Displacement is a universal symptom of war anywhere in the world.
Fighting in Central Africa has forced more than four million people out of their homes. In Southeastern Europe, more than one million people fled the 1999 war in Kosovo. Hundreds of thousands of Cambodians spent more than a decade in refugee camps along the Thai border, and tens of thousands still remain.
Besi, an ethnic Albanian, painfully recalled fleeing the war in Kosovo in 1999, when he was 11 or 12 years old. He doesn't remember exactly.
"First of all they caught my dad in front of my eyes. I was on a balcony and my dad and my brother who was 14 then ... they caught them," he said. "During the war I was a refugee. We had to go outside Kosovo because they already knew my dad and my brother. The first month I couldn't read well or write well because of the scenes I saw in the war."
Igbale Paqarizi fled the same war with her son and daughter.
"We were running toward the border," she recalled. "A Serbian policeman stopped us. First they burned my daughter's face. She started crying 'mother!' I just told her 'keep silent, keep silent.' Her face was covered in blood. They hit my son in the stomach and he fell to the ground. I was just saying, 'oh my God.'"
The terrified mother was then ordered to take her children, start walking, and not look back."So we walked. I was expecting 'bam, bam,' that they would kill the kids and me, but with God's grace we were saved."
"A refugee camp can be a very dangerous place," said Patrick Fruchet, who has worked for the United Nations Children's Fund (UNICEF) in a number of conflict zones. "You are putting an enormous number of people in very close proximity, and these are people who are tired, who have become ill. There are all sorts of health risks in a camp situation."
Fruchet most recently worked in Kosovo, where thousands of people displaced by the 1999 war still suffer in camps like one called Plementina, just outside Pristina.
Enver Krasniqi is the American Refugee Committee field agent in charge of the camp.
"For children it is a difficult life here in the camp, because only some of the people are free to move, but some are afraid to go outside to the village or to Pristina," he said.
Many of these children, especially Serbs and Roma—also known as gypsies—are afraid to leave because they fear ethnic attacks.So they make their home on the wet and muddy grounds of Plementina. Garments hang from clotheslines. A dilapidated playground stands empty except for a few sheep wandering among the swings and monkey bars. The slide is rusty, and wood from the benches has been stolen.
"You should see the pictures they are making," she said. "Even for people who have nothing to do with a psychosocial program, they can realize there are scars."
Sandra fears that such psychological trauma may be fertile soil for the next war.
"You can see many of the kids are violent without reason," she said. "They have suffered because of war and those scars can make them warriors, which we don't want. Let's have more doctors and teachers."
Rand Engle of the nonprofit relief organization Balkan Sunflowers agrees.
"We find that children are sponges," he said. "They need so much attention; they are needing support. They may be with their families, but their families can't give them the amount of attention and support they need. They are already distracted by events. We found that when volunteers go into a refugee camp, they are taken in, embraced by the children."
Beyond the physical discomfort and psychological trauma, children on the run from war face threats to their personal security, suffer from a lack of regular education, and receive little or no healthcare."A child is more likely to die from not being immunized as a result of armed conflict than to die as a result of the armed conflict," said UNICEF's Fruchet. "It is the same thing. Because of the disruption of the conflict, they are vulnerable to a whole slew of child killers, basically."
Shkumbin Dauti, who leads Child Advocacy International's work in Kosovo, said there are no easy answers.
"There are things which people have to learn from this case," Dauti said. "Could they be applied to other places? I don't know. The needs of the child in Afghanistan are different from those in Kosovo. We have to be flexible. You have to always have a voice from the ground, people who know the area. Even if you are sitting in the top institution in Cambridge, that is not enough. You have to include voices from the field."
Sandra of the Plementina camp agreed that each conflict situation is different and that humanitarian responses must be tailored to fit local needs."It has to be much more targeted," she said. "It would be better if the donors came down to the field. Please do not stay at headquarters!"
Fruchet said UNICEF is working in one particular Kosovo community to help families return, but the results are frustrating.
UNICEF has talked to a number of men whose wives and children are staying behind while they rebuild their homes. Asked whether their families will be returning, the typical response is "Well, not unless there is healthcare and education."
"So for UNICEF, the right to return is not just to return to a house, it is to return to a community with services," Fruchet said.
Simon Haselock, chief spokesperson for the United Nations Mission in Kosovo, said UN plans for returning refugees and displaced people to their homes are based on creating both safe conditions and local services.
And he knows that for children and adults alike, this is an urgent task.
"The next two or three years are critical for returns," he said. "If it lasts any longer than that, of course, you then come to the problem where these people become too embedded where they are, and it is less likely they will return at all."That's a sobering thought and a vivid reminder that child refugees can be just as much victims as those injured in war. And it is up to their parents to resolve the underlying problems that led to war in the first place.