Social healing in war-affected and displaced children

Social healing in war-affected and displaced children

Full-text article

Author: Dr Jo Boyden
Senior Research Officer
Refugee Studies Centre, University of Oxford

"The protection of children confronting adversity has become one of the central priorities of childhood interventions internationally, especially since 1979, the International Year of the Child. Advocacy for child war victims, working children and those variously exploited or handicapped has successfully attracted the attention and commitment of legislators, policy-makers, rights activists and practitioners throughout the world. And with the near universal ratification of the UN Convention on the Rights of the Child, there now exists a global framework for the protection and care of children living in extreme situations.

Undoubtedly this emphasis is appropriate: most of us would surely accept that children exposed to misfortune merit the best support the world has to offer. However, the protection of children is an uncertain art, with outcomes that are not always positive and cannot always be predicted. Sometimes shortcomings in implementation are due to poor management or lack of expertise, but very often the problem is erroneous conceptualisations of children and childhood due to an absence of valid empirical and theoretical information. Given the lack of systematic research and theory in many key childhood issues, policy affecting children in adversity has, by default, become heavily dependent on studies and normative ideas relating to children in North America and Europe. The global power of western models and understandings is evident, but their applicability and utility across cultures and social contexts is highly questionable. Furthermore, policy often adheres quite uncritically to western theoretical paradigms that have been extensively challenged in academic circles. In this paper, I argue that effective policy requires sound theories and sound field research if it is to benefit children. I focus on children affected by armed conflict and other forms of political violence, and begin by considering some of the ideas and assumptions underlying conventional perspectives and then assess the implications of recent research for a revised view of both children and child-centred emergency interventions.

Conceptualising childhood
Policies relating to children affected by armed conflict and other forms of political violence are commonly influenced - whether directly or indirectly - by two separate strands of research, with important implications for the kinds of interventions devised.

The first strand consists of an extensive body of work in several disciplines concerning the nature of children, childhood and child development. In essence, scientific thinking in the 20th century has tended to emphasise that childhood is a natural, distinct phase in the human life cycle, extending from birth through to, and increasingly beyond, adolescence. Since the advent of the UN Convention on the Rights of the Child, the upper age limit for this life phase is commonly accepted as 18 years. The broad understanding is that childhood has its own dynamics, interests and rights, this normally being attributed to the fact that, as immature persons in the process of development, children have different abilities from adults, as well as special emotional, physical, psychological and social needs. Such thinking is explicit in the existence of an international convention dedicated exclusively to children. It is apparent also in statements such as that made in a recent draft training document, that "Children and adolescents are not short adults B they are qualitatively different" (International Save the Children Alliance/UNHCR, 1999, p. 3) and by the 'first call for children' policy employed by UNICEF and other agencies in emergency settings (Last, 1994). Because they are in a condition of development and weakness and lack adult insight, children are framed also as dependent, requiring continuous nurturing and protection.

Out of this paradigm of vulnerability and dependence emerges the conviction that a 'proper' childhood involves being reared by parents within a family and secluded from the dangers of the adult world (Jenks, 1996; Boyden, 1997). In order to secure these conditions, children are to be kept as much as possible within the home and school, distant from the workplace and from hardship and misfortune. Thus, children are not merely perceived to be different, but also in modern, western childhood, as living in a mythologised and privileged state. In contrast to adults, children are variously cast as pre-logical, pure and 'natural' beings, innocent of the ways of the world and incompetent in it (Freeman, 1983, p. 7; Hockey and James, 1993). Hence, childhood has become a joyous time free of social and economic responsibility, and marked by learning and play; upon these conditions children's happiness and fulfilment are seen to depend.

These sentimentalised notions of childhood originated in the Romantic and Reform movements in Europe (Cunningham, 1991 & 1993) and received their most concrete expression in the region in the aftermath of the industrial revolution, when they began to radically transform the social integration and treatment of children. Such perspectives have been endorsed and institutionalised in the 20th century by research and practice in the west in eugenics, pedagogy, child psychology and child guidance (Weindling 1994; Woodhead, 1998; Nsamenang and Dawes, 1998). Among these disciplines conceptualisations of child development have generally been informed by an understanding of children as needy and dependent and requiring adult nurture and socialisation through to the late teen years. The broadly accepted scientific wisdom has been that age is the most crucial indicator of child development, this being the core thesis of a body of developmental psychologists, influenced by the work of Jean Piaget, whose ideas have come to dominate international policy in the last few decades. Other theorists who have viewed things rather differently have generally had little impact on childhood policies globally.

Although Piaget's theory of child development was highly complex and his structural model was only one facet of this theory, his interpreters and followers have tended to emphasise one aspect in particular, that child development is governed by universal psychological and biological structures and marked by fixed stages. In fact, this kind of stage theory has its origins in the medical works, didactic literature and moral treatises of medieval Europe (Shahar, 1992). Each stage of development is said to be marked by certain defining features and developmental expectations and builds on the accomplishments of the previous stage, development during childhood also being seen to define psychological states and adaptiveness in adulthood. Adherents of stage theory (especially Piaget) certainly acknowledge the formative role children play in their own development. However, the thrust of the academic work on childhood and child development this century has been the identification of universal biological and psychological factors in child development. Even anthropological and sociological accounts, which tend to give much greater weight to cultural and social influences in child development than to universal structures, have tended to focus on children primarily as the receivers of adult protection, socialisation and training, rather than social agents in their own right (Baker, 1998).

