1 August 2021 – Each month we present some human interest stories about people whose lives have been changed thanks to the generous and continuous support of the European Civil Protection and Humanitarian Aid Operations (ECHO) and the relentless dedication of our partners on the ground in northwest Syria.

The story of Um Khaled and her experience with depression disorder

Um Khaled is 42 years old and was displaced from the Damascus countryside to Idlib. She has been divorced for a long time and her daughter lives far from her and her other child has been living with his father since the divorce. She is currently living alone in her friend's house without any privacy, far from all her family members who all live in and near Damascus. She has no relatives in Idlib and was displaced there due to the conflict.  

For more than 7 months, Um Khaled had suffered from symptoms of chest tightness, headaches, sleep disturbance, and a lack of interest in daily activities. Also, her bad financial status increased the severity of her symptoms and she was always crying and generally in a heightened state of depression. One day, she took action to visit the mobile clinic run by the Qatar Red Crescent Society and supported by WHO through the ECHO fund.

At the centre, the psychosocial worker developed a comprehensive approach and established an appropriate care plan for Um Khaled to reduce the severity of her client’s psychological symptoms and provide psychosocial support to improve overall well-being and resilience. The psychosocial worker implemented interventions to achieve these goals that focused on providing psychoeducation to her client about depression, its symptoms and how to deal with them. She also communicated with the client’s friend and her family (the only trusted people in displacement) and engage them in the psychosocial support programme and referred her to a women's centre to help her engage in the programme and empowerment activities.

Due to the ECHO fund that enabled WHO to support the mobile clinic, the life of Um Khaled has dramatically improved and her outlook on life has become more positive and focused. Um Khaled’s depressive symptoms were reduced after she received mental health and pyschosocial interventions and her social status improved. Also her friend succeeded in resolving the marital dispute between her and her husband as she has since been granted access to see her young child. We are also very happy to report that she has become a seamstress after engaging in empowerment activities in the women's centre and is now able to work and support herself.

The story of Abdullah and his experience with psychosis disorder

Abdullah is 37 years old has been separated from his wife for the past 4 years due to a worsening psychological condition. He lives in the Aleppo countryside with his widowed mother and his married brother, who has 3 children and they live in a very basic house that is not really inhabitable. 

After his separation from his wife, he started to experience strange symptoms and behaviours. He became afraid of many things, sometimes even the sound of people's voices, and a state of nervousness, panic, anxiety and tension overcame him. He started to isolate himself so he quit his job and he refused to leave his house. As a result, his economic situation declined and his problems multiplied. The severity of his condition and symptoms worsened. He began to suffer from auditory and visual hallucinations and started clinging to false beliefs and delusions. He slowly became addicted to captagon pills. 

Abdullah’s mother heard of the mobile mental health clinic in their place of residence, so she visited the clinic asking for assistance. The psychosocial worker developed a comprehensive approach and established an appropriate care plan to reduce the severity of his psychological disorder and provide psychosocial support for the other family members. Abdullah was referred to the mental health hospital in Azaz because of the severity of his disorder 

The psychosocial worker implemented interventions to provide psychoeducation for the client's family (mother and older brother) about the psychological disorder and the client’s needs during the period ahead. He also set about providing psychological support to the mother to deal with her symptoms of distress that included severe crying and fatigue and referred the family to a organization which provides shelter services to improve the conditions of people's houses. Also, the psychosocial worker referred the children of the older brother to an organization that provides child protection services because risks were identified among the children. 

The effect of such treatment was astounding and has changed the life of Abdullah and his whole family and within a month in Azaz hospital his psychotic symptoms were greatly reduced. His health improved as too did the health and psychological status of his mother. The house that they lived in underwent improvements with support from the organization. The children of his brother too have benefited and are now all safe and functional and back at school. 

Due to the ECHO funds that enabled WHO to support this mobile clinic, the life of Abdullah and his immediate family have become more hopeful and he is slowly regaining calmness and serenity. Abdullah’s case was one of the more extreme cases of mental health disorder and we are very pleased to announce that due to ECHO’s continual support to WHO and this mobile clinic, both he and his family are living in a healthy and happy home, with bright visions of the future. 

1 August 2021 – With the kind support of the European Civil Protection and Humanitarian Aid Operations (ECHO) WHO was able to continue to support INSAN that means ‘human’ in Arabic. INSAN, is a non-profit organization that offers psychosocial support to Syrian refugees, plus training to those working in refugee camps. It was set up by a group of psychologists back in 2012. We cannot stress how important the work of INSAN is on the ground and to the people most in need across northwest Syria. 

With ECHO funding INSAN was able to operate from mobile clinics supported by WHO through war-torn northwest Syria to dramatically increase access to those that need life-saving and life-sustaining, coordinated, equitable health services. One such story is that of Um Muhammad in 2021.

Um Mohammad's story

Um Muhammad is a 71 year old woman who was displaced from eastern Almaara 3 years ago and moved to the Al-Jeb camp in Maaret Tamasrin. As an elderly lady she suffers from health problems that include joint and bone pain, in addition to high blood pressure. 

