Syrian refugees find mental and physical rehabilitation in Jordan

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HARI SREENIVASAN: The Syrian conflict is in its fifth year, making Jordan home to more than 1.3 million Syrian refugees, many struggling with trauma and the psychological costs of war.

With fewer than 100 psychologists in Jordan, doctors and social workers are struggling to fill the mental health care gap.

University of California, Berkeley, journalism students bring us this story.

It’s narrated by Lacy Jane Roberts.

LACY JANE ROBERTS: The war in Syria led Nisreen Katbi to flee her home country four years ago. Now she runs a center in Amman, Jordan, that cares for refugees fleeing from Syria.

They’re recovering from the trauma of war. Souriyat Across Borders is a home away from home for refugees suffering from both physical and emotional disabilities. They get rehabilitative care and live full-time at the center, all free of charge.

NISREEN KHAZNA KATBI, Souriyat Across Borders: This is where they have their physical therapy training.

LACY JANE ROBERTS: Nisreen and her staff care for a rotating group of 30 men, women, and children. The residents can stay at the center until they’re rehabilitated, after which many return to their families in war-torn Syria.

Nisreen sees people with amputations, spinal cord injuries, and head traumas. But she says the injuries aren’t only physical.

NISREEN KHAZNA KATBI: They faced some frightening situations, like the bombings, the killing, losing their limbs or had these severe injuries.

LACY JANE ROBERTS: But Souriyat Across Borders has no full-time mental health professionals on staff. So, when a mental health training project run by a group of California-based doctors came to Amman, Nisreen signed up.

Dr. Saad Shakir leads CPR, or Care Program for Refugees. At first, CPR’s goal was to give direct mental health care to Syrian refugees, but after seeing the overwhelming number of people needing help, they instead began offering mental health first aid training to clinicians, counselors, teachers, and even legal consultants, anyone who works with refugees.

DR. SAAD SHAKIR, Care Program for Refugees, Alalusi Foundation: While being a physician, I’m a humanitarian. So, seeing all the devastation going on, it’s like I want to have an impact in a positive way.

LACY JANE ROBERTS: Dr. Atef Al-Qasem is CPR’s on-the-ground partner and training manager for the Noor Al-Hussein Foundation’s Institute for Family Health. He was eager to partner with Dr. Shakir after seeing an increase of refugees needing quality mental health care.

DR. ATEF AL-QASEM, Institute for Family Health, Noor Al-Hussein Foundation (through translator): The goal of the training is to have anyone dealing with refugees be able to provide psychological first aid; 19 percent of people we see have been victims of torture. We also see PTSD, depression, anxiety. All of them need immediately treatment.

LACY JANE ROBERTS: Dr. Al-Qasem says that it is hard to provide individual treatment, with so many patients and so few professionals.

So, he is encouraging caretakers and mental health workers to apply group therapy. At their field clinic in the Zaatari refugee camp, the counselors with the Noor Al-Hussein Foundation try to see as many people as possible in group therapy. The camp is one of the biggest in the world, home to 70,000 refugees.

Am Sanad Al-Badi works as a counselor in the camp, where he says he confronts mental health stigmas.

AM SANAD AL-BADI, Institute for Family Health, Noor Al Hussein Foundation (through translator): We have a mobile team which make visits to refugees to talk about the need of psychosocial counseling because the psychological support is necessary.

LACY JANE ROBERTS: Once individuals start coming to group therapy, counselors help them cope with trauma and loss.

AM SANAD AL-BADI (through translator): Common trauma we see is loss trauma. I ask them to remember their happy memories and encourage positive thinking about the future.

LACY JANE ROBERTS: Back in Amman, Doctors Without Borders is treating refugees who have been physically disfigured from Syria, Yemen, and Iraq.

Dr. Gwenola Ghanes manages the hospital’s mental health program. She says there is no way to predict how people will react to a traumatic event.

DR. GWENOLA GHANES, Doctors Without Borders: On a psychological point of view, there is no rules. It’s not a mathematical equation. Most of the people will develop symptoms such as depression or anxiety disorder, and a small percentage of PTSD.

LACY JANE ROBERTS: Children especially can be affected by the trauma of war.

Talha Al-Ali is a pediatric counselor. He works with young victims to rebuild trust.

DR. TALHA AL-ALI, Pediatric Counselor: They start at the beginning to have the small social networks while playing or while doing activities together. Like, a child will start to adapt again with building relationships, and especially to build trustful relationships. But to protect them from the trauma, no one will be able to protect them while they are living in a war.

LACY JANE ROBERTS: After the training, Nisreen Katbi says she will be able to provide better care for the patient-residents.

NISREEN KHAZNA KATBI: I have learned how to deal with certain cases, like if he is having constant nightmares, or if he is aggressive in a certain way or depressed.

LACY JANE ROBERTS: Dr. Ghanes agrees that, while this kind of training is useful, much more is needed.

DR. GWENOLA GHANES: It’s useful, but it’s not enough. On a humanitarian point of view, we need to train a lot of people in a short time.

LACY JANE ROBERTS: CPR hopes to return to Amman once a year. And Nisreen hopes she will eventually be able to train her whole staff.

NISREEN KHAZNA KATBI: This is the most important thing for us to do.

We have to raise an awareness about how to deal with victims of war.

LACY JANE ROBERTS: For the “PBS NewsHour,” I’m Lacy Jane Roberts in Amman, Jordan.

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