The Role of Silence in Burundian Former Child Soldiers

The mental, reproductive, and physical health impacts of female children's association with armed forces and groups

BACKGROUND

Globally, over 300,000 children are being used in armed groups, including young girls some as young as eight years old. These young girls often called female children associated with armed groups and armed forces (CAAFAG), are exposed to high levels of violence and experience extensive abuse.

OBJECTIVE

This review aimed to understand the unique health consequences of association on female CAAFAG and the factors associated with their increased health vulnerability.

METHODS

The research utilized a review protocol, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. The search yielded 449 unique articles, 53 (12 %) of which were included for final analysis to identify health concerns for female CAAFAG. Qualitative literature was also analyzed using thematic analysis to identify factors and experiences associated with female CAAFAG's increased risk of experiencing adverse health outcomes.

RESULTS

Internalizing and functional impairment presented unique challenges for females, largely due to their distinct experiences with stigma upon return to communities and returning with children.

CONCLUSIONS

Based on the findings of this review, female CAAFAG are at a unique risk for internalizing, functional impairment, and reduced adaptive behaviors. This review also highlights girls' post-conflict experiences of stigma, internal tensions, and returning with a child as modifiable risk factors for poor mental health.

Child Soldiers: Children Associated with Fighting Forces

Around the world, there are an estimated 300,000 to 500,000 children involved in armed conflict. Children can be abducted into a fighting force to fight or serve as sex slaves. Child soldiers have depression, anxiety, and posttraumatic stress symptoms; however, evidence is mixed because of methodologic limitations. Various mental health interventions have been tried, with promising results. Child and adolescent psychiatrists are uniquely trained in understanding and assisting youth to heal from such extraordinary experiences. A public health paradigm could include interventions that are based on a comprehensive assessment of interweaving developmental, biological, psychological, and sociocultural factors.

Indero: intergenerational trauma and resilience between Burundian former child soldiers and their children

Since many former child soldiers are aging and having children of their own, this study aimed to understand how the effects of trauma are passed to the next generation. In this qualitative study, semistructured interviews, focus groups, and observations were conducted with 25 former child soldiers and 15 matched civilian parents. Analysis used a grounded-theory approach. Trauma may be transmitted from former child soldiers to their offspring via (a) the effect on indero (how to raise a child); (b) severe parental emotional distress; and (c) community effects. Incorporating themes of indero values on how to raise children, the effects of parental posttraumatic stress and depressive symptoms on offspring, and the stigma associated with the families of former child soldiers may provide key areas of intervention in mental healing.