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The pre-teen superstars stopping disease in Iraqi refugee camps

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(The Guardian ) In the 45-degree heat and billowing dust of Kapartu camp in northern Iraq, staying neat and tidy presents a challenge, but there is one group of people who are always immaculately turned out and easily identifiable as humanitarians: a collection of children aged 11 to 13 who take great pride in their roles as junior health workers (JHWs). Smartly dressed in clean black T-shirts, black caps, and with lanyards round their necks, these children help fight the spread of infection, promote healthy habits and humanitarian ideals.

“I like wearing it, and my friends also like me wearing it,” says Hyatt, who is unsure of her age but thinks she is 12. “They wish they could dress like me and be a junior health worker.”

A few years ago in 2014, Hyatt was one of an estimated 300,000 people living in the Iraqi city of Sinjar when ISIS laid siege. The majority were Yazidi, an ancient religious minority who became a particular Isis target; under the threat of rape and enslavement they fled the city. Many spent weeks trapped in the mountains during August, unable to access clean drinking water and exposed to terrible conditions.

She was picked out of a class of 38 to be the JHW. Like every JHW I speak to, she says it was a great morale boost. “Now I have more confidence, and it’s made it much easier to talk to other people,” she says. “I talk to my friends and classmates about how they should go to school every day and about hygiene, especially handwashing, because they are bad at this. It frustrates me when I see people skipping handwashing.”

The thing I like most is talking to people
Hussein, 13
NGO International Medical Corps (IMC) started the scheme when they realised that children are much more likely to listen to peers than to adults, and that children needed extra help because they are much more susceptible to infection. Alex Bartoloni, community health worker for IMC, explains that the kids need JHWs they can look up to. “We go to fourth, fifth and sixth grade classrooms and ask who is the best student, as well as who is charismatic and communicates best,” he says. “They get a couple of days of training on humanitarian ideals as well as hygiene. To spread the message, they use comics and skits, paintings and murals, and then on a day-to-day basis they’ll talk to their classmates.”

Polio, typhoid, measles and cholera are in danger of spreading around the camp, so the scheme is of great importance. The JHWs dispense advice about how hands should be washed and whether water is safe to drink. Children are often weak when they arrive so their immune systems are vulnerable to infection.

In Kapartu camp for internally displaced people (IDPs) there are 30 JHWs, but across the IMC’s projects in Iraqi refugee camps there are a couple of hundred children promoting these messages.

“We also give them clothes so they look like aid workers,” Bartoloni says. “They enjoy the fact they’re listened to as humanitarians in the T-shirts and the caps.”

Hussein, 13, fled Sinjar with his family after Isis launched their deadly attack in 2014. They were hungry and thirsty, unable to go down the mountain to the river to get water because Isis fighters would kill them. Hussein now lives in Kapartu and is a JHW in the camp. “The thing I like most is talking to people,” he says. “I like feeling important and I have a lot of responsibility.”

However, despite the aims of the scheme, there are the same problems found around the world when working with teenagers. One JHW has been caught smoking several times by IMC staff, who are frustrated that a child meant to be teaching other kids about healthy habits is smoking. “I have friends who have smoked before, and if you smoke it stops you being hungry,” he protests. “Lots of the children here start smoking young, at eight, nine or 10. Other kids drink beer around the camp, too. They go outside Kapartu to a shop where you can get it for $1.”

Cigarettes are popular because they’re so cheap – you can get one for $0.25 (£0.19). While I’m speaking to the boy, Bartoloni chips in, telling him off in a reproachful voice. “Do you think you can run around and play football if you smoke? Messi doesn’t smoke.”

Adults also do unhealthy things all the time, like smoking and swimming in the fetid ponds behind the camp on hot days. Making them aware of the risks is another benefit of the JHW scheme. Thirteen-year-old Zainab explains that it is difficult to keep grownups on-message. She is evangelical about the healthy habits, talking to her friends about them every day. However, her single attempt to address her father’s smoking didn’t go well. “One time I tried to talk to him about it but he said: ‘For me, it’s OK.’” Does her mother listen to her? “For sure.” Her mother, who is sitting across the sheltered yard outside the family tent, nods and laughs.

In a different tent across the camp, Habib, a 12-year-old boy with brilliant auburn hair and a shy smile, walks in with his copy of the comic Back to My Home pressed to his chest. It’s one of the materials IMC gives to the children in the camp to help explain the healthy habits. “It’s the story of all refugees escaping Isis from Sinjar,” he says. “It’s about two kids, one called Ahmed and the other is called Majid and they’re on their own without their parents.” Dilemmas that come up in the story include identifying safe and unsafe drinking water, as well as personal hygiene, and the spread of disease. Navin, 12, also brings the comic to show me. “It’s good – it’s our reality and that’s why we like it.”

The children I speak to all have families, but they carry more responsibility for their own personal safety than the majority of children on the planet. “Children are the mostly likely to become sick in a displacement situation, and when children get sick they’re often the most severely affected,” says Bartoloni.

According to Unicef, there are 1.4 million children displaced by violence in Iraq alone. Many IDP and refugee camps operate beyond capacity, which means hygiene is often compromised and disease can rapidly spread.

The junior health worker scheme gives actionable advice on what to do to guard against leishmaniasis – a nasty disease spread by sandfly bites – and they are able to explain to bored children with few resources or outlets for entertainment why playing in garbage is a bad idea.

“We hope that the values we have taught them today will help them thrive and give them a bright and healthier future,” says Zaid Sulaiman Jallood, community health officer in the camp. “The kids are very creative and we give them the right support to make themselves positive influencers.” Many junior health workers want to be doctors, scientists or teachers, so Isis may have indirectly created a new generation of responsible health professionals.

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