0:00:00.640,0:00:05.800
Worldwide, over 1.5 billion people[br]experience armed conflict.

0:00:06.880,0:00:09.576
In response, people are forced[br]to flee their country,

0:00:09.600,0:00:12.720
leaving over 15 million refugees.

0:00:13.520,0:00:14.856
Children, without a doubt,

0:00:14.880,0:00:17.360
are the most innocent[br]and vulnerable victims ...

0:00:18.640,0:00:21.256
but not just from[br]the obvious physical dangers,

0:00:21.280,0:00:25.000
but from the often unspoken effects[br]that wars have on their families.

0:00:26.280,0:00:29.496
The experiences of war[br]leave children at a real high risk

0:00:29.520,0:00:32.439
for the development[br]of emotional and behavioral problems.

0:00:33.960,0:00:35.816
Children, as we can only imagine,

0:00:35.840,0:00:37.920
will feel worried, threatened and at risk.

0:00:38.560,0:00:39.760
But there is good news.

0:00:40.400,0:00:44.136
The quality of care[br]that children receive in their families

0:00:44.160,0:00:47.616
can have a more significant[br]effect on their well-being

0:00:47.640,0:00:51.320
than from the actual experiences of war[br]that they have been exposed to.

0:00:52.440,0:00:55.176
So actually, children can be protected

0:00:55.200,0:00:59.640
by warm, secure parenting[br]during and after conflict.

0:01:01.920,0:01:05.256
In 2011, I was a first-year PhD student

0:01:05.280,0:01:08.480
in the University of Manchester[br]School of Psychological Sciences.

0:01:09.040,0:01:10.496
Like many of you here,

0:01:10.520,0:01:13.520
I watched the crisis in Syria[br]unfold in front of me on the TV.

0:01:14.560,0:01:16.856
My family is originally from Syria,

0:01:16.880,0:01:18.136
and very early on,

0:01:18.160,0:01:20.840
I lost several family members[br]in really horrifying ways.

0:01:21.760,0:01:24.440
I'd sit and I'd gather with my family[br]and watch the TV.

0:01:25.200,0:01:26.616
We've all seen those scenes:

0:01:26.640,0:01:28.696
bombs destroying buildings,

0:01:28.720,0:01:30.160
chaos, destruction

0:01:31.040,0:01:32.612
and people screaming and running.

0:01:33.440,0:01:37.376
It was always the people screaming[br]and running that really got me the most,

0:01:37.400,0:01:39.640
especially those[br]terrified-looking children.

0:01:41.400,0:01:45.096
I was a mother to two young,[br]typically inquisitive children.

0:01:45.120,0:01:46.696
They were five and six then,

0:01:46.720,0:01:49.776
at an age where they typically[br]asked lots and lots of questions,

0:01:49.800,0:01:51.920
and expected real, convincing answers.

0:01:53.120,0:01:55.776
So, I began to wonder[br]what it might be like

0:01:55.800,0:01:59.200
to parent my children[br]in a war zone and a refugee camp.

0:02:00.240,0:02:01.560
Would my children change?

0:02:02.680,0:02:05.880
Would my daughter's bright,[br]happy eyes lose their shine?

0:02:06.520,0:02:11.520
Would my son's really relaxed and carefree[br]nature become fearful and withdrawn?

0:02:12.800,0:02:14.040
How would I cope?

0:02:15.440,0:02:16.640
Would I change?

0:02:18.640,0:02:20.856
As psychologists and parent trainers,

0:02:20.880,0:02:24.776
we know that arming parents[br]with skills in caring for their children

0:02:24.800,0:02:27.360
can have a huge effect[br]on their well-being,

0:02:28.200,0:02:30.080
and we call this parent training.

0:02:30.680,0:02:32.616
The question I had was,

0:02:32.640,0:02:36.376
could parent training programs[br]be useful for families

0:02:36.400,0:02:39.416
while they were still in war zones[br]or refugee camps?

0:02:39.440,0:02:42.016
Could we reach them[br]with advice or training

0:02:42.040,0:02:44.160
that would help them[br]through these struggles?

0:02:45.840,0:02:48.576
So I approached my PhD supervisor,

0:02:48.600,0:02:50.096
Professor Rachel Calam,

0:02:50.120,0:02:54.400
with the idea of using my academic skills[br]to make some change in the real world.

0:02:54.760,0:02:56.999
I wasn't quite sure[br]what exactly I wanted to do.