Another feature of child development research has been its emphasis on early childhood, identified as a critical period of accelerated growth and change and as central to successful adaptation in later life. As a consequence, systematic information on children in the middle and later years of childhood is quite sparse, the emphasis on the first years of life further reinforcing scientific notions of children's vulnerability, immaturity and dependence. At the same time, developmental psychology has often stressed a safe, stable family environment - one in which children are protected from upset and receive love, stimulation and continuous nurture - as an essential prerequisite for children's well-being and normal development. This profoundly affects interpretations of children=s experiences of and responses to political violence.

The second strand of research underlying emergency policy deals with the nature of human responses to highly stressful events. This discourse has been largely informed by research and therapeutic work conducted in Europe during and in the aftermath of the Second World War and more recently by investigations undertaken in the United States with veterans of the Vietnam War. Research into human suffering normally observes the common sense view of the world, long promoted by the social sciences, as a safe, predictable and nurturing place. Anthropology, in particular, has advanced numerous theories about the homogeneity and continuity of culture and symmetry, reciprocity and exchange in social relations. Society is portrayed as an integrated, self-equilibriating system in which political violence and other such phenomena of mass destruction are an exception, outside the range of normal human experience (Allen, 1989; Boyden 1994; Davis 1992; Le Vine, 1999). As a consequence of this view of political violence as a massive and overwhelming catastrophe, researchers, practitioners and policy-makers, unsure about social causes of, and unable to imagine social solutions to, conflict, commonly resort to models that emphasise individual functioning.

Throughout most of the 20th century, emergency interventions with children affected by political violence have reflected the pre-eminence given to the bio-medical model in studies and measures dealing with human suffering. In this model the origin of illness and disease is held to be in the physically bounded body, which, in turn, is understood to function as the receptacle of the mind. Thus, physical and mental health are separated and illness is thought to reside either in the body or the mind, with physical health B especially nutrition, water, sanitation, immunisation and other basic survival needs B receiving overall priority. Psychological and emotional well-being has generally been understood to play a secondary and derivative role, psychological measures being of peripheral concern given pressing survival needs (Myers, 1992). Social and economic matters have received still less attention, these being regarded as the stuff of longer-term development interventions mounted during times of peace. Within the biomedical model, academic and policy attention has centred increasingly on the psychiatric category, Post Traumatic Stress Disorder (PTSD), which despite its profoundly cultural origin, many claim to be the condition that most effectively embodies the global human response to overwhelming traumatic events (Kinzie, et al, 1986; Magwaza, et al., 1993; Nader and Pynoos, 1993).

Recent conflicts (especially in Rwanda, Bosnia and Kosovo), however, have produced a rather different programmatic and research response, in which the study of psycho-social impacts on children have become a source of immense interest and psycho-social interventions abound (Bracken and Petty, 1998). In these measures, the effects on children of violence, separation and loss have been explained largely through medical models using a mix of stage, cognitive, psycho-dynamic and attachment theories, and therapy, based either on talking through the experience of stressful events, or medication (Le Vine 1999; Bracken, 1998). The individual as victim and patient has in the main been the focal point for intervention, with just a few agencies working at the community level in an effort to restore social structures and a sense of normalcy.

Prevailing ideas characterising children, childhood and child development and prevailing theories of human suffering have made a significant mark on research and interventions in areas affected by political violence, with many consequences B some subtle and indirect, others far more obvious B for the nature of institutional responses to children in areas of political violence. Here, I highlight some of the most significant consequences.

First, since continuity, stability, predictability and security are said to be essential for children=s well-being and healthy development, children who experience catastrophic circumstances like mass violence are considered to be at inordinate risk of developmental delay, emotional or psychological impairment, or failed adaptiveness in adulthood. Hence, the programmatic focus on their treatment, rehabilitation and social reintegration.

Second, the view of children as dependent and of limited competencies encourages an understanding of those children exposed to political violence as helpless and traumatised, dependent on adults for their salvation and protection. Children are thus treated as passive victims, as opposed to competent survivors, of conflict, with the effect that they are excluded from plans and decisions concerning them(Bracken and Petty, 1998).

Third, orthodox perspectives on the universality of child development and of the human psyche more generally have served to legitimate the notion B promoted especially in the psychiatric literature B that children=s responses to catastrophic events observe uniform patterns. These patterns are thought to be determined by underlying biological and psychological imperatives, social and cultural factors being relegated to a secondary role (Kleinman 1987, cited in Parker, 1996, p. 266). Such universalistic explanations of childhood and child suffering coexist with, and are to some extent supported by, a medicalised view of children=s responses to adversity which stresses individual pathology over and above structural forces. Hence, the universalising theories and practices of modern medicine are privileged in emergency interventions over social and economic measures and indigenous healing approaches that are regarded as having little credibility and efficacy.

Fourth, an assumption is made that children=s needs are best served within the context of the family, which is thought to automatically offer greater stability, support and protection for children than they can themselves provide through their own energy and initiative. Such views prevail despite a lack of qualitative information on child care or family circumstances and an unfamiliarity with children=s own coping strategies during periods of political violence.

The diversity of childhood
The proposition that children=s development and well-being is determined wholly or even largely by universal conditions and structures needs serious interrogation. Undoubtedly some aspects of childhood are universal, in that unless they experience a major disabling condition, all children gain in strength and stature as they grow to puberty. Certain physical needs (food, fluids, rest and sleep) in particular are indispensable. And certain cognitive processes are sequenced according to underlying neurological development. There are, in addition, commonalities in the acquisition of language and in the way biology and culture interact in the development of children. Beyond this, the physiological experience of suffering undoubtedly has universal characteristics, for, as Melissa Parker (1995, p. 20) notes, human beings have a limited repertoire of responses to catastrophic experiences and a number of responses recur across cultures. Moreover, it should in theory at least be possible to define the broad boundaries Abeyond which childhood environments Y are likely to have pathological consequences, by any standards, in terms of stunted growth, emotional disturbance, social isolation, and learning disability@ (Woodhead, 1998, p. 8).

Nevertheless, assertions of universality definitely have their limits. Scientific studies that claim to have discovered a general condition of childhood belie the ethnographic evidence that childhood is an extremely diverse life phase and ignore also the fact that the globalised image of childhood they project is in many respects merely a normative view. In practice, childhood is not a fixed state defined by an upper age limit of 18 and bound by predetermined developmental stages, but a diverse, shifting category that follows certain biological sequences, and responds to cultural and social context, as much as to genetic heritage, personal agency and economic and political circumstance. Social constructions of childhood are extremely variable and context-specific. For example, in Bangladesh an individual who goes to school and has no economic or social responsibilities may be termed a >child= (shishu) up to the age of puberty, whereas a boy or girl who works will no longer be referred to as shishu even at age 6 (Blanchet, 1996 ). Such distinctions radically affect the way children experience childhood. For instance, in many contexts gender differentiation brings childhood to an end for girls far sooner than for boys. In some settings childhood is a contested category. Thus, during the various apartheid regimes in South Africa, young political activists were defined by the authorities as >youth= to establish their legal culpability, while the activists referred to themselves as >children= in order to avoid adult penalties (Jean Comaroff, personal communication).

One of the most interesting aspects of recent research with children is that the search for common patterns of growth, development and socialisation has led to increasing appreciation of differences. It is now widely accepted in the scientific community that cognitive capacity and growth is not unitary, and that children have multiple and varied intelligences that are not merely a function of their age and stage of development (Gardner, 1983). Biology and culture, working together, generate both differences and commonalities of human development. There are genetic influences for diversity just as there are genetic bases for human similarity, both of which are necessary and both of which mesh with culture to ensure the survival of the species (Wilson, 1998). At the present time, genetic research emphasises that individual children achieve the ability to perform various tasks at very different rates according to their genetic make up, and that shared features of the gene pool account for developmental variation as well as similarity.

The significance of genetic heritage is confirmed by studies that reveal temperament and cognitive capacity to be major factors mediating resilience and vulnerability in children confronting high levels of stress. For example, there is some evidence that children who try actively to overcome adversity - by attempting to resolve the problems they face, regulate their emotions, protect their self-esteem and manage their social interactions - are likely to be more resilient than children who accept their fate passively, especially in the long run (Cairns, 1996; Beristain, Valdoseda and Paez, 1996; Garbarino, 1999). The ability to think critically facilitates the identification of valid alternatives and solutions to difficulties, thereby enhancing coping. It also helps shield children from simplistic interpretations of experience that can be self-defeating and socially destructive in the long term (Garbarino et al, 1991).

Certainly it is important to recognise the practical implications of variation in the patterns of children's native abilities. However, it is the social aspect of child development that most merits the attention of policy makers, for genetic attributes interact with and are moulded by environmental challenges and opportunities, such that the environment for development is fundamental to the actual competencies children develop. Researchers have been examining the ways in which society functions as an indispensable element in the growth of the human mind from the very first days of life onward. The modern progenitor of this perspective on child development was Lev Vygotsky, a contemporary and sometime interlocutor of Piaget, who called attention to the essential role of culture as part and parcel of children=s cognitive development.

In fact, Piaget, probing children's inborn capacities and development patterns, recognised all along that caretaker relationships and other environmental factors are of great importance to children's physical and mental growth. What is new in recent decades is the much greater stress being placed on relational factors in child development. According to this view, human beings are co-operative problem solvers and development consists of learning how to deal effectively with the problems of everyday life within a cultural and social context (Rogoff, 1990, p. 11). Moreover, each community tends to define child development in terms of the basic skills required to survive and succeed in that society.

Understanding the goals and skills valued in children's communities is essential for defining developmental endpoints as well as for examining children's cognitive skills ... Rather than having to explain the fact that development occurs, it is necessary to determine the circumstances in which development takes one course

rather than another (Rogoff, 1990, p. 12). Even the most primary aspects of a child's development are social. As Vygotsky pointed out, the very acquisition of language is an intensely social act that consists of structuring the self through a set of social codes. There is no essential separation between the individual and the social, for one cannot become an individual without becoming social. Consequently, the social construction of human experience is one powerful source of differentiation between children globally in terms of behaviour, thinking, adaptation and, indeed, responses to political violence (Dawes and Donald, 1994; Serpell, 1996; Woodhead, 1998; Super and Harkness, 1986).

Social prescriptions of vulnerability and resilience
Because childhood is to a large extent socially constructed, it follows that children in different social and economic categories are likely to experience very different kinds of childhood, this leading to major discrepancies in their safety and resilience during times of social upheaval and conflict. Many, if not most, children in war zones are in jeopardy not merely through chance but because of who they are, depending to a considerable degree on how they are valued and treated by their families and communities. In fact, political violence often accentuates differences between children in the extent and nature of risk, placing new or increased demands, as well as removing pre-existent protective mechanisms, on certain categories. Recognising power and status differences within childhood is essential therefore for understanding why it is that some children are in peril when others are not and also why children in different categories may learn different coping techniques and susceptibilities.

Family survival strategies in war zones often single out children in particular categories as expendable, whether through abandonment, sale, or militarisation. Such children are commonly expelled from the domestic unit to reduce the economic burden on the family, generate income, or create political alliances that are critical for economic or physical security. For example, in Burma's Shan State, an area exposed to decades of warfare, the eldest member of either sex in the sibling group is at greatest risk of harm, although gendered risks have very different causes. Many families would aim to place an elder son in the military as a safeguard for other family members against extortion, rape, intimidation or theft (Boyden, nd). Hence, eldest sons were often militarised and exposed to intense violence. Younger sons would be sent to the monastery, where they were housed, fed, clothed and protected from conscription. Teenage daughters would be either kept at home, where they replaced the labour of absent males and were liable also to fulfil the household's forced labour obligations - work that was both arduous and dangerous - or sold to traffickers who traded them into prostitution in Thailand.

Ed Cairns (1996) has assessed the research for links between power and status differences within childhood and children's responses to political violence. His observation is that research in this area is neither very strong nor particularly conclusive, seldom disaggregating effectively between children on the basis of age, ethnicity, class or religion, although specifying gender distinctions more frequently. The psychiatric literature tends to be especially neglectful of social power within childhood. While the psychoanalytic research does address this issue at some length (Parker, 1996), it has failed to provide consistent data addressing the links with variations in children's resilience and vulnerability. That said, studies of the impacts of political violence that do treat gender as a significant variable generally find that at least up to the age of puberty, boys are more likely than girls to be at risk when exposed to a range of stressors (Cairns, 1996). Dawes et al (1989), though, reveal a more subtle pattern, in which gendered responses to suffering change with age, boys in the youngest age group in this study having more symptomatic behaviour than girls, with the levels appearing very similar during middle childhood and girls presenting more symptoms by adolescence. To the extent that children may be protected by adopting active survival strategies, boys may be more resilient than girls in many settings, simply because society offers them more independence training and more encouragement and opportunities to take active control of their lives.

The relationship between social power, exposure to misfortune, and resilience and vulnerability during childhood is critical to the development of effective emergency policies. And yet, despite extensive exploration of gender issues in many longitudinal studies of risk and resilience (for example, Werner and Smith, 1992 & 1998), social power is treated poorly in the research on children affected by political violence. Effort is needed to combat this oversight if emergency assistance is to support children=s sense of self-efficacy as well as prioritise those who are most vulnerable.

Social meanings of suffering
I have suggested that most of the research and practical measures concerning the adverse effects of political violence on children adhere to a biomedical framework. Biomedicine tends to concentrate on the functioning of the individual, perceived as a universalised victim of a specific traumatic experience and bearing a disorder as a consequence of that experience (Le Vine, 1999). This model presents a number of theoretical problems that have major operational impact.

Biomedicine is particularly insensitive to the subjective interpretation of human experience, since by de-contextualising and privileging the individual as representing the psychic unity of humanity, it disallows society and culture as integral to human development, adaptation and healing (Lock and Scheper-Hughes, 1990, p. 53; Hinton, forthcoming; Parker, 1996: Le Vine, 1999; Ahern & Athley, 1999). Patrick Bracken (1998) has highlighted such shortcomings in trauma research. He disputes the notion that the meaningful nature of reality is something 'conferred' on it by the schemata running in individual minds and that trauma disrupts the meaning of the world through its impact on these schemata. He argues that meanings are fundamentally a product of the public realm of language and practice, much of which simply cannot be understood by allusion to universal theoretical schema (pp. 49-50). Similarly, Allison James (1998, p. 59) contends that psychological structures are best regarded as constraints on children's actions that must be culturally contextualised. In other words, while there may be a limited repertoire of human responses to crisis determined by the generalised psychic configuration affecting all humans, suffering, grief, healing and loss are all experienced in context and are thereby patterned by the cultural meanings they manifest.

Healing involves making sense of distressing events and experience, assimilating and processing grief, anger or anxiety. While healing may be an intensely personal process, individuals engage with misfortune not as isolated beings, but in socially mediated ways that are shared (Reynolds-White, 1998, also citing to Kleinman and Kleinman, 1991; Bracken, (1998). Most societies have their own approach to healing, depending on their concepts of causality in misfortune, of well-being, power, personhood and social identity (Hinton, forthcoming; Schweder and Bourne, 1982; Parker, 1995 & 1996; Le Vine, 1999; Bracken 1998; Summerfield, 1991 & 1998; Bit, 1991). These notions are not necessarily fixed or shared by all members of the community, but nevertheless, do tend to structure the way people experience and respond to adversity. Therefore, even while children=s responses to adversity may not always be the same as adults=, such responses cannot be understood without reference to the social, cultural and moral contexts they inhabit.

