South Sudan’s civil conflict has had many dark chapters, but one of the worst is the forced recruitment of children into the ranks of competing armed groups. These young combatants were highly prized by their adult commanders as they would often follow orders without understanding the impact of their actions.

Former child soldiers are often traumatised: separated from their families and forced into a brutal life of violence and forced labour. In some cases the children were beaten and sexually abused. The horrors many saw in battle are seemingly impossible for them to forget.

But over the last six months a group of government and non-government organisations, including MSF, have worked to reintegrate these children back into their communities. MSF psychologists and counsellors have played a key role, providing mental healthcare to the children. In total, 632 have been enrolled in the demobilisation programme, with different groups graduating throughout the year.

“It is important to realise that not all the children need psychological counselling,” says Rayan Fattouch, MSF mental health activities manager in Yambio. “The human spirit is resilient and has its own way of coping with problems. But some of the kids show symptoms of post-traumatic stress or have flashbacks, which can lead to anxiety and depression.”

These strong emotions are not only associated with their experiences as soldiers. Many are fearful of an uncertain future. They are afraid of how they will be accepted by their communities and what will come of their lives.

What it means to be demobilised, for the children and their communities

Demobilisation can be a complicated situation. Former child soldiers realise that, during their years of captivity, life has moved on and the world they knew has changed. In some cases, their families were forced to move away and can’t be found. In others, family members may have died. These types of realisation can have a lasting, detrimental effect.

Former child soldiers do not always receive a welcome return. Their former communities are often afraid to accept them back. During the years spent fighting, some armed groups used the children to loot supplies from civilians. Armed groups extorted protection money from communities, and those who could or would not pay sometimes faced violent confrontations.

Part of the reintegration process involves helping communities to appreciate the circumstances of the children while in armed captivity and to take the time to look at their own experiences during that restive period.

Easing the burden of guilt and building trust

“Some of the children carry the burden of guilt,” says Carol Mwakio Wawud, an MSF psychologist with the programme. “This is not just about something they might have done or seen while in uniform; some still feel guilty about being captured and being taken from their families. In their minds it was their fault.”

Mwakio and other MSF mental health staff try to help them understand that they were not entirely responsible for their actions while in uniform. “We remind them that their commanders were the ones who were in charge and forced them to commit atrocities. This was a period of their life when they had no control, but now the future offers lots of possibilities,” Mwakio explains.

Trust is at the heart of the relationship between the counsellors and their young clients. This is not just part of the psychologist’s ethical code, it is a crucial bond needed to ensure these young patients can express themselves freely.

“Every detail is taken into consideration to make the psychological consultations for these sensitive cases as comfortable as possible. This is important so that we can develop a bond of trust”, Mwako says. “Details like where our client sits during our sessions are really important. We let them see the entrance of the tent, so they know that there is nobody listening. Our aim is to show them that they have regained control over their own lives.”

It is important that each child is well looked after. They have been promised, and desperately need, basic amenities. Many of these children feel insecure; they worry they might be dragged back into their old lives. In such circumstances, any improvements to their mental health can be lost quickly. If they feel that the demobilisation programme has let them down in some capacity, disillusionment sets in. There is even a risk that some will want to return to their old lives.

“Nearly all the children want to return to a normal life and a future,” says Paul Maina, the MSF programme manager. “When you talk to them they all want to go to school like other kids their age. They know that it is only through education that they will be able to secure a new life.”

A whole country of children in need of healing

The healthcare system in South Sudan is rudimentary and there are few local mental health professionals who can look after the needs of these children and their communities.

To counter this, South Sudanese members of staff in the project are being trained as counsellors. These trainees are participating in an accelerated training programme and in the months to come will be able to support cases under supervision.

The programme in Yambio is helping the children turn their lives around. But this is just one small part of the country that needs a great deal of healing.

It is estimated that, across the country, 19,500 children served as combatants during the conflict and need to be demobilised. While some may find their own ways of dealing with the past, others will need help in this new chapter of their lives.