Navigating waves of trauma

How the UN supports Syrians from eastern Ghouta

One of the largest humanitarian emergencies facing the world today, the Syria Crisis is well into its eighth year with no end in sight. The upsurge in violence in eastern Ghouta has triggered a mass wave of displacement of people out of their homes and into a number of displacement sites across rural Damascus. The United Nations estimates that nearly 158,000 people were displaced from the enclave since early March this year of which 40,000 people remain in eight sites.

Many Syrians displaced from East Ghouta were forced to leave everything behind including family members and loved ones. Photo: OCHA/Linda Tom

Together with local humanitarian partners, UN agencies are working to meet the multiple needs of these vulnerable people. From the onset, the UN has been on the front lines, doing whatever it takes to deliver life-saving assistance to those who need it. Displaced families are receiving shelter, food, water, sanitation, hygiene, healthcare, nutrition as well as protection assistance, including trauma and psychosocial support. Pregnant women also receive reproductive health and safe birth support.

Eager to restart their lives, those who remain in the displacement sites wish they could go back home someday. Here are some of the voices of the victims of Syria’s long-standing conflict who have experienced significant trauma and how the UN’s various agencies are helping them.

Comfort in the midst of chaos

After enduring a crippling siege and intense military operations, men, women, and children from eastern Ghouta found themselves in overcrowded displacement sites where basic living requirements are lacking.

Queues of displaced people waiting to receive food, cleaning supplies or medical help can stretch for at least one kilometer. Photo: UNICEF/Yasmine Saker.

Immediately the lack of privacy is apparent; but what’s hardest to bear for these displaced Syrians is the loss of dignifying living conditions that displaced families face daily.

Women, men, and children haven’t had a change of clothes in over a month because they left all their belongings in underground basements where they hid for safety. “I never thought I would one day dream of showering!” one woman told UNICEF.

UNICEF is working to meet the mounting needs by trucking water to the displacement sites and installing sanitation facilities such as toilets and sinks.

But much more is needed. Queues for the washroom and showers are becoming longer by the day and have forced people to give up on their use altogether, leading to serious health issues.

“I’m treating many children for lice, diarrhea and insect bites,” a UNICEF-supported doctor said as she examined children and administered vaccinations at one of the schools.

UNICEF is supporting three mobile health teams across the eight displacement sites , providing primary healthcare services for children and mothers, including screening and treatment for malnutrition.

Making space for a future

Othman on the job in one of the displacement sites in Adra where UNDP runs a cash-for-work programme. Photo: UNDP

Those who left eastern Ghouta to escape the siege didn’t only abandon possessions; they also had to give up their livelihoods, neighbours and even loved ones.

“Before this job, I was overwhelmed with a sense of emptiness. Now I have hope again.”

Othman, like many others, lost his job due to the conflict and had been unemployed for over three years. But since moving to Adra displacement site in rural Damascus two months ago, he found a job through the UNDP’s cash-for-work programme to support its Solid Waste Management project in the displacement sites.

“Before this job, I was overwhelmed with a sense of emptiness. Now I have hope again,” Othman told UNDP after describing his new role as a data clerk.

UNDP runs programs that help displaced people re-establish themselves by employing them to improve conditions in the displacement site that they have to call home, for now.

Thanks to the hard work of employees like Othman, over 157 tons of solid waste have been collected and removed from the displacement site through the UNDP’s project, which has improved hygiene and living conditions for the 40,000 displaced people currently residing there.

More than 700 people are currently employed under a cash-for-work programme while another 67 emergency jobs were also created to carry out management, supervision and monitoring activities.

Remembering a generous past

Amira, like many Syrians, wishes to return home during the fasting month of Ramadan. Photo: WFP/Marwa Awad.

With the arrival of Ramadan, the Muslim month of fasting, many families displaced from eastern Ghouta and now living on very little away from home are feeling their limited means deeply. To these people who thrived on farming, Ramadan was the month of sharing and generosity. Now their homes and livelihoods are gone, their loved ones are missing, and nothing of their past remains except for memories of home.

“This is my dream, to return home and host you and everyone who has helped us survive. I want you to see how beautiful Ghouta is.”

Amira who had to flee her home in Hamouriyeh in eastern Ghouta two months ago is now living in Herjella in rural Damascus. She fiercely hangs on to the memory of her home — a farmhouse surrounded by abundant fields and livestock, with which her family used to produce their own food.

“We were farmers and had livestock. We are generous hosts, used to hosting others — not surviving on charity,” said Amira, adding that they had to leave it all behind when they fled the bombing.

In Hurjella, Amira and others receive weekly food rations and bread from the World Food Programme (WFP), along with other humanitarian support. WFP provides life-saving food and nutritional assistance to around 40,000 people currently living in the displacement site in Rural Damascus. While this food is enough to keep families like Amira’s well fed, it does not allow for large Iftar gatherings — when family, friends, and neighbours come together to break-fast at sunset.

“Though I’m grateful to WFP, my dream is to return home and be able to host you and everyone who has helped us. I want you to see how beautiful Ghouta is,” she said.

On the road to recovery

WHO-trained community psychosocial support workers talk to Hayla to help her heal. Photo: WHO

Losing their sense of stability, your home, your belongings, and — sometimes — your loved ones, Syrians who fled eastern Ghouta now deal with significant emotional and psychological trauma. The World Health Organization (WHO) helps displaced people overcome these difficulties by training psychosocial support staff.

