 00:01:53,493 --> 00:01:55,911 So, I began to wonder what it might be like 40 00:01:55,911 --> 00:01:59,472 to parent my children in a war zone and a refugee camp. 41 00:02:00,337 --> 00:02:02,330 Would my children change? 42 00:02:02,805 --> 00:02:06,821 Would my daughter's bright, happy eyes lose their shine? 43 00:02:06,821 --> 00:02:11,741 Would my son's really relaxed and carefree nature become fearful and withdrawn? 44 00:02:12,946 --> 00:02:14,725 How would I cope? 45 00:02:15,592 --> 00:02:17,435 Would I change? 46 00:02:18,821 --> 00:02:21,158 As psychologists and parent trainers, 47 00:02:21,158 --> 00:02:25,004 we know that arming parents with skills in caring for their children 48 00:02:25,004 --> 00:02:28,569 can have a huge effect on their well-being, 49 00:02:28,569 --> 00:02:30,745 and we call this parent training. 50 00:02:30,989 --> 00:02:32,906 The question I had was, 51 00:02:32,906 --> 00:02:36,652 could parent training programs be useful for families 52 00:02:36,652 --> 00:02:39,480 while they were still in war zones or refugee camps? 53 00:02:39,806 --> 00:02:42,288 Could we reach them with advice or training 54 00:02:42,288 --> 00:02:44,838 that would help them through these struggles? 55 00:02:45,976 --> 00:02:48,884 So, I approached my PhD supervisor, 56 00:02:48,884 --> 00:02:50,456 Professor Rachel Calam, 57 00:02:50,456 --> 00:02:54,444 with the idea of using my academic skills to make some change in the real world. 58 00:02:54,962 --> 00:02:57,644 I wasn't quite sure what exactly I wanted to do. 59 00:02:58,235 --> 00:03:00,100 She listened carefully and patiently, 60 00:03:00,100 --> 00:03:01,823 and then to my joy she said, 61 00:03:01,823 --> 00:03:03,322 "If that's what you want to do, 62 00:03:03,322 --> 00:03:04,682 and it means so much to you, 63 00:03:04,682 --> 00:03:05,930 then let's do it. 64 00:03:05,930 --> 00:03:08,940 Let's find ways to see if parent programs 65 00:03:08,940 --> 00:03:11,751 can be useful for families in these contexts." 66 00:03:12,234 --> 00:03:13,592 So, for the past five years, 67 00:03:13,592 --> 00:03:15,175 myself and my colleagues -- 68 00:03:15,175 --> 00:03:17,779 Professor Calam and Dr. Kim Cartwright -- 69 00:03:17,779 --> 00:03:19,920 have been working on ways to support families 70 00:03:19,920 --> 00:03:22,546 that have experienced war and displacement. 71 00:03:23,650 --> 00:03:27,252 Now, to know how to help families that have been through conflict 72 00:03:27,252 --> 00:03:28,730 support their children, 73 00:03:28,730 --> 00:03:32,408 the first step must obviously be to ask them what they're struggling with, 74 00:03:32,408 --> 00:03:33,478 right? 75 00:03:33,478 --> 00:03:35,084 I mean, it seems obvious. 76 00:03:35,084 --> 00:03:37,378 But it's often those that are the most vulnerable 77 00:03:37,378 --> 00:03:38,715 that we're trying to support 78 00:03:38,715 --> 00:03:40,014 that we actually don't ask. 79 00:03:40,014 --> 00:03:43,185 How many times have we just assumed we know exactly the right thing 80 00:03:43,185 --> 00:03:47,348 that's going to help someone or something without actually asking them first? 81 00:03:47,602 --> 00:03:51,302 So, I travelled to refugee camps in Syria and in Turkey, 82 00:03:51,302 --> 00:03:52,568 and I sat with families, 83 00:03:52,568 --> 00:03:54,102 and I listened. 84 00:03:54,551 --> 00:03:57,247 I listened to their parenting challenges, 85 00:03:57,247 --> 00:03:59,690 I listened to their parenting struggles 86 00:03:59,690 --> 00:04:01,805 and I listened to their call for help. 87 00:04:01,805 --> 00:04:03,821 And sometimes that was just paused, 88 00:04:03,821 --> 00:04:05,820 as all I could do was hold hands with them, 89 00:04:05,820 --> 00:04:08,716 and just join them in silent crying and prayer. 