Healing invisible wounds in Nigeria: MSF uses art and counseling to treat children's trauma

In group or individual sessions, the youngsters learned how their feelings and behaviors were linked to their personal experiences. MSF counselors used drama, drawing, breathing techniques, and most of all mutual listening to help reduce the psychological pressure.

Before the military brought the massacre to an end, around 700 people had been killed. MSF started to provide emergency medical aid to those who had fled. While treating many physically injured and sick adults and children in displaced persons camps, members of the MSF team began hearing horrific stories about what people had experienced.

The team realized that many survivors, including a large number of children, were living with severe psychological trauma. In response, MSF started a psychosocial program to help adults and children as they returned home and tried to rebuild their shattered lives. The program for traumatized children used creative techniques and community support to achieve its success.

Getting started

The MSF team visited schools and community leaders in Yelwa to explain how children might manifest their trauma. Difficulty concentrating, crying jags, becoming easily upset in the classroom, missing school or abusing substances - any of these behaviors might be seen after such an event.

"Making the teachers and schools aware of the symptoms was a way to offer them support so the teachers weren't so overwhelmed with containing the emotion," explains Gwen Vogel, the MSF psychologist who directed the MSF project. "It's all a byproduct of the trauma."

In group or individual sessions, the youngsters learned how their feelings and behaviors were linked to their personal experiences. MSF counselors used drama, drawing, breathing techniques, and most of all mutual listening to help reduce the psychological pressure. MSF provided art therapy and counseling to approximately 2,500 children enrolled in schools in Yelwa and the surrounding area.

During their initial visits to schools, the MSF team distributed paper and pens and asked the children to draw what they had experienced in May. The youngsters leaned over their pieces of paper, concentrating intensely as horrific scenes took shape: men with oversized weapons, people riddled with bullets, burning houses and people with severed limbs.

"Some children find it hard to express their emotions and traumatic memories verbally," explains Vogel. "These children can often present their emotions better by drawing, and the pictures they draw show what worries, scares and moves them."

During the sessions, Vogel and other members of the team asked the children to explain their drawings and listened to the descriptions: a father being shot, uncle decapitated, sister abducted, house ransacked and burned down. This sort of scene cropped up hundreds of times, recounted by the children in strangely absent, calm voices.

Helping the children move on

Once the program had been under way for several months, Vogel and other staff members began talking to the children about their changing feelings. Most were feeling better and more secure, and their pictures started to reflect it. The MSF staff encouraged them to draw bridges to illustrate how they were moving away from the dark days of May toward a brighter and safer time. In the final months of the project, the team helped the children start creating pictures that reflected their hopes and dreams for the future.

MSF's project appears to have been successful in helping these children break free of their traumatic experiences. Gwen and her team gave them a safe place to tell their stories and taught them how to integrate these horrific experiences into their lives, allowing most of them to move on.

"It's not as if all of the problems are healed," concludes Vogel, "but I think they have returned to the way things were before the crisis. In some ways, everyone who participated became a mini-therapist themselves. They said it felt so nice just to have someone listen - not to judge them or tell them what to do. That means a lot."