Bangui, Central African Republic – They look like ordinary schoolchildren, sprawled on mats, drawing pictures of their homes and families with felt pens, but the girls’ disturbing images depict scenes of violence – men with guns, missing limbs and lost children.

This class of eight at Gobongo school in Bangui, the capital of the Central African Republic (CAR), is no ordinary lesson, but a group therapy session for children showing symptoms of post-traumatic stress disorder (PTSD), such as aggression, bed-wetting, night terrors, lack of concentration and developmental disorders.

It’s a reality for many in CAR, a country in which every community has been traumatised by a cocktail of brutal conflict, displacement, hunger and poverty.

CAR’s sectarian strife peaked in 2013/14 after a mostly Muslim coalition of fighters, called Seleka, seized power. A coalition of Christian fighters, called anti-balaka, was formed and a cycle of religious and ethnic violence followed, including gun and machete attacks, kidnappings and the burning and looting of homes. More than 6,000 were left dead and nearly one million displaced, according to the UN.

The NGO Action Against Hunger has begun running trauma sessions in an effort to start the healing process, in which children use pictures and role play to describe their symptoms.

Programme coordinator and clinical psychologist Coraline Galliot said many of the children had lost parents and relatives, and had witnessed violence. 

“They can be aggressive and don’t know why. They might be bed-wetting and don’t understand it. They cannot imagine their friends might have the same symptoms, and think they are alone. They often don’t want to share their feelings because of the shame and loss of trust – totally, in everyone.”

The charity has already trained local medical students and teachers, and plans to train 20 additional teachers to help them to identify children with PTSD.

“To defend a feeling of sadness, children often suffer from hyperactivity, which impairs their concentration and can be confused with disobedience,” Galliot explained. “The kid with PTSD might be the most annoying one in the whole class.”

* The names of the children have been changed.