It follows that an operational focus on individual concerns and the separation of mental and physical functioning is not appropriate in all societies. This is especially true of those societies familiar with more holistic health systems, for these do not logically distinguish body, mind and self, and therefore cannot conceive of illness as being situated in body or mind alone (Scheper-Hughes and Lock, 1989). The synergy of mind and body and congruence of the human, natural and spiritual worlds are pivotal to the experience of suffering in many parts of the world. In such systems, sickness is caused often by the intervention of powerful 'others' - social, natural and supernatural agents - rather than individual pathology:

Social relations are ... understood as key contributors to individual health and illness. In short, the body is seen as a unitary, integrated aspect of self and social relations. It is dependent on, and vulnerable to, the feelings, wishes, and actions of others, including spirits and dead ancestors. The body is not understood as a vast complex machine, but rather as a microcosm of the universe (Scheper-Hughes and Lock, 1989, p. 21).

Hence, disease is often portrayed as being caused by the witchcraft of neighbours or relatives or by malevolent ancestors, or the forces of nature, spirits or deities.

As with other philosophies and theories, biomedicine assumes that it objectively describes reality and that this reality is valid everywhere. But discrepancies between the meanings given to suffering in this model and other medical systems raise major concerns about the validity of applying northern therapeutic methods in emergency interventions globally, as several writers have observed (Bracken & Petty, 1998; Parker, 1996; Perren-Kligler, 1996a and 1996b). Such discrepancies have led some communities, for example Bhutanese refugees in Nepal (Hinton, forthcoming, p. 6), whose ideology denies the centrality of the self, to reject modern medical treatments. Where cultural axioms are less assured, health seeking patterns involve negotiation between alternative therapeutic models and systems. In Cambodia, for example, the preferred treatment is normally that provided by traditional healers, the kruu Khmer. But many Khmer find that traditional healers have not been able to give adequate account of the widespread and entrenched violence of the Pol Pot era and so also consult practitioners trained in the bio-medical tradition (Boyden and Gibbs, 1997). As biomedicine is Aincreasingly being understood as one of many medicines ... culturally and historically distinct, specific and far from universal@ (Gorden, 1988, p. 20), so northern medical therapies are coming under closer scrutiny in emergency contexts and efforts are being made to integrate alternative philosophies and approaches.

Similarly, a growing number of agencies are attempting to move away from psycho-social interventions at an individual level and to forge programmes, especially in post-conflict settings, that focus on social reconciliation and healing. This variously entails reinstating services, rebuilding family and community structures and networks, re-establishing productive capacity, developing mechanisms for justice and retribution and other such interventions. These approaches promise greater sustainability and closer social and cultural adaptation than individual therapy. Nevertheless, they often exist in an information vacuum in which ethnographic research on and knowledge about pre-conflict society and culture is extremely poor. This commonly leads to stereotyped views of universal social norms, values and dynamics and power structures, thereby often undermining the process of social reconciliation and healing. This suggests a need for far greater ethnographic research during and following conflict.

Children's agency and resilience in situations of adversity
Biomedicine is only one of the operational models coming under scrutiny in emergency contexts internationally. There now exists a body of research that questions orthodox ideas about children as helpless victims in the face of misfortune and the world as a safe, predictable and peaceful place. In the late 1920s John Dewey (Reynolds-White, 1998) depicted the human condition as inherently precarious and perilous, embodying uncertainty, ambiguity and contingency rather than homogeneity and equilibrium. Others have stressed also that political violence is continuous with normal social experience and is not necessarily the harbinger of social breakdown and chaos (Colson, 1989; Davis, 1992; Duffield, 1990).

Some doubt has even been cast on whether children, in order to flourish, really do need enduring security and stability in their social milieu. Infants and young children are inevitably quite dependent on the resourcefulness of elder siblings and adults for their care and safety. Some older children too may lack the competence, ingenuity and resilience to deal with adversity, especially if they have been overwhelmed by multiple stressors, suffer low self-esteem or have experienced humiliation, rejection or abuse. But to generalise about middle childhood and adolescence from the uncontroversial facts of dependence and immaturity in the first years of life is to ignore the resourcefulness of many children in all age groups and the social competencies of those beyond early childhood in particular. Research has provided new understanding of how cultural values are assembled and sustained by societies and new insights into how children perceive and process discontinuities, inconsistencies, and indeed outright conflicts in their environment. Ideas emphasising the value of stability in the development and well-being of children have given way to a far more dynamic view, which emphasises the active, constructive nature of human development and the dynamic nature of culture. Engagement with their environment involves children interpreting the world about them, making choices, defining their own roles and identities, managing crises, reaching decisions and working collaboratively with others (Save the Children, 1995; Punch, 1998; Baker, 1998; James, Jenks and Prout, 1998; Mayall, 1994 ; Woodhead, 1998; Hutchby and Moran-Ellis, 1998; Waksler, 1994 & 1996).

Studies indicating the dynamic, interactive nature of child development and highlighting children=s coping during adversity challenge the assumption that all, or even most, children are helpless in the face of turbulence and strife (Summerfield, 1998). In general, it transpires that children have considerable inner resources for coping with contradiction and that fears of permanent psychosocial stunting by change, confusion and misfortune may be somewhat overblown. "Through interacting with our ambiguous and troublesome surroundings we refine our abilities to imagine, plan, control" (Diggins, 1994, p. 223, quoted in Reynolds-White, 1998). Several researchers have found, for example, that a significant proportion of children exposed to stress remain resilient (Werner & Smith 1992 and 1998; Cairns, 1996), although emphasising that the experience of multiple stressors is likely to have a cumulative effect, in most cases ultimately overwhelming coping capacity. Others (Ressler et al 1992, p. 39) observe that well-adjusted, well-cared for children are seldom suddenly overcome by a single traumatic experience. Growing up in the context of constant change and contradiction can for some children be a potential source of strength, not merely of risk and vulnerability (Turton, Straker and Mooza, 1990, p. 78; Leyens and Mahjoub, 1992; Dawes and Donald 1994; Zwi et al., 1992; Werner, 2000).

