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Collateral Damage: The Children of Iraq

birth-defect.We are generally cognizant of the impact that war has on soldiers. We know of old veterans of World War 2, the Korean War, and the war in Vietnam and so on. They used to be 'shell shocked', now they suffer the effects of Post Traumatic Stress Disorder. Veterans deal with the horrors of war in many cases until the day they die. War is hell!

But what about the children that have been invaded? They lived through the horror. If soldiers are traumatized for the rest of their lives from taking part in the initiative to wage war, what about those that have war come to them, inside their town, neighbourhood, and home? Children, utterly helpless and trembling in fear; what about them?  

According to a Washington Post article by Sudarsan Raghavan, "Since the U.S.-led invasions in 2003, 4 million Iraqis have fled their homes, half of them children, according to the United Nations Children's Fund. Many are being killed inside their sanctuaries -- at playgrounds, on soccer fields and in schools. Criminals are routinely kidnapping children for ransom as lawlessness goes unchecked. Violence has orphaned tens of thousands."

"UNICEF officials estimate that tens of thousands children lost one or both parents to the conflict in the past year. If trends continue, they expect the numbers to rise this year, said Claire Hajaj, a UNICEF spokesperson in Amman, Jordan."

This is one of a myriad of the consequences of war. Children suffering the agony of losing parents may not gather a lot of sympathy, especially in the West. But, like many of the effects of violence, they do not bleed and they do not explode; they may not be salient to us. The effects of war on children however, are not only crippling to the children, the legacy may come home to roost for generations to come.

Consider for a moment, the psychological impact that the war/occupation has and will continue to have on the children of Iraq.  

Attachment Theory

As the Raghaven article states, many thousands of Iraqi children have been orphaned by war.

In the 1950s, John Bowlby developed the study into the subject of human attachment. Bowlby found that the quality of attachment to a primary caregiver to be a profound element in healthy human development. His studies and the groundbreaking work of Mary Ainsworth, who developed the famous "strange situation" studies, have enlightened our understanding of the importance of attachment. Previous to this, many professional and learned doctors held beliefs that would suggest that coddling babies may be detrimental to them. We now know this to be not only erroneous, but that loving contact is vital to healthy development.

Since Bowlby's time, attachment research has been key in our understanding of human needs. Attachment research has focused on healthy parenting practices, on the pathological aspects of poor attachment including the connection between profoundly disrupted attachment and psychopathology, Attachment research has also shed light on adult relationship patterns, spousal violence dynamics, and many other related areas. Perhaps the most enlightening aspect of attachment research is the effects of attachment on brain development.

According to DJ Seigel in an article entitled "The Developing Mind: How relationships and the Brain interact to shape who we are" (New York: Guilford Press): "In childhood, particularly the first two years of life, attachment relationships help the immature brain use the mature functions of the parent’s brain to develop important capacities related to interpersonal functioning.  The infant’s relationship with his/her attachment figures facilitates experience-dependent neural pathways to develop, particularly in the frontal lobes where the aforementioned capacities are wired into the developing brain."

Optimal development of these neural pathways is crucial. Children that are affected by insecure attachment may suffer from poor affect regulation, poor capacity for empathy, control issues, a propensity to violence, abnormal speech patterns, cognitive dysfunction, poor impulse control, a low capacity for future attachment, poor social skills, lack of conscience, inadequate verbal intelligence development, and a general incapacity to develop anything but superficial relations with others. Attachment disordered individuals may be more prone to developing addiction problems, mental health problems, and they may be more prone to deviant behaviour and consequently, criminal behaviour.

The outcomes for children that are taken into the protective services of the state in developed countries are not good in many cases. Attachment disorders and other social and psychological problems may have a lasting and undesirable result for many of the children in this unfortunate situation. Children in foster homes do normally have a primary attachment figure they can bond with however and in many cases the outcomes are positive. Their plight pales in comparison to children that are taken into orphanages where the logistics and practicality of attaching to a primary caregiver are remote. Most of these children that have been orphaned in Iraq do not have a bright future.

