Traumatized Syrians face major mental health issues with little care available

Displaced Syrians take refuge at the Sultan Ibrahim Mosque in the regime-controlled town of Jableh, northwest of the capital Damascus, on February 12, 2023 following a deadly earthquake in Turkey and Syria. (AFP)
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Updated 29 June 2023
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Traumatized Syrians face major mental health issues with little care available

  • Years of war, and the earthquakes in February, have taken a deep psychological toll on people, delegates at a conference in Washington heard
  • Charitable organization MedGlobal said there has been ‘a severe psychological impact’ on civilians, resulting in depression, anxiety and PTSD

WASHINGTON: After more than a decade of civil war, the devastating earthquakes in Syria this year inflicted further trauma on an already vulnerable population, experts said during a conference in the US on Wednesday.
Many Syrians are not only suffering the physical effects of the crises in their country but also severe mental repercussions, including post-traumatic stress disorder, that are taking a deep psychological toll on Syrian society as a whole and those in the northwest in particular.
The knock-on effects of this mental health crisis, which affects not only victims of the conflict and the natural disaster but also those who provide them with healthcare, include substance abuse of drugs such as the amphetamine Captagon, narcotics and pain medications.
These effects are observed across many segments of Syrian society, according to medical and social experts who shared their experiences and findings during Wednesday’s event, which was organized by the Middle East Institute in Washington and attended by Arab News.
As the civil war approached the end of its 12th year, two earthquakes, of magnitude 7.8 and 7.5, caused devastating damage to parts of northern Syria and southern Turkiye on Feb. 6.
According to report by MedGlobal, a charitable, non-governmental organization that provides emergency humanitarian aid and healthcare, the “Syrian conflict has had a severe psychological impact on its civilians, resulting in high levels of mental health problems such as depression, anxiety and post-traumatic stress disorder.”
It added that many Syrians have experienced traumatic events such as bombings, shootings and forced displacement, which have contributed to mental health issues. The lack of access to adequate mental healthcare and support has exacerbated the psychological effects of the war on the population.
The conference heard that almost half of the Syrian population, and especially those worst-affected by the earthquakes, is suffering from some degree of mental disorders, and many have developed severe condition and show the full symptoms of PTSD.
Dr. Nora Abdullah, a psychiatry resident at Yale New Haven Hospital in Connecticut and a MedGlobal volunteer, said there is an acute mental health crisis in the parts of northwestern Syria that are outside the control of the Syrian regime, with only two psychiatrists to serve a population of about 3.5 million people.
She described the scale of the crisis as “staggering” and said a “telehealth” approach, using technology to provide treatment and support services to patients and to medical staff working under highly stressful conditions, who often fall victim to mental health issues themselves, is helping to compensate for this lack of mental health professionals in parts of Syria.
Dr. Dania Albaba, a psychiatry resident at Baylor College of Medicine in Houston, Texas, and a volunteer and report author for MedGlobal, said “psychological first aid” is being used in the field in Syria to help people recognize the warning signs of mental trauma and disorders, and teach them what they can do to address them.
“We know emergency mental health aid is very valuable and is needed in the immediate aftermath of an earthquake, or any crisis,” she added.
Alex Mahoney, acting director for the Middle East, North Africa and Europe at the US Agency for International Development’s Bureau for Humanitarian Assistance, said that in addition to supporting the provision of emergency mental health treatment, the agency is also helping to provide psycho-social support services for the Syrian people, including material aid and training for displaced refugees.
He acknowledged that the region remains “a dangerous environment,” especially for organizations with direct links to the US, and so USAID works with the UN and is careful not to reveal the identities of those who help it distribute aid to communities.
He also spoke about “telehealth” and said it is one of the services his agency provides, through the work of specialist partners.
Natasha Hall, a senior fellow with the Middle East Program at the Center for Strategic and International Studies in Washington, said the situation in northwestern Syria is dire, especially since the earthquakes. Between 60 and 85 percent of people are unemployed and about 9,000 who did have jobs have lost them because of funding cuts by international donors, she added.
International aid and funding for refugees in the country is drying up yet the situation Syrians find themselves in has not improved in years, said Hall.
“This population is completely dependent on humanitarian aid,” she added.

