Information and news about syria

Mental Health for Syrian Refugees
Since the Syrian crisis in 2011, the displaced population has migrated to neighboring countries such as Turkey, Lebanon and Jordan. Currently, 50 percent of the population are children without parents. Mental health issues have risen in the Syrian refugee community since then and the world has stepped up in treating the debilitating aspects of suffering traumatic events. This article highlights the improvements in the mental health of Syrian refugees.

Challenge and Impacts

Refugees that have to leave their homes and migrate elsewhere face many obstacles and challenges. Post-migration challenges often include cultural integration issues, loss of family and community support. Refugees also experience discrimination, loneliness, boredom and fear, and children can also experience disruption. Circumstances uproot them from friends and family and cut their education short. Refugees experience barriers in gaining meaningful employment and they face adverse political climates.

Depression, anxiety and post-traumatic stress disorders (PTSD) are all effects of exposure to traumatic events. Traumatic events for Syrian refugees include war terrorist attacks, kidnapping, torture and rape. Meta-analysis all show a positive association between war trauma and the effects of certain mental health disorders. For example, a study examining the mental health of post-war survivors from Bosnia, Croatia and Kosovo showed PTSD as the most common psychological complication.

Post-Traumatic Stress Disorder is a debilitating disorder that intrudes on the patient’s mind. It also intrudes on relationships and the patient’s ability to live a quality life. Thoughts of suicide and/or avoidance are also symptoms of PTSD.

A study of Syrian trauma and PTSD participants found that those between the age of 18 and 65 have experienced zero to nine traumatic events. Of those, 33.5 percent experienced PTSD and 43.9 percent depression. Another study in Lebanon showed that 35.4 percent of Syrian refugees will experience a lifetime prevalence of PTSD.

According to the United Nations High Commissions, 65.6 million people worldwide are “persons of concern.” That total includes 22.5 million termed “refugees” and several other millions termed “asylum seekers” or “internally displaced persons.” Survivors of torture account for 35 percent.

Health Care and Integrated Care

The National Institute of Mental Health identifies integrated care as primary care and mental health care; cohesive and practical. Primary care practitioners recommend conducting a thorough history check of any exposure to or experience of traumatic events. Health care professionals must be able to effectively address mental health issues. Barriers have long been the cause of mental health issues left untreated. Such barriers include communication, lack of health practitioners to patients in need, the physical distance patients must travel and the stigma of having the classification of “crazy.”

Treatments and Evidence-Based Interventions for Refugees

There have been several test instruments that provided significant results in the treatment of mental health as well as scalable interventions. Currently, the only FDA-approved drug both abroad and in the U.S. are paroxetine and sertraline; both selective serotonin reuptake inhibitors (SSRI). Other instruments include the Narrative Exposure Therapy, Eye Movement Desensitization and Reprocessing. Many found EMDR to be successful in reducing episodes of PTSD and depression in a study with Kilis refugees.

In 2008, the World Health Organization launched the Mental Health Gap Action Programme (mhGAP). This endeavor focused on assisting low and middle-income countries in providing effective mental health treatments. Inventions such as Task-shifting, E-Mental Health and PM+ fall under the mhGAP umbrella. First, the task-shifting initiative aims at alleviating the pressure on a limited number of specialized practitioners. Task-shifting shifts duties and tasks to other medical practitioners which otherwise highly-trained specialists would perform. This initiative is cost-effective and proves to be a promising alternative. Refugees can receive treatment in primary and community care locations instead of specialized facilities. Meanwhile, E-Mental Health and PM+ aim to address multiple mental health symptoms at once, while allowing treatment to remain private and within reach to Syrian refugees. Finally, the EU STRENGTHS, also created under the mhGAP umbrella, strives to improve responsiveness in times of refugees affected by disaster and conflict.

Many Syrian refugees continue to face obstacles and barriers, however, there is hope. Initiatives such as those mentioned in this article provide a promising outlook for the continued mental health improvements of Syrian refugees.

Michelle White
Photo: Flickr

5 Mental Health Effects of the Yazidi Genocide
In the past few years, the Yazidi populations of northern Iraq and northern Syria have faced forced migration, war, the enslavement of women and girls and genocide. These traumatic events have resulted in several, severe psychological problems among Yazidis. A lack of adequate treatment and a prolonged sense of threat compounds the five mental health effects of the Yazidi genocide.

The Yazidis, a Kurdish religious minority, practice a non-Abrahamic, monotheistic religion called Yazidism. When the so-called Islamic State declared a caliphate in Iraq and Syria, it specifically targeted the Yazidis as non-Arab, non-Sunni Muslims. ISIS has committed atrocities against the Yazidis to the level of genocide, according to the United Nations Human Rights Council (UNHRC); these crimes included the enslavement of women and girls, torture and mass killings. This violence caused many Yazidis to suffer from severe mental health disorders.

5 Mental Health Effects of the Yazidi Genocide

  1. Disturbed Sleep: According to a study by Neuropsychiatrie, 71.1 percent of Yazidi refugee children and adolescents have reported difficulty sleeping due to the trauma they have experienced. These sleeping problems include trouble falling asleep, trouble staying asleep and nightmares. Children are afraid that if they fall asleep they will not wake up again. Importantly, disturbed sleep will worsen other problems, such as anxiety.
  2. Post Traumatic Stress Disorder: PTSD is one common mental illness that the Yazidi genocide caused. According to the European Journal of Psychotraumatology, 42.9 percent of those studied met the criteria for a PTSD diagnosis. Women and men experienced traumatic stress differently. Women with PTSD were more likely to show symptoms such as “flashbacks, hypervigilance, and intense psychological distress.” Men with PTSD more frequently expressed “feelings of detachment or estrangement from others.” Additionally, more women than men reported having PTSD. According to a study that BMC Medicine conducted, 80 percent of Yazidi women and girls who ISIS forced into sex slavery had PTSD.
  3. (Perceived) Social Rejection: Perpetrators of genocide have often employed systematic sexual violence against women to traumatize the persecuted population. In addition to the devastating injuries women experience, they also suffer from several psychological disorders, including PTSD, anxiety, depression and social rejection. Families and communities frequently reject survivors; Yazidi women who suffered enslavement perceive social rejection and exclusion from their communities at high rates. For instance, 40 percent of Yazidi women that BMC interviewed avoid social situations for fear of stigmatization, and 44.6 percent of women feel “extremely excluded” by their community. Social support is a crucial way to alleviate some of the pain from sexual violence and enslavement since rejection from their community magnifies the likelihood that girls will experience depression. Thus, social support, such as community activities organized by schools, can help by decreasing the factors that worsen psychological disorders like depression and by increasing the rate at which girls report instances of sexual violence.
  4. Depression: The Neuropsychiatrie researchers also found that one-third of the children they studied had a depressive disorder. In another study by Tekin et al., researchers found that 40 percent of Yazidi refugees in Turkey suffered from severe depression. Similarly, a 2018 Médecins Sans Frontières (MSF/Doctors without Borders) study in Sinuni found that every family surveyed had at least one member who suffered from a mental illness. The most common problem was depression. As a response to the growing mental health problems among Yazidis, MSF has been providing emergency and maternity services to people at the Sinuni General Hospital since December 2018. MSF has set up mobile mental health clinics for those displaced on Sinjar mountain and provides services such as group sessions for patients. In 2019, MSF health care officials conducted 9,770 emergency room consultations, declared 6,390 people in need of further treatment in the inpatient wards and have helped 475 pregnant women give birth safely. While MSF has increased its health care activities in the region, there are still people on the waiting list to receive treatment.
  5. Suicide: Since the ISIS takeover of the Sinjar region of Northern Iraq, the Yazidis’ historical homeland, the incidents of suicide and suicide attempts among Yazidis have increased substantially according to Médecins Sans Frontières. The methods of suicide or attempted suicide include drinking poison, hanging oneself and drug overdose. Many Yazidis, particularly women, have set themselves on fire. To alleviate this uptick in suicide and other negative mental health effects, MSF increased its presence in the area and offered psychiatric and psychological health care. Since the start of this initiative in late 2018, MSF has treated 286 people, 200 of whom still receive treatment today.

In the aftermath of ISIS’ genocide against the Yazidis of northern Iraq and northern Syria, many survivors have experienced mental health problems stemming from the trauma. These genocidal atrocities will have long-term psychological effects on the Yazidis, but such issues can be mitigated by psychological care. The five mental health effects of the Yazidi genocide outlined above prove the necessity of such health care for populations that have endured genocide and extreme violence.

– Sarah Frazer
Photo: Flickr

 

Public Health Crisis in Syria
Syria has been the target of one of the most comprehensive and far-reaching sanctions campaigns worldwide. The U.S., the EU, the U.N., the Arab League, OFAC and several other entities have all applied economic sanctions against the country. The goal is to punish Syrian President Bashar al-Assad for his brutal violence against unarmed, civilian anti-government protesters. U.S. sanctions are also in response to the Syrian government’s support for terrorist groups and its pursuit of weapons of mass destruction. Imposing these restrictive measures has been the preferred method of Western powers for decades. However, sanctions have continuously failed to stop Assad from doing business with the U.S. and hurt the Syrian public.

Sanctions’ Impact on Syria’s Economy

Sanctions have caused serious damage to Syria’s economy. These sanctions include oil embargos, restrictions on certain investments, travel bans, freezing the assets of central banks and export restrictions on equipment and technology. The country used to be primarily an exporter, but it now relies on imports, mainly from Lebanon, Iraq and China. Before the EU sanctions, 90 percent of its oil exports went to Germany, Italy and France. Since President Trump recently imposed sanctions on its ally Iran, Syria is suffering even more difficulty obtaining goods. The value of the Syrian currency has plummeted, while prices have sky-rocketed, especially because of restrictions on oil imports.

To continue prioritizing the purchase of guns and bombs from Russia, the Syrian government has simply removed the country’s safety nets. Further, the country has cut back on subsidized fuel, food and health spending. Living was less expensive for Syrians during the peak of the civil war. Technically, legitimate businesses and individuals in Syria should be able to undertake critical transactions. However, foreign suppliers are often unwilling to send anything to Syria. These suppliers do not want to risk triggering unexpected violations of the complex sanction rules.

Sanctions and the Public Health Crisis in Syria

Similarly, there are exemptions for importing pharmaceuticals and food. But in reality, health facilities are feeling the effects of sanctions just as much as the rest of Syria’s private citizens, with life-threatening consequences. The consequences of these sanctions have led to a significant public health crisis in Syria. For example, hospitals cannot import nitrous oxide necessary for anesthetics, due to the fact that others could use it to make bombs. Also, they cannot import helium for cooling MRI scanners for the same reason. The humanitarian exemption for exporting software to Syria for medical equipment requires a complicated application process. Thus, health facilities have little access to foreign life-saving machines, drugs and supplies.

Unable to obtain repairs for European dialysis machines, about 10 percent of people dependent on dialysis have died of kidney failure. Russia, China, Lebanon or Malaysia must now provide medical supplies rather than the EU. This further slows down the process and delays the treatment of those with chronic illnesses. Cancer medication, insulin and anesthetics are among the medications Syria relies on imports for. Now, there are shortages of these medicines, as well as in specific antibiotics, serums, intravenous fluids and some vaccines. This has resulted in delayed treatment for cancer and leukemia patients. The government’s health care budget cuts since the civil war began, combined with the detrimental effects of sanctions, have made most imported medicines unaffordable. Finally, only 44 percent of hospitals are now fully functioning and many of them have closed.

The Real Impact of Sanctions

Meanwhile, President Assad’s policies of violence against his people have not changed. The Syrian government, which still carries out million-dollar deals with the U.S. and other countries that applied sanctions, seems to have found ways to circumvent the sanctions and remain largely unaffected. Assad claims that the sanctions are simply creating more refugees. As the inefficiency of sanctions to reduce human rights violations and their drastic effect on public health becomes increasingly clear, Western powers should rethink their policy of sanctions on Syria.

Sarah Newgarden
Photo: Flickr

Women’s Health Care in Syria
Syria, officially known as the Syrian Arab Republic, is a war-torn country in Western Asia. These war efforts have caused a series of attacks against women’s health care in Syria and made female health care more difficult to come by. In Syria’s civil war, violent attacks continue to target health care workers and clinics, and particularly female health clinics.

Fear of Attack

Fear of attack also plays a role in keeping women from what health resources they do have. Many of the childbirth centers that remain are located in rural areas, making them difficult for many women to reach. Fear of attack in the vicinity of health clinics inhibits patients and health professionals alike. The regime’s campaign of gender-based sexual violence is a large contributor to this fear. The vulnerability that comes with the travel necessary to reach the available health clinics put women at further risk of attack.

These attacks and the consequent shutdown of many maternal health facilities are seriously threatening maternal health. Between 2011 and 2017, more than 320 health clinics suffered attacks. These attacks have resulted in the deaths of at least 826 health workers, 85 of whom were women. By the end of 2015, only 16 of the 43 childbirth centers previously available in Syria remained. The lack of access to these facilities and health professionals leave many women with no safe conditions to deliver their children. Moreover, they have no opportunity for checkups or preventative shots once they deliver their children.

Overall Health Care

The conflict also threatens basic preventative care for women. Things like mammograms and regular checkups are no longer available and few female health professionals remain in Syria, making health care even more difficult for practicing Muslims to find. Gynecological services and even menstruation pads are incredibly difficult to come by. Women who do survive the hardships of the war suffer from malnutrition and struggle with even the basic necessities for survival.

The Molham Volunteering Team

In the midst of the conflict, however, there are efforts to preserve and improve female health care. Groups like the Molham Volunteering Team are working to fill in the gaps in women’s health care in Syria. A group of Syrian students brought this group together to provide necessities, such as food and medicine, to Syrians in need. When crises emerge, the Molham Volunteering Team assembles emergency campaigns to help, such as its campaign to raise money to support victims of the attacks targeting Maarat Al-Numan. The campaign has nearly reached its goal of $250,000.

Another focus of the Molham Volunteering Team is to raise the funds necessary to cover hospital fees for women and other costs of childbirth. It has even begun a campaign to raise money in support of health workers and clinics against the attacks. To date, the campaign has raised about a quarter of its $10,000 goal.

The Violet Organization

The Violet Organization, a nonprofit organization in Turkey, has opened a health center in rural Idlib where women have access to maternal and reproductive health care. A group of young volunteers, with the goal of helping secure the basic needs of families through food and cash donations, founded The Violet Organization. Today, The Violet Organization focuses not only on immediate aid but also on long-term projects like the Idlib health center, which offers treatment for ovarian and breast cancer, as well as basic checkups and consultations.

The Mazaya Center

The Mazaya Center attempts to educate women about their health issues. The Mazaya Center, which volunteers started to empower women, is another nonprofit organization that focuses on women’s issues in northern Syria. It provides paramedic training and first aid classes. These two-month training sessions, which female nurses lead, aim to educate women about reproductive and maternal health as well as family issues.

In the face of the Syrian civil war, civilians are struggling to find the basic necessities for survival, and safe access to women’s health care in Syria has become yet another casualty. Despite the looming threat to women and health professionals, it is evident that there are people continuing their work to ensure that health care and education are available to the women who need it most.

– Amanda Gibson
Photo: Flickr

 

Nonprofits Helping Syrian Refugees

The Syrian civil war has been ongoing since 2011, making the Syrian refugee population the world’s largest group forcibly displaced from their country. At the end of 2018, there were 13 million refugees from Syria, accounting for more than half of the country’s total population. The vast majority of Syrian refugees in Lebanon (70 percent) and Jordan (90 percent) are living below the poverty line. Fortunately, a number of groups are stepping in to deliver humanitarian aid to Syrian refugees. Keep reading to learn more about these three nonprofits helping Syrian refugees.

3 Nonprofits Helping Syrian Refugees

  1. Sunrise USA – Founded in 2011, Sunrise USA is a nonprofit organization focused on providing humanitarian assistance for Syrians in need whether they still live in the country or not. The group is focused on sustainable development in areas including education and health care.
    • Health Care With help from donations, Sunrise USA built a full-time clinic in the Tayba camp in Syria, as well as a clinic in Istanbul and a polyclinic in Rihanli, Turkey. The organization has also established 22 trauma care facilities in Syria.
    • Education As of 2018, around 5.8 million children and youth in Syria were in need of education assistance. About 2.1 million of them were out of school completely. Sunrise USA has built four schools and provided books and supplies to students and families around refugee camps. In 2015, Sunrise USA was a lead sponsor in the creation of the Al-Salam School which had 1,200 students.
    • Care for Orphans The number of Syrian orphans, both in Syria and neighboring countries, has increased to more than 1 million since 2011. Through Sunrise USA’s orphan sponsorship, hundreds of orphans have been provided with food, clothing, education and medicine.
  2. Doctors Without Borders (DWB) – Officially founded in 1971, the organization’s core belief is that “all people have the right to medical care regardless of gender, race, religion, creed, or political affiliation, and that the needs of these people outweigh respect for national boundaries.” Here’s a look at DWB’s efforts to help Syrian refugees:
    • Jordan – In 2017, Jordan closed off the border connecting the country to Syria and in 2018 canceled all subsidized health care for Syrian refugees. Doctors Without Borders has three clinics in Irbid, Jordan that focus on non-communicable diseases, which are the leading causes of death in the region. In 2018, the organization provided 69,000 outpatient consultations, 11,900 individual mental health consultations and 2,690 assisted births.
    • Lebanon – Shatila refugee camp in South Beirut is home to Palestinians, Syrians and Lebanese people living in poor and overcrowded conditions with minimal services. Doctors Without Borders has set up both a primary health care center and a women’s center inside the camp in 2013. The organization also launched a vaccination campaign around the camp, opened a mental health support branch in a clinic in Fneideq, offer family planning and mental health care services in the Burj-al-Barajneh refugee camp, and operate a care program in Ein-al-Hilweh refugee camp for patients with mobility issues.
  3. Concern Worldwide US – Founded in 1968, Concern Worldwide works in the world’s poorest countries to provide emergency response, education, water and sanitation, as well as help communities develop resilience to higher impacting climates. The organization works to help Syrian refugees in a few ways:
    • Lebanon – Concern Worldwide is not only focused on creating “collection centers,”–which are multi-family shelters–but also on improving water, sanitation and hygiene conditions in the highly concentrated refugee areas of the country. The organization has provided assistance for 56,000 refugees and is also helping hundreds of children get access to education.
    • Syria – Since 2014, Concern Worldwide has worked in Syria to tackle waterborne diseases by installing generators and chlorinated water sources and also providing hygiene supplies. The organization also provides basic necessities to Syrians by distributing food baskets and for families with access to markets, food vouchers.

– Jordan Miller
Photo: Flickr

Water Crisis in the Middle East
Syria, Egypt and Afghanistan are among the bottom 10 countries when talking about access to clean water. Water is a primary necessity for human life. Without food the body can survive for up to three weeks, however, without clean water, the body will perish within three to four days, but not before going into shock and fading in and out of delirium. The water crisis in the Middle East is a serious problem now that ongoing conflicts in the region have only worsened.

Afghanistan

Of the three countries listed above, the water crisis in the Middle East affects Afghanistan the least. Despite that, Afghanistan is in the middle of the worst drought it has seen in the past 10 years. In addition, it cannot effectively distribute resources since 40 years of armed conflict following Soviet intervention in Afghanistan has ruined the country’s infrastructure. As a result, about 260,000 Afghani civilians living in extremely dry areas have had to leave their homes, making them refugees.

The drought has drained natural water sources such as the Kabul River Basin, the primary source of water for the nation’s capital. The established system for distributing water is no longer applicable, so civilians must draw water from unofficial wells. In Afghanistan, a country with over 35 million people, 87 percent of accessible water is polluted. Fortunately, India is providing assistance with the Afghan-India Friendship Dam on the Hari River. With further plans to build another dam on the Kabul River, Afghanistan will have water for irrigation and will not have to live with the threat of flash floods.

Syria

In 2006, a massive drought began that would displace tens of thousands of Syrian farmers. By 2011, there were over a million angry, unemployed former farmers in the country ready to fight in a violent civil war that would go on for years. If one said that the water crisis in the Middle East was the proverbial lit match in the powder keg, it would be inaccurate. One cannot, however, deny that it did fan the flames.

Now that tensions are dying down, Syrian civilians have little infrastructure to help provide them with water. Militant groups that occupy water plants and reservoirs hold monopolies on the water for entire regions. Oftentimes, these groups distribute water selectively to blackmail their enemies. Prior to the civil war that started in 2011, water allocation was already inequitable. President Bashar al-Assad allocated more water to fellow members of his particular sect of Islam. Now that Syria is rebuilding its infrastructure, there exists an opportunity to distribute water equally across the country in order to help prevent humanitarian disasters like this in the future.

Egypt

Even in the time of the pharaohs, Egypt has owed its life to the Nile. The Nile is the primary source of water for a country with rice as its number one agricultural export. Rice requires a great deal of water for cultivation and harvest. One kilo of rice needs about 3,000 liters of water. The water in the Nile now contains dead fish due to heavy metals from industrial pollution. Using heavily polluted water diminishes crop yields leading to a further strain on resources.

Egypt faces more than just a drop in the quality of water. As a result of the Blue Nile dam that Ethiopia built, Egypt is also concerned about the quantity of water. By building a hydroelectric dam on the Nile upstream from Egypt, Ethiopia is developing a power grid to reach 86 million Ethiopians living without electricity. Consequently, this will divert about a quarter of the Nile’s water away from Egypt. The Nile supplies 85 percent of Egypt’s fresh water. Egypt has the most to lose in the event of armed conflict breaking out because of its water scarcity, so it is now pushing for diplomatic and scientific solutions to the problem. Negotiating with Ethiopia to share in the dam’s benefits and investments in desalination technology is helping to alleviate the water crisis.

The water crisis in the Middle East is serious and requires much work to alleviate the problem. Through the building of better infrastructure, however, Egypt, Syria and Afghanistan should be able to improve.

– Nicholas Smith
Photo: Flickr

10 Facts About Child Labor in Syria

Since 2010, at least half of all Syrians have been displaced by the ongoing conflict. Children are the most vulnerable members of society, particularly during times of war or conflict. As a result, they often bear adolescent hardships far into adulthood. The poverty caused by extended warfare has forced many children to seek to supplement their household income by getting jobs of their own. Child labor in Syria is a serious issue that continues to worsen with time. Here are 10 facts about child labor in Syria.

10 Facts About Child Labor in Syria

  1. Child labor in Syria was a problem prior to the start of the war, but the conflict has greatly exacerbated the situation. Children are working in more than 75 percent of households with almost half of them being reported as providing a “joint” or “sole” source of income.
  2. The situation in Syria is characterized by hidden forms of exploitation and child labor. It is not uncommon to see children maintaining produce stands and working out in the open. However, child labor in Syria has increasingly turned towards working in factories or laboring as cleaners, garbage collectors, construction workers, mechanics or carpenters.
  3.  The hours that the children work prevent them from being able to seek adequate help in the form of counselors or therapists for dealing with traumatic stress. Save the Children and SAWA for Development and Aid are organizations that offer psychosocial support services and schools for refugee children. Additionally, UNICEF works with a number of other local organizations and NGOs to protect children’s rights. Enmaa is an NGO that does this specifically for children in Raqqa, one of the most devastated cities in Syria.
  4. Syrian law bars anyone who has not completed their basic education or is under the age of 15 from working. However, since the escalation of the war, this is rarely enforced. In Damascus, children as young as seven-years-old can be found working. In Lebanon, Syrian refugees as young as five-years-old work. Many children see nothing strange about their circumstances since they are surrounded by other children of similar ages.
  5. A joint report between Save the Children and UNICEF estimated that around 2.7 million youth in Syria are not in school. Furthermore, according to Human Rights Watch, nearly half of the refugee children outside of Syria do not have access to formal education. One in three schools cannot be used because they have been damaged, destroyed or now serve as centers for resettlement or military activity.
  6. Of the 1.1 million registered Syrians in Lebanon, the United Nations estimates there are at least another 400,000 unregistered. Seventy-one percent of Syrian refugees live below the poverty line, which is part of the reason many children are forced into being wage earners for their families. In Syria, more than 85 percent of the population now lives below the poverty line. Many of these children are forced into work as their parents are either unable to work or are unable to afford living expenses on their own.
  7. A report from the American University in Beirut found that around 70 percent of Syrian refugee children between the ages of four and 18 were working. According to UNICEF, upwards of 180,000 Syrian refugee children are child laborers in Lebanon.
  8. Agriculture, construction and cleaning are the only Lebanese industries in which Syrian refugees can work without a permit. Workers in these industries are among the lowest paid, and often times the work itself is temporary, meaning that constant uncertainty follows these laborers around.
  9. Some 30 percent of Syrian refugee children have been injured while working in Lebanon. Of these injuries, a mere 14 percent were reported to have been covered by the employer. The remaining 86 percent had to be paid for out of the pockets of the child or a relative.
  10. Children are sent away from their families either within Syria or to a neighboring country in order to earn money. Since Syria and the surrounding countries have nominal laws to prevent child labor, children are bereft of any bargaining power and sometimes work 10 hours a day for one to two dollars per shift.

Although these 10 facts about child labor in Syria are serious, there have been improvements in the lives of Syrian children made by organizations like UNICEF. In 2018, UNICEF trained 57,000 teachers, helping to ensure that there is not a shortage of teachers for the student in school. In 2019, UNICEF provided 289 consultations for women and children to receive healthcare  Significant resources are being mobilized to end child labor in Syria.

– Evan Williams
Photo: Flickr

Child Labor in Turkey
Child labor in Turkey continues as both an international and domestic issue for the country. Despite Turkish and international community efforts to establish policies and initiatives to prevent child labor and protect the interests of children, child labor persists. The below facts highlight the details of the type of labor children typically perform as well as the efforts the government of Turkey has made to end child labor.

