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Worldwide, over 1.5 billion people
experience armed conflict.

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In response, people are forced
to flee their country,

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leaving over 15 million refugees.

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Children, without a doubt,

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are the most innocent
and vulnerable victims ...

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but not just from
the obvious physical dangers,

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

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The experiences of war
leave children at a real high risk

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for the development
of emotional 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 receive in their families

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can have a more significant
effect on their well-being

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

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So actually, children can be protected

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by warm, secure parenting
during and after conflict.

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In 2011, I was a first-year PhD student

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in the University of Manchester
School of Psychological Sciences.

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Like many of you here,

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I watched the crisis in Syria
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
in really horrifying ways.

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I'd sit and I'd gather with my family
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
and running that really got me the most,

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especially those
terrified-looking children.

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

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They were five and six then,

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

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and expected real, convincing answers.

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So, I began to wonder
what it might be like

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

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Would my children change?

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

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Would my son's really relaxed and carefree
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
with skills in caring for their children

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can have a huge effect
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
be useful for families

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while they were still in war zones
or refugee camps?

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Could we reach them
with advice or training

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that would help them
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
to make some change in the real world.

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

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She listened carefully and patiently,

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and then to my joy she said,

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"If that's what you want to do,
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
in these contexts."

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So for the past five years,
myself and my colleagues --

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Prof. Calam and Dr. Kim Cartwright --

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have been working
on ways to support families

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that have experienced
war and displacement.

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

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support their children,

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the first step must obviously be
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
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
we know exactly the right thing

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

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So I travelled to refugee camps
in Syria and in Turkey,

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and I sat with families, 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 was hold hands with them

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and just join them
in silent crying and prayer.

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They told me about their struggles,

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they told me about the rough,
harsh refugee camp conditions

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that made it hard to focus
on anything but practical chores

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like collecting clean water.

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They told me how they watched
their children withdraw;

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the sadness, depression, anger,

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bed-wetting, thumb-sucking,
fear of loud noises,

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fear of nightmares --

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terrifying, terrifying nightmares.

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These families had been through
what we had been watching on the TV.

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The mothers --

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almost half of them
were now widows of war,

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or didn't even know
if their husbands were dead or alive --

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described how they felt
they were coping so badly.

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They watched their children change
and they had no idea how to help them.

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

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What I found incredibly astonishing
and so motivational

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was that these families were
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 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
in a camp for four days,

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and had already made two attempts

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at seeking support
for her eight-year-old daughter

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who was having terrifying nightmares.

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But sadly, these attempts
are almost always useless.

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Refugee camp doctors, when available,

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are almost always too busy,

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or don't have the knowledge or the time
for basic parenting supports.

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Refugee camp teachers and other parents
are just like them --

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part of a new refugee community
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?

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The families were struggling with things
much bigger than they could cope with.

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The Syrian crisis made it clear

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how incredibly impossible it would be
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
at a population level

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and low costs

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in these terrifying, terrifying times?

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After hours of speaking to NGO workers,

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one suggested a fantastic innovative idea

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of distributing parenting
information leaflets via bread wrappers --

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bread wrappers that were being delivered
to families 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
at all in their appearance,

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except for the addition
of two pieces of paper.

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One was a parenting information leaflet
that had basic advice and information

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that normalized to the parent
what they might be experiencing,

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and what their child
might be experiencing.

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

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such as information like spending
time talking to your child,

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showing them more affection,

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being more patient with your child,

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talking to your children.

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The other piece of paper
was a feedback questionnaire,

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and of course, there was a pen.

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So is this simply leaflet distribution,

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or is this actually a possible means
of delivering psychological first aid

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that provides warm,
secure, loving parenting?

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We managed to distribute
3,000 of these in just one week.

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What was incredible was
we had a 60 percent response rate.

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60 percent of the 3,000
families responded.

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

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but that kind of response
rate is fantastic.

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To have that in Manchester
would be a huge achievement,

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let alone in a conflict zone in Syria --

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

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

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The families had left
hundreds of messages --

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most incredibly positive and encouraging.

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But my favorite has got to be,

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"Thank you for not forgetting
about us and our children."

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This really illustrates
the potential means

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of the delivery of psychological
first aid to families,

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and the return of feedback, too.

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Just imagine replicating this
using other means

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such as baby milk distribution,
or female hygiene kits,

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or even food baskets.

