From Bombs to Bread | Aala El-Khani | TEDxManchester

Good Morning

Worldwide, over 1.5 billion people
experience armed conflict

In response, people are forced to flee
their country.

leaving over 15 million refugees.

Children without a doubt are

the most innocent and vulnerable victims.

But not just from the obvious
physical dangers,

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

The experiences of war leave children
at real high risk

for the development of emotional
and behavioural problems.

Children as we can only imagine,

will feel worried, threaten and at risk.

But there is good news,

the quality of care that children receive

in their families, can have a
more significant effects

on their well-being, than from

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

So actually, children can be protected

by warm, secure parenting,

during and after conflict.

In 2011, I was a first year PHD Student

in the University Of Manchester

School Of Physiological Sciences.

Like many of you here, I watched
the crisis in Syria

unfold in front of me on the TV.

My family are originally from Syria,
and very early on

I lost several family members
in really horrifying ways.

I sat and I gathered with my family
and watched the TV.

So we have all seen those scenes,

bombs destroying, buildings,
chaos, destruction.

and people screaming and running.

It was always the people screaming
and running

that really got me the most.

Specially those terrified
looking children.

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

They were five and six then.

At an age when they typically
ask lots and lots of questions

and expect real convincing answers.

So I began to wonder what it might be like

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

Would my children change?

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

Would my son's really relax
care-free nature

become fearful and withdrawn?

How would I cope?

Would I change?

As psychologists and parent's trainers

we know that arming parents

with skills and caring for their children

can have a huge effect on their
well-being.

We call this parents training.

So the questions I had

was could Parent Training programs
be useful for families

while they're still in war-zones or
refugee camps?

Could we reach them with
advice or training

that would help them through
these struggles?

So, I approached my PHD supervisor,

professor Rachel Calam,

with the idea of using my academic skills

to make some changes in the real world.

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

She listened carefully and patiently,

And then to my joy,
she said:

"If that is what you want to do,

and it means so much to you, then
let's do it.

Let's find ways to see if
parent programs can be useful

for families in this contexts."

So for the past five years myself
and my colleagues,

professor Calam and Dr. Kim Cartwright

have been working on ways
to support families

that have experienced war
and displacement.

Now, to know how to help
families that have been

through conflict, support their children,

The first step must obviously be

to ask them what are they
struggling with. Right?

I mean, it seems obvious,

but often those are the
most vulnerable

that we are trying to support that
we actually don't ask.

How many times have we just assumed

we know exactly the right thing that
is gonna help someone or something

without actually asking them first.

So i travelled to the refugee camps
in Syria and in Turkey.

And I sat with families and I listened.

I listened to the parenting challenges

I listened to the parenting struggles

And I listened to their call for help

And sometimes that was
just paused

as all I could was hold hand
with them and just join them

in silence crying and prayer

So they told me about their struggles

They told me about the rough,
harsh refugee camp condition

That made it hard to focus on
anything but practical chores

like collecting clean water.

He told me how they watch their
children withdrawn,

the sadness, depression, anger
bed-wetting, thumb sucking

fear of loud noises, fear of nightmares,
terrifying terrifying nightmares.

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

The mothers almost half of them were
now wisdom of the war

or didn't even know their husbands
were dead or alive,

described how they thought they
were coping so badly

They watched their children change

and they had no idea
how to help them.

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

Why I found incredibly
astonishing and so motivational

was that these families was so
motivated to support their children

Despite all these challenges they faced

they were trying to help their children

they were making attempts at seeking
support from NGO workers

from refugee camp teachers,
professional medics, other parents.

One mother I met had only been
account for 4 days

and had already made two attempts
at seeking support

for her eight -year-old daughter

who was having terrifying nightmares.

But sadly, these attempts are
almost always useless.

Refugee camp doctors when available
are almost always too busy or

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

Refugee camp teachers and other
parents are just like them

part of a new refugee community
who's struggling with units

So then we began to think
how could we help these families.

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

The Syrian crisis made it clear how
incredibly impossible it would be

to reach families on an individual level.

How else could we help them.

How would we reach families
at a population level and low-cost

in these terrifying terrifying times.

After hours of speaking to NGO workers

one suggested a fantastic innovative
idea of distributing

parenting information leaflets
by a bread wrappers.

Bread wrappers that were being
delivered to families

in a conflict zone in Syria
by humanitarian workers

So that's what we did

The bread wrappers haven't changed
at all in their apperance

except for the addition of two pieces
of paper.