The reality of having no adult to care for them is only part of their story. What may be even more significant are the effects of growing up in constant and sporadic violence.
Effects of War on the Brain

Violence has a profound impact on the human brain and particularly, the developing human brain. Brain development runs sequentially, from primitive regulation at the brainstem (which develop first) to highly complex functions in the frontal cortex.

Within the context of this ongoing development, the more a general neural system is activated, the more the brain develops a neural representation to the environment.  Through this process, the well developed higher functions of the cortical system increases capacity to moderate frustration, impulsivity, and aggressive urges. Loss of function of higher brain activity of cortical function from an accident or a stroke may result in the victim being unable to regulate frustration, impulsivity, and aggression.

As the brain grows, poor development of lower area brain functions in the brain stem and the mid-brain areas will compromise optimal development of the higher functions of the cortex. Without this internalized adult (cortical functions) achieving full development, the victim will be at the mercy of his or her primitive urges. The ratio of activity between the lower functioning part of the brain and the, impulse mediating higher part, dictates the brains ability to curb anti-social impulses.

In a research article entitled "Incubated in terror: Neurodevelopment Factors in the Cycle of Violence"
Bruce Perry states, "In the developing brain, undifferentiated neural systems are critically dependent upon sets of environmental and micro-environmental cues (eg. Neurotransmitters, cellular adhesion molecules, neurohormones, amino acids, ions) in order for them to appropriately organize from their undifferentiated, immature forms. Lack, or disruption of these critical cues can result in abnormal neuronal division...". These molecular cues depend on the experiences of the developing child. If that child happens to be growing up in a war that will obviously impact this development.

Some stages of this development of the growing brain are more critical than others. According to Perry, "Disruptions of experience dependent neurochemical signals during these periods may lead to major abnormalities or deficits in neurodevelopment, some of which may not be reversible. "  Disruptions of critical cues may result from "extremes of experience". Experiences that affect the development of the lower areas (brainstem and mid-brain) "...necessarily alter the development of limbic and cortical areas because critical signals these areas depend on for normal organization originate in these lower brain areas."

Early childhood development is key to a healthy and promising future. Children's vulnerabilities need to be protected and events that disrupt this development (domestic violence, war) need to be removed from the child or the child needs to be removed from the violence. The age of the child is a key consideration. For instance, a 12 year old can easily go several weeks without a hug. For an infant, this would have a profound and lasting impact. The developmental needs of children need to be considered when we assess the impact of war and violence on its victims.

Overdevelopment of the stress response apparatus in the brain, as a result of continual state of hyper-vigilance, "will result in an altered cortical modulation ratio and a predisposition to act in an aggressive, impulsive, behavioural reactive fashion." (Perry)

Children growing in an environment like this will develop a consistent focus on non verbal cues. In all cases, children take cues from their primary caregiver. In Iraq and Afghanistan, parents are often enduring horror as well. Their fear penetrates the psyche of their children. Moreover, their children know that this means that they cannot be protected; that death may come at any moment. They live with the reality of  bombs exploding, gun shots, screams and so on.  A child born into this situation will be affected one way or another.

Children born into violence "are characterized by persistent physiological hyper arousal and hyperactivity. They are observed to have increased muscle tone, frequently a low-grade increase in temperature, an increase startle response, profound sleep disturbances, affect regulation problems, and generalized anxiety." (Perry)

