Re­portage

The cri­sis in Syria has seen one mil­lion refugees flood into Le­banon. Of th­ese, 300,000 are chil­dren, some hav­ing made the per­ilous trip across the bor­der un­ac­com­pa­nied. Read our re­port on this ‘lost gen­er­a­tion’.

Friday - - Society Living Leisure -

Farah’s wails filled the air, the haunting sound of tragedy re­flect­ing the daily re­al­ity of this over­crowded Tripoli Gen­eral Hos­pi­tal. Cradling her son’s limp body the heart­bro­ken mother held him close, wish­ing that the life cours­ing through her veins could sus­tain not just one but two. Rock­ing his 17-year-old life­less frame back and forth her ob­vi­ous de­spair matched the trauma etched on the faces of her other seven sons, hud­dled around the hos­pi­tal bed. Dirty and de­spon­dent they looked on help­lessly, ab­sorb­ing yet an­other scene of loss that should be re­served only for a child’s worst night­mares. With a fa­ther un­ac­counted for in Syria and their old­est brother now dead, re­spon­si­bil­ity to look af­ter the fam­ily would fall on 15-yearold Mo­ham­mad, a tra­di­tion of suc­ces­sion that is be­ing re­peated end­lessly as Syria’s fa­thers, broth­ers and sons are slaugh­tered.

It is of­ten said that chil­dren are the prin­ci­pal vic­tims of war and the Syr­ian cri­sis is no ex­cep­tion. The silent ma­jor­ity of refugees stream­ing into neigh­bour­ing lands are un­der the age of 18, some ac­com­pa­nied by fam­i­lies, many not.

Ac­cord­ing to the lat­est UN fig­ures, one mil­lion chil­dren have now been dis­placed and the bur­den of war they bear is unimag­in­able, says Unicef’s child pro­tec­tion spe­cial­ist An­thony Mac­Don­ald. “We have many ex­perts on the ground who have worked through­out the world in disas­ter zones and their re­ports say the trauma and the var­i­ous lev­els of dis­tress are un­prece­dented.”

Le­banon feels the strain

Syria’s small­est neigh­bour Le­banon is home to the high­est num­ber of th­ese refugees. Govern­ment es­ti­mates sug­gest just over one mil­lion peo­ple are cur­rently shel­ter­ing across 1,400 dif­fer­ent lo­ca­tions in the coun­try, while 3,000 peo­ple a day con­tinue to stream over the per­ilous bor­der. Some­times that num­ber is far higher and aid agen­cies are strug­gling to cope with the in­flux. “The num­bers are swelling day by day,” says Dr Mo­ham­mad Al Safadi, health area di­rec­tor from Qatar Red Cres­cent. “Last week 15,000 peo­ple en­tered the coun­try in just 24 hours and many of th­ese peo­ple re­quire ur­gent med­i­cal at­ten­tion.”

In Le­banon, the Of­fice of the UN High Com­mis­sioner for Refugees (UNHCR) says the cur­rent num­ber of reg­is­tered refugees and those await­ing regis­tra­tion stands at 720,000, of whom around 300,000 are chil­dren. As­ton­ish­ingly, the num­ber of child refugees has in­creased so dra­mat­i­cally over the past few months that they now make up 25 per cent of all chil­dren in the coun­try. Of th­ese, Unicef says 3,500 have crossed the bor­der un­ac­com­pa­nied, hav­ing ei­ther lost their fam­i­lies to the con­flict, or hav­ing been sep­a­rated from loved ones in the ex­o­dus. “Chil­dren have been the most af­fected in this cri­sis as is usu­ally the case in emer­gency sit­u­a­tions,” says Miriam Azar from Unicef. “Many have lost their fam­i­lies and been forced to flee alone… th­ese par­tic­u­lar kids are among the most vul­ner­a­ble.”

Child refugees whether or­phaned or ac­com­pa­nied, run a very high risk of ex­ploita­tion and dis­ease in which­ever coun­try they chose to seek refuge. How­ever, chil­dren reach­ing Le­banon are en­ter­ing into an­other con­text of war, es­pe­cially those who choose to set­tle in Tripoli.

