Although he’s far from any danger zone, Mohamed Abdullah* looks frightened. His pained expression says much about his emotional suffering in the wake of war. Sheltering in the ruins of a destroyed warehouse with his family, he’s experienced more than any ten-year-old should have to endure, and it shows. He wouldn’t engage
in conversation with me when I met his parents. 

Abdullah, his parents and two younger siblings were forced to flee several times from their village near the front lines in Hodeidah Governorate in western Yemen. Once they escaped under a hail of bullets.

Mohamed’s mother, Souad Hamoud,* recalled how her son shook with fear at the sound of each shell, rushing to hide under his bed with every blast.

 “We would leave the house and come back or move between neighbouring houses in horrible conditions,” Hammoud said. “I was terribly nervous and afraid for my children when the bullets struck our walls.”

Once the family arrived at the Sawama’a camp for internally displaced Yemenis in the al-Mualla district of Aden governorate, Hamoud noticed a change in her son’s behaviour. 

“In addition to his trouble sleeping and concentrating, he spoke less and became detached,” she said. “He suffered from panic attacks.” 

Hamoud noticed also a shift in her son’s attitude towards his brothers and friends: he no longer showed any desire to interact with them. 

Dr Najwin Magharif, a neurologist and psychiatrist in Aden, said Mohamed’s symptoms show all the signs of post-traumatic stress disorder, or PTSD, which usually manifests in extreme fear, an inability to focus, isolation, and difficulties in self-expression. 

A Pandemic of Mental Illness

A June 2022 report by the World Health Organization, Responding to Yemen’s Unseen Mental Health Crisis, says nearly eight million Yemenis –more than one in four of the total population – suffer from mental and psychosocial problems, which are exacerbated by armed conflict, forced displacement, unemployment, food shortages, and other dire conditions. Only four hospitals in the country provide care for people with mental disorders.

In Yemen, people with mental health issues are stigmatised because their symptoms are wrongly associated with insanity, according to an article published by Doctors Without Borders, known by its French acronym MSF. Antonella Pozzi, the group’s mental health director, said a lack of awareness about such issues results in discrimination and segregation. “This leads to people hiding their conditions,” she said. As a result, she added, their suffering and isolation increase, making it more difficult for them to seek treatment.

Serious Long-Lasting Effects

Fear and anxiety can have a debilitating impact on children, according to Five Years of Fear and Loss: The Devastating Impact of War on the Mental Health of Yemen’s Children, a 2020 report by Save the Children. Continued exposure to severe anxiety causes both physical and psychological symptoms, such as a weakened immune system. That makes young people more vulnerable to other health problems later in life.

Living in areas plagued by violent conflict can impact children differently, the report says. Sometimes it manifests in aggressive behaviour, impulsiveness, and a lack of control. 

The long-term effect of violent conflict is yet to be fully understood. While some theories posit that prolonged exposure to violence eventually numbs people to it, others argue that aggressive behaviour becomes a kind of outlet through which children express their anger at a lack of control over the world around them.

According to Dr Magharif, trauma is treated first through an initial evaluation of a patient’s condition, which then helps determine whether it requires medication or therapy. Cases must be monitored weekly until patients appear stabilised.

Mohamed Abdullah is one of the lucky few who’s had access to psychotherapy. Many more practitioners are needed. A study in the Health and Human Rights Journal published by Harvard and Drexel Universities puts the number of trained therapists in Yemen at 130, with fewer than 60 psychiatrists in the entire country. 

Mental health services in the form of therapy, sensitisation and education can help alleviate the trauma of violent conflict in Yemen. Increased funding for activities centred on mental health and psychosocial services is crucial, especially child-focused projects. If this is made a priority, Yemen’s children may live fulfilled lives – despite the legacy of war.