War and flight: When children no longer want to live

Vova, a blond boy, kneads his fingers. More and more often he tears at his nails. “We need a short break,” said Alfia Dietmayer, a psychiatrist at Augsburg Pediatric Clinic Josefinum. “Otherwise we will have a massive problem. A tantrum may follow.”

Nail plucking is a kind of tic, often Vova will pull until the nails bleed. The boy is autistic. His mother now pulls a clipper out of his pocket and starts cutting his son’s nails. That Vova is sitting at the table during doctor Dietmayer’s consultation is a step forward for the family.

After fleeing Ukraine: A week in a state of anxiety

The week after fleeing the Kiev area, he just sat under a table instead of sitting at it. And that for days his doctor reports: “He was in this state of anxiety for almost a week, he wanted to hide because everything was simply unknown to him and no longer known.” The worst case scenario for an autistic child.

The team led by Alfia Dietmayer and chief physician Thomasz Jarczok is trying to help children like Vova, who were already mentally debilitated before the war – knowing that many more refugee children with wounded souls now live with us. Chief Physician Jarczok can only assess how high the number of unreported cases is. “But it’s definitely hugely loud.”

Every fourth child is affected

According to studies, every fourth child suffers from war and displacement in the long run. And to an extent that is daunting even for experts. Guido Terlinden can be reached via Zoom. Before moving to the “Refugio Munich” organization, the psychiatrist was part of the medical team at Josefinum in Augsburg.

Terlinden has been treating traumatized refugees for years. “It’s a little scary to see what it can do to a person. Yes, one almost has to say how it can ruin him. Even small children.”

Already in childhood suicidal thoughts

How severely the war in Ukraine traumatized children even surprised the psychiatrist: “We see very serious depressive states with enormous lethargy. And there are children who have strong suicidal thoughts at the age of eight, or who have already hurt themselves,” Terlinden continues. . He worked in a psychiatric emergency room for a long time, “but I do not remember ever seeing such sick children there.”

Parents also have symptoms of depression

Vova is now in her mother’s arms. The fingernails are cut. The parents take a deep breath for a moment: “We both have depressive symptoms,” says the father, who was a musician at a university before the war. “We are feeling bad and therefore our son is feeling worse. He always asks when we can go home again, he had a lot of people who liked him and who he was in contact with.”

Traumatic situations and experiences

The experience is so stressful for Vova that he started wetting at night again. Vova’s doctor has started a form of emergency treatment, which includes medication. “It is extremely important for very young children that they can play,” adds Terlinden. “Even if they are playing war, you should let them play first. It can also be a way for a small child to process it.”

Bomb attacks or the sight of disfigured corpses usually leave the worst emotional wounds. “But there are also other traumatic situations. For example, a child has witnessed a birth in a collective home,” says psychiatrist Terlinden. It can also be traumatic.

Quick help is essential

It is crucial to help the children quickly, to give them the opportunity to talk about what they have experienced. With each passing week, the risk of stress becoming permanent increases. Terlinden tries to give children and young people help with how to deal with nightmares or panic attacks. He explains to them where they are coming from and that they want to go again. It’s about relaxation and breathing techniques.

Many therapy offers in Ukraine

It is also positive that there were many offers of therapy in Ukraine after the first Russian attack in 2014. Ukraine is well positioned in terms of digitization so that these offers can still be used via online consultation hours.

Refugee children need structure and everyday life in Germany

In the end, however, the whole society is required, the trauma therapist emphasizes. The refugee children in Germany need everyday life, school or a place in a kindergarten. An apartment and maybe the chance to join a football club somewhere. In addition to medical care, this is crucial for the children to be able to process what they have experienced.

Observe the children’s behavior carefully

Terlinden advises parents of affected children to monitor the situation. “Anything that lasts longer than a week or two, if children recreate scenes over and over again or become afraid of noise – for example, a construction site – then parents should pay attention and seek help from the family doctor or a clinic,” says the psychiatrist. Terlinden. Fainting spells or aggressive behavior are also symptoms.

Waiting times for therapy are long

One big problem remains: it is difficult to get qualified medical care. Vova was lucky in the accident. He is trapped in Augsburg. But because of the pandemic, psychiatric clinics and practices are crowded. Waiting times can be weeks or months. Many refugee children will probably be left alone with their trauma until further notice.

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