Children exposed to chronic neuro-developmental trauma are often diagnosed to have ADHD due to their constant state of hyper-vigilance.  The effects may be mitigated when the episodes of violence are predictable. When that condition is in place, the children do not have to be constantly hyper-vigilant. For instance, if they know the bombs will drop every Friday afternoon and no other time, they can relax to some extent on the other days. But if the violence is sporadic, then they are in a constant state of hyper-arousal. And in that state, their brain is affected by the constant release of cortisol, a hormone that will calm you or I in a stressful situation. Cortisol on an ongoing basis however, in a  developing brain, may contribute to further poor development.
A study led by Dr. Michael DeBellis, Director of the Developmental Traumatology Laboratory at Western Psychiatric Institute and Clinic at the University of Pittsburgh Medical Center of children with Post Traumatic Stress Disorder (part 1 in the May 15, 1999, issue of Biological Psychiatry) suggests that chemical changes in the brain of hyper-vigilant children disrupt or alter developmental processes.
Eighteen abused children with PTSD were compared with 10 children with generalized anxiety disorder (GAD) and 24 controls. Fifteen of the PTSD group had been sexually abused, and 11 of those children had also witnessed domestic violence. The average age of onset for sexual abuse was 4 years, with an average duration of two years. The average onset for witnessing domestic violence was 2 years, with an average duration of five years before disclosure, according to DeBellis.

The PTSD group had higher levels of the catecholamine neurotransmitters norepinephrine, dopamine, and epinephrine than the group with GAD and higher levels of cortisol than healthy controls.

The longer duration of abuse corresponded with increased levels of the catecholamine neurotransmitters and cortisol in the PTSD group and severity of PTSD symptoms, according to DeBellis. "Symptoms of hyperarousal, intrusive thoughts, and avoidance were associated with increased levels of norepinephrine, dopamine, and cortisol, according to the study."

“Results of animal studies suggested that higher levels of catecholamines and cortisol may adversely affect brain development through accelerated loss of neurons, delays in myelination, or abnormalities in developmentally appropriate pruning of neurons,” said DeBellis.

Mission Accomplished  

Iraq has been destroyed and continues to be destroyed in America's efforts to secure control of the sea of oil that lies beneath the ground. One of the many pretexts to sell the war was that getting rid of Saddam is worth it. Another sales pitch was that bringing the Iraqi people into the warm bosom of democracy and Western life makes war worth the effort. Not even the most naive war hawk makes these arguments any more. It was about oil and the geo chessboard that America needs to control.

Iraq is a destroyed nation. The people of Iraq have endured eight years of war and ten years of crippling sanctions before that. Sanctions that did not touch Saddam Hussein but killed and injured many thousands of Iraqis. During the war the people have endured terror by American forces. They have also endured the terror of sectarian violence that has swept Iraq since the American invasion. They continue to endure massive social upheaval and unemployment, the crippling of utilities and sources of vital needs such as water, electricity, and medicine. Families have experienced night raids, unpredictable and frequent explosions of violence, arbitrary imprisonment and torture of Iraqis. 
The infrastructure is destroyed. It can be fixed, replaced, and rebuilt. America however, has destroyed the people of Iraq. That cannot be fixed or replaced. There is nothing America can do to fix what they have broken. And the effects of this war will live on for years, decades, and generations. There will be ongoing violence and Iraqis will be the perpetrators. They will be blamed for their violence as individuals who are violent. Nobody will trace a line back to the war. Children will do poorly in school. The child will be deemed 'slow' and nobody will trace it back to the war. Young men will strap suicide vests on their bodies and blow Westerners to bits. They will be called terrorists. 

How much of the vast oil wealth of that nation will be utilized to help the people that continue to suffer from this terror unleashed on them by the United States of America? 

And in the USA, tears flow on the anniversary of 9 11. It is presented as the most devastating act of terror or war in living memory. Families have lost loved ones and those loved ones cannot be replaced. However, the people of New York and Washington can recover. Most of their daily reality is unaffected by the attacks. The attacks came and they ended.

How much attention do we place on Iraq's 9 11? Ongoing terrorist attacks that lasted eight years and continues to kill, maim, and terrorize. An attack that killed many thousands of Iraqis and has adversely affected the lives of millions. An attack that will be endured by the people of Iraq for generations.

A thorough analysis of the impact war has had on the people of Iraq needs to be carried out. It will only be then when the American government can make reparations to that country. The people of the United States of America and specifically, the American government owe the people of Iraq far more than they can ever pay, but one way or another, they will pay. These things have a way of coming home to roost.

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