Some have nightmares or insomnia. Others are depressed all the time. Still others are developing schizophrenia or other mental illness.
They are people who lived under ISIS in Syria and who are now living in tents in a camp in northeastern Syria.
Paula Orsi, a Doctors Without Borders psychologist, treats people at the Ein Essa camp, which houses thousands of displaced people, mostly Syrians who fled from ISIS’ former de-facto capital of Raqqa as well as from ISIS-held Deir-Ezzour. She visits the camp about two to three times a week to have consultations with 10 to 12 patients a day.
Following are excerpts from a recent, edited conversation with Orsi.
How are people who came from Raqqa coping in the camp?
People came from war and airstrikes. They were trapped and lived very, very stressful lives. Some of them lost family members and saw people die in front of them. They managed to leave to a place where the stress continues. People live in tents. Sometimes they don’t have a place to stay. The tent is supposed to be for six to eight people, but sometimes many more people live in one tent. They have to queue up for the toilet. There’s no moment for them to start recovering. For them to start a process of healing they need to feel that they are in a safe place. The cause of the stress is still there. Even if it wasn’t perfect before, they maybe used to garden, have their sheep, have their home. Suddenly they’re in a place that is not home. The mental state of the whole camp is very compromised. It’s very heartbreaking and catastrophic. The majority of people have resilience and can cope. They will cope and rebuild their city. A minority is going to develop a mental disease due to a combination of environmental factors and genetics. Maybe if they could have been taken to a super-comfortable place where they feel safe and welcome that could have helped prevent the development of a disease.
What types of mental diseases do you see people developing?
I see people developing schizophrenia, hallucinations, delusions. Some are developing depression and experience sadness all the time. They feel tired and are losing a lot of weight. They have no appetite and less strength to take care of the children and get food. So the whole family suffers. I treat people who have nightmares, insomnia and hypervigilance. For some, every noise reminds them of what happened and of the time when they saw someone killed in front of them. I think all of them are going to carry the luggage for life, but for some it’s going to be more severe than others. It will be a trauma that they will never forget, but you can give this trauma new meaning. For example, the meaning of this trauma can be, “I am a poor woman put in this terrible place,” or the meaning can be “I went through a war and I survived. Maybe I can have a second chance.”
PHOTO: Women and children converse as they stand outside tents at the Furat (Euphrates) camp for the displaced from Deir Ezzor, north of the town of Kafr Dariyan, Syria Nov. 27, 2017. (Ibrahim Yasouf/AFP/Getty Images)
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Do you meet other psychologists in the camp?So far I haven’t met any psychologist from any other place. There are counselors, yes, but not people who can offer specialized care and from the level of suffering that I’ve seen, that’s what we need.
How many patients do you see?
I’ve been seeing quite a lot of patients - between 10 and 12 patients every day, not more than 13 in a day. Most of them need medication. Some of them need close follow-up sessions to help them talk about their experiences. It can be difficult for the families to understand a person who is not coping. A depressed person is seen as a lazy person who doesn’t want to help. It requires a lot of education for the family.
US-led airstrikes near Raqqa in March killed at least 84 civilians, including 30 children: Human Rights Watch
Civilians trapped in Raqqa with little access to urgently needed healthcare, organizations warn
Syrian children suffer from 'toxic stress' after 6 years of war, new report says
Can you give some examples of the patients you treat?
One is a 19-year-old boy who fled from Deir Ezzor. I don’t know his whole story. He almost doesn’t speak, he’s catatonic. He got lost from his family when he was running away. He’s alone. What’s heartbreaking about him is he’s so scared and quiet. He didn’t eat anything for a week and is emaciated, looking almost sick. He’s suspicious, but not psychotic. He’s not delusional and not hallucinating. But he’s so apathetic that when you look at him it’s almost like his soul is not there anymore.
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