How to heal Peshawar's traumatised children

Media playback is unsupported on your device
Media captionAs Saba Eitizaz reports, children affected by the massacre are traumatised

How can children who have witnessed so much violence at a young age ever heal? That's the question many Pakistanis are asking in the wake of the brutal Taliban attack on schoolchildren in Peshawar where 132 pupils were killed and hundreds injured.

There are serious concerns about the psychological trauma endured by the surviving children in a conservative tribal society where therapy and counselling is often shunned.

The playground for Peshawar Army Public School has been converted into a memorial for the dead children who once used to play there.

Hundreds of shocked Pakistanis arrive there to light a candle, say a prayer and find some closure in the face of this tragedy.

But for the children who were witness to this violence, recovery will not be easy.

Not a sound

Some of the injured children are still being treated at Peshawar's Lady Reading Hospital.

Image caption Pupils are gathering at the homes of teachers rather than going to school

The staff have dealt with the aftermath of many militant attacks in a city that has become the front line in Pakistan's struggle against militancy.

Despite having a well-equipped trauma wing, the hospital is under-resourced when it comes to offering qualified and sustainable psychological help to the young patients who were brought in.

They admit that the children's wounds are more than just skin deep.

One of the doctors in the emergency ward says: "The children were so quiet when they were brought here after the attack. There is always screaming and crying in such a situation but they didn't make a sound. They were braver than adults."

He sighs. "Or they were in shock," he says.

Fifteen-year-old Ahmad Nawaz is propped up on the hospital bed, his arm and legs bandaged.

His parents have pinned a badge of the Pakistani flag to his shirt and he is always smiling for the camera crews and visitors who are constantly crowding around him.

Image caption Thirteen-year-old Ans Mumtaz saw his mother, a teacher at the school, die in the attack

But no-one has told him his younger brother was killed in the school attack that he survived. His aunt pulls on my sleeve.

"Could you please tell Ahmad his brother has been martyred," she asks. "We don't know how to tell him, we don't know how to talk about this with him."

No words

Meanwhile, 13-year-old Ans Mumtaz is back home after his ordeal. He is learning to play with his cousins again but the night brings nightmares.

He survived the Peshawar school attack but saw his mother, who was a teacher, die. His father, Dr Naeem Mumtaz, is a surgeon and was busy saving other children's lives when his own son was brought in, bringing news that his wife was dead.

He says he's still too numb to talk his son through his grief.

Ans is too terrified to feel loss. He thinks the militants will come back.

"I'm afraid to leave my home because even now people are saying they will return," he says.

"I don't know if it's a rumour or true but someone was saying 400 terrorists have come to Peshawar. "

He tugs constantly at his chin with one hand, the other one clenched and picking at his sweater.

'Aggression and frustration'

Dr Iftikhar Hussein, one of the few leading psychologists in the city, thinks the children are showing early signs of post traumatic stress disorder (PTSD).

Brief counselling sessions may help but a without a long-term psychological rehabilitation process, the consequences could be dangerous.

"This could have adverse affects on the children's development, their achievements in future life," he says.

Image copyright ARSHAD ARBAB
Image caption Pakistani school children attend a memorial ceremony outside the army-run school in Peshawar.

"There could be feelings of aggression and frustration that could lead to violent behaviour and in the worst cases, even retaliation."

As Pakistan increases military strikes on militant strongholds in the bordering semi-autonomous tribal regions, Peshawar is on a high security alert, fearing further retribution from militants.

School walls are being hurriedly rebuilt and reinforced, giving the impression of fortress walls. One head teacher says they are considering arming staff with weapons. For now, schools remain closed.

Sher Alam Shinwari, a local teacher, has started teaching children from his small home, so their studies will not be affected.

But more than lessons, the children need counselling, after being exposed to years of violence in a city that has experienced the worst of the blowback from the conflict.

"They now identify school with a fearful place," says Sher Alam.

"Their activities have become very limited, even if they go to school, they are not even allowed to come out of their classrooms for morning assembly. Their confidence is badly shaken, and this will be a major hurdle in future."

Peshawar's children face tough years ahead.

They are being raised in a conservative tribal society where fears and feelings are not talked about and where mental problems are still a stigma.

Just how high a price the country pays may only be clear years from now when a generation of traumatised children becoming equally traumatised adults.