0:02:58.040,0:02:59.896
She listened carefully and patiently,

0:02:59.920,0:03:01.496
and then to my joy she said,

0:03:01.520,0:03:04.376
"If that's what you want to do,[br]and it means so much to you,

0:03:04.400,0:03:05.656
then let's do it.

0:03:05.680,0:03:08.656
Let's find ways to see if parent programs

0:03:08.680,0:03:11.040
can be useful for families[br]in these contexts."

0:03:11.960,0:03:14.856
So for the past five years,[br]myself and my colleagues --

0:03:14.880,0:03:17.456
Prof. Calam and Dr. Kim Cartwright --

0:03:17.480,0:03:19.696
have been working[br]on ways to support families

0:03:19.720,0:03:21.920
that have experienced[br]war and displacement.

0:03:23.560,0:03:26.976
Now, to know how to help families[br]that have been through conflict

0:03:27.000,0:03:28.416
support their children,

0:03:28.440,0:03:32.256
the first step must obviously be[br]to ask them what they're struggling with,

0:03:32.280,0:03:33.496
right?

0:03:33.520,0:03:34.896
I mean, it seems obvious.

0:03:34.920,0:03:37.296
But it's often those[br]that are the most vulnerable,

0:03:37.320,0:03:38.736
that we're trying to support,

0:03:38.760,0:03:40.096
that we actually don't ask.

0:03:40.120,0:03:43.296
How many times have we just assumed[br]we know exactly the right thing

0:03:43.320,0:03:46.960
that's going to help someone or something[br]without actually asking them first?

0:03:47.400,0:03:51.056
So I travelled to refugee camps[br]in Syria and in Turkey,

0:03:51.080,0:03:53.440
and I sat with families, and I listened.

0:03:54.240,0:03:56.976
I listened to their parenting challenges,

0:03:57.000,0:03:59.256
I listened to their parenting struggles

0:03:59.280,0:04:01.496
and I listened to their call for help.

0:04:01.520,0:04:03.536
And sometimes that was just paused,

0:04:03.560,0:04:05.616
as all I could do was hold hands with them

0:04:05.640,0:04:07.840
and just join them[br]in silent crying and prayer.

0:04:08.600,0:04:11.016
They told me about their struggles,

0:04:11.040,0:04:14.816
they told me about the rough,[br]harsh refugee camp conditions

0:04:14.840,0:04:18.055
that made it hard to focus[br]on anything but practical chores

0:04:18.079,0:04:19.880
like collecting clean water.

0:04:20.600,0:04:23.160
They told me how they watched[br]their children withdraw;

0:04:23.920,0:04:27.096
the sadness, depression, anger,

0:04:27.120,0:04:30.296
bed-wetting, thumb-sucking,[br]fear of loud noises,

0:04:30.320,0:04:32.176
fear of nightmares --

0:04:32.200,0:04:33.920
terrifying, terrifying nightmares.

0:04:34.960,0:04:38.640
These families had been through[br]what we had been watching on the TV.

0:04:39.240,0:04:40.456
The mothers --

0:04:40.480,0:04:42.656
almost half of them[br]were now widows of war,

0:04:42.680,0:04:45.456
or didn't even know[br]if their husbands were dead or alive --

0:04:45.480,0:04:48.160
described how they felt[br]they were coping so badly.

0:04:49.480,0:04:53.536
They watched their children change[br]and they had no idea how to help them.

0:04:53.560,0:04:56.520
They didn't know how to answer[br]their children's questions.

0:04:57.440,0:05:00.776
What I found incredibly astonishing[br]and so motivational

0:05:00.800,0:05:05.696
was that these families were[br]so motivated to support their children.

0:05:05.720,0:05:08.136
Despite all these challenges they faced,

0:05:08.160,0:05:10.416
they were trying to help their children.

0:05:10.440,0:05:14.056
They were making attempts[br]at seeking support from NGO workers,

0:05:14.080,0:05:15.976
from refugee camp teachers,

0:05:16.000,0:05:17.216
professional medics,

0:05:17.240,0:05:18.440
other parents.

0:05:19.040,0:05:22.256
One mother I met had only been[br]in a camp for four days,

0:05:22.280,0:05:23.896
and had already made two attempts

0:05:23.920,0:05:26.336
at seeking support[br]for her eight-year-old daughter

0:05:26.360,0:05:28.400
who was having terrifying nightmares.

