Case Study 2 – Rehabilitation and Reintegration

Psychosocial factors affecting the girl
· The traumatic events experienced by her during the captive period e.g. raped by three, witnessing her colleagues being killed, being forced to kill and other inhumanities. The memories will recur in flashbacks and nightmares. Her experience will also result in lack of self esteem and self confidence, hopelessness and despair. It is doubtful whether adequate emotional support will be available in her family/community.
· Potential issues in inter-personal and social relations due to her traumatic experience in captivity, e.g. she would have become ‘hardened’ and ‘closed up’, and she will find it difficult to relate to people, trust them, or open up as she has been exposed to unusual and extremely painful experiences. Especially her future intimate relationships are bound to be complicated/ problematic due to the unwholesome (probably violent) spousal relationship with the rebel that she was forced into.
· Having to give birth and rear a child at the age of 15 (while being a child herself) without any support or physical/psychological preparation.
· Becoming fully reintegrated into her family and community will be challenging. There will be issue around her identity, i.e. ex-rebel cadre mothering the child of a rebel, which would render her vulnerable and powerless within her community, and being accepted by the community a challenge. Getting adjusted to ‘normal’ life and becoming ‘functional’ will take considerable time and re-conditioning. Further, her community too would have changed due to their experience of the conflict and may not be in a position to support her.
· Coping with stigma and feelings of guilt and shame regarding being associated with the rebels and especially for being raped and having to return to her family/community with the child of a rebel, as a single (unmarried) mother. Her family might not have the physical or psychological resources to support her adequately.
· Lack of skills and knowledge to engage in any economic activity and to provide for herself and her child, specially the child’s education.
· Health repercussion e.g. could have contracted STD/HIV

Action Plan for Rehabilitation and Reintegration
Resources needed
With whom
Pit falls/ challenges
How to overcome
Finding a safe place
-Guardians have not yet been found
-Having been with an armed group and having undergone many traumatic experiences for a while the child cannot be immediately integrated into her former family /community
-Existing safe places
-If none is existent find temporary space e.g. converted school
-Temporary building
-Human resources to run the place
-Financial resources
1 week after finding the child
Might not be available/ risk of being institutionalized
Lobby with the Govt. and other INGOo to convert a possible building as a safe place
Medical screening
She may have protracted STD/HIV or any other health issues. Especially as she has gone through child delivery in an unsafe environment her health could be very weak.
Through a multidisciplinary team of medical professionals while she is with the military.
-Medical team
-Medicine and medical equipment
-Financial resources for medical supplies and subsistence for medical team
Transport for medical team
Medical practitioners from the Govt., NGO sector and private sector
Within the 1st week of finding the child
-Child may have contracted a fatal or a contagious illness. E.g. - HIV/STD/ Chickenpox

-Child may need long term medical attention.
-If Curable contagious decease the child will be segregated. If fatal the available options will be explored with the child e.g reintegrating with family, referral to support services.

Emotional support/ counselling
-Provide space for ventilation
-To deal with the emotional trauma that has been experienced and the resultant psycho-emotional issues e.g nightmares
-To help regain a sense of normalcy
- To help develop coping strategies
-Relevant Counseling & therapy methods e.g humanistic/ CBT/ art therapy.
-Group counseling/ therapy if other girls like her are available.
-Periodic progress reviews conducted by the resource persons with the supervisor
-Counsellor /psychologist/ psychiatrist & a supervisor
-Financial resources to remunerate the resource persons, material required for sessions
Practitioners from the Govt., NGO sector and private sector
If the child is ready from the 1st week itself till reintegration
-Child may take a long time to respond.
-Child needing continuous professional support which will not be available following re-integration.
-Community strengthening for providing emotional support.
-Training a group of community helpers and providing them with follow up supervisory support periodically at least for 2 years.
Need assessment of the child & development of care plan
-To understand the strengths & needs in order to develop her care plan.
-The care plan will be developed in consultation with the child
-Objective of the care plan is to develop her strengths in the following area. Physical , Psycho-emotional, Educational, Economical, and Spiritual
-Resource persons
-Financial resources for remuneration
Psychosocial worker and counselor
From the time the counselor advices that the child is ready. Development of the plan will take at least three months (b’cause this child not having been exposed to normal life will not have clarity on what she wants and what is possible
-Child may not be too participatory due to lack of capacity to articulate.
-Child’s interests might not be feasible.

-Child might be aggressive and un cooperative.
-Explore different tools. If nothing works decide for the best interest of the child.

