Group 2
Case Study 2: Rehabilitation and Reintegration
Susan is 15 years old. She was a refugee living in a camp with her family for two years. While living as a refugee she began school for the first time. During studies one night, a group of armed rebels came to the camp and abducted her and five other boys and girls. The rebels made them walk for six days carrying heavy loads of looted supplies. One child collapsed and was killed by the rebels on day three. On day four another child - Susan's cousin - collapsed. The children were told to kill the boy or die. They killed him. On arriving at the camp, Susan was raped by three rebels and given to one as a wife. She became pregnant, but still worked hard cooking and carrying weapons to battle. A big battle took place with the military. There was much confusion, so Susan ran away with her baby. She was found by the military and demobilised. She wants to go home.

1. Discuss psychosocial factors that might affect this child.
Trauma due to:
· The abduction and the fact that she was forced to start a new life there (including getting married and being pregnant). The fact that, while still a child, she was exposed to very difficult life conditions in a hostile environment without any support whatsoever.
· The fear and indoctrination that she has experienced there.
· Having witnessed or participated in extremely violent events (the killing of the child and the participation to the murder of her cousin) and the guild and loss of reference that may be associated with it.
· The trauma associated to the sexual violence, the forced marriage and the anxiety of the pregnancy while being isolated, not supported by her relatives and subjected to hard labour.
· Fear of being stigmatised by the community upon her return home, not knowing how to deal with interactions with others.
· The pressures of having to care for a child while she is still a child could also cause trauma and place the Susan’s child in danger/subject to abuse.

As a result:
· She may suffer from post traumatic stress disorder, nightmares and anxiety or may have psychological difficulties; she may resort to violence herself, and be a harm to herself and/or others.
· She may also have physical problems due to the hard labour she was subjected to, lack of clean and sanitary conditions, lack of access to proper food, medical care, the sexual violence and the pregnancy is such difficult conditions, other health related risks such as HIV/AIDS and other sexually transmitted diseases in addition to being exposed to other communicable diseases such as malaria.
· Use of violence to resolve conflict and having the notion that violence is the solution to dealing with problems.

2. Develop a PLAN OF ACTION for the social reintegration and rehabilitation of this child.

Before the reintegration in the community:
A rehabilitation and assistance program should be set up in a Centre dedicated to this purpose and incorporates community based and institutional initiatives that involve the wider community and other state and non-state actors that are connected to the wellbeing of the child/children.
· As a first priority, she needs to be supported by professional psychologists in order to identify her trauma, the extent to which this may hinder the reintegration process and try to address the more dramatic manifestations of it. She also needs to see a doctor for physical problems and examination.
· Psychological as well as practical support should also be provided in order to help her assume her role as a mother and normalize her relationship with her baby. This mother- children relationship may have been affected due to the circumstances of her marriage and the conditions of her pregnancy.
· Qualified professionals also need to assist in the determination of a life project and help her conceptualize her future and what she may want to do in a more longer term.
· Depending on the project that has been designed, professionals should identify with her the problems that she may face and try to figure out the best strategy to address them and realize the life / professional project.
· She also needs to be with children having the same kind of history and facing the same problems in order for her to understand that she is a victim. Through the sharing of experiences, the children can also deal better with the guilty feeling that may arise in such a situation. It may also help to recreate the feeling of belonging to a group that may have disappeared due to the abduction and the state of consent fear experienced while living with the armed group.
· However this period before rehabilitation should not last too long so that it would not add to the exclusion from the community and hinder the reintegration process. It must also be associated with an exposure to / relearning normal life conditions.
· She should be able to interact with her family and friends from her village, if this is possible under the circumstances. this should be done in a sensitive manner so that the visitors nor the child feels they are being observed or being treated as a threat.
Reintegration:
· After this period in the Centre, she must be accompanied while returning to her community.
· A psychological and material support should also be provided.
· A professional training should be carried out in order to implement her project.
· The Plan should also work out ways that the child can be supported after leaving the centre. This should be done through community systems and also support to the family, and should not be threatening or demeaning in any way. It should include sensitisation and awareness components so that aspects of stigma are also dealt with.

3. What do you suspect might be the problems/pitfalls of this PLAN?
· She wants to go home but she grew up in a camp which adds to the difficulties of her reinsertion.
· There may be a strong stigma in the community attached to children associated with armed groups, especially girls.
· She also comes back as a single mother, which depending on the region where she comes from may also be highly stigmatized.
· She is uneducated and not used to attending school either, which may render the learning process in order to acquire professional skills difficult.
· Establishing a sense of normalcy for her and her child.
· Being able to reconstruct her family, getting married again.
· Livelihood activities getting established

4. How might you alleviate these problems/pitfalls?
· Not only the child has to be prepared to be reintegrated but the community too needs to be sensitized.
· There should be a sensitization program for the members of the family and the community at large including group discussion and common psychological support for the child and her family.
· The professional training should be specifically designed in order to take into account the learning difficulties due to the lack of previous exposure to such institution as well as the difficulties specifically due to her traumatic experience. If it is feasible (depending of the number of children in the same situation within the community) the training can be conducted in a specific institution. However it is important that this institution is not associated with former child soldiers but be open to children facing the same type of difficulties due to different factors.
· there should be a long term follow up on a regular basis (few weeks, then few months, then every year) in order to assess the difficulties faced and the progress made (both psychologically sociologically and professionally).
· Continued monitoring of the conditions that the child has to reintegrate into and institutional support that can be provided to do so.