Finding Therapy in Jordan

When Obada Alasmi rode his motorcycle in August 2012, he did not know it would be his last ride. Alasmi was on his way to work, unaware that someone was aiming to fire at him. Riding on a main street in Daraa, Syria, he was shot in the spine by a Syrian military sniper. The 22-year-old was initially rushed to a Syrian hospital to be treated, but the war devastated the hospitals as it did the country. Alasmi was told that the bullet simply went under his skin.

“That couldn’t be true,” Alasmi said. “Because I wasn’t able to move my legs.”

When he was rushed to Jordan the following day for treatment, he learned that he had become paralyzed from the waist down. He was taken to a rehabilitation center for Syrian refugees, Souriyat Across Borders. Alasmi met men and children who were all recovering from moderate to severe injuries from the war. Often he would simply keep them company in the physical therapy room, where gym equipment neatly filled the center’s living space.

But Alasmi was more than just a resident at the center. He became an integral part of the small community there, as someone who understood the young men’s pain and struggles in their road to recovery. In one proud instance, Alasmi helped push the youngest resident to continue his education—not an easy feat for a 13-year-old boy who lost both legs, a hand, and eyesight in one eye.

Alasmi quickly realized how much of a help he could provide to injured war victims who continued to cross the border.

“There are some young men who remember the war in Syria. They have nightmares about what happened,” he said. “This is a state they all go through. I went through it when I was at the hospital [in Jordan]. When I heard an airplane, I would think I was still in Syria.”

Today, Alasmi provides peer counseling for injured Syrian men and children in several centers that house refugees.

However, Jordan doesn’t officially provide mental health treatment to refugees. In fact, according to the World Health Organization there are only 60 to 100 psychiatrists in Jordan. It’s a cause for concern, as 20 percent of Jordan’s entire population is in need of psychiatric care, and 75 percent of them never receive any type of therapy treatment.

Hind Izzat sits in her small apartment, where she lives with over 100 Syrian refugees, all widows and orphans. Image by Sawsan Morrar. Jordan, 2017.

Hind Izzat sits in her small apartment, where she lives with over 100 Syrian refugees, all widows and orphans. Image by Sawsan Morrar. Jordan, 2017.

There are roughly 600,000 registered Syrian refugees residing in all of Jordan. The government places that number closer to 1.4 million, as thousands of refugees have entered through the border undocumented. Jordan’s population is just above 9 million, and government officials are not reluctant to express concern about how new refugees are impacting the country economically and environmentally. Jordan’s Ministry of Water reported that the limited water supply over the past summer was partially due to the influx of new refugees. Local resources have been spread thin. The United Nations and several NGOs have assisted Syrians in Jordan, just as they have aided previous refugees in the country. Over the last century, Jordan has hosted millions of people who fled conflicts—beginning with the Palestinians in the 1960s and later with the Iraqis in the 2000s.

The International Medical Corps identifies Syrian refugee children as particularly at risk for mental health issues, as 79 percent of them have experienced death in the family, and 60 percent of them have witnessed someone kicked, shot, or injured. Altogether, nearly half of the children have shown signs of PTSD

“Mental health is as important as food and water,” said Roweida Tailakh, a psychosocial officer at United Muslim Relief in Amman, Jordan. She runs group therapy sessions for Syrian refugees who are living in camps in the capital city. Children express how life in Jordan is impacting them emotionally, and Tailakh encourages them to draw out their frustrations, play games, act out, but most importantly—confide in the counselors.

Days before Tailakh invited children for a midsummer session, a 7-year-old Syrian boy was kidnapped and killed in Amman’s neighborhood of Jabal Hussein. The news of the murder shook Amman intensely, making headlines, and deeply frightening the Syrian community. The children at United Muslim Relief were thoroughly aware of the incident, unable to escape the news that everyone grieved over during the summer. Tailakh encouraged them to talk openly about their fears, but not without experiencing pushback.

