In early July 2017, the coalition1 military offensive to oust so-called Islamic State in Iraq and Syria (ISIS) from Mosul reached its grisly climax. Civilians have borne the brunt of this conflict, with half a million school-aged children amongst the displaced. 2 Amid the horror of the ISIS occupation of Iraq’s cities and villages, it is comforting to believe that once the group has been defeated militarily, normality will return and traumas inflicted will quickly recede. Yet in the medium to long-term, the suffering of Mosul’s children looks set to continue.

Sudan has endured the longest civil war in Africa, with ongoing conflict since 1983. As a result, it has one of the largest internally displaced populations on the continent. The gap in care for mental health in Sudan is large, therefore, most of the people affected do not have access to the treatment they need (World Helath Organization, 2009). Mental health facilities in current day Sudan are few and concentrated in urban centres, where they are difficult to access and lack adequately trained professionals who are, in particular, lacking training for trauma related disorders.

For the past six years, children in Syria have been bombed and starved. They have seen their friends and families die before their eyes or buried under the rubble of their homes. They have watched their schools and hospitals destroyed, been denied food, medicine and vital aid, and been torn apart from their families and friends as they flee the fighting. Every year that the war goes on plumbs new,  previously unimaginable depths of violence against children, and violations of international law by all sides.

According to humanitarian minimal standards, humanitarian programmes should maximise participation of affected populations within their response. Participation has been a key point in proposals, evaluators are aware of it and every aid worker has heard of it. In theory, it is a perfectly implemented, well understood and a well respected construct. In the field of mental health and psychosocial support, participation is core principle number two.