In the coun­try’s sec­ond largest city where 51 per cent of res­i­dents live on a salary of less than $4 (Dh14.70) per day, the in­flux of refugees has ex­ac­er­bated an al­ready com­plex sit­u­a­tion. Ex­treme poverty cou­pled with an al­ready tense ri­valry be­tween the ma­jor­ity Sunni pop­u­la­tion, who op­pose Syria’s Pres­i­dent Bashar Al As­sad and the smaller Alaw­ite com­mu­nity who sup­port his regime, has fur­ther di­vided Le­banese and Syr­i­ans. The sit­u­a­tion has caused many to voice con­cern that the Syr­ian con­flict will spill over and last month’s twin car bombs in Tripoli that killed over 45 peo­ple dur­ing Fri­day prayers seemed to echo the war next door.

Yet de­spite the tense se­cu­rity sit­u­a­tion, this north­ern port city is pro­vi­sion­ally called home by more than 42,000 Syr­ian refugees, de­spite the fact it can of­fer them very lit­tle in terms of shel­ter. Like the rest of Le­banon, Tripoli does

not have recog­nised UNHCR camps. As a key ally of As­sad, the Shi­ite Hezbol­lah-dom­i­nant govern­ment has re­fused to al­low of­fi­cial refugee sites, pos­si­bly fear­ing that the mainly anti-As­sad refugees will re­main.

So Syr­i­ans ar­riv­ing here are left to sur­vive on their own, ei­ther rent­ing tiny rooms with no san­i­ta­tion fa­cil­i­ties at over in­flated prices, mov­ing into de­crepit derelict build­ings or mak­ing chaotic im­pro­vised camps where tents roast un­der the sum­mer sun. As Roberta Russo, a com­mu­ni­ca­tions of­fi­cer for the UNHCR, ex­plains, “We have re­quested tran­sit sites in the case that there is a fur­ther es­ca­la­tion of con­flict but the govern­ment is re­luc­tant and at the mo­ment we don’t have a roof to put over many of the refugees’ heads. We’re see­ing a lot of in­for­mal tented set­tle­ments mush­room­ing all over the coun­try in ar­eas far from ser­vices so they don’t have ad­e­quate shel­ter, san­i­ta­tion, ac­cess to wa­ter or ed­u­ca­tional fa­cil­i­ties.”

The bac­te­ria that breed in th­ese types of un­san­i­tary en­vi­ron­ments can cause havoc on young im­mune sys­tems and high num­bers of chil­dren are be­ing ad­mit­ted to Tripoli’s lo­cal gov­ern­men­tal hos­pi­tal daily with ill­nesses rang­ing from de­hy­dra­tion to gas­troen­teri­tis, of­ten need­ing emer­gency med­i­cal as­sis­tance.

Deal­ing with a fund­ing deficit

The pae­di­atric ward at Tripoli’s gov­ern­men­trun hos­pi­tal is over­run. In­no­cent cries spill out of its hot, crowded rooms where flimsy cur­tains hang at open win­dows, do­ing lit­tle to al­le­vi­ate the op­pres­sive sum­mer heat, the de­funct air-conditioning units an ob­vi­ous sign of un­der­fund­ing.

Many here can­not af­ford treat­ment. The mother of one-and-a-half-year-old twins Ab­dul­lah and Ah­mad says, “My boys have gas­troen­teri­tis; we have been here for 10 days. At first we were turned away but a doc­tor saw how sick my boys were and ad­mit­ted us. We have med­i­cal costs cov­ered by the UNHCR and [Qatar] Red Cres­cent but we still have to find an ex­tra [Dh500]. It’s too much, we can’t even buy bread!”

In the case of UNHCR-reg­is­tered refugees at Tripoli Gen­eral, 75 per cent of their med­i­cal bill is paid by the or­gan­i­sa­tion, while a fur­ther 15 per cent of the bill is paid by Qatar Red Cres­cent. Fam­i­lies must find the money for the re­main­ing 10 per cent, and those who can­not af­ford it are some­times not ad­mit­ted. This deficit in med­i­cal care costs didn’t al­ways ex­ist; ini­tially the UNHCR was able to pro­vide 85 per cent cov­er­age. How­ever, with the ris­ing num­ber of refugees and the fi­nan­cial reper­cus­sions, and hav­ing raised only 26 per cent of its re­quired $1.7 bil­lion fund­ing, it has been forced to cut costs.

