Treating the Invisible Injuries of War

Psychosocial programs help refugees in Jordan, Lebanon, and Iraq overcome trauma
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A Yezidi woman with her children during a psychosocial first aid session in Dalal City. © Florian Seriex / ACF - 2015 - Iraq

When it comes to delivering humanitarian assistance to victims of conflict, most people would list food, clean water, shelter, and healthcare services as the most urgent priorities. Until fairly recently, humanitarian organizations focused their efforts on meeting the most urgent physical survival needs of people affected by violence or disaster. But the humanitarian mandate to alleviate suffering should include mental health along with physical health. Trauma can be one of the most damaging—yet overlooked—health needs for populations affected by emergencies, especially children.

In Jordan, Lebanon, and Iraq, Action Against Hunger has been working to help refugees and displaced families overcome trauma and heal.

Addressing the impact of conflict on children  

Our emergency teams in Jordan, Lebanon, and Iraq identify people in need and assess their psychological welfare. Psychologists then develop and manage individual treatment protocols, recognizing the unique needs of each community and adapting our approach to respect their customs.  

Our teams have found that children, who make up more than half of the conflict-affected population in the Middle East, often develop regressive behaviors like bed-wetting, and can exhibit increased irritability and outbursts of anger.  Our teams have also reported additional symptoms of trauma among communities affected by war in Iraq, Lebanon, and Jordan:

  • Sleep disorders, depressive symptoms, regressive behaviors, and high levels of anxiety among children are the most common disorders affecting Syrian refugees and internally displaced people in Iraq.
  • Refugees living in camps often suffer less stress than those living in host communities.
  • The psychological impact of crisis on communities that are hosting refugees and displaced populations is significant and must also be addressed.

Nuria Diez Carrillo, the head of Action Against Hunger’s Department of Mental Health Department in Iraq says,

“Working with people who have experienced trauma is very delicate work. We provide psychosocial sessions for children and for adults and families, addressing their unique needs. This work presents an opportunity to destigmatize mental health conditions like depression, so that each family member is able to understand not only what the affected person is going through, but also how they can best support them.”

Treating anxiety among refugees and host communities

Carrillo says that the psychosocial needs of people living in refugee camps can sometimes differ from those of people living in the communities that host refugees: "Families living in refugee camps usually suffer lower levels of stress, because they have more assurance that humanitarian aid will be provided. But they struggle with feeling deprived of liberty, dignity, decision-making, and autonomy." People in host communities also experience challenges, says Carrillo: “Individuals in host communities often feel somewhat empowered because they aren't living in camps, but their lives can be more difficult. They feel anxiety about earning income and providing for their families."  

To facilitate open communication and relationships, and to ensure we understand and respect the customs of the local population, our teams in Jordan, Lebanon, and Iraq are diverse.  For example, in the city of Dohuk in Iraqi Kurdistan, our staff comprises Kurds, Iraqis, Syrians, and Yazidis working in partnership to heal the divisions and wounds of conflict.

In Jordan, we facilitate dialogues between refugee Syrians and host Jordanians to defuse resentment regarding the on strain on resources that large numbers of refugees can cause.

The healing power of art and photography

Syrian children painting murals in Action Against Hunger's psychosocial workshops. © AptArt / 2015, Iraq

In Iraq, we have expanded our work with child refugees from Syria. For over a year, we have engaged refugee children in photography workshops. Children receive a camera, which they use to capture moments from their daily lives over 10 days. Our psychosocial team then facilitates a session that encourages the children to share their photos and talk about their experiences and challenges. "In addition to improving their sense of well-being, many children find that these workshops enhance their communications with members of their host communities," says Carillo.

In another artistic expression program for children in the Gawilan refugee camp in Dohuk, Iraq, we are partnering with a local arts organization called AptArt to give children confidence, encourage them to express themselves, and to help them develop relationships with peers.

“There is nothing more rewarding than seeing a child affected by trauma heal and begin to be a child again,” says Carrillo. 

Action Against Hunger is providing food, safe water, basic sanitation—and psychological support—to more than 3.5 million people in Syria, Lebanon, Jordan, and Iraq.

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About Florian Seriex

Florian is a regional communication officer reporting from our program and assessment sites in the Middle-East.