Fergal KeaneSpecial correspondent
BBC
Content warning: this article includes details about the impact of conflict on children in war zones and descriptions of injuries that some readers may find distressing.
The first thing was that Abdelrahman’s dad was killed. The family home was struck by an Israeli air strike. The boy’s mum, Asma al-Nashash, 29, remembers that “they brought him out in pieces”.
Then on 16 July 2024 an air strike hit the school in Nuseirat, central Gaza. Eleven-year-old Abdelrahman was seriously wounded. Doctors had to amputate his leg.
His mental state began to deteriorate. “He started pulling his hair and hitting himself hard,” Asma recalls. “He became like someone who has depression, seeing his friends playing and running around… and he’s sitting alone.”
When I meet Abdelrahman at a hospital in Jordan in May 2025, he is withdrawn and wary. Dozens of children have been evacuated to the Kingdom from Gaza for medical treatment.
“We will return to Gaza,” he tells me. “We will die there.”
Abdelrahman is one of thousands of traumatised children I’ve met in my nearly four decades of reporting on conflicts. Certain faces are embedded in my memory.
Some as though I had only met them yesterday. They reflect the depth of terror inflicted on children in our time.
AFP via Getty Images
AFP via Getty Images
AFP via Getty Images
Hundreds of thousands of children have lived through more than two years of war in Gaza
The first was on a hilltop in Eritrea in the mid-1980s. Adonai Mikael was a child victim of an Ethiopian napalm strike, crying in agony as the wind blew dust on to his wounds. The cries, the expression of pure agony in his eyes sent me fleeing from the tent where he was being treated.
In Belfast a few years later, I remember a boy following the coffin of his father, blown up by the IRA. Never before had I seen such a distance in anyone’s eyes.
In Sierra Leone during the civil war, there was the girl whose hands were hacked off by a drunken militiaman; from Soweto there is the image of a child helping her mother mop the blood of a murder victim on their doorstep; and in Rwanda the boy who broke down when I asked him why the other children called him “Grenade” – a moment of insensitivity I will always regret.
He had been wounded by an explosion that killed his parents.
Figures underscore the sheer scale of the crisis. In 2024, 520 million children were living in conflict zones – one in every five children worldwide – according to an analysis by the Peace Research Institute Oslo, which pieced together conflict records with population data to arrive at the estimate.
Prof Theresa Betancourt, author of Shadows into Light, a book about former child soldiers, calls this “the largest humanitarian disaster since World War Two”.
She warns trauma has an impact that lasts long into the future. “[It can affect] the developing architecture of the brain in young children, with lifelong consequences for learning, behaviour, and both physical and mental health.”
But given how much time has been spent researching the impact of war on children’s minds, what can help?
This is a question that has never been more relevant following this period of multiple global conflicts that have affected millions of children: from those Sudanese children who, in October, saw their mothers and sisters raped by militiamen in el-Fasher, Darfur; the youngsters abducted from Israel by Hamas on 7 October, 2023, many having witnessed the slaughter of family and neighbours; the children of Bucha in Ukraine whose parents were among the people massacred by Russian troops in February 2022; and the hundreds of thousands of children like Abdelrahman who have endured more than two years of war in Gaza.
AFP via Getty Images
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Sudanese refugees in 2025
I should declare a personal interest. I suffered from post traumatic stress disorder – PTSD both as a child in a broken home, and later as an adult, witnessing war and genocide. Though different from experiencing war as a child, I know the symptoms all too well: the extreme anxiety, hypervigilance – being constantly on guard against threats – flashbacks, nightmares, and depression. The symptoms were severe enough to require several hospitalisations.
Personal experience has made me intensely curious about how children respond and are treated.
“The evidence is quite solid across different studies that the exposure to war and displacement is associated with a higher risk of mental health problems,” says Michael Pluess, a professor of psychology at the University of Surrey.
He has carried out long-term research into the children of Syrian war refugees, and cautions against making assumptions. “It’s important to recognise that children differ in how they respond.”
A variety of factors can influence the outcome. How long was the child exposed to the traumatic events? Were they physically wounded? Did they lose an important person in their life, or see them killed or injured? Did they have physical security and emotional support in the aftermath?
In a sample of 2,976 children from Bosnia-Herzegovina – all of whom had been exposed to war and were aged between nine and 14 – high levels of post-traumatic symptoms and grief symptoms were reported.
Getty Images
Getty Images
Getty Images
Bosnia-Herzegovina: Children in Sarajevo
But there is the potential for long-term health damage – heart disease, autoimmune problems – linked to “toxic stress”, where the body is flooded with hormones like cortisol and catecholamines, which produce adrenaline.
There is also a developing field of research into epigenetics, which asks whether the experience of trauma by one generation can show up in later generations through changes in the way our genes behave.
Are we more susceptible to, say, poor mental health, addictions or other health problems if our families have a history of trauma – and how much has this to do with genetics versus our family setups and everyday lives?
The family drip-feed effect
Epigenetics is a tentative and debated area of s
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