10 Facts About Child Labor in Turkey

  1. Work in Hazelnut Fields: Hazelnut production in Turkey is the largest sector of agricultural production, making up approximately 20 percent of Turkey’s agricultural exports. For this reason, many migrant agricultural workers travel along the eastern and western regions of Turkey looking for work during the hazelnut harvesting season. The children of these workers travel with their families and also contribute to the harvest of hazelnuts in Turkey. In 2017, nearly 800,000 children worked in the hazelnut fields. Most children work 11 hour days, seven days a week in the fields.
  2. The Second National Action Plan on Combating Human Trafficking: The Second National Action Plan on Combating Human Trafficking is an existing program in Turkey. This program identifies and protects both the victims of child trafficking as well as those children who are at high-risk for trafficking, such as the children of migrant agricultural workers. The high-risk children this program identified are the recipients of additional security precautions that the shelters took in. Victims of human trafficking frequently become migrant agricultural workers.
  3. Children of Syrian Refugees are High-Risk: As the number of Syrian refugees in Turkey continues to grow, so does the number of Syrian families working as migrant agricultural workers. Due to their status within the country of Turkey, many of these laborers work longer hours than those of the Turkish migrant workers and receive lower wages, with children oftentimes earning half of an adult’s wage. The children of the Syrian refugees are at an even higher risk of becoming permanently part of the sector of migrant labor due to lower access to education, discrimination and financial barriers.
  4. Efforts of the Turkish Government to Eradicate Child Labor: The Turkish government has made efforts to combat the high levels of child labor with a variety of government-funded programs. The Conditional Education and Health Care Assistance Program “aims to reduce poverty through cash transfers,” which takes the form of free milk and books given to primary school children. In 2017, approximately 190,000 children benefited from this program. By providing food and educational support, the Turkish government aims to create a learning environment for children where their families feel that they can afford the time for their children to be in school instead of working to earn extra money.
  5. Child labor in Turkey Increased in 2018: Despite the sweeping measures that the Turkish government has taken to prevent and eventually put an end to child labor in Turkey, the number of child laborers saw a marked increase in 2018. The Turkish government made a commitment to the International Labor Organization (ILO) that it would put an end to child labor by 2015, but that has not been the case thus far.
  6. Education Rates of Child Laborers: Due to the long hours that child laborers in Turkey work, they are unable to consistently attend schools in the areas where they work on hazelnut farms. The children also move around too frequently with their families to establish a lasting record at any one school, contributing to these children’s decreased likelihood of school attendance. In addition, the vocational schools that exist in areas that have heavy industry provide an education to children that promotes their continued work in the industrial sphere.
  7. Minimum Age for Child Labor: Turkey has existing laws in place that are to protect children from child labor. There is a minimum age requirement of 15 for agricultural work and a minimum age of 18 for hazardous work. A prohibition of forced labor and child trafficking also currently exists in Turkey. Despite the efforts of the government of Turkey, holes continue to exist in the legal framework that aims to protect children from hazardous child labor.
  8. Effective Enforcement of Existing Child Labor Laws: Though the Turkish government has age limits in place for child labor, as well as a list of light work that the Regulation on the Principles and Procedures Governing the Employment of Children and Young Workers permits, high levels of child labor in Turkey persist. Part of this gap in the legislation and actual protection of child laborers is due in part to the low numbers of inspectors and the classification of agricultural work as light labor. The Regulation on Principles has indicated that the country must legally consider picking fruit and vegetables as light work, therefore placing very few restrictions on migratory agriculture. Despite this, the gaps that exist in the legal framework “may hinder adequate enforcement of [Turkey’s] child labor laws.”
  9. National Program to Combat Child Labor in Turkey: The government of Turkey has made an effort to maintain compliance with international child labor laws. The National Program to Combat Child Labor began in 2017 and is to run until 2023. This program focuses on maintaining surveillance of the labor sectors of migratory agriculture, street work and work performed in small to medium industries to ensure that none of Turkey’s existing child labor laws are in violation.
  10. The Global March Against Child Labour: There are multiple NGOs in the international sphere that are fighting to end child labor worldwide. The Global March Against Child Labour is one such organization with a mission is to “mobilise worldwide efforts to protect and promote the rights of all children, especially the right to receive a free and meaningful education and the right to be free from economic exploitation.” Global March operates through the advocacy of issues to policymakers, raising awareness of child labor around the world and building partnerships with existing organizations such as the International Labour Organization. The Global March has seen success in many of its areas of focus. In 2018, Global March organized the Meet of Parliamentarians Without Borders for Children’s Rights in Brussels, Belgium. At the conclusion of the parliament, in which MPs from Sri Lanka, Benin, Togo, Paraguay, Uganda, Ghana, the Netherlands and Costa Rica attended, all MPs committed to working within their respective parliaments to end child labor in their countries.

Turkey still requires progress to put an end to dangerous and damaging child labor, but the steps that it has made in its own programs, as well as international programs, shows hope for a future for child labor in Turkey. That future includes stronger protection of a child’s right to receive an education and lead a stable life out of the fields.

– Anne Pietrow
Photo: Flickr

QANDIL's Humanitarian Efforts
Sweden’s renown as a humanitarian superpower stems from its involvement in global aid initiatives. In 2018, the country devoted 1.04 percent of its gross national income (GNI) to overseas development, making Sweden the sixth-largest humanitarian aid contributor among the world’s countries and the largest one proportional to its Gross Domestic Product (GDP). From 1975 onward, Sweden’s humanitarian aid efforts have continually surpassed the U.N.’s minimum target of developed nations spending 0.7 percent of GNI on overseas development initiatives.

