Syria's Lost Generation


Syrian children risk becoming a “lost generation” if they don’t receive medical care, psychological support, and education, according to representatives of groups grappling with how to protect children displaced by the Syrian civil war.

At least 4 million Syrians have fled their country since the civil war began in 2011, according to the UN, and estimates of those displaced inside the country range from 7.5 to 12 million. According to UNHCR, about ½ of the Syrian refugees are under 18, as are 1/2 of internally displaced Syrians.

Many still in Syria have little or no access to health care, according to Unni Karunakara, MD, former international president of Médecins Sans Frontières (MSF). Speaking at a panel discussion Monday at Yale University, Karunakara estimated that 70% of health facilities in Syria have been destroyed. “What used to be a relatively good health care system has crumbled—completely fallen apart,” Karunakara said. Syrian doctors and nurses have exposed themselves to “incredible amounts of risk” to bring in medicine and medical supplies, according to Karunakara, and thousands of health care workers have been killed.

MSF has not been allowed to work in areas held by Syrian President Bashar al-Assad, who controls about 1/3 of the country. Where MSF does have access, directly or through local networks, Karunakara reported that it has provided basic health care including neonatal care, vaccinations, surgery, and mental health counseling. He added that the many children who have been burned, injured or maimed need reconstructive surgery and long-term rehabilitation. Karunakara also noted that by some UN estimates, 250,000 people have died inside Syria.

Nicholas Alipui, MD, UNICEF’s director of programs, was one of several panelists to cite the psychological trauma of being uprooted. “It’s important not to underestimate the psychosocial impact of these experiences on young children,” said Alipui. “At times the trauma lasts years.” The International Rescue Committee is trying to provide counseling for some of the displaced people living in 13 camps in Syria, said Katie M. Murphy, MEd, an advisor on early childhood development for the group. Counseling and parenting education can support traumatized parents themselves as they attempt to nurture their distressed children.

In Turkey, which has taken in more Syrians than any other country, only about 3 in 10 refugee children attend school, said Ayla Göskel, MSC, who directs the Mother Child Education Foundation in Turkey. “Without the chance of education, these children risk falling into radical groups,” she said. Göskel noted that Turkey has taken in more Syrians than any other country. “3 years ago, the government said their red line was 100,000 [people].” Now the number has reached 2 million ‘guests,’ at a cost of $6 billion. “I don’t think Turkey can spend another $6 billion,” Göskel said. “The burden-sharing has to happen, and it has to happen very quickly.”

The number of asylum seekers in Europe is comparatively small. From April 2011 through August 2015, 441,000 Syrians sought asylum in European Union countries. For comparison, Lebanon, once a country of 4.5 million people, has accepted 1.1 million refugees.

The US could accept far more Syrian refugees than the 1,500 who entered during the fiscal year that ended last week, said Christopher George, executive director of IRIS, a refugee resettlement agency in New Haven, Connecticut. He described as inadequate President Obama’s recent promise to increase that number to 10,000 this year. George asserted that the nation’s 350 refugee resettlement agencies could take in as many as 200,000 Syrians this year.

Karunakara noted that although the Universal Declaration of Human Rights asserts the right to asylum, “all sorts of barriers are being placed to prevent refugee families from seeking asylum.”

He noted that on October 1, Somalia became the 196th nation to confirm its commitment to the UN Convention on the Rights of the Child—leaving the US as the only UN member not party to the Convention. Karunakara recommended that American university students take up ratification as a cause.

Göskel said agencies like hers could use guidance. “We have tons and tons of evidence of what works, but we never seem to use it,” she said. She would like to see recommendations for the future based on what is helping refugees in the current situation, “so the next time the crisis comes around—and believe me, it will—we will know what to do.”

The full article appears on Global Health Now Website: