For RefugeeChildren, Reading Helps Heal Trauma Psychologists find that story time can build the strong relationships they need for healthy development.
As the war in Syria has uprooted lives by the millions, humanitarian organizations have worked to supply food, shelter and medical relief. These services are a lifeline for millions, and it’s a herculean task to fulfill them on the scale that refugee crises demand. But humanitarian workers are also now doing more to address the mental and emotional health of refugees, particularly children. It’s a need that until recently has been largely overlooked. Research reveals that the traumatic experiences of many refugees can affect their health in wide-ranging ways that can last a lifetime — social anxiety, depression, addiction, cardiovascular disease and more. Children and youth are most vulnerable. A mounting body of evidence demonstrates that repeated traumatic events early in life, if unbuffered by adults who can restore a child’s sense of calm, interfere with healthy brain development. This physiological response is known as “toxic stress.” But the damage is not irreparable if treated in time. Alexandra Chen, a child trauma specialist affiliated with Harvard who works with refugee families around the world, said humanitarian intervention has not done nearly enough to build resilience in children who face circumstances unimaginable to those who have never been forced to leave their homes for safety; and programs that have been designed to provide psychosocial support have been insufficient in their reach and inadequate in their quality. “We need to act in a strategically different way,” she said. That includes exploring the potential for intervention procedures that haven’t previously fallen into the psychosocial services category “but that may in fact be more effective” in providing psychosocial support.
Rasha Al-Masry, who fled Syria in 2014, may be part of this shift in the community in Jordan where she now lives. Ms. Al-Masry, 30, is an “ambassador” for We Love Reading, a local organization that trains adults to read aloud to children in dedicated public spaces and provides books written specifically for the context they’re going to be read in, with messages and images that the children can relate to. “It’s through these stories that kids learn to deal with their challenges,” from gender inequality to migration, said Rana Dajani, the founder of We Love Reading. A few months ago, Ms. Al-Masry started leading story times twice a week at a nearby community center, and she has already noticed changes in the children who attend. One book in particular, “Above the Roof,” has helped some identify and overcome fears triggered by everyday events, a residual effect of having lived through conflict. “It’s about children who hear sounds like wind and rain, and there’s one boy, he always feels afraid,” Ms. Al-Masry said, through a translator. For some children she was reading to, sudden sounds and other everyday things had become emotional triggers, and the book We Love Reading in action at the Zaatri camp in Jordan. Abdallah abu Dayyak resonated with them. By the end of the story, the boy understands the wind and rain are sounds of nature and that there’s nothing to be afraid of.
One boy in Ms. Al-Masry’s group had been wetting his bed at night because he was afraid to go to the bathroom alone. His parents had no idea what was happening, so they couldn’t help. After a few reading sessions with Ms. Al-Masry, that changed. He no longer wets his bed, but the root issue — the discomfort or fear of talking openly about the problem — is what the story sessions really helped him overcome. As Ms. Al-Masry put it: “The children, they can’t speak about their fears, they can’t share these fears with others. After the stories, they start to share their fears.”
Ms. Dajani, a molecular biologist, started We Love Reading in 2006 in her neighborhood in Amman, Jordan, with the goal of fostering a love of reading in the children. The program has since been adopted more widely, and it demonstrates the links between education and psychosocial health, and between supportive, loving relationships and resilience in children. With the backing of Unicef, the organization embarked on a pilot program for Syrian refugees in the Za’atari refugee camp in Jordan in 2014. Two years later, it was working in all of Jordan’s refugee camps for Syrians and in the Gambella camp for South Sudanese refugees in Ethiopia. The program has gained the respect of renowned child specialists like Ms. Chen because it not only makes space for education in environments where that is so often missing but also restores a semblance of normalcy and fosters healthy relationships. “Because of the way in which it’s designed, bringing together parents and children in a positive organic way of reading together at home, my theory is that this improves the bond between parent and child, and in doing so may very well improve children’s psychosocial well-being,” Ms. Chen said. It can also be adapted to different cultures and remain responsive to children’s specific needs. While refugee camps have long had dedicated safe places for children, said Catherine Panter-Brick, a medical anthropologist at Yale, “they’re just providing a safe space, without changing anything for the family or their structural environment.” Books are also read in the children’s native language, which Ms. Dajani emphasized is crucial for building confidence and a sense of identity — important qualities for healthy development in anyone, but paramount for building resilience in children dealing with trauma. “If you want to plant a love of reading — not education, but a love of reading — it has to be in your native tongue,” Ms. Dajani said. “We use We Love Reading as a steppingstone to falling in love with your identity, which is so important for psychosocial health. When you know who you are, you don’t get lost.” The bonding that the dedicated reading time promotes is especially important. The most powerful finding about trauma’s effects on brain function and development is that a healthy, loving relationship with a parent or caregiver can provide a buffer against the problem, even — perhaps especially — in highly stressful settings. To the degree that story times increase the time that grown-ups focus on and attune to children, they may help to form or strengthen that protective buffer.
