Credit: Dominique Soguel
MAFRAQ, Jordan (WOMENSENEWS)--The women in this small blue room in the northern city of Mafraq, a hub for Syrian refugees, have experienced an array of bitter hardships.
But for the purpose of this particular group therapy session, organized by the International Red Crescent in Mafraq, they are focused on their one common anguish: traumatized children.
"I have two boys, ages 3 and 5. They are scared of everything," said Ward Saleh, one of more than a dozen women in the group.
Then Umm Ihab spoke up. "I have two little girls and the smallest thing triggers tears."
Beginning to feel at ease, other women start to unload and describe the challenges they face at home with their children: violence, autistic or anti-social behavior, involuntary peeing, nightmares followed by high levels of daytime anxiety and fear.
The crackle of fireworks, the hum of airplanes and the sight of men in uniform are common stressors that can instill terror in a child who has survived war in Syria. Some saw air strikes and incredible violence firsthand and now see it replayed on TV or the Internet.
"Everything that happens to a child before the age of 5 stays with them forever," said Suha, a Syrian volunteer leading the session, who asked that her full name not be used due to security concerns. "Even if they are safe now, they do not feel safe."
That message resonated strongly with Hanan Fikawi, 38, a mother of five children. A native of Karm al-Zeitoun, a mixed Sunni-Alawite neighborhood in the Syrian city of Homs, Fikawi left her home roughly a year after the outbreak of protests against President Bashar al-Assad. In March 2012, as her community endured shelling by the Syrian army, a massacre left dozens dead, including children.
The event was documented by opposition activists and residents on YouTube, who blamed the regime for the bloodshed. Syrian state media blamed "armed gangs."
'Sitting in Pure Fear'
From that time Fikawi remembers a backdrop of shelling, kidnappings and rising sectarian tensions. In the foreground of memory, what stands out is the day in March when she was warned that Assad loyalists were out to kill. She took shelter with her family in a neighbor's basement.
"We were sitting there in pure fear. My kids were crying, crying, crying. Either way, we die, I thought. I didn't know what was happening around me. The next day we turned the TV on and saw our neighbors killed. The level of terror we felt was unspeakable," she said.
Two days later the family fled to the outskirts of Homs and when that was no longer safe, they headed to Moadamiyet al-Sham, near Damascus. In June 2012, after moving several times within Syria and surviving a number of air strikes, they crossed into Jordan.
Fikawi now suffers from a thyroid condition, bone ache and gradual vision loss. The stress of losing her home and health is compounded by the difficulties of caring for children who shared every step of her traumatizing journey to Jordan.
Dua, her 5-year-old, is the biggest handful. "She is wild and when she wants something she just hits me or pinches me. I can't take it anymore," Fikawi told Women's eNews after the group therapy session had broken up.
Her boys, meanwhile, channel some of their traumas through role playing, setting up fake frontlines and checkpoints, battling out their anger as members of the rebel Free Syrian Army or as regime soldiers or shabiha, a term used in Syria for pro-regime thugs.
"The problem of a child, a mother can either solve it or exacerbate it depending on how she deals with it," Suha, the group session leader told Women's eNews. "If the child is hostile or aggressive or violent, many mothers don't know how to deal with it."
Credit: Dominique Soguel
Syrian female refugees living in Jordan, she noted, are under a lot of pressure. Many of those living in cities are struggling to feed their children, spending full days doing the rounds of charities in the hope of securing some sustenance.
Financial stress can lead to domestic violence and dark thoughts, Suha added. "The biggest problem whether inside or outside Syria is securing food," she said. "Before there is psychological support, there has to be material support. There are many Syrian women who think about suicide as a result of the pressures they face."
While the International Red Crescent sessions are focused on mothers in Mafraq, some refugee aid efforts are focused on direct psychological interventions with children.
One of these is Syria Bright Future. Run by a team of volunteer Syrian psychiatrists and psychologists, it is based in Amman, the capital city of Jordan, and has a branch in the city of Irbid, a refugee population center in the north.
In the first eight months of this year, the organization, which is funded by Doctors of the World, an international humanitarian organization with headquarters in New York that provides emergency and long-term medical care to vulnerable populations, helped more than 300 children and referred about 20 percent of them, the more severe cases, for individual counseling.
The organization gives five-session cycles of group therapy to children between the ages of 8 and 15. The sessions are focused on providing techniques for managing symptoms of post-traumatic stress disorder, including "intrusive thoughts, ideas and images," said Syrian psychiatrist Mohammed Abu Hilal, who works for the group in Amman.
"These children are expected to have a lot of problems when they become adolescents. If we do not heal and repair now, we will see a lot of problems like alcohol and drugs and anti-social behavior," he added.
Limited Help Available
The majority of traumatized refugee children may never get such help due to limited availability of free counseling. Many refugee parents are so squeezed economically that they cannot even afford associated costs, such as transportation. Stigma also plays a role in limiting access to therapeutic help.
The most afflicted children, Abu Hilal said, are those who have lost a parent, most often a father. "You can see all the bad behaviors – aggression, hyperactivity – among these children. The mother will also have her own issues so that is reflected on the child."
Lamia Gorra, who is also working for Syria Bright Future in Amman, said it is especially hard for mothers who have lost their husbands because they have to "play the role of the mother and the father" at the same time. "The toughest situation for mothers is deciding whether to tell their children that their father is dead or alive," she added.
Gorra teaches relaxation techniques that include deep breathing and exercises in visualization, such as imagining a safe place the child can return to when experiencing anger, fear or stress.
The clinicians with the Syria Bright Future team have noticed that boys generally display more signs of trauma and anti-social behavior than girls. They say a possible reason could be that the girls were slightly more sheltered from the horrors of war than the boys.
The organization, however, has documented two suicide attempts among girls.
"One girl saw her father's body delivered in pieces in a plastic bag," Gorra said. "She threw herself from the roof and broke her legs. These children grow up seeing terrible scenes, believing the world is killing and bloodshed."
When the children cry, Gorra said, they don't cry normally. "They explode in tears."