 


Hamas says Gaza ceasefire efforts are back at square one

Updated 11 May 2024
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Hamas says Gaza ceasefire efforts are back at square one

  • Israel has killed more than 34,700 Palestinians, according to Gaza’s Health Ministry

CAIRO: The Palestinian militant group Hamas said on Friday that efforts to find a Gaza Strip truce deal were back at square one after Israel effectively spurned a plan from international mediators, and the White House said it was trying to keep the sides engaged “if only virtually.”
Hamas said in a statement it would consult with other Palestinian factions on its strategy for talks to halt seven months of war triggered by its deadly Oct. 7 attack on Israel.
Hours earlier, the United Nations warned that aid for Gaza could grind to a halt in days after Israel seized control this week of the Rafah crossing between Gaza and Egypt, a vital route for supplies to the devastated Palestinian enclave.
Despite heavy US pressure, Israel has said it will proceed with an assault on the southern Gaza city of Rafah, where more than 1 million displaced people have sought refuge and Israeli forces say Hamas militants are dug in.
Israeli tanks captured the main road dividing the eastern and western sections of Rafah, effectively encircling the eastern part of the city in an assault that has caused Washington to hold up delivery of some military aid.
The White House said that it was watching “with concern,” but the Israeli operations appeared to be localized around the shuttered Rafah crossing and did not reflect a large-scale invasion.
“Once again, we urge the Israelis to open up that crossing to humanitarian assistance immediately,” said White House national security spokesman John Kirby.
Israel’s plan for an all-out assault on Rafah has ignited one of the biggest rifts in generations with its main ally. Washington held up a weapons shipment over fears of massive civilian casualties.
In a report to Congress, President Joe Biden’s administration on Friday said it was reasonable to assess that Israel had used US arms in instances “inconsistent” with international humanitarian law.
However, the administration said it still found credible and reliable Israel’s assurances that it will use US weapons in accordance with international humanitarian law.
Indirect diplomacy has failed to end a war that health authorities in Hamas-run Gaza say has killed almost 35,000 people since the Oct. 7 attack. Some 1,200 people were killed in Israel and 253 taken hostage on Oct. 7, according to Israeli tallies.
Ceasefire talks in Cairo broke up on Thursday with no agreement.
Hamas had said it agreed at the start of the week to a proposal by Qatari and Egyptian mediators that had previously been accepted by Israel. Israel said the Hamas proposal contained elements it cannot accept.
“Israel’s rejection of the mediators’ proposal through the amendments it made returned things to the first square,” Hamas said in Friday’s statement.
“In the light of (Israel Prime Minister Benjamin) Netanyahu’s behavior and rejection of the mediators’ document and the attack on Rafah and the occupation of the crossing, the leadership of the movement will hold consultations with the brotherly leaders of the Palestinian factions to review our negotiation strategy.”
“Hamas did not suspend nor withdraw from the negotiations; the occupation (Israelis) turned against the mediators’ proposal,” a senior Hamas official, Khalil Al-Hayya, said in comments to Al Araby TV published by Hamas.
Kirby said the end of the talks — which CIA Director William Burns was helping mediate — was “deeply regrettable,” but the US believed the differences were surmountable.
“We are working hard to keep both sides engaged in continuing the discussion, if only virtually,” he said.

EXPLOSIONS AND GUNFIRE
Residents described almost constant explosions and gunfire east and northeast of Rafah on Friday, with intense fighting between Israeli forces and militants from Hamas and Islamic Jihad.
Hamas said it ambushed Israeli tanks near a mosque in the east of the city, a sign the Israelis had penetrated several kilometers from the east to the outskirts of the built-up area.
Israel has ordered civilians out of the eastern part of Rafah, forcing tens of thousands of people to seek shelter outside the city, previously the last refuge of more than a million who fled other parts of the enclave during the war.
Israel says it cannot win the war without assaulting Rafah to root out thousands of Hamas fighters it believes are sheltering there. Hamas says it will fight to defend it.
Supplies were already running short and aid operations could halt within days as fuel and food stocks get used up, UN aid agencies said.
“For five days, no fuel and virtually no humanitarian aid entered the Gaza Strip, and we are scraping the bottom of the barrel,” said the UNICEF Senior Emergency Coordinator in the Gaza Strip, Hamish Young.
Aid agencies say the battle has threatened hundreds of thousands of displaced civilians.
“It is not safe, all of Rafah isn’t safe, as tank shells landed everywhere since yesterday,” Abu Hassan, 50, a resident of Tel Al-Sultan west of Rafah told Reuters via a chat app.
“I am trying to leave but I can’t afford 2,000 shekels ($540) to buy a tent for my family,” he said. “There is an increased movement of people out of Rafah even from the western areas, though they were not designated as red zones by the occupation.”
Israeli tanks have sealed off eastern Rafah from the south, capturing and shutting the only crossing between the enclave and Egypt. An advance on Friday to the Salahuddin road that bisects the Gaza Strip completed the encirclement of the “red zone” where they have ordered residents out.
The Israeli military said its forces in eastern Rafah had located several tunnel shafts, and troops backed by an air strike fought at close quarters with groups of Hamas fighters, killing several.
It said Israeli jets had hit several sites from which rockets and mortar bombs had been fired toward Israel.
The UN General Assembly overwhelmingly backed a Palestinian bid to become a full UN member by recognizing it as qualified to join and recommending the UN Security Council “reconsider the matter favorably.”