90 00:04:09,029 --> 00:04:11,319 They told me about their struggles, 91 00:04:11,319 --> 00:04:15,092 they told me about the rough, harsh refugee camp conditions 92 00:04:15,092 --> 00:04:18,216 that made it hard to focus on anything but practical chores 93 00:04:18,216 --> 00:04:20,330 like collecting clean water. 94 00:04:20,724 --> 00:04:24,201 They told me how they watched their children withdraw; 95 00:04:24,201 --> 00:04:27,229 the sadness, depression, anger, 96 00:04:27,229 --> 00:04:30,511 bed-wetting, thumb-sucking, fear of loud noises, 97 00:04:30,511 --> 00:04:32,490 fear of nightmares -- 98 00:04:32,490 --> 00:04:34,536 terrifying, terrifying nightmares. 99 00:04:34,999 --> 00:04:38,861 These families had been through what we had been watching on the TV. 100 00:04:39,414 --> 00:04:40,491 The mothers, 101 00:04:40,491 --> 00:04:42,937 almost half of them were now widows of war, 102 00:04:42,937 --> 00:04:45,731 or didn't even know if their husbands were dead or alive, 103 00:04:45,731 --> 00:04:49,009 described how they felt they were coping so badly. 104 00:04:49,662 --> 00:04:51,345 They watched their children change, 105 00:04:51,345 --> 00:04:53,745 and they had no idea how to help them. 106 00:04:53,745 --> 00:04:57,195 They didn't know how to answer their children's questions. 107 00:04:57,536 --> 00:04:59,524 What I found incredibly astonishing, 108 00:04:59,524 --> 00:05:01,081 and so motivational 109 00:05:01,081 --> 00:05:05,779 was that these families were so motivated to support their children. 110 00:05:06,012 --> 00:05:08,373 Despite all these challenges they faced, 111 00:05:08,373 --> 00:05:10,676 they were trying to help their children. 112 00:05:10,676 --> 00:05:14,265 They were making attempts at seeking support from NGO workers, 113 00:05:14,265 --> 00:05:16,240 from refugee camp teachers, 114 00:05:16,240 --> 00:05:17,546 professional medics, 115 00:05:17,546 --> 00:05:18,899 other parents. 116 00:05:19,285 --> 00:05:22,535 One mother I met had only been in a camp for four days, 117 00:05:22,535 --> 00:05:24,159 and had already made two attempts 118 00:05:24,159 --> 00:05:26,640 at seeking support for her eight-year-old daughter 119 00:05:26,640 --> 00:05:29,404 who was having terrifying nightmares. 120 00:05:30,161 --> 00:05:33,446 But sadly, these attempts are almost always useless. 121 00:05:33,791 --> 00:05:35,017 Refugee camp doctors, 122 00:05:35,017 --> 00:05:36,042 when available, 123 00:05:36,042 --> 00:05:37,743 are almost always too busy, 124 00:05:37,743 --> 00:05:41,887 or don't have the knowledge or the time for basic parenting supports. 125 00:05:42,639 --> 00:05:46,473 Refugee camp teachers and other parents are just like them -- 126 00:05:46,473 --> 00:05:50,248 part of new refugee community who's struggling with new needs. 127 00:05:51,092 --> 00:05:53,563 So, then we began to think. 128 00:05:54,068 --> 00:05:56,542 How could we help these families? 129 00:05:57,471 --> 00:06:01,594 The families were struggling with things much bigger than they could cope with. 130 00:06:01,594 --> 00:06:05,912 The Syrian crisis made it clear how incredibly impossible it would be 131 00:06:05,912 --> 00:06:08,116 to reach families on an individual level. 132 00:06:08,596 --> 00:06:10,396 How else could we help them? 133 00:06:10,563 --> 00:06:14,693 How would we reach families at a population level, 134 00:06:14,693 --> 00:06:17,314 and low costs 135 00:06:17,314 --> 00:06:20,163 in these terrifying, terrifying times? 136 00:06:21,026 --> 00:06:23,749 After hours of speaking to NGO workers, 137 00:06:23,749 --> 00:06:26,374 one suggested a fantastic innovative idea 138 00:06:26,374 --> 00:06:31,086 of distributing parenting information leaflets via bread wrappers -- 139 00:06:31,086 --> 00:06:35,527 bread wrappers that were being delivered to famlies in a conflict zone in Syria 140 00:06:35,527 --> 00:06:37,319 by humanitarian workers. 