0:05:30.000,0:05:32.920
But sadly, these attempts[br]are almost always useless.

0:05:33.680,0:05:35.736
Refugee camp doctors, when available,

0:05:35.760,0:05:37.536
are almost always too busy,

0:05:37.560,0:05:41.640
or don't have the knowledge or the time[br]for basic parenting supports.

0:05:42.360,0:05:45.480
Refugee camp teachers and other parents[br]are just like them --

0:05:46.120,0:05:49.600
part of a new refugee community[br]who's struggling with new needs.

0:05:51.000,0:05:53.200
So then we began to think.

0:05:53.760,0:05:56.120
How could we help these families?

0:05:57.240,0:06:01.376
The families were struggling with things[br]much bigger than they could cope with.

0:06:01.400,0:06:03.096
The Syrian crisis made it clear

0:06:03.120,0:06:08.416
how incredibly impossible it would be[br]to reach families on an individual level.

0:06:08.440,0:06:10.416
How else could we help them?

0:06:10.440,0:06:14.376
How would we reach families[br]at a population level

0:06:14.400,0:06:15.960
and low costs

0:06:17.120,0:06:19.840
in these terrifying, terrifying times?

0:06:20.880,0:06:23.456
After hours of speaking to NGO workers,

0:06:23.480,0:06:25.936
one suggested a fantastic innovative idea

0:06:25.960,0:06:30.976
of distributing parenting[br]information leaflets via bread wrappers --

0:06:31.000,0:06:35.336
bread wrappers that were being delivered[br]to families in a conflict zone in Syria

0:06:35.360,0:06:37.000
by humanitarian workers.

0:06:37.360,0:06:38.976
So that's what we did.

0:06:39.000,0:06:41.976
The bread wrappers haven't changed[br]at all in their appearance,

0:06:42.000,0:06:44.200
except for the addition[br]of two pieces of paper.

0:06:44.800,0:06:49.696
One was a parenting information leaflet[br]that had basic advice and information

0:06:49.720,0:06:53.136
that normalized to the parent[br]what they might be experiencing,

0:06:53.160,0:06:55.176
and what their child[br]might be experiencing.

0:06:55.200,0:06:59.016
And information on how they could[br]support themselves and their children,

0:06:59.040,0:07:03.256
such as information like spending[br]time talking to your child,

0:07:03.280,0:07:05.376
showing them more affection,

0:07:05.400,0:07:07.456
being more patient with your child,

0:07:07.480,0:07:09.296
talking to your children.

0:07:09.320,0:07:11.896
The other piece of paper[br]was a feedback questionnaire,

0:07:11.920,0:07:13.520
and of course, there was a pen.

0:07:14.160,0:07:17.656
So is this simply leaflet distribution,

0:07:17.680,0:07:21.496
or is this actually a possible means[br]of delivering psychological first aid

0:07:21.520,0:07:24.576
that provides warm,[br]secure, loving parenting?

0:07:24.600,0:07:28.680
We managed to distribute[br]3,000 of these in just one week.

0:07:30.160,0:07:33.816
What was incredible was[br]we had a 60 percent response rate.

0:07:33.840,0:07:38.056
60 percent of the 3,000[br]families responded.

0:07:38.080,0:07:40.576
I don't know how many[br]researchers we have here today,

0:07:40.600,0:07:42.936
but that kind of response[br]rate is fantastic.

0:07:42.960,0:07:46.216
To have that in Manchester[br]would be a huge achievement,

0:07:46.240,0:07:48.936
let alone in a conflict zone in Syria --

0:07:48.960,0:07:52.680
really highlighting how important[br]these kinds of messages were to families.

0:07:55.200,0:07:59.136
I remember how excited and eager we were[br]for the return of the questionnaires.

0:07:59.160,0:08:01.656
The families had left[br]hundreds of messages --

0:08:01.680,0:08:04.056
most incredibly positive and encouraging.

0:08:04.080,0:08:05.816
But my favorite has got to be,

0:08:05.840,0:08:08.840
"Thank you for not forgetting[br]about us and our children."

0:08:10.280,0:08:12.336
This really illustrates[br]the potential means

0:08:12.360,0:08:15.136
of the delivery of psychological[br]first aid to families,

0:08:15.160,0:08:17.256
and the return of feedback, too.