In the case of refugees not reg­is­tered with the UNHCR, how­ever, The Qatar Red Cres­cent is able to cover 100 per cent of their costs. Con­se­quently, many reg­is­tered fam­i­lies seek out Dr Al Safadi on his rounds, plead­ing for fi­nan­cial as­sis­tance.

In the neona­tal in­ten­sive care unit, the sit­u­a­tion is the same – rows of pre­ma­ture ba­bies lie in­cu­bated, some with par­ents by their side, oth­ers alone. One mother holds her tiny child in her arms, des­per­ate to take her home. She says that be­cause their child was born pre­ma­ture, she and her hus­band have in­curred huge med­i­cal bills and can­not take their baby away un­til they find $2,000. Her hus­band has told her to aban­don the child – bet­ter that, than not be able to feed the rest of her fam­ily.

Back in the main ward sto­ries of de­spair are in abun­dance. Zaara, 12, has been wait­ing two ag­o­nis­ing days for an op­er­a­tion on two bro­ken shoul­ders as her fam­ily can’t find the 10 per cent charge of $250. Her brother, Rabih, says

they were forced to pay for a taxi to get here as all the am­bu­lances re­fused since her con­di­tion was not life threat­en­ing. Rabih, 16, says the re­spon­si­bil­ity for find­ing the money lies with him now. He re­counts los­ing his fa­ther in Syria, the death of his fam­ily and friends, his face emo­tion­less be­ly­ing the trauma. When asked where he sees him­self in a few years he replies, “I’m just grate­ful if we make it to to­mor­row.”

Ad­dress­ing psy­choso­cial needs

Rabih’s ob­vi­ous psy­cho­log­i­cal is­sues are the norm for al­most all of Syria’s child refugees. Unicef’s Mac­Don­ald ex­plains, “Many of the chil­dren are se­verely af­fected; the great ma­jor­ity are deal­ing with huge neg­a­tive ex­pe­ri­ences of los­ing fam­ily and friends. In some cases we have had young girls and boys wit­ness­ing se­vere vi­o­lence, such as the bru­tal mur­der of a par­ent, and you can imag­ine the im­pact is huge, not just for the short term, but the long term.”

Child am­putees wait around the hos­pi­tal, hope­ful that per­haps their wish for pros­thetic limbs will be granted. “My arm was blown off when a bomb hit our gar­den, thank­fully it was just me that was hurt,” says 14-year-old Fadil. “I’ve been here for two weeks on my own, my fam­ily is in the moun­tains, they couldn’t af­ford to be with me and I don’t have any phone credit to call them. So I’m just here, wait­ing.”

Most teenagers wait­ing for a pros­thetic limb would be ac­com­pa­nied, but such are the hard­ships borne by Syr­ian chil­dren now and the psy­choso­cial ef­fects of their past and cur­rent ex­pe­ri­ences are huge. Psy­choso­cial care is an as­pect of health ser­vices pre­vi­ously over­looked, but it is rapidly be­ing recog­nised that the im­pli­ca­tions of not ad­dress­ing dis­tress at all lev­els, ba­sic or post trau­matic, are huge. As Mac­Don­ald says, “If we don’t re­spond to cases of post-trau­matic dis­tress or other forms of psy­cho­log­i­cal ill­nesses now, then of course that child is at im­me­di­ate risk of harm to him­self or oth­ers be­cause [the dis­tress] can man­i­fest it­self in many forms. Psy­choso­cial care is life sav­ing.”

In June, the UN an­nounced that Syria’s war had reached “new lev­els of bru­tal­ity” with ev­i­dence of chil­dren be­ing taken hostage, be­ing forced to watch tor­ture and even take part in be­head­ings. Chil­dren who have wit­nessed the kind of atroc­i­ties that most of us will never see in a life­time des­per­ately re­quire coun­selling.

By the end of this year Unicef hopes to have pro­vided 81,500 chil­dren with ac­cess to psy­choso­cial sup­port ser­vices and given them back a sense of nor­malcy. They are car­ry­ing out recre­ational ac­tiv­i­ties with other chil­dren in safe spa­ces.

Mac­Don­ald says, “Fail­ure to ac­knowl­edge their dis­tress and help them find ways to build re­silience can end up in neg­a­tive cop­ing mech­a­nisms where they ex­pose them­selves to ex­ploita­tion and abuse. In some cases they may not be able to fully in­te­grate into school sys­tems and teach­ers will mis­di­ag­nose them as prob­lem chil­dren rather than chil­dren af­fected by this hor­ren­dous war.”

