Memories of the ground shaking at 4:17am on a cold February night still haunt Elif, an eight-year-old girl from Gaziantep, Turkey, the epicentre of an earthquake that killed more than 50,000 people and destroyed hundreds of thousands of homes.

Elif sits holding a doll that she grabbed that night she had to run out of her house.

“This doll helped me fall asleep while I was afraid of all the aftershocks that lasted for weeks,” she said. Elif and her family found temporary refuge at her father’s workplace.

Six months have passed since the Turkey-Syria earthquake, which displaced millions, and many children who lived through the disaster continue to experience trauma. Some still live in tents, and many have been unable to return to school.

According to UNICEF, more than four million children across Turkey have been affected by the tragedy. Those who witnessed injuries and deaths are struggling with post-traumatic stress symptoms, such as anxiety and flashbacks.

“Children need stability more than adults because, at that age, they can’t understand or cope yet with the instabilities of life,” said Zeynep Bahadir, a clinical psychologist with expertise on disaster traumas. “Playtime is the most important tool for them in this situation. It can work as therapy.”

That could be why, for some children, the first object they grabbed when they had to abruptly leave their homes was their favourite toy, helping them feel safe amid the chaos. “Toys have a bigger meaning; they are their words,” Bahadir said. “They can express themselves through toys.”

In February, eight-year-old Eymen lived in a car with his parents and two siblings for three days after the earthquake. It was the only place where he felt safe. Since then, he has carried a toy car around. His mother says it makes him feel protected.

Hisa’s family of five initially fled the Syrian city of Idlib in 2018, but they were displaced again when the earthquake hit their new home in Nurdagi, Turkey. They have since been living in a tent by the ruins of that home.

“This doll I’m holding is a gift from my mother when I was younger and we were still living in Syria,” said Hisa, 11, adding that she received it as a form of encouragement before they left Idlib, and carried it on her journey across the Syria-Turkey border. “I’m very attached to it, and I’m happy I was able to retrieve it from my house and bring it to our tent.”