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Video: Syria’s shockwaves – A mental health crisis for victims of explosive violence

Video and photos: Nicole Tung/AOAV

Sitting in an empty community hall in northern Lebanon, 36-year-old Rouba wipes her eyes on her headscarf as she tells how she was forced from her home in the Damascus countryside. “The bombing was getting worse and worse,” she relates. “We were very scared. Eventually we had to leave, an Air Force rocket actually fell on the house next to us. Three people were killed, and we were so afraid.”

“The children were very much influenced by what happened to them,” she continues. “My son, the one who was next to the bomb when it exploded, stopped talking for a couple of days and was shaking all the time […] Every time they heard the sound [of bombing] they would both be shaking, they were very scared…”

Rouba’s is one of a sea of similar stories. Lebanon is now host to more than a million Syrian refugees, many of whom are battling with the trauma of their experiences and the psychological fallout of escaping a brutal civil war.

AOAV was recently in Lebanon, talking with the injured, the bereaved, the scarred, and with the doctors trying to fight back the tide of pain and distress. The video above tells of the scale and severity of the suffering still experienced by many who escaped their encounter with explosive weapons in Syria.

The sheer extent of medical needs alone threatens to engulf Lebanon’s overstretched public healthcare system. The United Nations has barely received a third of the funding it has requested, and has had to target its limited resources to only the most vulnerable and urgent cases. The focus has been on physical injuries and primary health needs, but this is coming at the cost of what has been described as a tidal wave of trauma.

How big is this crisis? Well over 9 million people are thought to have fled Syria. Many more remain, enduring the continuing bombings and rocket fire. The World Health Organization has said that 3-4 percent of people affected by an emergency like war or natural disaster will develop severe mental health disorders, while up to 20 percent will develop mild or moderate anxiety or depression disorders or PTSD, as much as double the ordinary level. Conservatively we’re talking about nearly two million registered refugees suffering with mental health disorders.

It’s a massive problem, and one that is getting crowded out by other pressures, or is otherwise nudged into the background.  Lauren Wolfe, of Women Under Siege, has written extensively on the scale of the Syrian mental health crisis. She highlights a long-standing taboo surrounding mental health in the region, stating that, while work is being done, exactly who is doing what to tackle the crisis is unknown. In her most recent piece for Foreign Policy, she highlights the increasing fear that people in their despair are turning to suicide. For one woman, a teacher who was the sole survivor of an airstrike on 30 April 2014 that killed two teachers and 17 children as they prepared to exhibit their school artwork, the pain seems too great. She is now refusing treatment for the shrapnel still embedded in her back, saying “I see them all in my dreams every night. I feel responsible and guilty for their death. I wake up wishing I died with them.

I need to be with them.”

The agencies that are working to fill the void recognise that far more is needed. One mental health advisor working for Doctors Without Borders acknowledges, “There is a big, big gap in accessing care for mental health for all Syrian refugees. We need to do more, definitely.”

The problem is firstly one of resources, of a lack of money, training and time to address urgent mental health needs.

What can you do to help tackle this hidden crisis, I asked one Syrian doctor. “On a personal basis we try and help,” he replied. “But we aren’t qualified. Psychotherapy is not just for the wounded. It is needed by everybody, even us doctors. It is important that we too get separate help. We’re seeing people on a daily basis, always with their suffering that they tell us about, the suffering we see, and our own problems.”

“We’re seeing people on a daily basis, always with their suffering that they tell us about, the suffering we see, and our own problems. It’s a very difficult situation for us.”

The full report, Syria’s Shockwaves: the consequences of explosive violence for Syrian refugees, can be read here.