This ex­plains why the pri­mary aid agen­cies are pro­vid­ing psy­choso­cial in­ter­fer­ence not only in the home but also in schools. Unicef’s Back to Learn­ing cam­paigns and out-of-school sup­port are help­ing to pre­pare the most trau­ma­tised for their even­tual rein­te­gra­tion back into the school sys­tem. Teach­ers are also re­ceiv­ing train­ing in psy­choso­cial sup­port so they can be bet­ter equipped to iden­tify the signs and pro­vide a more tai­lored ap­proach to class­room man­age­ment.

Class­rooms are tra­di­tion­ally as­so­ci­ated with safety, se­cu­rity and de­vel­op­ment, the very ba­sic rights that have been de­nied to th­ese chil­dren for al­most two years. Get­ting them back in school, in the right con­tex­tual en­vi­ron­ment and with specif­i­cally trained teach­ers, is tan­ta­mount to the heal­ing process. If the ap­pro­pri­ate care is not pro­vided, chil­dren will be im­pacted in all ar­eas of their lives as they grow up and they will be fur­ther robbed of their child­hood, ed­u­ca­tion and fu­ture prospects.

The lost gen­er­a­tion

Nearly all of the mil­lion child refugees have had no rights to an ed­u­ca­tion for over two years now and the long-term con­se­quences for their lives and for post-con­flict Syria are dis­as­trous. By the end of the year an es­ti­mated 500,000 refugee chil­dren will need school­ing in Le­banon alone.

Due to space lim­i­ta­tions and lan­guage bar­ri­ers, only one in four child refugees is cur­rently at­tend­ing school in the coun­try. Le­banese pub­lic schools are al­ready full to ca­pac­ity and their English-fo­cused cur­ricu­lum rather than the Syr­ian Ara­bic cur­ricu­lum has led to a large drop-out and fail­ure rate for Syr­ian chil­dren.

Strength­en­ing pub­lic school ca­pac­ity is a pri­mary aim and many schools na­tion­wide are rolling out a shift-based pro­gramme, al­low­ing Le­banese to be taught in the morn­ing and Syr­i­ans in the evening.

But the prob­lems do not stop there. Many refugees do not send their chil­dren to school be­cause of the high costs of trans­porta­tion, books and uni­forms. Some feel that en­rolling their chil­dren in school means they are ac­cept­ing that their refugee sta­tus is long term.

Also, in some cases, young chil­dren are re­quired to start work­ing so as to put food on their fam­i­lies’ ta­bles.

Has­san is one of th­ese chil­dren and at just 17 he works on a con­struc­tion site in­stead of at­tend­ing school. Toil­ing for 10 hours a day he re­ceives just $15, barely enough to feed him­self, let alone the fam­ily of 11 he is pro­vid­ing for. He says his fa­ther and older brother have not been able to cross the risky Syr­ian bor­der as they are wanted by regime forces, so he is the sole bread­win­ner for his sib­lings. When asked if he has found him­self a nice girl to take as a wife he smiles briefly but re­sponds, “I don’t have time to think about those things. First I should con­cen­trate on find­ing food for the mouths of my fam­ily.”

His sit­u­a­tion is com­mon across the coun­try. UNHCR’s Russo says, “Un­for­tu­nately we’re see­ing that many chil­dren are forced to work to sus­tain them­selves and their fam­i­lies so they opt not to go to school. School is an ex­pense and many have to work to pay for food, rent and all their other ba­sic needs.”

Some schools run by the Ed­u­ca­tional Is­lamic So­ci­ety are as­sist­ing by pro­vid­ing free school­ing,

books, uni­forms and trans­porta­tion to counter the cost is­sue. The Iman School in Tripoli is ac­cept­ing Syr­ian chil­dren this term for the sec­ond year in a row and will pro­vide classes for 2,800 chil­dren be­tween 3.30pm and 6.30pm ev­ery day.

The newly ap­pointed di­rec­tor of the Syr­ian stream of school­ing, Rass­mie Al Masazani, is also co­or­di­nat­ing the sys­tem across six Iman schools in the north, pro­vid­ing free ed­u­ca­tion to a to­tal of 8,000 stu­dents. The 250 teach­ers they have hired are all qual­i­fied Syr­i­ans who will re­ceive salaries as op­posed to the many vol­un­teers across pub­lic schools. The or­gan­i­sa­tion feels this is the most ef­fec­tive way to pro­vide the best ed­u­ca­tion for the chil­dren.