A few studies even suggest that in some situations children may better able to accommodate dissonance and change than adults (Palmer, 1983). Rachel Hinton found that in Bhutanese refugee camps in Nepal children were particularly adept at adjusting to crisis and, through their conscious care-giving strategies, were able to have considerable positive impact on the psychological and emotional worlds of adults (Hinton, forthcoming, p. 17). She cites the example of children who, well beyond normal weaning age, resumed breastfeeding in order to restore in their mothers a sense of purposefulness and self-worth. Some of the children were able to describe this as a conscious strategy. Arati, a girl of thirteen, for example, remarked: "Sometimes I play at being a child, I am grown up now but my mother likes to have babies and it makes her happy when I sit on her lap and she gives [spoon feeds] me food" (Hinton, forthcoming, p. 17). Indeed, there is considerable anecdotal evidence that in situations of adversity children, both boys and girls, often bear the prime responsibilities within the family, as carers of incapacitated adults or younger siblings, prime earners of family income and so on. This circumstance is of considerable significance in terms of children's wellbeing and development and yet tends to be neglected in both research and practice.

Clearly such insights have major implications for the way the relief community conceptualises and responds to children during political violence and civil strife. While a view of a significant proportion of children as resourceful in many stressful situations definitely does not imply that children should be expected to tolerate adversity, or that a violent environment is propitious for children, it does bring into question the inevitability of catastrophic effects on children of such circumstances. It also brings to the fore the importance of acknowledging children's own coping efforts and their contributions to family maintenance, protection and survival.

Societal approaches to risk management
The notion that children's wellbeing is best safeguarded by separation from the trials and tribulations of the adult world is also cultural. It may even in some cases have the practical effect of undermining children's resilience and coping in the context of adversity. It has to be recognised that for many reasons children cannot always rely on the support and nurture of adults during periods of political violence and that they must therefore learn their own strategies for integrating their experiences, overcoming feelings of helplessness, fear, grief and loss and coping in general (Perren-Klingler, 1996). Occasionally children have fewer options than adults, which can be a source of either vulnerability or resilience, but often they have far more options simply because societies tend to be less prescriptive about children=s tasks and roles. Adults generally take little notice of them, for example, and this can make it possible for children to engage in survival activities that adults are barred from, such as foraging and scavenging in areas controlled by security forces.

But it is not simply a matter of opportunity, for children's ability to cope with misfortune is likely to be influenced by any training they may have received in risk management. Perceptions of hazard and approaches to dealing with it are relative to culture and it is likely that different approaches to child rearing will have different outcomes in terms of the ability of an individual to overcome adversity. While some societies, especially in the industrialised world, seek to protect children by isolating them from sources of risk, elsewhere learning to protect oneself is often regarded as more conducive to children's development.

In many societies children are encouraged to engage in activities that develop physical strength, endurance, confidence, dexterity and self-discipline. Inuit children in Canada, for example, are taught to cope with a dangerous and often unpredictable Arctic environment, continuously tested in all spheres of knowledge and competence relating to the world around them and expected to experiment with uncertainty and danger. They learn that the world is constituted of problems to be solved, the ability to discover those problems, to observe them actively and accurately, and to analyse the implications of exposure to hazardous situations being highly valued (Briggs, 1986, p. 8). Similarly, Somali boys forced into exile as unaccompanied minors were found to be far more resilient than might have been expected (Rousseau et al, 1998). This was attributed to the traditional nomadic pastoral practice of sending young boys away to tend herds. The long periods of separation from their families and communities enabled these boys to learn self-sufficiency and autonomy and confirmed their proto-adult status in society. Hence, in this context, exile and separation from family was viewed as having certain positive attributes. In some societies resilience learning is institutionalised in formal rites of passage. For a boy, initiation into adulthood may involve circumcision or a trial of strength (Gilmore, 1990). Thus among the Sambia, Gisu and Mende, boys become men by passing exacting tests of performance in war, survival, economic pursuits and procreativity.

Several researchers have established that child rearing which stresses self-assurance and independence and gives children some experience of responsibility at an early age, such as sibling care taking and income-producing activities promotes well-being, self-efficacy and social skills (Fromm and Maccoby, 1970; Whiting and Whiting, 1975; Aptekar, 1989). This fits in broadly with studies, mentioned above, that find those children in conflict zones who actively and creatively engage with their situation and adopt constructive approaches to the management of risk are the more resilient. Indeed, staying alive - and sometimes even flourishing - during warfare can involve extraordinary ingenuity. In Cambodia during the Pol Pot era it often meant feigning a fictitious personality - pretending to be deaf, dumb, confused or foolish - for people who were 'smart' risked detention, torture or execution (Mollica et al., undated, p. 90).

