Traumatized – The psychological impact of the earthquake on war-torn Syria – Syrian Arab Republic

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Executive summary

Earthquakes and natural disasters as a whole have noticeable and immediate effects on the physical and psychological landscape of a nation. Natural disasters have been shown to increase the likelihood of mental health disorders in many studies following hurricanes, tsunamis, earthquakes and floods alike. A magnitude 7.8 earthquake struck southern Turkey and northern Syria on February 6, 2023. It affected 23 million people in both countries and was the worst earthquake to hit the region in the past 200 years.

The Syrian conflict, now in its twelfth year, has led to a complex humanitarian emergency, including the displacement of half of its population, a global refugee crisis, and the disintegration of the public health system. Syria has been divided into four regions controlled by different groups, each with a separate healthcare system. The crisis has also created unprecedented stress on health services and systems due to the protracted nature of the war, targeting of doctors and healthcare infrastructure, displacement of doctors and nurses, shortages of medical supplies and medicines, and massive and unprecedented shortages. The displacement of the population internally and externally, and the disruption of education and medical training.

The Syrian conflict has had a severe psychological impact on civilians, leading to high levels of mental health problems such as depression, anxiety, and post-traumatic stress disorder. Many Syrians have experienced traumatic events such as bombings, shootings, and forced displacement that have contributed to these psychological problems. Lack of access to mental health care and support is exacerbating the psychological impact of the war on Syrians, leaving many without adequate treatment or resources.

The aim of the MedGlobal Mental Health and Psychosocial Support program is to build on lessons learned from work experience in the Syrian context to improve access to mental health services for victims of war and displacement, especially marginalized and vulnerable communities. MedGlobal achieves this goal through partnerships with local organizations to provide a variety of mental health services in Turkish-administered areas of northern Syria.

In February 2023, MedGlobal deployed a team of psychiatry specialists to conduct post-disaster mental health training in northwest Syria. The training covered a myriad of topics that were found essential in the sub-acute disaster period. After the training, surveys were distributed to the participants. The survey showed that 46.5% of participants had not received training similar to what we provided, 100% of participants reported that they were able to learn new information from our presentations, and 97.2% reported that they felt they could use the lessons. Learned from the exercises to apply to their work on the ground.

In the aftermath of the earthquake, rebuilding Syria’s shattered health system must be a priority. This task requires a comprehensive approach that addresses a number of issues. Among the most important are a focus on retaining health workers, providing support and training, and establishing incentives for those who have left to return. In addition, building resilience through training should be a priority for healthcare authorities, NGOs and funders. Health care workers should receive training in vulnerabilities, screening, mental health and trauma medical treatments related to a specific culture of punishment and harm caused by trafficking. They should receive services on childhood trauma and refugee mental health. NGOs should be trained in psychological first aid and psychological recovery skills in accordance with the recommendations of the WHO ISAC. This can be incorporated into existing trainings on gender-based violence, or mental health in disaster situations. Coaches should adopt a multifactorial approach when dealing with mental health. Mental health issues are complex and can be affected by different social, economic and cultural factors. It is essential to consider all of these to effectively address mental health issues.

In the aftermath of the disaster and after twelve years of war, substance use has increased as a coping mechanism in Syria among vulnerable groups including healthcare workers. Use of Captagon, narcotics, and pain medications has become a major problem. There should be a concerted effort to create awareness campaigns about drug use, educate healthcare workers about withdrawal symptoms and intoxication, and create a substance use training program to educate the local population. Psychosocial support team and the establishment of more substance abuse recovery programmes.

The United Nations (UN) and other funders should direct more money to support mental health, and to train health care providers, nurses, and community health workers. Additional funds should also go to education to reduce the impact of the crisis on children’s mental health. Cross-border humanitarian assistance under UN auspices must be maintained through the three border crossings currently open and expanded to prevent delays or disruption of humanitarian aid to northern Syria. Post-crisis recovery plans, linking separate healthcare systems, and rebuilding the healthcare system should be developed with the participation of local health authorities and healthcare-focused NGOs. The United Nations must reach a political solution to the Syrian conflict on the basis of Security Council Resolution 2254.

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