Millions of children live in war zones and face a trauma they are likely to carry for the rest of their lives. At the same time, many of them show "tremendous resilience" and will to survive, experts told DW.
The image of five-year-old Omran Daqneesh drew worldwide attention when the boy was photographed after being pulled from the rubble of Aleppo. Fates like his, however, are by no means unusual. UN data show that 250 million youths are living in war zones - and half of all refugees are children.
Adult family members can play a key role in helping children cope with the mental strain, experts say.
"The children see and experience war through the experiences of their parents," says Theresa Betancourt, Director of the Research Program on Children and Global Adversity at the Harvard School of Public Health.
The child suffers when the parents' emotions are "stretched too thin" by the stress and fear they themselves face, she told DW. However, the youths can "manage many frightening events, including living in an active war zone," as long as the parents can provide soothing and comfort.
Caregivers and their relationship with the child are also an important factor in protecting the child from developing post-traumatic stress disorder, according to Betancourt.
In turn, children can also help their parents to endure the physical hardship of living in a war zone. One such example is Sarajevo, where thousands of children endured almost four years of siege by Bosnian Serbs in the 1990s.
Many young residents were forced take an active role in fighting for survival, said Zilha Mastalic-Kosuta, an associate at the Institute for Research of Crimes against Humanity and International Law at Sarajevo University.
"The children took their role very seriously. They would stand in line for water or bread, collect firewood and take care of their siblings, mothers and relatives," she told DW.
"Some children would handle it better and go through war without difficult consequences, but others had a lot of trouble while fighting for survival in extremely tough conditions," Mastalic-Kosuta said.
The consequences of the trauma could include "a lot of suffering and injuries to bodily or mental integrity," she added.
Mastalic-Kosuta has interviewed a number of survivors who experienced the war as children, and is a one of the co-authors of the book "Crimes Against the Children of Sarajevo During the Siege."
She says that even people who were very young during the war had formed strong memories from that period.
"They remember the death or wounding of childhood friends and family members especially well," she said.
Youth not 'contaminated' by war
Over 1,600 children died during the siege of the Bosnian capital. The children were often targeted on purpose, including those sheltering in the city's maternity ward and children's soccer fields. Despite this, the survivors in Sarajevo would still find a way to live out their childhood.
"They would take a basement and create a place to play, draw, learn or sing," Mastalic-Kosuta said.
More than two decades after the end of the war, the children of Sarajevo have grown into young adults who still carry vivid memories from the time of the siege. However, Mastalic-Kosuta said, they had not been "contaminated" by hatred and desire for revenge towards Bosnian Serbs, their wartime opponents.
"They are mostly normal and ready to live together in the future, without hatred and divisions," she said.
Fighting against trauma
Commenting on the long-term consequences of childhood trauma, Betancourt notes that some children can display anger, aggression, or conduct problems later on.
However, "this is not the majority of cases," she said.
"In fact, there is often tremendous resilience observed among war-affected children, with many able to overcome trauma and lead a normal life."
Access to school and community acceptance can help those efforts, Betancourt said, citing her study on youth affected by war in Sierra Leone. Conversely, factors such as economic instability and social isolation can still present obstacles to young people who have been affected by conflict.
Mastalic-Kosuta concurs that children traumatized by the war can still lead healthy lives as adults.
"Of course it is possible," she said. "It's just a long and somewhat thorny road."