Protecting Syrian children’s mental health after 10 years of war

Last week marked a grim milestone for the people of Syria. Ten years since thousands took to the streets across the country to protest against the dictatorship of Bahar al-Assad, the conflict that has raged ever since entered its second decade.

The war has left nearly 400,000 dead, including around 12,000 children, 200,000 missing and displaced 12 million people - over half of the country’s population. Fifty per cent of Syria's hospitals are destroyed as well as one in three schools, and more than half of children are facing food insecurity. But as fighting continues to destroy lives, and formal peace talks in Geneva stall, millions of Syrians face a bleak future.

As the war in Syria passes its tenth year, the psychological impact it is taking on civilians both inside and outside the country is striking. And in a country where more than half of the population are under 25, the mental health of children and young people is of particular concern.

A new survey by the International Committee of the Red Cross (ICRC) highlights the impact of the conflict on young people’s mental health, both inside Syria and in neighbouring host countries. Some 73 per cent of those surveyed had experienced anxiety over the past 12 months and 58 per cent had suffered depression due to the conflict. In all the countries surveyed, young Syrians said access to psychological support was one of the things they needed most.

“With the level of internal displacement, the level of destruction, the length of the conflict and the impact of sanctions, a lot of the people in Syria are traumatised and affected psychologically by these past 10 years of war,” says Andrei Engstrand, director of the International Federation of Red Cross and Red Crescent Societies (IFRC) country office in Damascus, speaking to Geneva Solutions. “People are saying that life is harder now than it has been since the beginning of the war…that should give us a sense of how the reality of today is. ”

Helping children on the ground. According to UNICEF, the reported numbers of children in Syria displaying symptoms of psychosocial distress doubled in 2020 as a result of continued exposure to violence, shock and trauma. Engstrand explains that the ongoing conflict, combined with the worsening economic situation in the country, greater restrictions on humanitarian actors and dwindling aid, makes meeting the growing needs particularly challenging. “With life being harder and the resources put at our disposal being less than they were several years ago, we don't have a good recipe for a brighter future,” he says.

The IFRC’s operations in Syria are coordinated with the Syrian Arab Red Crescent, which runs six mental health clinics across the country as well as a range of psychosocial support services for children and young people including safe spaces, educational activities and child protection awareness sessions for children and families. As well as the trauma suffered as a direct result of the fighting, millions of children in the country are facing a multitude of risks that are putting an added strain on their mental health.

Nearly 2.45 million children in Syria and an additional 750,000 Syrian children in neighbouring countries are out of school, of which 40 per cent are girls. With more children out of the classroom than ever before, many struggling families are sending their children to work due to the increasingly dire economic situation in the country. Engstrand also says escalating levels of poverty in the country have partly fuelled a rise in cases of child marriage, recruitment of child soldiers by armed groups, and risks many young people falling into crime. “There is a risk that this generation of young children and teenagers, without a prospect of a future, could take to violence and criminal activities in order to generate an income and survive,” he says.

The impact of the ongoing crisis and the imposition of economic sanctions have worsened the situation in the country over the past year, and hampered the operations of humanitarian actors. Over the past 12 months, the average price of a food basket increased by over 230 per cent, leaving many families unable to feed their children. More than half a million children under the age of five in Syria now suffer from stunting as a result of chronic malnutrition, and cuts to donor air have meant organisations such as the IFRC are forced to focus their resources on emergency aid rather than long term psychosocial support and rehabilitation.

Children struggling outside Syria. The situation for Syrian refugees displaced in neighbouring countries is little better. In Lebanon, which hosts an estimated 1.5 million refugees from Syria, children are facing similar risks. Mira Moussa, manager of Swiss NGO Terre des hommes’ child protection programme in Lebanon, says these dangers have risen rapidly over the past year.

“Even more now, with the economic situation of the Covid-19 pandemic and everything that we're going through in Lebanon for the past 12 months, refugee children are vulnerable to several protection risks including psychosocial distress, child labour, domestic and sexual violence,” says Moussa, speaking to Geneva Solutions from Beirut. “Not to mention the negative coping mechanisms that a lot of women and girls have had to resort to due to the economic situation such as child marriage.”

Syrian children in Lebanon have also had their access to education limited over the past year, leading many to drop out of school altogether and be pushed into unsafe work to help support their families.

While poverty rates in Lebanon skyrocketed throughout 2020, Syrian refugees were hit particularly hard, with nearly 90 per cent of Syrian refugee families now living below the extreme poverty line. The explosion at the port in Beirut last August which killed over 200 people, injured over 6000 and left 300,000 homeless also had a disproportionate impact on the city’s refugee population, a large proportion of whom lived near the site of the blast.

Moussa explains that a combination of all these factors is driving up mental health and psychosocial support needs among the Syrian children Terre des hommes works with. “We've seen a lot of psychological and social distress among them - it's common, and it's resulting in a wide range of emotional and physical and behavioural problems,” she says. Depression and Post-Traumatic Stress Disorder (PTSD) are common, as are anxiety and sleep disorders as a result of the distress they’ve suffered both in Syria and in their host country.

Terre des hommes offers a range of psychosocial support services for children and their families including psychological first aid and support sessions for victims of Gender-Based Violence (GBV) or abuse. While also putting children at greater risk of violence, the strict lockdowns that have been imposed on Lebanon to halt the spread of Covid-19 have also meant many services have had to be run remotely, making many of the most vulnerable children harder to reach.

“With what we’ve been facing recently, I feel like a lot of people are losing hope in the future,” says Moussa.

“It’s crucial to understand the experiences those children are going through - their hopes, their ambitions - and it's very crucial to strengthen their well being,” she continues. “This in turn ensures that the children are not just passive victims of harmful practices, but they can be agents of change in transforming their lives.”

Back in Syria, IFRC’s Engstrand explains that it’s in fact young people who make up the largest proportion of volunteers on the ground, driven by a resilience and desire to help rebuild their country. However, as the conflict enters its second decade, their hopes of a brighter future are dwindling. “The young adults of today still have a fading memory of what their future could have been like,” he says. “They see that becoming more and more of a distant memory, and the hope of rebuilding is getting thinner and thinner.”