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Personal Essay: Caring For Mental Health Under The Bombs

In this installment of our series of diaries from Syrian care providers, Abdullah, a psychosocial community health worker with a local partner of the International Rescue Committee in Idlib, discusses his work helping families cope with depression and other mental health issues that are rampant across the city.

Written by Abdullah Published on Read time Approx. 3 minutes
Wreckages and heavily damaged buildings are seen at a marketplace after an airstrike in the de-escalation zone of Harem district of Idlib, Syria on March 23, 2018. Ahmed Rahhal/Anadolu Agency/Getty Images

IDLIB, Syria – The bombs and missiles falling on Idlib are getting more frequent by the day.

Usually, when it’s calm, my colleagues and I make home visits to provide psychological support to individuals and families. If there is fighting in the area, we can’t move from the health center. Recently, we had to stop working for an entire day because of the intense fighting. But we haven’t closed our operations and are trying to keep it running until the fighting stops. If God wills, this will end soon.

A few weeks ago, I went to visit a family at their home – you couldn’t imagine their situation. I found four men between the ages of 18 and 40, all of whom were paralyzed and suffering from mental disabilities. Both parents are too old to work. It was raining hard that day and they didn’t have a heater. I asked myself, what can I give them? I don’t know. They said: “Please just bring us medicine and God will appreciate your kindness.” Frankly, they needed more than just medicine: they needed heaters, food and relief from their poverty.

The mother didn’t talk very much, but what I saw in her eyes makes one go crazy.

I was able to get them some medicine but they also needed to see a doctor. It’s been so long since they had seen one. A week later, I returned with a car, but it was hard to get them into the vehicle because they are adults and disabled. We finally managed to get them into the car and started driving. But then fighting began again. We couldn’t go on, we had to turn back. I couldn’t take them to the doctor; the only thing I could do was give them two bottles of medicine.

This had a huge impact on me. I was in a bad mood all day.

Before the war, I remember wanting to graduate, get a job, get married and build a house. Now, my own family is broken. One of my brothers died in a bombing and another fled. Some of my sisters left, too. My younger brothers have no future because there are hardly any schools left – they are open a couple of days a week, and when one school is attacked, the others close out of fear. Schools are being used as shelters because they are safer than houses. Children are afraid, and we are worried about their mental health and inability to go to school.

In Idlib, many Syrians also suffer from depression. Most cases are a result of the war. They are sad, they do not love anything any more. Many desire death rather than continue living this way. Half of all Syrians in the country are in need of mental health support, but the World Health Organization estimates that 50 percent of psychiatrists have fled the country.

One of my sisters was diagnosed with extreme depression after my brother died. She was so sad about what happened to our family. She became very isolated and was unable to do things around the house or activities she usually enjoyed. She’s now on antidepressants and has shown great improvement. I have tried to support her along the way.

Before the war, we had money and our economy was good. Now poverty is everywhere. Everything is expensive, from bread to vegetables to fuel. We get help here and there. Only a small amount of aid comes through since the roads are blocked, so most people borrow from others or beg on the streets. It’s worse for the poorer families, who, for example, can only eat meat every two to three months. Eggs are rare, milk is unaffordable. Because of that, we have many cases of malnutrition, especially among children.

I work to make a living. But I also work because of what the war has done to people. Sometimes, I have no hope. But it comes back when I see the positive impact of my work. It comes back when I see cases nobody has yet seen, and I am able to give people support and motivate them in a positive way. Although I face a lot of trauma in my daily life, in a way, this job helped me, too. It helps me believe there are still good things in life, that we can do something to change human life, and that people still care about each other.

I want to tell the world that the people in Idlib suffer from extreme poverty, heavy shelling, fear of invasion, in addition to internal strife and its consequences. They are also suffering from permanent internal displacement between the regions. I want to tell the world that Syria’s civilians are victims of the conflict between the major powers in the country.

Despite all this, we are remaining here, in Idlib, because there is no place like home.

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