“A lot of children came to the first and second gathering, and they would sit in the corner refusing to speak to us,” Tailakh said. “After the third sitting, they would open up to the other children, even through art.”

Tailakh knows her work at United Muslim Relief is invaluable, and it’s also sufficiently funded through charitable donors from outside of Jordan. Souriyat Across Borders is also fully funded by five major donors outside the Middle East.

Children relieve stress at Homs League Abroad with various activities. Here they are practicing karate moves with a Japanese volunteer team. Image by Sawsan Morrar. Jordan, 2017.

Children relieve stress at Homs League Abroad with various activities. Here they are practicing karate moves with a Japanese volunteer team. Image by Sawsan Morrar. Jordan, 2017.

With international support, some Syrian refugees have been provided opportunities outside of the region—particularly sponsorship and immigration. Alasmi was so invested in counseling the young men at his center that he turned down the opportunity to immigrate to Canada.

“My trainer encouraged me to go and said there are better opportunities there,” he recalled. “I told him I will not leave. The project we started here, we must continue it.”

Alasmi’s intended project was to develop a peer counseling program in which he can outreach to more refugees in Jordan. While it required training and funding, discussing mental health therapy was still largely taboo in countries like Jordan, as many people deny they need help. Mohammed Ayyash is a 23-year-old who was left partially paralyzed after being shot by a sniper in Syria. He never sat with a psychiatrist, or any of the visiting doctors who offered to counsel him. But he sat with Alasmi.

“A lot of the people Obada worked with began to improve,” Ayyash said, referring to emotional and physical improvements. “Mental health therapy is more than physical therapy, because if you don’t improve emotionally then your physical body cannot improve.”

The key to Alasmi’s approach to therapy was the casualness of it all. He doesn’t approach them as a trainer or a therapist, but rather as a brother. And that broke barriers that psychiatrists and therapists can’t.

“When it comes to dealing with an injured man, doctors think he is sad, because he doesn’t like his wheelchair,” he said. “But there is more to his pain. He can’t treat him if he doesn’t know what he has been through. But I know. I’ve been there.”

Obada Alasmi watches as a trainer helps Mohammed Ayyash lift his legs. Ayyash was paralyzed in an attack in Syria. Image by Sawsan Morrar. Jordan, 2017.

Obada Alasmi watches as a trainer helps Mohammed Ayyash lift his legs. Ayyash was paralyzed in an attack in Syria. Image by Sawsan Morrar. Jordan, 2017.

Alasmi and Tailakh didn’t limit their work to just their own centers. Both of them have volunteered their therapy services at Homs League Broad, a center that houses 105 women and children. A walk through the center is proof of how many refugees Alasmi has impacted. On the wall, in a collage of pictures, Alasmi is smiling as he counsels dozens of children surrounding him in his wheelchair.

“Obada is an inspiration,” Homs League Abroad Manager Nada Barghot said. “They look forward to his visits, because he reminds them to be hopeful. These sessions lift their self-esteem.”

Homs League Abroad, provides assistance to Syrian refugees, in particular for widows and their orphaned children—the only one of its kind in Jordan. The center is nestled on a hilltop in Dhahyat al Rasheed, a middle-class area in Amman. To her, the lack of resources available comes with little surprise. They rely solely on charity from the organization’s Syrian founders in Europe and North America, as well as a charity fund from Jordan University.

“People wonder why we didn’t choose a cheaper neighborhood for them,” Barghot said. “But what we don’t accept for ourselves, we won’t accept for the orphans.”

The center towers at five stories not including the basement, where the 75 children who live in the building can play, and a craft room where their mothers sew clothing to make a living.

Nearly all the children are accompanied by their mother, with an exception of two orphans who live with their grandmother. Islam, and majority-Muslim countries like Jordan, define an orphan as a child who lost their father. Around 20 percent of the children at the center have fathers who are declared missing or not confirmed dead.