141 00:06:37,666 --> 00:06:39,214 So, that's what we did. 142 00:06:39,214 --> 00:06:42,300 The bread wrappers haven't changed at all in their appearance, 143 00:06:42,300 --> 00:06:44,636 except for the addition of two pieces of paper. 144 00:06:45,074 --> 00:06:50,114 One was a parenting information leaflet that had basic advice and information 145 00:06:50,114 --> 00:06:53,546 that normalized to the parent what they might be experiencing, 146 00:06:53,546 --> 00:06:55,552 and what their child might be experiencing. 147 00:06:55,552 --> 00:06:59,288 And information on how they could support themselves and their children, 148 00:06:59,288 --> 00:07:03,505 such as information like spending time talking to your child, 149 00:07:03,505 --> 00:07:05,716 showing them more affection, 150 00:07:05,716 --> 00:07:07,769 being more patient with your child, 151 00:07:07,769 --> 00:07:09,255 talking to your children. 152 00:07:09,508 --> 00:07:12,231 The other piece of paper was a feedback questionnaire, 153 00:07:12,231 --> 00:07:14,100 and of course, there was a pen. 154 00:07:14,480 --> 00:07:18,028 Is this simply leaflet distribution, 155 00:07:18,028 --> 00:07:21,785 or is this actually a possible means of delivering psychological first aid 156 00:07:21,785 --> 00:07:24,754 that provides warm, secure, loving parenting? 157 00:07:24,754 --> 00:07:28,673 We managed to distribute 3,000 of these in just one week. 158 00:07:30,453 --> 00:07:33,774 What was incredible was we had a 60 percent response rate. 159 00:07:34,023 --> 00:07:37,840 60 percent of the 3,0000 families responded. 160 00:07:38,234 --> 00:07:40,778 I don't know how many researchers we have here today, 161 00:07:40,778 --> 00:07:43,307 but that kind of response rate is fantastic. 162 00:07:43,307 --> 00:07:46,490 To have that in Manchester would be a huge achievement, 163 00:07:46,490 --> 00:07:49,241 let alone in a conflict zone in Syria -- 164 00:07:49,241 --> 00:07:53,284 really highlighting how important these kinds of messages were to families. 165 00:07:55,538 --> 00:07:59,395 I remember how excited and eager we were for the return of the questionnaires. 166 00:07:59,395 --> 00:08:01,930 The families had left hundreds of messages -- 167 00:08:01,930 --> 00:08:04,316 most incredibly positive and encouraging. 168 00:08:04,316 --> 00:08:06,030 But my favorite has got to be, 169 00:08:06,030 --> 00:08:09,512 "Thank you for not forgetting about us and our children." 170 00:08:10,422 --> 00:08:12,463 This really illustrates the potential means 171 00:08:12,463 --> 00:08:15,468 of the delivery of psychological first aid to families, 172 00:08:15,468 --> 00:08:17,516 and the return of feedback, too. 173 00:08:17,516 --> 00:08:20,153 Just imagine replicating this using other means 174 00:08:20,153 --> 00:08:22,595 such as baby milk distribution, 175 00:08:22,595 --> 00:08:24,709 or female hygeine kits, 176 00:08:24,709 --> 00:08:26,502 or even food baskets. 177 00:08:28,205 --> 00:08:30,052 But let's bring this closer to home, 178 00:08:30,052 --> 00:08:31,305 because the refugee crisis 179 00:08:31,305 --> 00:08:34,494 is one that is having an effect on every single one of us. 180 00:08:34,757 --> 00:08:39,462 We're bombarded with images daily of statistics and of photos, 181 00:08:39,462 --> 00:08:41,082 and that's not surprising, 182 00:08:41,082 --> 00:08:42,419 because by last month, 183 00:08:42,419 --> 00:08:45,436 over one million refugees had reached Europe. 184 00:08:45,436 --> 00:08:46,808 One million. 185 00:08:47,172 --> 00:08:50,338 Refugees are joining our communities, 186 00:08:50,338 --> 00:08:52,004 they're becoming our neighbors, 187 00:08:52,004 --> 00:08:54,912 their children are attending our children's schools. 188 00:08:55,371 --> 00:08:59,869 So, we've adapted the leaflet to meet the needs of European refugees, 189 00:08:59,869 --> 00:09:02,420 and we have them online, open-access, 190 00:09:02,420 --> 00:09:04,747 in areas with a really high refugee influx. 