Masazani, who has held a po­si­tion at the school for 32 years, will con­tinue to be as­sis­tant prin­ci­pal for the Le­banese chil­dren while work­ing in the evenings as the Syr­ian school di­rec­tor.

Changes have been made this year at the school to ad­dress the high fail­ure rate – only 10 of the stu­dents passed their ex­ams, dash­ing the hopes and dreams of those who felt their lives slowly be­gin to re­sem­ble some sort of nor­malcy. Many chil­dren who fled Syria with­out their ID cards, let alone proof they had passed ex­ams be­fore the con­flict be­gan, failed their ex­ams due to in­suf­fi­cient doc­u­men­ta­tion re­quired by the Le­banese govern­ment.

This year The Iman School pro­duced a new cur­ricu­lum that will be rolled out for Syr­ian chil­dren, it has been passed on to Syria’s main op­po­si­tion, the National Coali­tion, in Lon­don who have au­tho­rised it as an ac­cepted and of­fi­cial exam.

For those chil­dren not en­rolled in th­ese schools, op­tions are trick­ling in too. Aid or­gan­i­sa­tions are par­tic­u­larly fo­cused on get­ting kids back into school and in the mean­time have rolled out mo­bile units to bring learn­ing op­por­tu­ni­ties to com­mu­ni­ties that can’t ac­cess school, some­thing Unicef’s Azar says isn’t ideal but is nec­es­sary. “It’s an ex­pen­sive way of do­ing it, but it needs to be done here in Le­banon. When you have a sit­u­a­tion like this where refugees are scat­tered across some 1,400 lo­cal­i­ties it re­ally makes it much more dif­fi­cult to pro­vide school­ing.”

A slow tsunami

Un­less some­thing is done, the mil­lion child refugees across the re­gion fac­ing the mul­ti­ple dev­as­tat­ing con­se­quences of war will not only have their fu­tures de­stroyed, but the knock-on ef­fect will be dis­as­trous for post-con­flict Syria. As Mac­Don­ald ex­plains, “Fail­ure to ad­dress th­ese con­cerns now will have the great­est longterm im­pact upon the dis­placed pop­u­la­tions.”

The needs of the refugees young and old are a very real mod­ern-day disas­ter that is not go­ing away any­time soon. The UNHCR, as the big­gest provider of as­sis­tance to the two mil­lion dis­placed and hav­ing raised only a small por­tion of its re­quired fund­ing, is hard-pressed to meet the crit­i­cal needs.

As the years of civil war drag on and pub­lic em­pa­thy be­comes less in­tense, so crit­i­cal fund­ing de­creases, some­thing Miriam says can be ill af­forded. “It’s just over­whelm­ing and a huge is­sue is fund­ing be­cause the needs are con­stantly grow­ing. This is an emer­gency that’s rolling out like a slow tsunami.”

It is the world’s re­spon­si­bil­ity to en­sure 15-year-old Mo­ham­mad’s gen­er­a­tion is not lost to a war that chil­dren don’t even un­der­stand and that by seek­ing refuge their child­hood is not lost, but found.

re­portage

Vic­tims of a war they don’t un­der­stand… (clock­wise) one of the twin boys re­cov­er­ing from gas­troen­tiri­tis at Tripoli Gen­eral Hos­pi­tal whose mother is bat­tling to pay her bills; refugee chil­dren play on makeshift swings in Kobbeh; and a lit­tle refugee boy holds his small bag of be­long­ings in the Le­banese re­gion of Akar on the Syr­ian bor­der

re­portage

A dif­fi­cult life: (clock­wise from top left)The Kobbeh neigh­bour­hood of Tripoli where many Syr­i­ans have sought refuge; a de­serted play­ground in Tripoli; area health di­rec­tor of the QRC Dr Al Safadi at­tends to sick refugee chil­dren at Tripoli Gen­eral; refugees have been forced to live in makeshift homes

An al­ready tense sit­u­a­tion in Le­banon’s north­ern port city Tripoli has been ex­ac­er­bated by the refugee cri­sis with pro- and anti-As­sad fight­ers wag­ing war on its streets

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