Nariman is the only child who lives in the building without a guardian. At 16, she was quiet, but mustered a partial smile when we entered her small apartment. She sat down on a large floor cushion, common traditional seating in the Arab world. Her windows were covered with sheets, darkening the room, but just enough light permeated through to shine on her face.

Nariman initially lived with her mother and two sisters in Jordan when they fled Syria six years ago, at the start of the war. Her father died when she was young, and she had very few memories of him, just as she vaguely remembered the bombings in home country.

After years of struggling financially in Jordan, Nariman’s mother decided to take her daughters to Libya and cross the treacherous Mediterranean Sea to Europe on a dinghy. Every year, thousands of refugees drowned on this journey, while others have been robbed by the smugglers who help them cross. In 2016, the year Nariman’s mother crossed the sea, over 5,000 refugees died, most of them were crossing from Libya. It wasn’t the decision to cross the sea that was troubling for Nariman’s mother, but the decision to leave Nariman behind in Jordan. The perilous trip costs each person roughly $3000, and she only had enough for her two younger daughters. She sent Nariman to the Homs League Abroad to be looked after until she could bring her to Germany, where she settled. Nariman applied legally to join her mother and was granted an interview. A year later, she is still waiting for a visa.

Counselors encouraged Nariman to stay busy. But while most teens are occupied with schoolwork, for many Syrian refugees, school isn’t a viable option. Nariman was upset that she hasn’t attended classes in six years, but Barghot had a solution: She trained Nariman and assigned her to teach kindergarten at the center. The last counselor to visit the center praised this decision.

“They help,” Nariman said, “but only when it comes from the heart.”

Barghot nodded in agreement, “If their words come from the heart, it will enter the heart.”

Crutches are set aside outside Souriyat Across Borders, a center for injured Syrian refugees. Residents receive physical therapy, and some receive mental health therapy. Image by Sawsan Morrar. Jordan, 2017.

Crutches are set aside outside Souriyat Across Borders, a center for injured Syrian refugees. Residents receive physical therapy, and some receive mental health therapy. Image by Sawsan Morrar. Jordan, 2017.

Barghot treats the children in the building like her family. She doesn’t have children of her own. She never married, committing herself to her lifelong work as a physics and chemistry teacher. She memorized the Quran in its entirety in Syria, an achievement more commonly accomplished by men. But since the war, her primary focus has been serving women who do have children, and who need help. “God created me for this job, not marriage,” Barghot said with a laugh.

Counseling the women can be overwhelming at times. Some of them, like Eman Jalali and her then nine-year-old daughter, experienced horrifying tragedies. Jalali’s husband went missing in 2013, and she hoped that he was still alive. Unable to support her children, she moved into Syria’s Yarmouk refugee camp, only to be shot in the leg. It was then she realized she needed to flee to Jordan. In her first attempt, Bashar Al-Assad’s army caught them and returned them back to their camp. Jalali feared they would kill her children, but instead the army fed them.

Determined to find freedom, Jalali and her children set out to the Jordan border again. She recalled running from bullets that were so near, that when a man next to them was hit, his brain matter fell on the ground in front of her kids.

“I forgot what fear is like,” Jalali said. “Death became normal.”

But no death affected them like the news of her husband’s murder. One day while scrolling the internet for any news of his whereabouts, she was able to confirm that he was tortured and killed. While Jalali can’t say she was surprised, she didn’t know how to face her children after she spent two years promising them that he was alive and well. The news pained her children. While Jalali recalled the moment she told them, her now14-year-old daughter ran out of the room crying.

“If any family can benefit from the counseling,” Barghot said, “It’s them.”

Tailakh said that often children cannot fully understand the atrocities that happen before them. War can be a numbing experience, filled with disbelief. Barghot recalled how often newly widowed mothers would ask therapists if this really was their new reality. Barghot understood how important it was to keep them occupied so that they don’t lament over the past.

“Even the smallest thing can be painful,” Barghot said. “Sometimes I find myself crying for my old bed.”