0:08:17.280,0:08:19.776
Just imagine replicating this[br]using other means

0:08:19.800,0:08:24.376
such as baby milk distribution,[br]or female hygiene kits,

0:08:24.400,0:08:25.680
or even food baskets.

0:08:28.021,0:08:29.736
But let's bring this closer to home,

0:08:29.760,0:08:31.056
because the refugee crisis

0:08:31.080,0:08:34.496
is one that is having an effect[br]on every single one of us.

0:08:34.520,0:08:39.135
We're bombarded with images daily[br]of statistics and of photos,

0:08:39.159,0:08:40.736
and that's not surprising,

0:08:40.760,0:08:42.015
because by last month,

0:08:42.039,0:08:45.136
over one million refugees[br]had reached Europe.

0:08:45.160,0:08:46.360
One million.

0:08:46.960,0:08:50.096
Refugees are joining our communities,

0:08:50.120,0:08:51.616
they're becoming our neighbors,

0:08:51.640,0:08:54.120
their children are attending[br]our children's schools.

0:08:55.280,0:08:58.840
So we've adapted the leaflet[br]to meet the needs of European refugees,

0:08:59.600,0:09:01.936
and we have them online, open-access,

0:09:01.960,0:09:04.616
in areas with a really high[br]refugee influx.

0:09:04.640,0:09:07.856
For example, the Swedish healthcare[br]uploaded it onto their website,

0:09:07.880,0:09:09.576
and within the first 45 minutes,

0:09:09.600,0:09:12.800
it was downloaded 343 times --

0:09:13.480,0:09:15.376
really highlighting how important it is

0:09:15.400,0:09:17.936
for volunteers, practitioners[br]and other parents

0:09:17.960,0:09:20.880
to have open-access,[br]psychological first-aid messages.

0:09:23.280,0:09:29.456
In 2013, I was sitting on the cold,[br]hard floor of a refugee camp tent

0:09:29.480,0:09:32.560
with mothers sitting around me[br]as I was conducting a focus group.

0:09:33.440,0:09:35.736
Across from me stood an elderly lady

0:09:35.760,0:09:39.216
with what seemed to be[br]a 13-year-old girl lying beside her,

0:09:39.240,0:09:41.520
with her head on the elderly lady's knees.

0:09:42.080,0:09:44.856
The girl stayed quiet[br]throughout the focus group,

0:09:44.880,0:09:46.176
not talking at all,

0:09:46.200,0:09:48.320
with her knees[br]curled up against her chest.

0:09:49.040,0:09:50.736
Towards the end of the focus group,

0:09:50.760,0:09:53.736
and as I was thanking[br]the mothers for their time,

0:09:53.760,0:09:56.736
the elderly lady looked at me[br]while pointing at the young girl,

0:09:56.760,0:09:59.160
and said to me, "Can you help us with...?"

0:10:00.080,0:10:02.456
Not quite sure what she expected me to do,

0:10:02.480,0:10:04.336
I looked at the young girl and smiled,

0:10:04.360,0:10:05.736
and in Arabic I said,

0:10:05.760,0:10:07.776
"Salaam alaikum. Shu-ismak?"

0:10:07.800,0:10:09.000
"What's your name?"

0:10:09.720,0:10:12.456
She looked at me really[br]confused and unengaged,

0:10:12.480,0:10:14.080
but then said, "Halul."

0:10:14.840,0:10:19.376
Halul is the pet's name[br]for the Arabic female name, Hala,

0:10:19.400,0:10:22.280
and is only really used[br]to refer to really young girls.

0:10:23.320,0:10:26.960
At that point I realized that actually[br]Hala was probably much older than 13.

0:10:27.800,0:10:32.080
It turns out Hala was a 25-year-old[br]mother to three young children.

0:10:32.920,0:10:36.896
Hala had been a confident,[br]bright, bubbly, loving, caring mother

0:10:36.920,0:10:38.136
to her children,

0:10:38.160,0:10:40.120
but the war had changed all of that.

0:10:41.000,0:10:45.376
She had lived through bombs[br]being dropped in her town;

0:10:45.400,0:10:47.840
she had lived through explosions.

0:10:48.440,0:10:50.896
When fighter jets[br]were flying around their building,

0:10:50.920,0:10:52.136
dropping bombs,

0:10:52.160,0:10:54.896
her children would be screaming,[br]terrified from the noise.