-Explain the possibilities to the child in a child friendly manner and discuss other options to the best interest.
-Refer for further therapeutic intervention.
Preparing the child for re-integration/re-unification i.e. implementing the care plan
Having been with an armed group and having undergone many traumatic experiences for a while the child needs re orientation and skill building in order to be integrated into her former family /community
Provision of psycho education/life skill training inc. child rights and women’s rights & child rearing skills / capacity building e.g vocational training in accordance with the care plan. This will also include skills in developing market linkages if needed, financial management, savings etc.
-Resource persons
-Material & equipment
-Financial resources for remuneration and material
-Transport for resource persons
Interdisciplinary team comprised of livelihood instructors, religious leaders, teachers, psychosocial worker, entrepreneurial trainer etc.
After the care plan is done for the duration indicated in the care plan. This will be a maximum of 6 months.
Child changes the mind mid way through re- the vocation
Discussion with child to understand the cause of change, if valid and feasible implement change, if not make the child understand and continue as planned.
Tracing and verifying guardians
Child wants to be reunited
Follow steps of reunification with special adherence to verification methods.
-Resource persons
-financial resource for remuneration and other expenditure
Psychosocial worker & counsellor
After getting the information from the child during the first week till the guardian is determined.
-Parents have died or untraceable.
-Parents not willing to accept.
-Child change mind.
-Guardians willing to accept but not able due to financial constraints and security issues.
-Alternative care. e.g Foster/ fit/ adoption or institutionalization(as a last resort)
-As above

-Discuss reasons for the change and possible alternatives.
-Explore possibilities of providing financial support and raise awareness on security measures.
Preparing family to receive child & baby (If the family is found and willing)
-To support the child in reintegrating
-To help the family to cope with issues that might arise.
-Sensitize them to the experience the child has been exposed to
- Provide them with psycho education on how to handle challenges. E.g stigma from the community, gender issues, rights of the girl child.
- Link with possible financial support mechanisms.
As above
Interdisciplinary team (as above)
Once the guardians are traced and verified.
-No resources for child care arrangement at home
-Link with childcare facilities if available, if not support community to come up with a mechanism. E.g. mother in the community looking after several children during day time to e compensated in cash or kind by the mothers of the babies.
Preparing the community (i.e. the camp)
-To accept the child
-alleviate fear of the child as she was associated with the rebels.
-stigma towards the child because she is raped and with a child
-for the child to reintegrate smoothly
-Sensitization and psycho education on child rights, issues of child combatants, gender issues
-Capacitate a group of community members to act as helpers/ be-frienders to provide emotional support. Periodic supervision and follow up done by psychosocial worker/ counsellor.
-Facilitating and follow up on mediation/NV conflict resolution . e.g. how to protect an underage single mother with a child.
-Depending on the need the camp community to be capacitated on livelihood activities.
-Depending on the need help community to organize a child care mechanism.
-facilitate any traditional healing processes to welcome the child.
-Strengthen existing supportive networks within the camp community, if any, or facilitate establishment of new ones if appropriate/ feasible.
As above
Interdisciplinary team (as above)
While preparing the family
Community resistance to accept the child regardless of all interventions
Community already burdened with lot of issues in the camp and will not have a capacity to support a child with so much psychosocial issues mentally or physically.

-Due to the camp setting being so volatile whatever interventions may fail.
-Alternative care plan which will be very difficult

-Try to maximize the support given to the community by providing support services in collaboration with other organizations. However given the severity of the human tragedy it’s extremely challenging to ensure the well being of the child within this context.
Because the child and family wish to.
Bring the child to the family after preparing the child, family and community as above.
As above
Psychosocial worker and Counsellor
Once preparation is over which will take a min of 6 months
-Child and family finding it difficult to adjust to each other

-Extreme conflicts between the community and child.
-Providing mediation and counseling support. If all interventions fail, will need to find an alternative care solution, e.g. fit persons.
-Continued mediation, failing which the child (and family) will need to be resettled elsewhere in consultation with them. (Problems might persist wherever they are, only solution is to strengthen their coping and relationship building skills to the greatest extent possible).
Assess whether the reintegration works well for the child
Personal visits
As above
Psychosocial worker and M&E officer
After re-integration once in two weeks at the beginning for two months and thereafter once in two months for another 6 months.
The community may be re-settled in mid way of the process.
This is a complex issue since it involves the entire resettlement process where new issues might arise. Thus, we need to get involved in the process and provide necessary support, e.g. psycho-education, livelihood, etc, to the community. If our organization does not have the capacity, will need to liaise with those involved in the process and integrate the issues of ex child combatants into their programmes.

- She is 16+ by the time we meet her
- Her family is still at the refugee camp
- She would have stayed with the rebel at least for a year.
- Staff trained on child Rights & protection, gender, conflict resolution, mediation etc. are available.
- The entire process will be done in collaboration with the Govt. and the military because child soldiers involve many political and security issues. E.g. Child soldiers are vulnerable as they are at risk from both the military and the armed groups from which they were demobilized. In addition it is the responsibility of the Govt. to reintegrate the children and we are acting as facilitators.
- The preliminary discussions with the Govt. and the Military have taken place where they have been sensitized on reintegration and rehabilitation of child soldiers.
- The rehabilitation and reintegration will take place within a maximum of 18 months, followed by another 8-12 months of monitoring.