Visiting a classroom or playground in the sprawling camps now home to Iraqis who have fled Isis, it can take a while to realise what’s missing at first.
There are colourful posters and drawings on the walls, toys to play with, music and games. But the sound of kids laughing, annoying each other and joining in the words to songs is muted.
Many children have obvious difficulty having fun as they associate music – banned for so long – with punishment. Some are so traumatised by what they’ve witnessed over the last three years that they’ve lost the ability to speak.
“What was striking was how introverted and withdrawn children have become. They rarely even smiled. It was as though they had lost the ability to be children,” said Dr Marcia Brophy, Save the Children’s senior mental health adviser for the Middle East of her research.
Every family has experienced the loss of their home, and 90 per cent of children interviewed for a new report from Save the Children have lost loved ones since Isis swept across a third of Iraq from neighbouring Syria in 2014.
“You would see people getting killed in the streets. And we didn’t have anything. They denied us everything, even playing,” said nine-year-old Sara, whose name has been changed. “No food, nothing at all.
“They killed my brother in front of me. They said he was passing information to the army. What can we do?”
The US-backed Iraqi coalition has already declared victory in the nine-month-long fight for Mosul, but the announcement has been criticised as premature by many. Fighting in the city continues and Isis clings on to considerable territory all the way up to the Syrian border.
And while almost all of the 600,000 children estimated to live in the city and surrounding Nineveh province are now safer in camps or the homes of relatives, the violence they’ve seen and endured stays with them.
All 65 children interviewed by experts are suffering from toxic stress, and mental images of an unidentified “thing”, “person” or “monster” are so vivid they appear to haunt children during the day as well as at night, Save the Children found.
The psychological damage is severe, and charities are warning a future risk of stigma and abuse – as well as arbitrary detainment by coalition forces – lies ahead.
While every parent will say they took their children out of school during the Isis occupation, where curricula reflected the extremist ideology, around half were probably forced to keep their children enrolled, said Rob Williams, CEO of WarChild UK.
“We are worried that now Isis is gone these kids will face being ostracised or worse by their communities. It’s like France at the end of the Second World War.
“I met a child used as a human shield during my last visit. When his family managed to return home to Mosul, ‘You are Daesh’ [the Arabic word for Isis] was graffitied over the house and now he’s too scared to go home because of what might happen.”
With psychological rehabilitation and sustained community reconciliation efforts, it is entirely possible for Mosul’s children to grow up to lead normal and stable lives.
Yet despite the fact that psychological support for both children and adults is a key factor in preventing further radicalisation and ending the cycle of conflict, most programmes are chronically underfunded with just two per cent of funding needs met.
Donor governments have been slow to respond to the UN’s 2017 Humanitarian Response Plan for the region, which only has 43 per cent of the necessary funding to implement any help at all – let alone mental health assistance.
“We’ve pulled the tooth of the Isis occupiers but we’ve left a gaping hole”, Rob Williams of WarChild said. “Who knows what infection will fill it again in future?
“Donors need to stop looking at this as a problem and see it more as an opportunity. But if they don’t, no one will be surprised if in five years’ time a conflict breaks out all over again.”