Iraq: Providing mental health care to people fleeing northeast Syria

Half brothers Adham (left) and Ahmed (right) came to Bardarash camp in mid-October 2019. Adham's older brother was killed in battle fighting for the Syrian Kurdish forces. His mother was killed in an airstrike carried out by the Turkish military. The two of them are alone in the camp.
Iraq 2019 © Vincent Haiges
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Doctors Without Borders/Médecins Sans Frontières (MSF) teams see a growing need for mental health care among people arriving at the Bardarash refugee camp in Iraq after fleeing conflict in northeast Syria.

“Roughly 50 percent of the people we saw during our mental health assessment in the camp were presenting symptoms linked to depression and anxiety,” said MSF mental health manager Bruno Pradal. Others exhibited medically unexplained physical symptoms like headaches and muscle pain, which could be related to mental health problems.

In Bardarash—which is currently at capacity with a population of 11,000 people from Syria as refugees continue to arrive—an MSF team is moving tent-by-tent to meet and talk to people, identify those most in need of mental health support, and refer them to a newly opened MSF health care center in the camp. In certain cases, we provide psychological first aid to people in particularly vulnerable conditions.

New arrivals in the camp describe many stressors.

“A shell landed near my neighbor, and he was wounded,” said Salih, a construction worker from Qamishli, Syria. “He asked me to take his disabled son with me and look after him. He is with me now amongst my children..... There is no safety in Syria anymore. I don’t sleep and eat properly. I’m scared, I don’t want to go back. I want to be able to sleep without the sound of gunshots and explosions and the fear of a rocket hitting my house.”

“People were worried about the future”

MSF mental health workers in the camp met people with suicidal thoughts as well as people with the early symptoms of post-traumatic stress disorder. In addition to psychological first aid and referrals, our teams also provide people with tips on caring for themselves and others and coping with stress.

“People were worried about the future and were feeling hopeless, thinking about the things they were forced to leave behind like their homes, jobs, family members, and loved ones,” Pradal said.

Most people said they came from the cities of Ras Al-Ayn or Qamishli, about 130 and 55 miles from the Iraqi border, respectively. A few said they fled Al-Hasakah, the capital city of the Syrian governorate of the same name, which borders Iraq. Some fled to at least one other location inside northeast Syria before making the decision to cross into Iraq.

Many described leaving other people behind. “Two of my daughters are still in Syria,” said Salih. “They told me to go and they would follow soon after with their families. It’s been 10 days and I haven’t had contact with them, and I don’t know whether they’ve come out or not, or what happened to them.”

In addition to mental health support, the new MSF health care center, which opened October 24, provides primary health services to men, women, and children in the camp, mainly for upper respiratory tract infections caused by the cool nights spent in tents. We have also treated people with non-communicable diseases including diabetes and asthma, as well as some cases of watery diarrhea.

In addition to our work in Bardarash camp, MSF continues the activities launched a week ago along the Syrian border in Al-Walid and Sahela refugee camps, where mobile clinics provide basic health care and screening for malnutrition.