 


Iranians vote in parliamentary runoff election

People vote during Friday’s runoff parliamentary elections in Tehran. (Reuters)
Updated 11 May 2024
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Iranians vote in parliamentary runoff election

  • Politicians calling for change in the country’s government, known broadly as reformists, were generally barred from running in the election

TEHRAN: Iranians voted on Friday in a runoff election for the remaining seats in the country’s parliament after hard-line politicians dominated March balloting.
People in 22 constituencies across the country will elect 45 representatives from a pool of 90 candidates, 15 of whom are considered moderate.
In the capital, Tehran, 16 representatives will be chosen from 32 candidates, all hard-liners.
Final results are expected on Monday, though counts in smaller constituencies are likely before that.
Iran’s parliament plays a secondary role in governing the country.
Supreme Leader Ali Khamenei has the final say in all important state matters.
State TV showed Khamenei voting on Friday immediately after the polls opened.
He urged people to vote and said the runoff election was as important as the main one.
In the March election, hard-liners won 200 out of 245 seats, with more moderate candidates taking the other 45. A total of 25 million ballots were cast, for a turnout of just under 41 percent.
The previous lowest turnout was 42 percent in the 2020 parliamentary election.
Politicians calling for change in the country’s government, known broadly as reformists, were generally barred from running in the election.
Those calling for radical reforms or for abandoning Iran’s theocratic system were also banned or did not bother to register as candidates.

 

 


Suspected pirate attack in Gulf of Aden raises concerns about growing Somali piracy

Updated 11 May 2024
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Suspected pirate attack in Gulf of Aden raises concerns about growing Somali piracy

  • Somali piracy in the region at the time cost the world’s economy some $7 billion — with $160 million paid out in ransoms, according to the Oceans Beyond Piracy monitoring group

DUBAI: A European naval force detained six suspected pirates on Friday after they opened fire on an oil tanker traveling through the Gulf of Aden, officials said, likely part of a growing number of piracy attacks emanating from Somalia.
The attack on the Marshall Islands-flagged Chrystal Arctic comes as Houthis have also been attacking ships traveling through the crucial waterway, the Red Sea, and the Bab Al-Mandeb Strait connecting them.
The assaults have slowed commercial traffic through the key maritime route onward to the Suez Canal and the Mediterranean Sea.
The pirates shot at the tanker from a small ship “carrying weapons and ladders,” according to the British military’s UK Maritime Trade Operations Center, which oversees Mideast shipping routes.
The pirates opened fire first at the Chrystal Arctic, whose armed onboard security team returned fire at them, the UKMTO said.

BACKGROUND

Maritime sources say pirates may be encouraged by a relaxation of security or may be taking advantage of the chaos caused by attacks on shipping by the Houthis.

The pirates then abandoned their attempt to take the tanker, which continued on its way with all its crew safe, the UKMTO said.
Hours later, the EU naval force in the region known as Operation Atalanta said a frigate operating in the region detained six suspected pirates.
The frigate seized the pirates, given “the unsafe condition of their skiff” and said that some had “injuries of varied severity.”
It was not immediately clear if those injured suffered gunshot wounds from the exchange of fire with the Chrystal Arctic.
The EU force declined to elaborate “due to the security of the operations.”
Once-rampant piracy off the Somali coast diminished after a peak in 2011. That year, there were 237 reported attacks in waters off Somalia.
Somali piracy in the region at the time cost the world’s economy some $7 billion — with $160 million paid out in ransoms, according to the Oceans Beyond Piracy monitoring group.
Increased naval patrols, a strengthening central government in Mogadishu, Somalia’s capital, and other efforts saw the piracy beaten back.
However, concerns about new attacks have grown in recent months.
According to the International Maritime Bureau, five incidents were reported off Somalia in the first quarter of 2024.
“These incidents were attributed to Somali pirates who demonstrate mounting capabilities, targeting vessels at great distances from the Somali coast,” the bureau warned in April.
It added that there had been “several reported hijacked dhows and fishing vessels, which are ideal mother ships to launch attacks at distances from the Somali coastline.”
In March, the Indian navy detained dozens of pirates who seized a bulk carrier and took its 17 crew hostage.
In April, pirates release 23 crew members of the Bangladesh-flagged cargo carrier MV Abdullah after seizing the vessel.
The terms of the release are not immediately known.
These attacks come as the Houthi campaign has targeted shipping since November as part of their pressure campaign to stop the Israel-Hamas war raging in the Gaza Strip.