191 00:09:04,747 --> 00:09:05,750 For example, 192 00:09:05,750 --> 00:09:08,309 the Swedish healthcare uploaded it onto their website, 193 00:09:08,309 --> 00:09:09,980 and within the first 45 minutes, 194 00:09:09,980 --> 00:09:13,668 it was downloaded 343 times -- 195 00:09:13,668 --> 00:09:17,341 really highlighting how important it is for volunteers, practitioners 196 00:09:17,341 --> 00:09:18,338 and other parents 197 00:09:18,338 --> 00:09:21,801 to have open-access, psychological first-aid messages. 198 00:09:23,575 --> 00:09:29,759 In 2013, I was sitting on the cold, hard floor of a refugee camp tent 199 00:09:29,759 --> 00:09:31,224 with mothers sitting around me 200 00:09:31,224 --> 00:09:33,246 as I was conducting a focus group. 201 00:09:33,643 --> 00:09:36,071 Across from me stood an elederly lady 202 00:09:36,071 --> 00:09:39,603 with what seemed to be a 13-year-old girl lying beside her, 203 00:09:39,603 --> 00:09:42,171 with her head on her elderly lady's knees. 204 00:09:42,353 --> 00:09:45,203 The girl stayed quiet throughout the focus group, 205 00:09:45,203 --> 00:09:46,547 not talking at all, 206 00:09:46,547 --> 00:09:48,936 with her knees curled up against her chest. 207 00:09:49,235 --> 00:09:50,917 Towards the end of the focus group, 208 00:09:50,917 --> 00:09:54,037 and as I was thanking the mothers for their time, 209 00:09:54,037 --> 00:09:57,002 the elderly lady looked at me while pointing at the young girl, 210 00:09:57,002 --> 00:09:58,032 and said to me, 211 00:09:58,032 --> 00:10:00,146 "Can you help us with...?" 212 00:10:00,438 --> 00:10:02,754 Not quite sure what she expected me to do, 213 00:10:02,754 --> 00:10:04,577 I looked at the young girl and smiled, 214 00:10:04,577 --> 00:10:05,935 and in Arabic I said, 215 00:10:05,935 --> 00:10:07,250 "Salaam Alaikum." 216 00:10:07,250 --> 00:10:09,760 (Arabic) "What's your name?" 217 00:10:09,978 --> 00:10:12,852 She looked at me really confused and unengaged, 218 00:10:12,852 --> 00:10:13,709 but then said, 219 00:10:13,709 --> 00:10:14,991 "Halul." 220 00:10:15,198 --> 00:10:19,577 Halul is the pet's name for the Arabic female name, Hala, 221 00:10:19,577 --> 00:10:22,827 and is only really used to refer to really young girls. 222 00:10:23,693 --> 00:10:27,573 At that point I realized that actually Hala was probably much older than 13. 223 00:10:28,026 --> 00:10:32,662 It turns out Hala was a 25-year-old mother to three young children. 224 00:10:33,215 --> 00:10:37,060 Hala had been a confident, bright, bubbly, loving, caring mother 225 00:10:37,060 --> 00:10:38,492 to her children, 226 00:10:38,492 --> 00:10:40,457 but the war had changed all of that. 227 00:10:41,313 --> 00:10:45,651 She had lived through bombs being dropped in her town; 228 00:10:45,651 --> 00:10:48,297 she had lived through explosions. 229 00:10:48,588 --> 00:10:51,044 When fighter jets were flying around their building, 230 00:10:51,044 --> 00:10:52,039 dropping bombs, 231 00:10:52,039 --> 00:10:53,597 her children would be screaming, 232 00:10:53,597 --> 00:10:55,041 terrified from the noise. 233 00:10:55,041 --> 00:10:58,389 Hala would frantically grab pillows and cover her children's ears 234 00:10:58,389 --> 00:10:59,824 to block out the noise, 235 00:10:59,824 --> 00:11:01,864 all the while screaming herself. 236 00:11:02,240 --> 00:11:03,905 When they reached the refugee camp, 237 00:11:03,905 --> 00:11:07,346 and she knew they were finally in some kind of safety, 238 00:11:07,346 --> 00:11:10,968 she completely withdrew to acting like her old childhood self. 239 00:11:11,282 --> 00:11:14,844 She completely rejected her family -- 240 00:11:14,844 --> 00:11:16,903 her children, her husband. 