In Burkino Faso, a young girl watches her father's throat being slit and her older brother being burnt alive by rebel soldiers. A 12-year-old girl from Sierra Leone is caught by rebels and forced to have sex with them. A teenage boy from Liberia witnesses his mother being skinned alive while trying to flee to a Guinea refugee camp.

These are just some of the stories shared in a new report released by Plan International that found children in West and Central Africa are suffering extreme psychological trauma as a result of civil war, ethnic cleansing, AIDS and trafficking.

"The children and young people in our studies have already been exposed to more violence in their short lives than most of us will ever experience in our lifetime," Alice Behrendt, one of the report's authors, said in a statement.

The first psychological study of its kind - "Silent Suffering" - in conjunction with Family Health International assessed more than 1,000 children and adolescents living in Liberia, Togo, Sierra Leone, Cameroon and Burkina Faso.

The report says violence and instability in West and Central Africa have forced growing numbers of children on to the streets where they are more vulnerable to being trafficked, sexually abused and exploited as cheap labour. Others were enlisted as child soldiers.

Of the former child soldiers interviewed in Liberia, most of whom were "recruited" by force, 60 percent said they had witnessed another child being punished to death. Nearly nine in 10 children said they had seen a member of their family being threatened with death or killed. In the same group, 84 percent had found themselves "surrounded by, lying underneath or stepping on" dead bodies.

"I tried to run away, but there was no way out," said one girl from Sierra Leone in the report. "There were dead bodies everywhere. I had to step on them, there were too many and I could not find my way out."

The study found that children who had no direct experience of violence and lived with their parents still suffered high levels of trauma in what researchers said was "a spill-over culture of violence brought about by years of social instability."

"Time and time again we found adults trying to raise children in societies in which they are themselves under enormous pressure - from economic insecurity, inter-ethnic hatred, political violence, the terrible aftermath of civil war and their own trauma," said Stefanie Conrad, who co-authored the study, in a statement.

Researchers found that children caught up in conflict faced high risk of mental illness, suicidal tendencies and post-traumatic stress syndrome. For example, in Sierra Leone, 70 percent of girls with no parental support had contemplated committing suicide and 80 percent of boys. Nearly one-third of that group had already attempted to kill themselves.

For many victims, the study was the first time they could detail the violence they experienced and the impact it had on them, and researchers said "they were impressed by the children's extraordinary resilience in extreme circumstances."

Since the research was carried out, Plan has set up mobile units made up of trauma counsellors and psychologists to treat the children judged most at risk. And it wants to see more psychosocial services on offer in the region.

"Often the emphasis is on rebuilding buildings, roads and infrastructure in countries like these, while the importance of 're-building people' and their fragile mental health is overlooked and dismissed," Behrendt said.

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