By Ma Cecilia L Rodriguez in Munai, Lanao del Norte (PHR No.9, 24-Oct 08)
A wry smile from seven-year old Hassan greeted visiting health workers waiting under a tarpaulin to give him and his playmates measles shots.
Hassan is one of the many Maranao children in the northern Mindanao town of Munai to be inoculated by a visiting department of health team to contain a possible epidemic. Maranao is the term used to describe the people of Lanao, a mainly Muslim region of Mindanao.
The evacuation centre in the remote town of Munai where Hassan and his family are currently living is one of the biggest encampments set up for internally displaced persons, IDPs, since clashes between government troops and the Moro Islamic Liberation Front, MILF, began in August.
Hassan sleeps in a small makeshift tent which he shares with his six siblings, his mother and grandparents. During the day, it is intolerably hot. At night, the ground is cold and damp and the dew seeps inside the thin roof. Hassan's younger brothers, sisters and grandparents have all fallen ill.
The family's circumstances are not unusual. The Geneva-based International Displacement Monitoring Centre, IDMC, reports that renewed fighting since a peace agreement between the government and the MILF collapsed the day before it was to be signed has so far left more than 296,000 people as internal refugees on Mindanao. The peace movement Kalinaw Mindanao has already placed the number of IDPs at 528,000.
More than 11,000 of them fled their homes in the interior villages of Lanao Del Norte province, where the army launched a mopping up operation against MILF groups after the latter attacked a series of seaboard towns in September. Immediate medical relief had to be given to the evacuees whose number included more than 2,000 children.
Hassan shook in fear as he was given his vaccine. Dr Sofia Omar, a visiting health worker tried her best to reassure the boy, knowing he had never seen a doctor in his life, much less receive a course of possible life-saving vaccinations. Munai is very seldom visited by health workers.
"The endless conflict has prevented basic services reaching the remote villages here and I pity the children most," said Dr Omar. "Many of those who come and seek shelter in Munai are either malnourished or undernourished and some already had lingering illnesses."
When the evacuees started arriving in the area after the latest clashes, the municipal health unit diagnosed 46 cases of measles among the children. Many were also suffering from bronchial asthma, pneumonia and malnourishment. Last month, five died. One of them was a nine-month old baby.
Hassan was just three when he first became a bakwit (refugee). In 2005, his family was forced to flee their small village after fighting between the MILF and the military came too close to ignore. They ran carrying only a few valuables to the town of Poblacion 15 kilometres away.
A similar thing happened again this August. Hassan says he no longer minds being a bakwit. For someone so young he seems resigned to his fate.
Social worker Fe Gogo of Munai's social welfare and development office said that many children who came to the evacuation centre were like Hassan: aloof, irritable and in need of immediate medical intervention.
"We usually conduct assessments for post-traumatic stress disorder among the evacuees, especially the children. But their sheer number was just overwhelming, we could barely cope up just feeding them," said Gogo.
Countless studies have shown the effects of war on children. The United Nations Children's Fund, UNICEF, suggests that more than ten million children have been traumatised by conflict over the past decade. Those exposed to intense stress aggression and heightened fear will most likely suffer from psychosomatic disorders, anxiety and depression, aggressive and regressive behaviour and emotional instability, experts say.
In its 2008 study The State of Asia-Pacific's Children, UNICEF specified periodic armed conflict and social unrest in Mindanao as factors that have destroyed "the supportive environment needed for child survival". It added that constant disruption to the lives of children in Mindanao was a violation of their basic rights.
The report echoed findings that have been told and retold countless times by other international organisations and agencies. In 2004, the Save the Children Foundation released a comprehensive study on the effects of the then ongoing war in central Mindanao on children. The study also pointed out the need to give long-lasting intervention for children torn in conflict.
"Children are the most vulnerable among all the sectors, yet their needs are also the least attended to in current aid programmes. Most of those who were affected by both 2000 and 2003 wars no longer have a fair chance of full childhood development before transcending to adulthood," the foundation said in its report.
With the collapse of peace agreement the Memorandum of Agreement on Ancestral Domain, MOA-AD, which had taken four years to draft, observers fear the situation is not likely to improve for some time. The Supreme Court's order to temporarily stop the signing of that proposed land pact in August allegedly forced some members of the MILF to retaliate against the military.
"I've been in this work for almost 20 years and never have I seen so much misery and hopelessness among the people," noted Gogo.
Unlike previous conflicts here, she said the recent evacuations have seen families taking as many of their belongings as they could carry to safety - in the belief that with the collapse of the peace agreement, they will be away from their homes for a long time to come.
Many evacuees might not have an idea what the recent army operation is all about. Yet while very few of them know about the controversial MOA-AD, they do know how the fighting can stop.
"Just leave us in peace in our land," said Mona Ali, a mother of two young children, who along with her family was the first to flee from Lindingan village some ten km away.
"We cannot go back as long as the army is there. We are scared of them," she said.
"I don't know what will happen to us now. You tell us."
Gogo said that although the authorities have been pushing the evacuees to go back to their homes, they have been politely ignored, "We tell them to go back for the sake of the children. They have all been away from school for more than two months now."
The elementary school in Munai has been converted to sleeping quarters and classes have not resumed since August.
"Disruption of the children's education is one of the negative effects of displacement," noted Gogo.
For Hassan and his playmates, though, not being in school is now normal. Providing their children with an education is sadly the least of their parents' worries as they seek to cope with daily life as evacuees.
As Olara Otunnu, former UN Special Representative on Children and Armed Conflict has said, children who have become exposed to the trauma of war, violence and the flagrant use of weapons have a tendency to become "instruments of war". In all too many documented cases, "children of war" like Hassan become rebels themselves or juvenile delinquents.
Looking at Hassan sitting meekly in one corner, unable to look the doctor straight in the eye, it is discomforting to think what the future will bring.
Ma Cecilia L Rodriguez is a journalist based in northern Mindanao.