BELGRADE, Serbia — Noor had never seen the sea, much less been in it. Of course, she couldn’t swim. But at 4:30 one recent morning, Noor, her parents and her three younger siblings put on life jackets barely thicker than sweaters and got into the dinghy.
They’d made it overland from Baghdad to the Turkish coast, and now it was time to venture onward to Greece.
The waves were high and rough, crashing into the cramped boat.
“I was crying a lot. I thought we were going to die,” said Noor, a 13-year-old Iraqi girl with a bright smile, one of thousands heading across Europe in search of a safer life.
The man in charge didn’t want to land the boat on the Greek island of Lesbos, so he told everyone to get out 30 yards or so from shore. The water was above their heads.
“I was so scared when my father told me to jump out of the boat,” Noor said, smiling meekly, at a “child-friendly space” in Belgrade, Serbia, run by UNICEF and the Danish Refugee Council.
More than 500,000 refugees and migrants have arrived in Europe this year, according to the E.U. border agency. Most have come from Syria, which is caught between President Bashar al-Assad’s regime and the Islamic State, and Iraq, caught between militias and the Islamic State.
Between a third and a half are children who, like Noor, point to the boat journey across the Aegean Sea as a singularly terrifying experience. And it was the image of 3-year-old Aylan Kurdi, washed up drowned on a Turkish beach, that refocused the public’s mind on the crisis.
But there are plenty of other sources of fear for children along their perilous journeys to Western Europe — from unscrupulous smugglers, Macedonian thieves and Hungarian police to the nights sleeping in the open in cold and rain.
The experiences are clearly taking a toll on the young. The soundtrack at the borders in the Balkans and in central Europe is of children crying.
A small minority of children will suffer from post-traumatic stress disorder, but experts say many others will experience anxiety and fear — which can be remedied if handled the right way.
In a bright room in an unoccupied office building near the muddy parks in Belgrade, where refugees and migrants have camped out, the child-friendly space is a place where children can draw, make things with modeling clay, run around in their socks or play board games. A place where kids can be kids, where they don’t have to think about lugging their belongings onto boats or through rainy cornfields.
Noor’s mother, Shaima, had brought her four children there on a recent day to get them out of the rain, which had turned parks into swamps.
While her children played, she recalled the most traumatic part of their journey.
“The little ones were crying loudly the whole time,” she said. “We saw death on that journey.” Shaima and her husband, Riad, who was a traffic policeman in Baghdad, fled Iraq because of the dangers posed by militias. They asked to withhold their surname to protect family members in Baghdad.
When Noor’s 12-year-old brother, Salaheddine, got to the shore, he turned and said to his mother: “All the blood has come back into my veins now.”
“After that, I was okay,” Salaheddine recalled.
Their parents carried ashore 2-year-old Amir and 8-year-old Dali. Everything they owned — papers, cellphones, meager belongings — was soaked. Their faces had been lashed by wind and salt water. Then they walked across the island for hours in wet clothes.
The length of time that the refugees and migrants are on the move compounds the psychological impact of their experience, experts say.
“This emergency is probably one of the most serious in terms of affecting children’s well-being that we have seen in years, because of the long-term impact,” said Amy Richmond, a child protection adviser at Save the Children. “The most important thing for children’s mental health is to have a sense of place and of belonging. But these kids have been through a really dangerous war and have moved to community to community for more than four years.”
The disruption often results in anxiety and fear, nightmares and difficulties sleeping, and bed-
wetting. Sometimes stress is manifested through sadness, other times through nervousness or aggression. Acting out and temper tantrums are common.
Many children also experience what psychiatrists call “ambiguous loss” — when a person isn’t sure what happened to someone who is missing.
“So there is a lot of reason to be worried about the current generation of Syrian children, who are exposed to violence, social breakdown, distressed parents, loss of family members,” said Peter Ventevogel, a senior mental health officer at UNHCR, the U.N. refugee agency.
Sitting on the border between Serbia and Croatia waiting to cross on a recent night, Judy Kalash talked about home with the kind of smile kids put on when they don’t want to cry.
“I miss my home, I miss my parents, I miss food, I miss everything so much. But now my memories of home are all of death and killing,” said the bespectacled 12-year-old from Yarmouk, a Palestinian area of Damascus. Judy’s parents stayed behind in Syria — her father is old and her mother was too sick to make the journey — so she was traveling with an older cousin. They were heading to Geneva, where Judy’s brother was.
“I’m not okay. I’m very scared. I’m so far from my parents,” Judy said.
“She often has nightmares about what happened. She was in school when the bombs were dropped,” her cousin said, referring to the barrel bombs that the Syrian military has used on civilian targets.
As a result of the fighting and the journey, Judy hasn’t attended school in more than a year. Neither has Stera, a 13-year-old from the Syrian city of Aleppo who was also waiting in the cold at the border.
The routine and structure of school are reassuring to kids, experts say, and most are eager to get back to class.
“I just want to go back to normal life and normal things,” Stera said, looking out from under her bangs.
Structure and routine are what children in this situation need most, said Lynne Jones, a British child psychiatrist who studied children in Bosnia in the 1990s.
“I don’t think that all these Syrian children need trauma counseling,” she said. “The social institutions that protect family, restore school and normality, are the most important things for mental health.”
Despite the turmoil they’ve been through, the vast majority of refugee children will recover once they’re back in a safe environment and in a routine, research from previous conflicts suggests.
“Keep families together. If children are with their parents and their parents are supported, then children do well,” she said.
But in many cases, families have not been able to stay together. Serbian government data provided to the U.N. refugee agency shows that about one-quarter of the 25,000 children younger than 18 who have arrived in Serbia this year have been unaccompanied.
Save the Children estimates that the number skyrocketed with the influx this past summer.
“We’re very worried about children arriving by themselves or children arriving with people who don’t seem to be their parents,” Richmond said. “Without strong family support, they are at risk of abuse, exploitation and trafficking.”
As Europe grapples with how to deal with the crisis — where refugees and migrants will be held, how their claims will be processed — parents are facing stress and uncertainty. And children absorb their parents’ stress.
“If their mothers are anxious and depressed and worried, that’s very stressful for the child,” Jones said, adding that the best psychological interventions in the current situation are physical.
“Make sure they have food, water and security, and then you’ll have far fewer psychological problems,” she said. “It’s not rocket science.”
Stera’s mother cradled her youngest daughter, 6-year-old Julia, on the border between Serbia and Croatia on a recent cold night. Julia “hasn’t stopped crying for a month,” since the family left Aleppo, her mother said. She did not want to reveal her name, because her husband had stayed behind in Syria.
But asked about the choice between conflict at home and trauma on the road, she was unequivocal. “We escaped from war, from terrorists on one side and terrorists on the other side,” she said. “All of this, we are doing it for our children and their future.”