One day as the INSAN mobile clinic was passing, her son brought her to be examined by a doctor. The doctor checked her and measured her blood pressure which he found high, so he immediately gave her medicine to reduce it. The doctor also referred her to specialized hospital in order to receive cardiac consultation. After several days, the nurse of the mobile clinic visited Um Muhammad in her tent to follow up on her case and to check her pressure again and make sure that she had recovered. This is the level of medical services and respect that all people deserve, especially the elderly. WHO would like to thank ECHO for their generous and continuing support of INSAN.

Um Ahmad's story

Um Ahmad was displaced from her home so many times across the Aleppo governorate to eventually Idleb where she has finally settled down in Allyth Camp in Haranbush. Now she has twins aged 6 months old. When the INSAN mobile clinic was in the camp she came to the clinic to have her children screened in its nutrition clinic. Community health workers screened the 2 children using the mid-upper arm circumference method and discovered that they both suffered from malnutrition. They instantly provided curative nutrition supplies and dietary instructions to be followed by their mother. They also set a follow-up date to return to the clinic to monitor both children until they had fully recovered. All people deserve this level of treatment and care, and particularly the most vulnerable, such as mothers and young children. WHO would like to thank ECHO for their generous and continuing support of INSAN.

One of Um Ahmad's twin girls being screened by mid-upper arm circumference

بين تموز/يوليو 2019 وأيلول/سبتمبر 2020، اكتشفت مئات الإصابات بالسل في شمال غرب سوريا. ولكن هناك تحديّات عديدة تشكّل عقبةً أمام التنفيذ الأمثل لاستراتيجية القضاء على السل وفقًا للمبادئ التوجيهية لمنظمة الصحة العالمية. فالسل المقاوم للريفامبيسين والمقاوم للأدوية المتعددة يتطلب علاجًا أكثر تعقيدًا من السل الحساس للأدوية، ويُعد أكبر العقبات التي تحول دون بلوغ أهداف عام 2020 المرحلية للقضاء على السل.

ومنذ بداية تموز/يوليو 2020، أُبلِغ عن زيادة في حالات السل المقاوم للأدوية المتعددة المكتشفة في شمال غرب سوريا، وبلغ مجموعها 12 حالة في أحدث فترة للإبلاغ.

لكن تظل الأدوية اللازمة لبدء علاج هذه الحالات نادرة. ونتيجة لذلك، تدهورت حالة هؤلاء المرضى الصحية العامة، كما حدث لمريض عمره 18 عامًا يدعى حسام* لم يحصل على العلاج الفعّال.

وحسام أحد الملايين الذين يعانون من ويلات الحرب في سوريا. وكان طفلًا يتمتع بالصحة، لكنه أصيب بالسل في سن 15 عامًا نتيجة للظروف التي عاناها خلال الحرب، كالظروف الاجتماعية والاقتصادية المتدهورة والنزوح الجماعي إلى شمال غرب سوريا. ولا يزال الحصول على أدوية السل يمثِّل تحدِّيًا لمعظم المدنيين في شمال غرب سوريا، بسبب ضعف النظام الصحي، وإغلاق أكثر من نصف المرافق نتيجة للأعمال العدائية المتزايدة، مما أدى إلى عدم اكتمال العلاج وعدم اتساق أدوية السل.

وفي أيلول/سبتمبر 2020، راجع حسام أحد مراكز مكافحة السل في شمال غرب سوريا وكان يعاني من السعال والتعرّق الليلي وفقدان الوزن. وتوافقت النتائج السريرية والمختبرية والإشعاعية التي أُجريت له في مركز مكافحة السل مع نتائج مرض السل. وقد اِخْتُبرت عينة من البلغم لديه بنظام «جين إكسبرت» وكانت النتيجة إيجابية واكتُشف مقاومة الريفامبيسين. استمرت حالة حسام في التدهور لعدم تأمين علاجه. وبعد شهر توفي حسام.

أما ليلى شقيقة حسام البالغة من العمر 32 عامًا فقد شُخِص إصابتها بالسل منذ نحو عام. وتلقت علاجاً للسل الحساس للأدوية مرتين دون فائدة قبل أن تُشَخَّص إصابتها بالسل المقاوم للريفامبيسين/والمقاوم للأدوية المتعددة، في نفس توقيت تشخيص حالة شقيقها. وقد عبرت بطريقة غير قانونية الحدود السورية التركية، على أمل أن تحصل على بطاقة الحماية التركية المؤقتة لتلقي العلاج في المستشفيات التركية حتى لا تواجه مصير شقيقها. وبينما تعمل منظمة الصحة العالمية عن كثب مع الشركاء لتأمين أدوية الخط الثاني الإضافية للسل المقاوم الأدوية المتعددة، لا تزال هناك تحديّات كبرى أمام شراء الأدوية.

*الأسماء خيالية وليست حقيقية