A photo that went viral last week depicting a young Syrian child "surrendering" in front of a camera she thought to be a gun is but a mere hint at the trauma which displaced and refugee children face across the Middle East, an aid worker says.

"In regards to the children, it's a very bleak and complex (situation). Circumstances are not good at all," Zerene Haddad told CNA during a March 31 phone call from Beirut.

Many times children in refugee camps "look empty, or they just look numb," she said, explaining that in her experience the recovery process for a child affected by war and violence "comes down a lot to the ability of the child to express themselves."

The lack of vocabulary to express their emotions and the lack of emotional maturity needed to process what they are feeling and experiencing can have a very negative effect on children, Haddad noted, begging the question "how do you help this child? What are you able to do when the child is so young?"

Haddad is in charge of Regional Advocacy and Communications for Jesuit Refugee Service in the Middle East and North Africa, which is the organization's newest region.

In addition to offering emergency assistance, JRS also offers educational, recreational, and psychosocial services to refugees. The regional office serves more than 2,000 Iraqi refugees in Jordan and Syria.

Haddad's words came after a photo went viral last week depicting a young Syrian girl raising her hands above her head to "surrender" when she thought the photographer was holding a gun rather than a camera.

Twitter user Nadia Abu Shaban, a photojournalist based in Gaza, tweeted the photo, which then spread through social media.

BBC Trending tracked down the original photographer, Osman Sagirli, who told the agency that he took the photo in December at the Atmeh refugee camp in Syria, which sits roughly six miles from the Turkish border.

After snapping the shot of 4-year-old Hudea, who came to the camp with her mother and two siblings after traveling over 90 miles from their home in Hama, Sagirli said he realized "she was terrified … because she bit her lips and raised her hands."

"Normally kids run away, hide their faces or smile when they see a camera," he told the BBC, but when he broke out his telephoto lens to capture the shot "(Hudea) thought it was a weapon."

Since it was first published in Turkey's "Türkiye" newspaper in January, where Sagirli previously worked for 25 years covering war and natural disasters outside the country, the original post has been retweeted more than 11,000 times, the BBC reports.

Now working in Tanzania, Sagirli explained that he finds pictures of children in refugee camps to be more revealing than those of adults.

"You know there are displaced people in the camps. It makes more sense to see what they have suffered not through adults, but through children. It is the children who reflect the feelings with their innocence."

Weighing in on the topic, Haddad said that in her experience of working with displaced and refugee children, there is a wide variety of reactions to their situation.

Some children, she said, "are visibly traumatized and shaken up," while others "are able to conceal it well, so they appear that they are coping well on the surface, but after a while signs begin to show."

There are children who become "very aggressive, (and) you have other children who are shell-shocked and (can't) speak, it's difficult for a lot of children to learn."

The majority of children JRS works with in Lebanon have experienced some sort of trauma, Haddad noted, saying that "they all have stories" of losing friends, family members or witnessing some form of extreme violence.

"Even the act of having to be forcibly displaced is a traumatic event to occur in someone's life, even without any violence having necessarily occurred around or directly in front of your eyes," she said.

This trauma is then exaggerated when families are forced to then live in "less than satisfactory conditions."

With people living in inadequate conditions while struggling to feed their families, the task of educating becomes a challenge, Haddad said, because "you can't teach a hungry child, it's hard to get them to focus. Even as an adult, if I'm hungry, I can't focus."

Children who come to their schools frequently arrive sick or with some sort of ailment, she said, explaining that it's easy for sickness to spread like wildfire due to the lack of sanitation and poor living conditions in the camps.

However, despite the gloomy circumstances, Haddad said she has been impressed by the children's resilience.

One of the main factors helping is access to education in the midst of a crisis in which many of Syria's children have not been to school for several years, including some who dropped out for one reason or another when the country's civil war broke out four years ago, prompting political leaders to lament a "lost generation" of Syrian children who grow up without an education in the midst of war.

Low enrollment numbers in Syria – currently at 50 percent of what they were before the war broke out – are "frightening," Haddad said, explaining that she has seen a major difference in the children who started attending the JRS-run schools after several years of not going.

The change "is just astounding," she said, adding that having a structured and disciplined environment for the children, who are taught to live with a specific Monday-Friday routine, "has a massively positive impact on their social development."

In what Haddad referred to as "an old-school pen-pal system," a boy in Alaska had the idea of making postcards for displaced and refugee children. He convinced his class to participate in drawing pictures on one side, writing a message on the other, and sending them to the schools.

When the children in Lebanon got the postcards, it launched a "very interesting dynamic," Haddad said, noting that the children responded by drawing mostly positive and happy things.

Some asked her what they should draw in response to the postcards from the U.S., saying "I don't want to draw about politics, I don't want to draw about war," Haddad recalled.

"It's very interesting seeing the children reject that narrative…they just want to be children…they take the time to recover and that's how they move forward."