Many children must live with the trauma of war. Here’s how to help them

Since the late 1990s, one frequently used method to understand the prevalence, and effect, of childhood traumatic events has been screening for Adverse Childhood Experiences (ACEs), which includes incidents like sexual abuse, a parent’s incarceration and divorce. The more ACEs a child has, the more likely they are to experience outcomes like depression, anxiety and drug use – particularly once they accumulate around three or more different types, experienced by around one in 10 US children.

But ACEs provide an incomplete picture. The original list doesn’t include exposure to war or terrorism – even though, as of 2022, more than one in six children worldwide, 468 million, were estimated to live in active conflict zones. That’s double the number of children affected by war in the mid-1990s.

More than half of Ukraine’s children were displaced within the first month of the war with Russia following the full scale invasion in 2022, according to Unicef, while more than 500 children have been killed and more than 1,100 injured, mainly from bombing of Ukraine’s cities. In the Gaza Strip, called “the most dangerous place in the world to be a child” by Unicef spokesperson James Elder, the agency estimates that 850,000 children have been uprooted and lost their homes. More than 11,000 children in Gaza are estimated to have been killed in Israeli attacks since the war there began in October 2023, according to figures from health officials in Gaza, a number that does not count those under the rubble or deaths from other war-related causes like starvation or lack of healthcare. 

Perhaps twice that many may have lost at least one or both parents, says the non-profit Euro-Mediterranean Human Rights Monitor. In Israel, up to 40 of 253 people taken hostage and around 30 of those killed by Hamas were children, while some 126,000 Israelis, including thousands of children, have been displaced from their homes during the war. In Sudan, around four million children have been displaced by the war that broke out in the country last year, with “terrifying numbers of children killed, raped or recruited” and more than 700,000 likely to suffer from severe malnutrition, according to Unicef.

Such war-exposed children, who often experience multiple traumatic events simultaneously, are at far higher risks of psychological disorders including PTSD, depression and anxiety.

They also tend to have poorer long-term physical health. For example, research done on German children who experienced trauma during World War Two found that, when they were elderly, children were twice as likely to experience congestive heart failure, three-and-a-half times more likely to have a stroke and five times more likely to get cancer, among other health problems.