One was a parenting information leaflet
that had basic advice

and information that normalizes
the parent

what they might be experiencing

and what their child
might be experiencing

and information on how they
could support themselves

and their children

such as information like spending time
talking to a child

showing them more affection
being more patient with your child

talking to your children.

The other piece of paper
was a feedback questionnaire

and of course there was a pen.

So is this simply leaflet distribution

or is it actually possible means of
delivering psychological first aid

that provides warm secure

loving parenting.

We managed to distribute 3000 of these
in just one week.

was incredible was we had
60-percent response rate

Sixty-percent of the three thousand
families responded.

I didn't know how many reasearches
we have here today

but that kind of response rate
is fantastic

to have this in Manchester
would be a huge achivement

Let alone in a conflict zone in Syria

really highlighting how important
these kind of messages work to families.

I remember how excited

and eager we were
for the return of the questionnaires

the families had left hundreds
of messages

most incredibly positive encouraging.

My favorite has got to be

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

This really illustrates a potential
means of the delivery of psychological

first aid to families and the return of
feedback too.

Just imagine replicating this using
other means

such as baby look distribution

or female hygiene kits
or even food baskets

Let's bring this closer to home

because the refugee crisis is one

having an effect on every single one of us

We're bombarded with images
daily of statistics

and photos

and that's not surprising

because by last month

over 1 million refugees
had reached europe

1 million refugees are joining
our communities

They're becoming our neighbors

their children are attending
our children schools.

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

and we have them online open access

and areas with a really high
refugee influx.

For example, the Swedish healthcare
uploaded it

onto their website

within the first 45 mintutes

it was downloaded 343 times

really highlighting how important it is
for volunteers,

practitioners and other parents
to have open

access psychological first aid messages.

In 2014, I was sitting on the cold
harsh floor of a refugee camp tent

with mother sitting around me as
I was conducting a focus group

across from East, an elderly lady

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

with her head on the other ladies knees.

The girls stayed quiet throughout
the focus group not talking at all

with her knees curled up
against her chest.

Towards the end of the focus group

and as I was thanking the mothers
for their time

the other lady looked at me while
pointing at the young girl

and said to me:" Can you help us with?"

not quite sure what she expected
me to do

I looked at the young girl and smiled,
in Arabic I said

(Arabic)

"What is your name?"

She looked at me really confused
and engaged

but then said:"Halluan"

Halluan is the best name for
the Arabic female name Halla

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

At that point, I realized that actually
Hallo was probably much

older than thirteen, it turns out Halla
was a 25-year-old mother

to three young children

Halla had been a confident bright
bubby loving caring mother

to her children.

But the war had changed all about.

She had lived through bombs drop
being dropped in her town.

She had lived through explosions,

when fighter jets were flying around
their building dropping bombs,

her children would be screaming
terrified from the noise.

Halla would frantically grab pillows

and cover her children's ears to
block out the noise.

all the while screaming herself

When they reached the refugee camp

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

she completely withdrew to acting

like her old childhood self.

She completely rejected her family,

her children, her husband.

Halla simply could no longer cope.

Now this is the parenting struggle
with a really tough ending

but sadly, it is not uncommon.

Those, who experienced armed conflict
and displacement

will face serious emotional struggles

and that's something we can
all relate to.

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

If you have lost someone or something
you really care about.

How would you continue to cope?

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

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

for healthy physical and
emotional development.

And that 1.5 billion people are
experiencing armed conflict.

Many of whom are now joining
our communities.

We can not afford to turn a blind eye

to a need of those who are
experiencing war and displacement.

We must prioritize these family needs
to those both burn internally displaced

and those who are refugees worldwide.

These needs must be prioritized

by NGO workers, policy makers,
the WHO, the UNHCR

and every single one of us
in whatever capacity,

it is that we function in society.

When we begin to recognize the
individual phases of the conflict.

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

we begin to see them as human too.

We begin to see the needs
of these families.

and these are the real human needs.

When these families needs
are prioritized

interventions for children
in humanitarian settings

will prioritize and recognize the
primary role of the family

in supporting children.

Family mental health will be
shouting loud and clear

in global international agenda

And children will be less likely
to enter social service systems

and resettlement countries

because their families would have
had support earlier on

and we will be more open-minded

more welcoming, more caring
and more trusting

to those who are joining
our communities.

We need to stop wars.

We need to build a world where
children can dream of planes

dropping gifts and not bombs.

Until we stop armed conflicts,

raging throughout the world, families
will continue to be displaced

leaving children vulnerable

but by improving parenting and
caregivers support,

It may be possible to weaken the links

between wars and
psychological difficulties

in children and their families.

Thank you.