One of the most well-regarded Sweden-based NGOs is QANDIL. Established in Stockholm in 1991, QANDIL’s initiatives aim to foster lasting peace and development in Iraq. Beneficiaries of its aid range from refugees and returnees to internally displaced persons and local host communities. Since 2016, QANDIL has concentrated its efforts on development in the Kurdistan region, serving as the most prominent partner of UNHCR in this region. Below are seven facts about QANDIL’s humanitarian efforts.

7 Facts About QANDIL’s Humanitarian Efforts

  1. Economic Assistance — Two Cash-Based Intervention projects implemented in 2017 raised $2,695,280 for 3,829 families in need in the Kurdistan region’s Duhok governorate. In Erbil, QANDIL distributed $3,155,800 to 3,054 families in the Erbil governorate, while $648,290 went to 1,900 families in the Sulaymaniyah governorate. Ultimately, QANDIL distributed $6,499,370 to 8,783 refugees and IDP families within three of the Kurdistan region’s governorates. This provides a foundation by which these uprooted people may become economically stable and productive.
  2. Shelter — Through the Shelter Activities Project, QANDIL supported uprooted people in search of shelter, which included 7,246 families. Among QANDIL’s successes in providing shelter-based aid is the implementation of 25 major shelter rehabilitation initiatives, encompassing five camps in the Sulaymaniyah governorate. This helped resolve the long-term problem of incomplete and hazardous structures allotted to displaced persons.
  3. Legal Services — The Outreach Project, operating in the Erbil and Duhok governorates, offers legal services to IDPs and refugees. With the participation of volunteers from both the displaced and host communities, QANDIL’s efforts have granted legal assistance to 319,773 IDPs and refugees and outreach services to 19,894 persons in the Erbil governorate alone. In the Duhok governorate, beneficiaries included 69,093 refugees and IDPs. Furthermore, in 2017, QANDIL participated in an initiative to provide mobile magistrates to administer court-related matters for displaced persons.
  4. Assistance for Gender-Based Violence Victims — With the participation of UNFPA, QANDIL commits resources to finance and submitting reports to seven local NGOs that operate 21 women’s social centers. These centers function in both responsive and preventative capacities for women both within and outside camps. Services that these centers offer include listening, counseling, referrals to other institutions, distribution of hygiene kits and even recreational activities. In total, this program has assisted 67,108 women and girls in the Duhok governorate, 11,021 in the Erbil governorate and 43,797 in the Sulaymaniyah governorate.
  5. Youth Education — Starting in 2017, QANDIL devised an educational initiative targeting Syrian refugee students, funded at approximately $271,197. The soft component of this initiative provided funding and resources for recreational activities and catch-up classes, as well as teacher capacity building training and the maintenance of parent-teacher associations, in schools enrolling refugee students in the Sulaymaniyah governorate. The initiative’s hard component comprises aid for special needs students at seven refugee schools in the Sulaymaniyah governorate.
  6. Skills Training — In collaboration with the German development aid organization GIZ, QANDIL embarked on a vocational and educational initiative aiming to benefit displaced persons residing at Debanga camp. These individuals received access to skills training and qualifications certification, ranging from plumbing and electricity to language and art, in three-week courses offering free tuition. As a whole in 2017, the vocational and educational training centers that QANDIL supported with funding from GIZ have improved the employment prospects for 1,756 individuals, out of which 546 were women.
  7. Immediate Response in Crisis Situations — With an upsurge in regional conflict on Oct. 16, 2017, came an increase in IDPs in Tuz Khurmatu, a city 88 kilometers south of Kirkuk. This event tested the efficacy and efficiency of QANDIL’s humanitarian aid efforts. By Oct. 24, QANDIL’s Emergency Response Committee began dispensing out emergency kits to persons that the conflict escalation affected. Included in these packages were necessities, food and non-food items alike. By Oct. 25, QANDIL parceled out 1,237 emergency kits to aid-seekers distributed over 25 locations in the Sulaymaniyah and Garmian regions. That same day, 600 aid-seekers received aid packages in the Erbil and Koya regions, while the rest of the aid made its way to other camps in the Sulaymaniyah area.

From education to vocational training to sanitation and hygiene and shelter and legal services, QANDIL’s humanitarian efforts in the Kurdistan region of Iraq continue to make a difference for the lives of thousands of displaced and settled people alike. Thus, QANDIL serves as an ambassador for Sweden’s humanitarian aid mission. Whether in the course of sustained initiatives or responses to imminent crises, QANDIL persists in its constructive humanitarian aid role in an unstable region. It is through the tireless efforts of such NGOs as QANDIL that Sweden continues to serve as a model in humanitarian aid initiatives to the rest of the world.

Philip Daniel Glass
Photo: Flickr

Health Costs of The Syrian Civil War
The Syrian civil war, which began in 2011, has led to a monumental refugee crisis, hundreds of thousands of deaths, the rise of the Islamic State of Iraq and Syria (ISIS) and destabilization in the Middle East. Yet another devastating effect of the war is the health consequences for people still living in Syria. Civilian doctors and nurses in active war zones face significant challenges not encountered in peacetime. These include a massive amount of trauma victims, shortages of medical equipment and personnel, infectious disease epidemics and breaches in medical neutrality. Here are 10 health costs of the Syrian civil war for the Syrian people.

