The town of Vardenis sits near the shores of Lake Sevan, encircled by mountains, on the eastern edge of Armenia. The surrounding beauty belies the troubled history of this area in the southern Caucasus.

Beyond the snow-capped peaks is Azerbaijan. For decades, the two neighbours have been locked in an ongoing battle over Nagorno-Karabakh, located roughly 50 miles away in what is today Azerbaijani-controlled territory. A year ago, the conflict over the territory escalated into a six-week war, killing thousands of people and further deepening the rift between the two countries.

Then, overnight on 9-10 November 2020, Moscow brokered a peace deal that ended fighting, with Azerbaijan making significant territorial gains, including the second largest city in Karabakh, Shushi (which Azeris call Shusha). According to the UN Sustainable Development Group, 90,000 people, mostly women and children, fled Nagorno-Karabakh during the war. Now a year on, thousands are still living across Armenia, many in Yerevan, the capital, and some in border towns such as Vardenis.

But while the fighting may have stopped, many are living with the after-effects of this brutal war.

On the outskirts of Vardenis, a bumpy road takes us to a cluster of buildings with a playground outside. Inside the walls are painted with bright colours and decorated with children’s artwork.

This is the base of Astghavard, an organisation that supports disabled children. It was set up by Melanya Yepremyan, a local resident, after her twin grandsons were born with cerebral palsy. Known by everyone in the town as ‘Tatik’ (grandma), Yepremyan now also helps displaced families from Nagorno-Karabakh, providing social and psychological services, particularly for children. Many of them have lost loved ones, sustained injuries, and continue to live in unstable conditions.

“Sometimes [at the start of the war] the families stayed here in the centre to sleep because they didn’t have a home to go to,” Yepremyan says. With the help of the Red Cross, they organised activities for the children, such as art classes and excursions that “helped take their mind off the war”.

Forced to flee

Upstairs in the centre, children are playing while their mothers sip black coffee from tiny china cups. All of them were forced to leave their homes in Karvachar, a town on the other side of the border, which was seized by Armenia during the first Nagorno-Karabakh war from 1988 to 1994 but was taken back by Azerbaijan last year. Many fled without taking any possessions or even their documents, having been told that they could return to their homes after ten days – by which time the town had already been taken.

Tamara, 38, has two sons aged 16 and 14, and one daughter who is six years old. “I’m from the generation that experienced the first war when I was a child, and then the four-day war in 2016, and now my children have seen this war, too,” Tamara says, adding that it has “badly affected” her two sons in particular.

“My youngest son had strange fears when we moved here during the war,” she says. “He was afraid of going to the toilet on his own and even had some episodes when he wet himself. My eldest son is not the same boy he used to be. He is very silent, closed off, and depressed. He doesn’t want to meet any new people or go to school.”

The other women say their children suffer from sleep problems and anxiety. Forty-five-year-old Liana’s daughter was ten at the time of the war and, a year later, is afraid of loud sounds. “From the first days of war, our home was badly damaged so we had to leave,” Liana says.

“When we were leaving in the truck, we were under fire. [My daughter] is always asking, ‘Could this happen again?’”

A few months ago, there were fears that the war would be repeated. “The Azeri soldiers have been shooting – and even shot at nearby schools. We got very scared and we thought we were under attack again,” says Haykanoush, 30, a former medical worker who now works as a hairdresser to support her family.

Haykanoush’s husband, along with the majority of the other women’s husbands, fought in the war. “We are very lucky that our husbands survived,” she says, as the other women nod. “There are no obvious wounds, but we have a lot of psychological issues – these wounds are hidden.”

‘We lost everything’

Twelve months on, the trauma many experienced is only just starting to surface as they come to terms with the prospect of not being able to return to their homes.

This trauma can have lasting impacts on children in particular and, without treatment, can affect their learning, development and brain function, explains psychologist Narine Abrahamyan-Tovmasyan, who works with the Children’s Support Centre in Yerevan.

When I visit the centre, the city is having an autumn heatwave. The sun blazes as children scuttle around the play area; a young boy with a bow and arrow made out of sticks tries to shoot nuts from a tree. Mira Antonyan is the centre’s child protection programme director as well as the president of the Armenian association of social workers, and is a whirlwind of energy with a deep passion for what she does. She describes trauma as “being in the blood of Armenians”, referencing the Armenian Genocide during the First World War, which is why she is so determined to help those that have been impacted by war.

Currently, the centre works with more than 2,000 displaced people from Nagorno-Karabakh. Social workers and psychologists go out to visit shelters, individual homes and other children’s centres such as Astghavard in Vardenis, to do one-on-one or group psychological sessions across the country, as well as in Nagorno-Karabakh, where there is a huge gap in psycho-social support.

Armenia is one of the poorest former Soviet states, with limited resources – particularly for mental health care. In 2019, 26.4% of the population lived under the national poverty line, according to the Asian Development Bank, and that percentage will have risen since then due to the influx of people uprooted by the war.

One family of six in Alapars, a rural village in Kotayk region, lives in a house with two rooms, which was last inhabited 20 years ago. The local authority gives out houses to displaced families, but most, like this one, are in poor condition. It is damp and dark, with bare walls and a musty smell in the air. Flies buzz everywhere, crawling on the furniture and circling around the family’s six-month-old baby. The family can’t afford basic utilities such as electricity, hot water, food, medicine (one child has epilepsy) or even nappies for the baby. They didn’t bring anything from their home in Kashatagh, in Karabakh.

