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August 25, 2008
Listening to child soldiers’ war stories spurs mental health study

By Carol Clark

Brandon Kohrt met with many traumatized young people as lead author for a study on the mental health of former child soldiers in Nepal, published by the Journal of the American Medical Association on Aug. 13.
All of the children he interviewed had moving stories, but some especially stick in his mind, says Kohrt, a final-year medical student and a Ph.D. candidate in anthropology. One boy was 14 when Maoist insurgents beat his father unconscious and coerced him to become a soldier in their battle against government troops.

“He and some other child soldiers were captured by the Nepali army,” says Kohrt. “The girls in the group were stripped and raped. The army troops then cut the girls’ bodies with knives and put chili powder in their wounds.”

In addition to witnessing such horrific events, the Nepali youth told Kohrt that he was shot in the leg during a battle. His best friend in the group was gravely wounded and begged for water, but none was available. He had to flee the encroaching Nepali army and leave his friend to die alone.

“He feels tremendous guilt over that,” says Kohrt. “The burden of experiences he carries is very apparent. He says they keep happening again and again in his head.”

The teenager was one of 141 former child soldiers included in the study, commissioned through the Transcultural Psychosocial Organization (TPO) Nepal. The study’s co-authors include Carol Worthman, Samuel Candler Dobbs Professor of Anthropology; Rebecca Speckman, an M.D.-Ph.D. student in Rollins School of Public Health; and researchers from Nepal and Amsterdam.

It is the first published study of the mental health of child soldiers that includes comparative data. The results showed that the former child soldiers, who were as young as 5 when conscripted, were more than twice as likely to suffer from symptoms of depression and post-traumatic stress disorder than Nepali children who experienced war trauma as civilians.

Kohrt is continuing his research with TPO, to support the development of mental health screening for war-affected children, and to create intervention programs targeted to a range of needs, including the stigmatization that child soldiers sometimes face when they return home.

After receiving his medical degree, Kohrt hopes to do a psychiatric residency for global mental health. “I want a career that allows me to do evidence-based research and provide mental health care to those in the most desperate need,” he says.

Kohrt speaks Nepali and has studied mental health issues in Nepal for nearly a decade. He originally envisioned a career focused solely on research.

“The people I was gathering information on would ask me for help all the time. Their problems were so severe and overwhelming, I felt an ethical obligation to provide clinical care as well,” he says, explaining his decision to enter medical school.

Listening to children tell war stories is one more motivation for him to meet the challenge of completing two degrees simultaneously. He is also inspired by the children’s resiliency. “Most of these kids are still capable of hope and believing in the future,” he says.

For instance, the Nepali boy who was forced to leave his dying friend on the battlefield is now 17, and working as a traditional healer in his village. “The only time he brightened up and made eye contact with me was when he talked about helping a sick little girl the night before,” Kohrt recalls.

“He said she had suffered a ‘soul loss.’ He performed a ritual to call her soul back and her vitality returned. After the tremendous suffering that he’s been through, what makes him feel better is helping others,” Kohrt marvels. “I’ll never forget that boy.”