Hayla, a mother of three, was identified by one of WHO-trained community psychosocial support workers after she was found struggling to interact with other families in the Adra displacement center.

Assessment showed that in addition to the distress caused by displacement and loss of belonging, her depression was linked to her husband’s refusal to receive treatment for injuries he had sustained during their escape.

The psychosocial support worker knew that to help Hayla, they would have to help her husband. A WHO-trained psychologist was called in to speak to Hayla’s husband and identify the reason for his pain: he was sick with worry over his sons from a previous marriage, who were still trapped in eastern Ghouta.

Support staff managed to track down his children and established regular lines of communication between them. Soon after, Hayla’s husband agreed to have his wounds treated after several sessions with the psychologist.

Such small victories have strong positive impact on people like Hayla, who now regularly attends a support group. Sensitivity and kindness, coupled with practical support, have rekindled the hope that still lingered in the couple’s hearts, helping them deal with their situation and find a way forward.

A Bundle of joy arrives

Om Mehi-Eddin proudly posing with her healthy new born baby, Sham. Photo: UNFPA/Kinda Katranji

Thirty-six-year-old Om Mehi-Eddin fled her home in Douma — the largest town in eastern Ghouta — to live in Fayhaa Sham site in rural Damascus with her five young children. More than seven months pregnant, the single mother found herself alone when she went into sudden labour.

“I started to panic. Being alone, and worrying about my children was scary,” she recalls, adding that her husband was missing and she had no relatives to care for her.

Luckily, Om Mehi-Eddin was quickly taken to a hospital in Damascus in a mobile medical clinic funded by United Nations Population Fund (UNFPA) and run by a local partner.

“They saved my life and my baby’s life,” Om Mehi-Eddin said, adding that she named her baby girl Sham (Arabic reference to Syria) in honour of her country.

Many women like Om-Mehi-Eddin who arrive to the displacement sites require reproductive healthcare, having left eastern Ghouta where there was limited electricity, very few functioning hospitals and no doctors.

There, UNFPA is supporting eight mobile clinics and five mobile medical teams providing general health consultations, prenatal and after delivery care, sexual and reproductive health counselling as well as psychosocial support.

Throughout the crisis in Syria, UNFPA and its partners continue to provide crucial services for women like Om Mehi-Eddin. This month, UNFPA reached more than 90,000 women with Gender-Based Violence services and 160,000 women with reproductive health and general health services.

A Glimpse of hope

“It’s like the weight of the world is off my shoulders, now I have hope my children can have a future,” said Malekah. Photo: UNHCR/ Vivian Tou’meh

Families arriving to the displacement sites with nothing but the clothes on their backs were quickly given shelter support by UNHCR in the form of blankets, mattresses, kitchen sets and clothes. Tents were also set up to create space for informal education and social support for children.

“We arrived empty-handed; we were given blankets, a box with a kitchen set, few sleeping bags and some clothes,” said Um Mohamad, a mother of three who like other families escaped the siege from eastern Ghouta. “It meant a lot to us, it helped us regain our dignity.”

Through its protection programme, UNHCR has assisted nearly 22,000 civil registration cases including cases of undocumented people who need to be registered and issued identity papers. People like Malekah, mother of two, received legal counselling from one of UNHCR’s national partners to take her children’s finger prints, photos and submit their applications for issuance of identity papers.

“It’s like the weight of the world is off my shoulders, now I have hope my children can have a future,” said Malekah to UNHCR.

Displaced for a second time

Mohammad receives humanitarian assistance from UNRWA including food rations and hygiene items. Photo: UNRWA/Fernande van Tets

Among those displaced from eastern Ghouta are Palestinian refugees who have been living under siege and now are doubly displaced in the sites and in Damascus city.

65-year-old Mohammed, a Palestinian refugee used to live in eastern Ghouta but had to flee because of violence, and now lives in Damascus city.

“We escaped violence and fighting but not hardship,” Mohammad told UNRWA with a wry smile. “We do not have the capacity and resources to meet our basic needs after displacement.”

Mohammad and his family are reliant on support from UNRWA which provides them and others families with food baskets, kitchen sets, hygiene items as well as mattresses and blankets. In addition, UNRWA provides regular cash assistance to Palestine refugees of US$32 a month.

While these provisions help Mohammed and his family stay afloat, the rising cost of living is making it harder for them day by day.

Nevertheless, Mohammed is hopeful for the future. “UNRWA’s cash assistance will allow us to pay for our own needs and to establish our own priorities,” he says. But the agency’s financial woes are a worry. “As this conflict continues, this assistance is an important source of support to us.”

More help is needed

The UN and its partners in Syria require nearly US$2.6 billion to respond to the humanitarian crisis across Syria, according to the Humanitarian Response Plan in 2018. Increased donor support is urgently needed to continue to respond to people in need of assistance.

Based on contributions by: Marwa Awad/WFP, Yasmine Saker/UNICEF, Kinda Katranji/UNFPA, Yahya Bouzo/WHO, Mysa Khalaf and Shaza Shekhfeh/UNHCR and Fernande van Tets/UNRWA.