There is a Cambodian saying, learned in Pol Pot times: 'plant the Kapok tree'. It is a play on the words, 'dem kor'. The allusion is to deaf mute. The meaning is that you will get further if you pretend to know nothing, hear nothing, say nothing. (Meas with Healy, 1995, p. 30).

Some children even make choices about their own care. Unaccompanied children who had been evacuated from Peru's Ayacucho region, the heart of insurgent territory, chose to live independently in child headed households and earn their income on the streets rather than avail themselves of local relief facilities (Diana Gamarra, personal communication). The latter would have entailed registration and therefore identification as Ayacuchanos which, because it carried the risk of reprisals, the children judged too dangerous. Similarly, street boys in Uganda who were living in army camps refused to leave when given the option by the government relief department, for the soldiers provided them with food, clothing, companionship and other benefits they had not known previously and did not expect to receive on demobilisation.

Sometimes relief interventions become an integral part of children's coping strategies, but not necessarily in ways imagined or intended by relief agencies. Take the case of a Cambodian girl who engaged actively with the 'special needs' status conferred on unaccompanied children by the relief community in order to avail herself of a new identity and related benefits (Boyden and Gibbs, 1995, p. 181). When it became apparent that the Khmer Rouge was about to arrive in their district, the girl was sent by her disabled mother to stay with her grandmother in Thailand. She was age about five or six at this time. She stayed with her grandmother for a while, but discovering there to be no school in the area, later travelled to the Thai-Cambodian border, where her uncle, who was in the army, was working in a refugee camp. When she found that she could not live in the barracks with her uncle, she registered with the camp authorities as an unaccompanied minor, which enabled her to stay in the camp and receive food, clothing and education.

In order to register, the girl had to state that she had been separated from her family. Having listened to some of the other children in the camp talking about their experiences of separation and forced migration, she decided that she would pretend to be the missing sister of one of the unaccompanied boys. Building up a picture of this boy's life, she constructed her own story to fit his. At first the boy denied that she was his sister, but when the authorities interviewed the two children separately their stories concurred, and in time the girl managed to persuade both the officials and the boy that she was indeed his sister. Eventually the two were resettled together in the United States, where the girl maintained the fiction, even participating in ceremonies for their 'dead' parents whilst silently hoping that her own mother was alive.

The evidence that children use their agency in a multitude of constructive and ingenious ways during periods of political violence challenges the validity and effectiveness of emergency interventions that cast all children as passive and helpless in the face of adversity. It suggests also that children are active in trying to overcome the problems they face and therefore may be better served by assuming, whenever possible, a constructive role in their own protection and at least some degree of responsibility for their own safety.

Children as valid subjects
Interpretations of children as weak and incompetent tend to justify research based on adult opinions about children and policies and interventions that treat children as the objects of adult decisions, rather than social subjects with valid insights and perspectives of their own. In this way, psycho-social assessments of children often rely on adults' views rather than children's own understandings. Typically, adult carers, teachers or others are asked to complete questionnaires quantifying children's exposure to traumatic experiences, such as violence, or separation from or loss of significant others, and/or gauging their responses by mapping pathological behaviours and somatic symptoms (Ahern and Athey, 1995; Gibbs and Boyden, 1995).

Some might justify resorting to adult knowledge and insight on the grounds that children may be too traumatised to speak of their experiences, too inarticulate to express their true feelings, or give views that appear inconsistent with their experience. Sometimes the concern is that children may not tell the truth. Certainly it is vital to ensure that children are not harmed by intrusive interviews or measures intended to assist them and undoubtedly children do not always express themselves in a consistent, logical manner, but then nor do adults. In fact, it turns out that adults are often poor interpreters of children's lives. There are many reasons why adults' recollections of childhood may not adequately represent the perspective and feelings of the children they once were, not least because human resilience partly involves blotting out memories as, for example, in the grieving process.

The use of pre-coded research instruments, in itself, acts as a barrier to understanding children's responses to political violence. The more refined of these instruments involve some adaptation to ensure cultural fit. Nevertheless, they inevitably invoke a universalist paradigm built on the preconceptions of the researcher. Further, ideas and words used by adult researchers in such instruments may be unintelligible to the research subjects. This applies especially to child informants, who may feel obliged to give answers to please adults, even when they do not understand the question. In any case, children=s own concepts, perceptions and understandings are likely to be far more pertinent than those of the researcher. Researchers may be completely unaware of events and situations that children find important, while circumstances that researchers regard as deeply disturbing may in fact be of far less concern to children. This is not to suggest that children are exotic creatures inhabiting their own universe and immune to the kinds of grief and suffering experienced by adults, but to highlight that their anxieties frequently differ from those of adults and also that adults are often ignorant of what really troubles children.

Sometimes listening to children produces surprising results. Colin McMullin (1999), for example, found that Palestinian war-affected children were not preoccupied by the kinds of individual concerns normally given prominence in psychological research but were anxious about public hygiene and other matters reflecting the collective culture in which they lived. Loss of educational and work opportunities is one of the most distressing experiences for many children exposed to political violence, for such losses remove all sense of continuity with the past and frequently children are all too aware of the extent to which they undermine their future integration into society. Thus, unaccompanied Sudanese boys living in Kenyan refugee camps were anxious that they were no longer able to tend their families' animals, fearing that this would mean a loss of respect in the community (Rädda Barnen, 1994, p. 28). Sometimes it is not just loss and bereavement that cause children to be distressed, so much as the way adults handle these situations. Thus, a young Bangladeshi girl whose father was killed in the war with Pakistan was distressed as much, if not more, by the fact that for two years her mother withheld this information and she learned the truth by accident from a friend whilst at play, as she was by the actual death itself.