“We had to leave at the last minute. We lost everything,” says Aregnas, 22, the eldest daughter, beginning to cry. That included their animals, which is how they earned money before. Now they rely on their parents’ pension, but that is not enough.

When I ask Sergey Ghazaryan, the permanent representative of Artsakh in Armenia, about the living conditions people are facing, he answers: “Unfortunately, the problems are so much that the restricted resources means we can’t help out all of the [displaced] people.”

Instead, both the Armenian and Artsakh governments’ main focus is on “residential reconstruction” in Karabakh, Ghazaryan says. This will be a difficult job: Armenia lost four districts in Nagorno-Karabakh to Azerbaijan, as well as three surrounding districts, which it had previously taken during the first war. Moreover, many people do not want to return to a place that is in perpetual turmoil.

Ghazaryan adds that the international community is “not helping enough”, especially compared to “the work they do in other warring countries”.

Impact on children

In 2019, 26 mental health professionals from the Children’s Support Centre were trained by British charity Action for Child Trauma International to deliver a special trauma technique specifically for children, called CATT (Children’s Accelerated Trauma Treatment).

This is child-centred arts or play-based therapy that is designed to relieve the symptoms of post-traumatic stress disorder. Art therapy is also used to help children process their feelings and ease anxiety.

I watch a session run by Narine Abrahamyan-Tovmasyan for a small group of children in Abovyan, a town just outside Yerevan in Kotayk region. The children sit at the table, nervously at first, but a plate of biscuits melts their shyness, and they each grab one and start talking. Ashot, ten, from Karvachar, has large, dark eyes and likes drumming – at the end of the session, he gives us an enthusiastic performance on his drum. Ashot is one of seven children in the group – his eight-year-old brother, Kolya, sits beside him. “I don’t like going to school – I miss my old friends in Artsakh,” says Kolya, explaining that he gets teased by other students at school, who call him ‘Coca Cola’ because of his unique name, which has Russian origins.

The oldest of the group is Larisa, a confident 17-year-old who studies history at Yerevan State University and wants to become a historian when she’s older. She says stress has impacted her a lot – she lost her hair during the war and has a problem with her leg that means she walks with a limp. “I miss my native land. I had a beautiful childhood there,” Larisa tells me.

After introducing themselves, the psychologist, Abrahamyan-Tovmasyan, instructs the children to split their blank A4 piece of paper in half and on one side draw a picture of their past (“What they want to leave behind”) and their future on the other side.

For his past, Ashot draws an outline of a hand with a small wound in the centre. As he explains his drawing he begins to cry – small snivels turn into sobs as he buries his head in his arms. Abrahamyan-Tovmasyan gives him a hug. Last year’s war began on Ashot’s tenth birthday and instead of celebrating, his family were forced to flee their home. In the chaos that ensued, his hand was injured. When he stops crying, he shows us what he’s drawn on the other side; a squiggly blob is actually Armenia “from sea to sea”, he says proudly.

Larisa’s artwork is more abstract. Her drawing of the past looks like rays of orange fire, which she says represents her friends and teachers who died in the war. “I want to be free of pain, suffering, feelings of missing home, feelings of loss. But, my stresses are not finished – the war has left a hole in my soul and maybe it will never heal.” For her future, Larisa leaves the page blank. “I want a clean page to start again,” she says.

Afterwards, I speak to a group of mothers who live in Abovyan. Maria, 45, is from Hadrut, in Karabakh, and out of her family of nine, she lost her husband and eldest son in the war. Two of her sons were injured – one is waiting to have an operation on his leg. She sighs frequently, her eyes glazed with tears. “Even though the war is over, it is still painful. I feel the same negative feelings,” Maria says. Her days are spent caring for her wounded son and her two young children, the youngest of whom recently said: “I would like to become a bird so I can fly home to Artsakh.”

The future

During my time in Armenia, whenever I ask mothers what their children want to be when they grow up, they usually answer “soldiers”. Abrahamyan-Tovmasyan tells me that a lot of children think that only fighting will help them improve their lives, which only adds to the cycle of aggression.

Gor, a five-year-old boy I meet in Martuni, a town close to the Azerbaijan border in Gegharkunik region, regularly says “They took our Shushi. When I grow up I will take it back,” according to his mother, Esther, 25. As Gor plays with playdough behind her, Esther tells me how they fled their home in Shushi, now under Azerbaijani control, in early October last year.

After struggling with speaking and aggressive behaviour during the war, Gor worked with a psychologist and things started to improve, says Esther, who is now six months pregnant with her second child. All she wants is a “peaceful life for my children. But what kind of plans for the future can we have when they are so close to us here?”

Back in Vardenis, the women from Karvachar are asking themselves the same question as Esther. Uncertainty pervades. But there are moments of hope.

Some of the mothers have started a sewing group and sell their wares to make money. “All of us have professions, but we couldn’t find this work here so we are open to learning something new and adapting. Even if we have a small salary it is a big improvement in our situation,” says Angin, 32, who used to work in finance but now sews and offers manicures. They are even learning the regional dialect to better communicate with locals.

“We have become a lot stronger here, even over the last few days when there have been drones [from Azerbaijan] flying above Vardenis, we weren’t scared,” says Liana, looking out of the window at the distant mountains. “But after this war, we always keep a suitcase packed in case we have to leave.”