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But let's bring this closer to home,

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because the refugee crisis

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is one that is having an effect
on every single one of us.

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

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and that's not surprising,

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because by last month,

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over one million refugees
had reached Europe.

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One million.

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Refugees are joining our communities,

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they're becoming our neighbors,

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their children are attending
our children's schools.

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

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and we have them online, open-access,

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in areas with a really high
refugee influx.

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For example, the Swedish healthcare
uploaded it onto their website,

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and within the first 45 minutes,

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it was downloaded 343 times --

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really highlighting how important it is

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for volunteers, practitioners
and other parents

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to have open-access,
psychological first-aid messages.

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

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with mothers sitting around me
as I was conducting a focus group.

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Across from me stood an elderly lady

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

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with her head on the elderly lady's knees.

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The girl stayed quiet
throughout the focus group,

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not talking at all,

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with her knees
curled up against her chest.

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Towards the end of the focus group,

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and as I was thanking
the mothers for their time,

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the elderly lady looked at me
while pointing at the young girl,

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and said to me, "Can you help us with...?"

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Not quite sure what she expected me to do,

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I looked at the young girl and smiled,

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and in Arabic I said,

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"Salaam alaikum. Shu-ismak?"

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"What's your name?"

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She looked at me really
confused and unengaged,

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but then said, "Halul."

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Halul is the pet's name
for the Arabic female name, Hala,

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and is only really used
to refer to really young girls.

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At that point I realized that actually
Hala was probably much older than 13.

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It turns out Hala was a 25-year-old
mother to three young children.

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Hala had been a confident,
bright, bubbly, loving, caring mother

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to her children,

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but the war had changed all of that.

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She had lived through bombs
being dropped in her town;

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she had lived through explosions.

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When fighter jets
were flying around their building,

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dropping bombs,

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her children would be screaming,
terrified from the noise.

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Hala would frantically grab pillows
and cover her children's ears

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to block out the noise,

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all the while screaming herself.

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When they reached the refugee camp

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and she knew they were finally
in some kind of safety,

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she completely withdrew
to acting like her old childhood self.

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She completely rejected her family --

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her children, her husband.

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Hala simply could no longer cope.

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This is a parenting struggle
with a really tough ending,

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but sadly, it's not uncommon.

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Those who experience
armed conflict and displacement

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will face serious emotional struggles.

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And that's something we can all relate to.

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If you have been through
a devastating time in your life,

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if you have lost someone
or something you really care about,

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how would you continue to cope?

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Could you still be able
to care for yourself and for your family?

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Given that the first years
of a child's life are crucial

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for healthy physical
and emotional development,

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and that 1.5 billion people
are experiencing armed conflict --

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many of whom are now
joining our communities --

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we cannot afford to turn a blind eye

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to the needs of those
who are experiencing war and displacement.

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We must prioritize
these families' needs --

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both those who are internally displaced,
and those who are refugees worldwide.

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These needs must be prioritized
by NGO workers, policy makers,

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the WHO, the UNHCR
and every single one of us

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in whatever capacity it is
that we function in our society.

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When we begin to recognize
the individual faces of the conflict,

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when we begin to notice
those intricate emotions on their faces,

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we begin to see them as humans, too.

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We begin to see
the needs of these families,

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and these are the real human needs.

252
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When these family needs are prioritized,

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interventions for children
in humanitarian settings

254
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will prioritize and recognize the primary
role of the family in supporting children.

255
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Family mental health
will be shouting loud and clear

256
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in global, international agenda.

257
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And children will be less likely
to enter social service systems

258
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in resettlement countries

259
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because their families
would have had support earlier on.

260
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And we will be more open-minded,

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more welcoming, more caring

262
00:13:25,120 --> 00:13:28,600
and more trusting to those
who are joining our communities.

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00:13:29,800 --> 00:13:32,000
We need to stop wars.

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00:13:32,720 --> 00:13:37,376
We need to build a world where children
can dream of planes dropping gifts,

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and not bombs.

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Until we stop armed conflicts
raging throughout the world,

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00:13:43,400 --> 00:13:46,096
families will continue to be displaced,

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leaving children vulnerable.

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But by improving parenting
and caregiver support,

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00:13:51,160 --> 00:13:56,416
it may be possible to weaken the links
between war and psychological difficulties

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in children and their families.

272
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Thank you.

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(Applause)