What should not surprise us about refugee situations
"We can't sleep or concentrate because we're angry and mad since this is all for no reason. Then our troubles become worse when we hear loud noises like planes and imagine we're back in Syria. The teens are now disrespectful, defiant, and rudely talking like I'm a sibling, not a parent. This is no way to raise a kid in a camp."
- Father displaced from Syria, now living in a refugee camp
Refugees are those who have fled war, armed conflict, disasters, or persecution due to social or religious reasons, and need safety for survival and livelihood. They have varied experiences - some do not directly experience violence, others do on a daily basis. Some migrate via planes, others by foot. They all are fleeing unstable situations, and experience multiple losses - of resources, security, family, culture, and identity.
Children can struggle with boredom, missing friends and loved ones, fear, and being unsure how to live in a refugee camp setting. Parents struggle with the shifts in family roles, uncertainty of how to provide to support the emotional and physical needs of their children, and how to manage their own feelings, to be able to buffer and support their childrens’. I’ve always thought it’s too much to ask of a person.
In my assessment for the IMC/UNICEF on mental health and psychosocial concerns for displaced youth in the Syrian refugee camp of Za’atari, it was clear that children and parents were struggling - and also trying their best to be resilient. The main concerns in the camp were family violence, fear of sexual violence, management of unaccompanied/separated children, exclusion of services from female-headed households, and caring for children and women with disabilities. Many were also concerned about child labor, early marriage, boys in gangs, and allegations of recruitment of boys by armed groups. For children, the main concerns were: fear in the camp, feeling sad and managing grief, and child abuse in the family.
In a follow up assessment a year later, I sought out not only displaced Syrian families in the Za’atari camp, but also in the Jordanian community, and also compared their mental health and concerns to those of Jordanians living in the community. Many were surprised to see that displaced Syrian adolescents in Jordan had more emotional distress, felt less supported, less safe, and had more perceived discrimination, when compaerd to those living in the refugee camp. The Syrian kids in Jordan were subjected to bullying, teasing, and name calling, since they were refugees. When I spoke to Jordanian parents, it was clear where their kids were learning that behavior.
So we should not be surprised. Here are a few common outcomes of refugee situations that we should be prepared for:
1.Community tension
Initially, a host country may be welcoming to newcomers, but after a few years, there tends to be conflict over resources. Who gets to attend school? Who gets the water source? Rent and food prices increase. The majority of temporary settlements are in low-income countries that already have few resources to provide for all.
2. Increase in family violence
Domestic violence increases in refugee and internally displaced persons camps. Family roles shift. The breadwinner (typically male) is now without job, feeling ashamed that he can’t provide basic necessities for the family. There’s a seemingly endless barrage of stress placed on families in refugee situations, and even those most “resilient”, have difficulty coping.
3. Grief, fear, and boredom
Among not only adults, but also children. Refugee camp sites are chosen in typically desolate areas where no one wants to live. Next to airports or in barren, uncomfortable land. Humanitarian actors know to get children back to a semblance of normalcy as soon as possible, building schools and child friendly safe spaces, but parents may not feel comfortable having children walk there. Or being taught by adults who are from a different country and therefore school system. Loss is paramount - normal ways of coping are gone. Their sense of self is lost. And people are left all day, loitering, trying to make each day go by as best they can.
Knowing these, we should not be surprised when events like violence, fires, family conflicts, arise in these refugee camp settings. We should be proactive and, as best possible, take a prevention approach, to give slight ease to the lives of refugees.
To learn about refugees and forcibly displaced people, feel free to:
Review the mental health and psychosocial assessment I did with displaced Syrian adolescents in the Za’atari refugee camp in Jordan.
Review the follow up assessment of displaced Syrians in the Jordanian community
Read this primer on the mental health of Syrian refugees, that I co-authored for the U.N. Refugee Agency
Watch this video or fact sheet I made for the American Psychiatric Association
Peruse any of the studies I’ve done on the mental health of survivors of torture,
Read my book, Child, Adolescent & Family Refugee Mental Health: A Global Perspective, co-edited by the senior mental health adviser, UN High Commissioner for Refugees