Research that ignores children's perspectives is unlikely to be able to predict the impact of exposure to adversity. For example, among those children who do suffer serious or prolonged psychological or emotional distress in conflict zones, a significant proportion have not suffered a major misfortune but have experienced less dramatic circumstances that are more deleterious or unfulfilling than catastrophic (Ressler et al, 1992). Researchers looking for traumatic responses to situations identified in advance by researchers as highly stressful could miss such important subtleties. Sometimes the most devastating situations are those involving insidious hardships and deprivations, such as constant humiliation, social isolation, or poverty related to long term unemployment. Even in terms of the physical impact of conflict, far more children succumb to secondary effects of starvation, exposure and untreated disease than to weapons. The more potent military leaders have long known this, often using psychological and economic warfare as the preferred and more effective option over physical violence. They find that tactics such as forced relocation, destruction of food supplies, continuous security checks, interrogation and the reversal of inter-generational power structures effectively destabilise communities and undermine trust and loyalty, making it far easier to manipulate and control civilian populations.

Studies that disregard children's perspectives risk resulting in misplaced interventions that do not address children's real problems or concerns and may even pose a threat to their self-esteem and self-efficacy. For adults to understand better children's problems and needs, they require children to explain and interpret their childhoods: children must be encouraged to provide real insight into their feelings and experiences. This suggests that we adults need to temper our assumption of childhood irrationality and adult expertise with some humility. It also implies the need for new research methods and methodologies that are child-centred, and provide psycho-social data that are sensitive to cultural context.

Conclusion
There is a long tradition in areas affected by political violence of child-centred interventions that are built on a universalised construction of childhood as a period of special need and vulnerability. Children are treated as victims, taken out of their social and cultural context and served with specialist measures based on centralised policies and the prior identification of need, physical and, more recently, psychological needs normally predominating over social and economic. Medical science is the professional arena considered most appropriate to the healing of children's suffering, and social work the most effective for the social reintegration and support of children in exceptional situations, especially those separated from their families. In both instances, measures take the form of remedial treatment based on a one-to-one, case-by-case approach.

But the idea of childhood as a decontextualised, universalised and yet (paradoxically) very individualised construct, is highly problematic. Children in different societies and social categories are raised in different ways and with different expectations. They thrive, and indeed flourish, in widely contrasting conditions and circumstances and have different capacities and needs, to which a universal child protection model - which is based on only one type of childhood - is not sensitive. Understanding that the culture in which children live shapes the way they are perceived and treated, the way they experience childhood, and the actual competencies they develop is an important departure from traditional policy based on universalist values which conceive of growing up as a standardised process which is the same for all children.

A universalist paradigm also ignores the diversity of children's responses to adversity and privileges expert medical intervention in the healing of sickness and suffering over measures built on local resources, strategies and understandings. Suffering must not be privatised within therapies for, as Gisela Perren-Klingler (1996, p. 9) forcefully argues, the focus on individual pathology disregards the social and political dimensions of misfortune. The shared search for meaning, the social recognition and validation of distress and common effort towards overcoming adversity and reinstating normalcy are all an essential part of integrating experience and healing in individuals and may be threatened by individualised remedial treatments based on 'expert' scientific skills and knowledge. If policy is to support healing effectively in the context of political violence it must allow that different cultures express and embody and give meaning to distress in different ways. It must be open to integrating alternative systems of health care, situating healing strategies within their social and cultural context, and using local resources whenever possible. That said, it is vital that social and cultural understandings be founded on systematic social and ethnographic research, using pre-conflict studies where they exist.

While it is important to acknowledge the painful, humiliating and profoundly debilitating experiences that many children suffer during periods of political violence, it has to be recognised that the dominant discourse of sickness, crisis and loss takes away the possibility of acting on one's own situation, with the potential for seriously undermining children's wellbeing (Burman 1994; Reynolds-White, 1998). Notions of children's passivity and susceptibility also disregard the important emotional, social, economic and political contributions children make to family and community during periods of political violence, as well as trivialising their coping efforts (Freeman, 1983, p. 7). The perception of the child as vulnerable victim may have powerful emotional appeal for adults, but can in many circumstances be quite detrimental to children since it renders them helpless and incompetent in the face of adult decisions and actions, many of which may not be in children's best interests. It also ignores the possibility that children may have insights and opinions that could be highly appropriate and valid even in extremely complex and difficult situations. If children are to be helped to overcome highly stressful experiences, their views and perspectives need to be treated as a source of learning and strength, not weakness. It should be stressed again that arguing for a view of children as at least potentially resourceful is not to sanction their exposure to adversity, nor to deny that children may be rendered very vulnerable. It is more to question normative ideas about childhood weakness and to consider whether a focus on children's susceptibilities really is the most effective way of supporting self-esteem and self-efficacy. The practical value of an understanding of children as resourceful is that it builds on children's strengths, rather than emphasising their frailty and dependence on adult (often outsider) expertise, which in any case in many settings is simply not forthcoming. Competence and acceptance are central features of well-being in children and adults alike, suggesting that insofar as policy purports to foster children's interests it should try whenever feasible to reinforce the active role of children in their family and community and in all decisions and processes affecting them. "

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