10 Health Costs of the Syrian Civil War

  1. Because of the war, Syrian life expectancy has plummeted by 20 years from 75.9 years in 2010 to 55.7 years through the end of 2014. The quality of life in Syria has also worsened. As of 2016, 80 percent of Syrians are living in poverty. Moreover, 12 million people depend on assistance from humanitarian organizations.
  2. The civil war devastated Syria’s health care infrastructure, which compared to those in other middle-income countries prior to the war. By 2015, however, Syria’s health care capabilities weakened in all sectors due to the destruction of hospitals and clinics. The country faced a shortage of health care providers and medical supplies and fear gripped the country.
  3. The Syrian Government has deliberately cut vital services, such as water, phone lines, sewage treatment and garbage collection in conflict areas; because of this government blockade, millions of Syrian citizens must rely on outside medical resources from places like Jordan, Lebanon and Turkey. In 2012, the Assad regime declared providing medical aid in areas opposition forces controlled a criminal offense, which violates the Geneva Convention. By the following year, 70 percent of health workers had fled the country. This exodus of doctors worsens health outcomes and further strains doctors and surgeons who have remained.
  4. The unavailability of important medications presents another health cost of the civil war. Due to economic sanctions, fuel shortages and the unavailability of hard currency, conflict areas face a severe shortage of life-saving medications, such as some for noncommunicable diseases. Commonly used medicines, such as insulin, oxygen and anesthetic medications, are not available. Patients who rely on inhaled-medications or long-term supplemental oxygen often go without it.
  5. A lack of crucial medications has led to increased disease transmission of illnesses, such as tuberculosis. Furthermore, the conditions Syrians live in, for instance, the “tens of thousands of people currently imprisoned across the country… offer a perfect breeding ground for drug-resistant TB.”  Indeed, the majority of consultations at out-patient facilities for children under 5 were for infectious diseases like acute respiratory tract infections and watery diarrhea. According to data from Médecins Sans Frontières-Operational Centre Amsterdam  (MSF-OCA), the largest contributor to civilian mortality was an infection.
  6. In addition to combatant deaths, the civil war has caused over 100,000 civilian deaths. According to the Violation Documentation Center (VDC), cited in a 2018 Lancet Global Health study, 101,453 Syrian civilians in opposition-controlled areas died between March 18, 2011, and Dec 31, 2016. Thus, of the 143,630 conflict-related violent deaths during that period, civilians accounted for 70.6 percent of deaths in these areas while opposition combatants constituted 42,177 deaths or 29.4 percent of deaths.
  7. Of the total civilian fatalities, the proportion of children who died rose from 8.9 percent in 2011 to 19.0 percent in 2013 to 23.3 percent in 2016. As the civil war went on, aerial bombing and shelling were disproportionately responsible for civilian deaths and were the primary cause of direct death for women and children between 2011 and 2016. Thus, the “increased reliance on the aerial bombing by the Syrian Government and international partners” is one reason for the increasing proportion of children killed during the civil war according to The Lancet Global Health report. In Tal-Abyad’s pediatric IPD (2013-2014) and in Kobane Basement IPD (2015–2016), mortality rates were highest among children that were less than 6 months old. For children under a year old, the most common causes of death were malnutrition, diarrhea and lower respiratory tract infections.
  8. The challenges doctors and clinicians face are great, but health care providers are implementing unique strategies that emerged in previously war-torn areas to meet the needs of Syrian citizens. The United Nations (the U.N.) and World Health Organizations (WHO) are actively coordinating with and international NGOs to provide aid. The Syrian-led and Syrian diaspora–led NGOs are promoting Syrian health care and aiding medical personnel in Syria as well. For instance, aid groups developed an underground hospital network in Syria, which has served hundreds of thousands of civilians. These hospitals were “established in basements, farmhouses, deserted buildings, mosques, churches, factories, and even natural caves.”
  9. Since 2013, the Médecins Sans Frontières-Operational Centre Amsterdam (MSF-OCA) has been providing health care to Syrians in the districts of Tal-Abyad in Ar-Raqqa Governorate and Kobane in Aleppo Governorate, which are located in northern Syria close to the Turkish border. The health care MSF-OCA provided included out-patient and in-patient care, vaccinations and nutritional monitoring.
  10. New technologies have enabled health officials to assist in providing aid from far away. For instance, telemedicine allows health officials to make remote diagnosis and treatment of patients in war zones and areas under siege. One organization that has used this tool is the Syrian American Medical Society, which “provides remote online coverage to nine major ICUs in besieged or hard-to-access cities in Syria via video cameras, Skype, and satellite Internet connections.” Distance learning empowers under-trained doctors in Syria to learn about disaster medicine and the trauma of war from board-certified critical care specialists in the United States.

Conditions on the ground in Syria make it more difficult for Syrian citizens to receive vital medical aid from health care workers. Many people and organizations are working diligently to help injured and sick Syrians, however. These 10 health costs of the Syrian civil war illuminate some of the consequences of war that are perhaps not as storied as the refugee crisis. While aiding refugees is an undoubtedly worthy goal for international NGOs and governments, policymaker’s and NGOs’ agendas should include recognizing and alleviating the harm to those still living in Syria.

Sarah Frazer
Photo: Flickr