 


Israeli troops drive further into Rafah as tanks split city in two

Updated 8 min 45 sec ago
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Israeli troops drive further into Rafah as tanks split city in two

  • Four Israeli soldiers killed as Hamas and Islamic Jihad put up a fierce resistance
  • Israel’s move into Rafah has been short of the full-scale invasion that it threatened

JEDDAH: Israeli troops pushed further into Rafah in southern Gaza on Friday as its tanks split the city in two and encircled the eastern half.

The Israeli forces faced fierce resistance from Hamas and Islamic Jihad fighters, and battles also resumed in northern Gaza, where Hamas has regrouped after being forced out earlier in the war. Four Israeli soldiers were killed in fighting there.
Israel’s move into Rafah has been short of the full-scale invasion that it threatened. The US and other Israeli allies are deeply opposed to a major offensive, and Washington has threatened to hold back arms to shipments to Israel.
But the heavy fighting has shaken the city and spread fear that a bigger assault is coming.

 

 

The UN agency for Palestinian refugees said more than 110,000 people had fled Rafah, and families who had already moved numerous times during the war were doing so again.
“The full invasion hasn’t started and things have already gotten below zero,” said Raed Al-Fayomi, a refugee in Rafah. “There’s no food or water.”
Those fleeing erected new tent camps in Khan Younis, which was half destroyed in an earlier Israeli offensive, and the town of Deir Al-Balah.
The charity Project Hope said there had been a surge in people from Rafah seeking care for blast injuries, infections and pregnancies in its clinic in Deir Al-Balah.
“People are evacuating to nothing. There are no homes or proper shelters for people to go to,” said the group’s Gaza team leader in Rafah, Moses Kondowe.

UN aid official Georgios Petropoulos said humanitarian workers had no supplies to set up in new locations.
“We simply have no tents, we have no blankets, no bedding, none of the items that you would expect a population on the move to be able to get from the humanitarian system,” he said.
The fighting in Rafah has left crucial nearby aid crossings inaccessible, and food and other supplies were running critically low, aid agencies said.
The World Food Program will run out of food for distribution in southern Gaza by Saturday, Petropoulos said.
Aid groups have said fuel will also be depleted soon, forcing hospitals to shut down critical operations and bringing to a halt trucks delivering aid across south and central Gaza.


US report criticizes Israel but does not block arms

Updated 11 May 2024
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US report criticizes Israel but does not block arms

WASHINGTON: A long-awaited State Department report on Friday criticized Israel’s use of US weapons in the Gaza war but did not find enough evidence of violations to block shipments.
The report said it was “reasonable to assess” that Israel has used weapons in ways inconsistent with international humanitarian law but that the United States could not reach “conclusive findings.”
The report had been held up for several days by debate within the State Department and was finally released after President Joe Biden publicly threatened to withhold certain bombs and artillery shells from Israel if it goes ahead with an assault on the packed city of Rafah.
The report does not affect that decision, with the White House reiterating on Friday that it was concerned about Israeli military action around Rafah, where some 1.4 million Palestinians have taken shelter.
Biden, responding to critics within his Democratic Party concerned by the toll on civilians in the Gaza war, had in February issued a memorandum known as NSM-20 that asked countries that receive US military aid to make “credible and reliable” assurances they are complying with human rights laws.
Israel — which launched a war against Hamas after the militants staged the deadliest ever attack on the country on October 7 — made assurances to the United States and “identified a number of processes for ensuring compliance that are embedded at all levels of their military decision-making,” said the public version of the report, which was submitted to Congress.
“The nature of the conflict in Gaza makes it difficult to assess or reach conclusive findings on individual incidents,” it said.
“Nevertheless, given Israel’s significant reliance on US-made defense articles, it is reasonable to assess that defense articles covered under NSM-20 have been used by Israeli security forces since October 7 in instances inconsistent with its IHL obligations or with established best practices for mitigating civilian harm,” it said, referring to international humanitarian law.
The report also said that while the Israeli Defense Forces have “the knowledge, experience and tools” to minimize harm, “the results on the ground, including high levels of civilian casualties, raise substantial questions as to whether the IDF is using them effectively in all cases.”
But despite some “serious concerns,” the report said that all countries receiving US military aid had made assurances credible and reliable enough “to allow the provision of defense articles covered under NSM-20 to continue.”
A US official described the report as a snapshot and said the State Department was still monitoring the use of weapons.
The other recipients of US military aid covered by the report were Colombia, Iraq, Kenya, Nigeria, Somalia and Ukraine.