241 00:11:17,413 --> 00:11:19,979 Hala simply could no longer cope. 242 00:11:20,791 --> 00:11:23,709 This is a parenting struggle with a really tough ending, 243 00:11:23,709 --> 00:11:25,664 but sadly, it's not uncommon. 244 00:11:25,664 --> 00:11:28,535 Those who experience armed conflict and displacement 245 00:11:28,535 --> 00:11:31,426 will face serious emotional stuggles. 246 00:11:31,823 --> 00:11:34,326 And that's something we can all relate to. 247 00:11:34,999 --> 00:11:38,883 If you have been through a devastating time in your life, 248 00:11:38,883 --> 00:11:43,746 if you have lost someone or something you really care about, 249 00:11:43,746 --> 00:11:46,264 how would you continue to cope? 250 00:11:46,846 --> 00:11:50,512 Could you still be able to care for yourself and for your family? 251 00:11:51,608 --> 00:11:55,028 Given that the first years of a child's life are crucial 252 00:11:55,028 --> 00:11:58,304 for healthy physical and emotional development, 253 00:11:58,304 --> 00:12:03,183 and that 1.5 billion people are experiencing armed conflict -- 254 00:12:03,183 --> 00:12:05,954 many of whom are now joining our communities -- 255 00:12:05,954 --> 00:12:07,893 we cannot afford to turn a blind eye 256 00:12:07,893 --> 00:12:11,470 to the needs of those who are experiencing war and displacement. 257 00:12:13,069 --> 00:12:18,090 We must prioritize these family needs to those who are internally displaced, 258 00:12:18,090 --> 00:12:20,797 and those are are refugees worldwide. 259 00:12:21,316 --> 00:12:26,289 These needs must be prioritized by NGO workers, policy makers, 260 00:12:26,289 --> 00:12:30,679 the WHO, the UNHCR and every single one of us 261 00:12:30,679 --> 00:12:34,343 in whatever capacity it is that we function in our society. 262 00:12:35,900 --> 00:12:41,084 When we begin to recognize the individual faces of the conflict, 263 00:12:41,084 --> 00:12:45,626 when we begin to notice those intricate emotions on their faces, 264 00:12:45,626 --> 00:12:48,053 we begin to see them as humans, too. 265 00:12:48,256 --> 00:12:51,084 We begin to see the needs of these families, 266 00:12:51,084 --> 00:12:53,550 and these are the real human needs. 267 00:12:54,047 --> 00:12:56,860 When these family needs are prioritized, 268 00:12:56,860 --> 00:13:00,164 interventions for children in humanitarian settings 269 00:13:00,164 --> 00:13:05,177 will prioritize and recognize the primary role of the family in supporting children. 270 00:13:05,944 --> 00:13:08,714 Family mental health will be shouting loud and clear 271 00:13:08,714 --> 00:13:10,937 in global, international agenda. 272 00:13:11,298 --> 00:13:15,007 And children will be less likely to enter social service systems 273 00:13:15,007 --> 00:13:16,659 in resettlement countries 274 00:13:16,659 --> 00:13:19,684 because their families would have had support earlier on. 275 00:13:20,667 --> 00:13:23,467 And we will be more open-minded, 276 00:13:23,467 --> 00:13:24,498 more welcoming, 277 00:13:24,498 --> 00:13:25,503 more caring 278 00:13:25,503 --> 00:13:28,821 and more trusting to those who are joining our communities. 279 00:13:30,097 --> 00:13:32,435 We need to stop wars. 280 00:13:33,018 --> 00:13:37,620 We need to build a world where children can dream of planes dropping gifts, 281 00:13:37,620 --> 00:13:39,181 and not bombs. 282 00:13:39,607 --> 00:13:43,496 Until we stop armed conflicts raging throughout the world, 283 00:13:43,496 --> 00:13:46,252 families will continue to be displaced, 284 00:13:46,252 --> 00:13:47,888 leaving children vulnerable. 285 00:13:48,303 --> 00:13:51,455 But by improving parenting and caregiver support, 286 00:13:51,455 --> 00:13:56,541 it may be possible to weaken the links between war and psychological difficulties 287 00:13:56,541 --> 00:13:58,347 in children and their families. 288 00:13:59,010 --> 00:14:00,247 Thank you. 289 00:14:00,247 --> 00:14:01,485 (Applause)