What Impact Has the Crisis Had on Families of Syrian Refugees Prior to the Disaster and How Has Displacement Affected Health Service Delivery Post-Disaster
The world is witnessing the highest levels of displacement on record. An unprecedented 70.8 million people around the world have been forced from home by conflict and persecution at the end of 2018. Among them are nearly 30 million refugees, over half of whom are under the age of 18. There are also millions of stateless people, who have been denied a nationality and access to basic rights such as education, healthcare, employment and freedom of movement.
Syrian internally displaced persons (IDPs) are individuals who continue to reside in a fractured Syrian state now comprising a patchwork of government- and opposition-held areas suffering from a breakdown in governance. As the Syrian conflict continues, the number of IDPs and Syrian refugees continues to grow according to data from the United Nations High Commissioner for Refugees (UNHCR). This growth is continuing despite some borders surrounding Syria being closed and in part due to a rising birth rate in refugee camps. This creates acute challenges for neighboring/receiving countries in terms of ensuring adequate capacity to offer essential services such as food, water, housing, security, and specifically healthcare. Though Syrian refugees and IDPs face similar difficulties in relation to healthcare access in a time of conflict and displacement, their specific challenges and health needs are distinctly different, as IDPs lack the same rights guaranteed under international law as refugees, and refugees have variations in access depending on their circumstances. Specifically, there are gaps in access to medical care and medicines for both the internally displaced and refugees, whether it be in Syria, in transit countries (including services for refugees living in camps versus those living near urban cities), or in eventual resettlement countries. In particular, treatment of chronic diseases and accessing of hospital care can be difficult, exacerbated by Syrian families depleting their savings, increased levels of debt, and a rise in those living in poverty (e.g., more than 50% of registered Syrian refugees in Jordan are burdened with debt).
Over the last year, hundreds of thousands of refugees fleeing war and persecution have travelled from the Middle East to Europe. Arduous journeys and poor living conditions are causing myriad health problems and access to basic healthcare is extremely limited for those on the move. At every stage of the journey, people are suffering, including after they settle in Europe. The difficulty in managing non-communicable diseases means that some refugees are not getting the treatment they need, which in the long term can have a significant adverse impact on their health (World Health Organization, 2016). Pregnant women are frequently unable to access antenatal care in Europe and the vaccination rate for refugee children is worrying low. Those who have suffered traumatic experiences in their home country are highly susceptible to developing psychological problems; an issue compounded by poverty, their displacement and being victims of violence (Clayton J. Holland H., 2015). In the wake of the rise in migration, many European countries have focused their policies on minimising and containing new arrivals – seemingly forgetting, or indeed ignoring, their duty to protect and care for people.
Generally speaking, these events only mark the latest emergencies to hit a country where war has persisted within its borders for nearly a decade. Since 2011, over half of Syria’s pre-war population — more than 12.7 million people — have been forced to flee their homes due to conflict. Families are struggling to survive inside Syria, or make a new home in neighboring countries. Others risked their lives on the way to Europe, hoping to find acceptance and opportunity. All together, the Syria crisis can feel overwhelming.
Clayton J. Holland H. Over one million sea arrivals reach Europe in 2015. Lesvos:: United Nations High Commissioner for Refugees; 2015.
Médecins du Monde Programme Migrants Nord littoral Dunkerque/Calais, Rapport D’Activities. 2015.
World Health Organization Refugee crisis. Situation update 3. Geneva:: WHO; 2016.