0:10:54.920,0:10:58.016
Hala would frantically grab pillows[br]and cover her children's ears

0:10:58.040,0:10:59.416
to block out the noise,

0:10:59.440,0:11:01.000
all the while screaming herself.

0:11:02.080,0:11:03.776
When they reached the refugee camp

0:11:03.800,0:11:07.016
and she knew they were finally[br]in some kind of safety,

0:11:07.040,0:11:10.440
she completely withdrew[br]to acting like her old childhood self.

0:11:11.080,0:11:13.160
She completely rejected her family --

0:11:14.480,0:11:16.440
her children, her husband.

0:11:17.200,0:11:19.320
Hala simply could no longer cope.

0:11:20.600,0:11:23.496
This is a parenting struggle[br]with a really tough ending,

0:11:23.520,0:11:25.336
but sadly, it's not uncommon.

0:11:25.360,0:11:28.336
Those who experience[br]armed conflict and displacement

0:11:28.360,0:11:30.960
will face serious emotional struggles.

0:11:31.720,0:11:33.760
And that's something we can all relate to.

0:11:34.920,0:11:37.920
If you have been through[br]a devastating time in your life,

0:11:38.600,0:11:42.240
if you have lost someone[br]or something you really care about,

0:11:43.400,0:11:45.480
how would you continue to cope?

0:11:46.680,0:11:49.800
Could you still be able[br]to care for yourself and for your family?

0:11:51.480,0:11:54.616
Given that the first years[br]of a child's life are crucial

0:11:54.640,0:11:57.896
for healthy physical[br]and emotional development,

0:11:57.920,0:12:02.896
and that 1.5 billion people[br]are experiencing armed conflict --

0:12:02.920,0:12:05.616
many of whom are now[br]joining our communities --

0:12:05.640,0:12:07.536
we cannot afford to turn a blind eye

0:12:07.560,0:12:11.280
to the needs of those[br]who are experiencing war and displacement.

0:12:12.800,0:12:15.256
We must prioritize[br]these families' needs --

0:12:15.280,0:12:20.120
both those who are internally displaced,[br]and those who are refugees worldwide.

0:12:21.080,0:12:26.096
These needs must be prioritized[br]by NGO workers, policy makers,

0:12:26.120,0:12:30.416
the WHO, the UNHCR[br]and every single one of us

0:12:30.440,0:12:33.840
in whatever capacity it is[br]that we function in our society.

0:12:35.600,0:12:40.776
When we begin to recognize[br]the individual faces of the conflict,

0:12:40.800,0:12:45.296
when we begin to notice[br]those intricate emotions on their faces,

0:12:45.320,0:12:47.200
we begin to see them as humans, too.

0:12:48.000,0:12:50.696
We begin to see[br]the needs of these families,

0:12:50.720,0:12:52.400
and these are the real human needs.

0:12:53.840,0:12:56.536
When these family needs are prioritized,

0:12:56.560,0:12:59.856
interventions for children[br]in humanitarian settings

0:12:59.880,0:13:05.160
will prioritize and recognize the primary[br]role of the family in supporting children.

0:13:05.840,0:13:08.416
Family mental health[br]will be shouting loud and clear

0:13:08.440,0:13:10.200
in global, international agenda.

0:13:11.080,0:13:14.776
And children will be less likely[br]to enter social service systems

0:13:14.800,0:13:16.376
in resettlement countries

0:13:16.400,0:13:19.080
because their families[br]would have had support earlier on.

0:13:20.520,0:13:23.256
And we will be more open-minded,

0:13:23.280,0:13:25.096
more welcoming, more caring

0:13:25.120,0:13:28.600
and more trusting to those[br]who are joining our communities.

0:13:29.800,0:13:32.000
We need to stop wars.

0:13:32.720,0:13:37.376
We need to build a world where children[br]can dream of planes dropping gifts,

0:13:37.400,0:13:38.640
and not bombs.

0:13:39.320,0:13:43.376
Until we stop armed conflicts[br]raging throughout the world,

0:13:43.400,0:13:46.096
families will continue to be displaced,

0:13:46.120,0:13:47.480
leaving children vulnerable.

0:13:48.080,0:13:51.136
But by improving parenting[br]and caregiver support,

0:13:51.160,0:13:56.416
it may be possible to weaken the links[br]between war and psychological difficulties

0:13:56.440,0:13:58.360
in children and their families.

0:13:58.840,0:14:00.056
Thank you.

0:14:00.080,0:14:01.960
(Applause)