Doctor Wissam works at the Crisis Intervention Center for Psychosocial Trauma in Kilis, a Turkish border town and well-travelled crossing point for both Syrian refugees and contraband dealers. Wissam is a Syrian psychiatrist who used to work at the Ibn Sina Hospital in Damascus before the violence erupted. He explains that the Ibn Sina, along with the Ibn Khaldoun hospital in Aleppo, were the two main psychiatric hospitals in the country, but both have now been destroyed in the conflict. Hundreds of patients that were treated there, he added, have now been displaced around the borders.
The need for psychosocial support does not just concern Syrians previously affected by mental illness. Wissam has spent the last three years working with civilians in Syria, Lebanon and Turkey who have been affected by post-traumatic stress disorder (PTSD) as a result of the conflict. He said that the number of cases identified is extremely high, especially among those who have been able to escape to the border areas. This is hardly surprising; having made it out alive, many survivors suffer from nightmares, guilt or shame for being the lucky ones, not to mention having lived through the violence and grief themselves.
The staff members at the center are mainly Syrians who have also experienced the war. They provide daily support to over 450 patients inside and outside the camps. Staff also visit families that live in public parks and offer support to students who would like to enter high school. Abdullah Aziz, one of the hospital workers, was 21 when he defected from the Syrian army and moved to Turkey: “When the war began I knew that the consequences would be horrible, but I never expected that they would have affected me and my people this much.”
At the center, the mothers and sisters of Syrians caught up in battles at home get together for afternoon tea. Biscuits and tea are on offer, but no one eats or drinks anything. They are too busy sharing their fears for the safety of brothers and sons back in Aleppo.
According to the World Bank, mental health continues to be shaped by the circumstances refugees find themselves in once they have left the warzone behind. Poverty and loss of community are common circumstances among displaced Syrians and many see no hope for the future. The psychological assistants at the center explain that women and children are the ones who suffer most in these postwar conditions. Due to language and cultural barriers they often live in social isolation: Children rarely leave their homes and women limit contact with the local community for fear of sexual harassment or violence.
The persistence of stress-related symptoms even in post-conflict environments is an alarming trend for future generations of Syrians. In Bosnia and Afghanistan, high levels of violence and drug addiction have been recorded in the aftermath of their respective wars, even among second-generation teenage victims. Similar cases among Syrian teenagers have already been reported to the center from other Turkish cities such as Istanbul. The risk here is the loss of a generation to violence and substance abuse; these youths will struggle to live normal lives due to hyper-aggression and depression.
For these reasons, Wissam insists that psychological assistance is as important to the refugees as physical healthcare. Humanitarian organizations, both inside and outside Syria, are trying to provide psychosocial support beyond the emergency services. The gap between the need and the provision of mental health services, however, is still too large, according to a recent UN refugee agency report that claims psychological problems are not being adequately addressed. The Kilis Crisis Intervention Center is currently sponsored by the Organization of Islamic Cooperation. However, without extra funding, they will have to close at the end of May, once again leaving all these people to fend for themselves.