Child Life in a Refugee Camp: When Two Worlds Collide

ACLP Bulletin | Spring 2017 | VOL. 35 NO. 2


Marais Pletsch, MA, CCLS
Refugee Trauma Initiative, Thessaloniki, Greece

Although I began my career as most child life specialists do, working in a hospital, I now use my skills to provide services in an unusual setting and to a different population than most child life professionals imagine. My previous experience as a child life specialist in the emergency department has taught me many valuable lessons about working with children experiencing trauma and providing opportunities for play in challenging situations. 

 I draw on this experience on a daily basis in my work as the early childhood development program manager at my small grassroots organization: Refugee Trauma Initiative (RTI). While completing a master’s degree studying child studies in London, I had the opportunity to intern with this organization and was then recruited to manage psychosocial programs on the ground in Greece. Our mission is to increase resilience and enhance well-being in refugee camps by offering culturally sensitive psychosocial support to the most vulnerable refugees, particularly children, on an individual, group, and family basis.

Allow me to set the scene of the refugee camps in Northern Greece: Typically held in abandoned, isolated warehouses with limited ventilation and light; hundreds, sometimes thousands of predominantly Syrian refugees are crowded in rows of small tents holding only the possessions they carried with them on their journey. Some swam for hours before being rescued. Others watched family members drown on the journey. Children of all ages run around the camp and surrounding areas playing with anything they can find, from rusty nails to stray dogs. There is a dense fog of hopelessness and fear that floats through the camp. For these reasons and many more, psychosocial support services are vital while families wait for an unknown amount of time to be granted asylum. 

Instead of introducing services and making rounds from hospital room to hospital room, I now go from tent to tent. Here I am not validating feelings regarding hospital frustrations such as annoying monitor sounds and waiting times; instead I am validating feelings of anxiety regarding the lack of heating in the camps during winter and lack of adequate nutrition for children under two. Each family has been through their own horror; whether it be during the war, on the journey, or inside the refugee camp. Everyone here is vulnerable, especially children whose development has suffered immensely. 

Children in the refugee camp during free play

In collaboration with other organizations, my work helps fill the gaps to provide support to children. Instead of a playroom, I have access to an old shipping container that has been converted to a comfortable space with books and toys. When I feel overwhelmed by the challenges of providing services in this setting, I remember that play is a universal language.

These children are desperate for structure, for stimulating and imaginary play that will take them out of the camp and into a better place.

Our early childhood development program focuses on providing psychosocial support and early learning to children ages 0-6 and their caregivers. 

The program is family-centered and provides sessions for parents to alleviate their stress and address their trauma, but also to support them in keeping their children safe and healthy in transient and uncertain times. I teach the families how to utilize guided imagery and therapeutic activities that give their children opportunities for self-expression and help to normalize their experiences. This program gives mothers an opportunity to engage with their infants and work to form secure attachments that have been hindered by the difficult circumstances. Similar to the teen groups I facilitated for hospitalized adolescents, we have teen groups focused on normalization activities such as nail painting, dancing to traditional music, yoga, and arts and crafts activities. I have observed children who had not spoken since arriving in Greece speak after attending our sessions. I have celebrated with families who felt empowered by being able to calm their child back to sleep after night terrors. 

I have been moved to tears hearing of previously-isolated teenagers from different cultural backgrounds connecting after attending our teen groups. I have praised children who after much practice have learned how to place trash in the trash can and how to share with other children. Although these children and adolescents have a long way to go to be able to assimilate into their future societies, I am thrilled to have played a small part of making this excruciatingly painful journey more tolerable.

Working with Refugee Children and Families in the Hospital Setting

It is of utmost importance to understand the cultural norms of the child and family you are working with, and it is equally significant to recognize that the attachment between parent and child may be disrupted due to the trauma they have likely experienced. Among refugee children, hospitals or sick people may trigger memories of conflict and suffering. Similarly, being separated from parents may trigger immense anxiety. It would be helpful to have an in-depth understanding of PTSD to be able to support the children and families who suffer from it. Some of the children I work with are developmentally delayed and have behavioral difficulties and lower socio-emotional intelligence. Many of the children I work with have difficulty expressing emotions appropriately and can be particularly aggressive. Because they have been in a refugee camp environment for so long they are often not able to sit still for extended periods and need extra encouragement to complete basic tasks. But most importantly, these children are resilient. They have been treated ‘differently’ for so long. They desire to be understood as humans, not as refugees. They crave normalcy, structure, and play. As these children and families adjust into their new societies, it will be particularly important to give them opportunities to process and express their emotions. Doing so will help alleviate barriers to successful coping with experiences such as hospitalization. 

Instead of advocating for children at multidisciplinary rounds, I now advocate at camp coordination meetings, regional meetings, and to the government and United Nations to ensure that the needs of the children and families we work with are being recognized. Similar to my work in the hospital, my current role is fast-paced, unpredictable, challenging, and deeply rewarding. While my two worlds of hospital and refugee camps can feel very different, they also feel exceptionally close. Ultimately, I am working toward the same goal: to provide support for vulnerable children and families undergoing challenging experiences. By facilitating opportunities for these groups to come together and share stories, process trauma, and breathe, we are giving them an opportunity to come alive again. And that is something incredible to be a part of.BulletinArticleBlueIcon

Follow and support the work of RTI on Facebook (Refugee Trauma Initiative) or on the RTI website. Marais can be contacted directly at
Children in the refugee camp practicing how to be calm sleeping animals.