Dima Amso, a neuroscientist at Brown University who studied the impact of We Love Reading on children’s cognitive function and ability to regulate their emotions, said that one of the most important benefits identified wasn’t literacy but mental health, particularly relating to anxiety and anger management. And it had the greatest impact on the most traumatized or vulnerable children. When We Love Reading was being set up in the refugee camp in Ethiopia, Zahra Kassam, an independent consultant who helped the rollout, noticed something similar. Children fleeing South Sudan have experienced different kinds of trauma than children in Syria, and started out with different backgrounds. Yet the reading program filled a need that was not being addressed by the services providing food and shelter. At the Kuelle camp in Gambella, Ethiopia. Plan International “It helps to create connection in a lost space,” Ms. Kassam said. “Imagine these kids, they’ve left everything they’ve ever known. These camps are not places where people are thriving. They’re simply surviving. A program like this gives kids a little bit of focus, even without the formal setting of schools.” That provides a value that can be hard to see and even harder to measure. “We grow up and we forget these little things need, she said. “I’m grown up and I completely forget that maybe bedtime stories had more things attached to them than getting kids to go to sleep.” We Love Reading has received grants from both Unicef and USAID, an indication that the humanitarian community is waking up to the growing body of evidence about toxic stress. Ms. Dajani has partnered with researchers at institutions that include Yale and New York University Abu Dhabi to demonstrate the importance of such mental health intervention.
There is still a long way to go, both in the quality and the reach of programs, Ms. Chen said. “Even the best psychosocial support intervention programs in existence require more precise impact evaluation and more dedicated coaching supervision for front-line facilitators and service providers.” Efforts toward those goals are growing, if slowly. The humanitarian organization Mercy Corps now runs a program specifically for adolescents affected by the Syrian crisis. The goal is to foster healthy socialization in safe spaces, through activities like sports and chess, and education or training in skills like technology and carpentry, to help them start dreaming and preparing for their future. The International Rescue Committee, under its Healing Classrooms initiative, has developed resources for teachers in the Democratic Republic of Congo and other conflict areas to ensure that schools support not just academic learning but psychological and social development as well. The International Rescue Committee has also formed a partnership with “Sesame Street” to provide early childhood education to refugees in Syria, Iraq, Lebanon and Jordan. They plan to introduce a version of “Sesame Street” this fall with Arabic-speaking Muppets that deal with experiences that children in these countries can relate to. The first season will focus on the “emotional ABCs,” to help children develop the social-emotional skills that build resilience.
The program also works with community centers to train staff and provide educational tools like books and activity sheets, and conducts home visits. Ms. Dajani is an adviser on the project. Ms. Dajani says We Love Reading and programs like it offer examples of an intervention that helps to fill the gap in psychological and social health services — without reinforcing the power dynamic that all too often prevails between nonprofit organizations and communities they aim to serve. “If you’re designing for refugees, you should have refugees with you at the table,” Ms. Dajani said. “And make sure that the power dynamics at that table are equal.” That’s a shift that many see as long overdue in the humanitarian world in general. For working with traumatized populations, it is particularly important. “We may need to shift the narrative from trauma and stress to resilience,” Ms. Panter-Brick said, observing that the world has focused on the narrative of a lost generation of children in Syria. “There’s a counternarrative,” she said, ” in the hopes and aspirations, in the resilience of these children.”
Rachel Cernansky is a freelance journalist based in Denver.