Column People hit by indiscriminate violence need psycho-social help

The civil war in Syria has killed and injured innumerable people, many of them innocent civilians. We are trying to help survivors repair the damage to their bodies – and to their minds, writes Jane-Ann McKenna.

ABDUL* SITS STOICALLY upright in bed as he explains how he came to be here, in this hospital in Jordan. “I was a civilian, not a fighter. My brother was captured by the regime and killed. I was arrested and imprisoned for seven months, where I was tortured on a regular basis”. He points to the burns all over his chest and arms and the gaps in his mouth indicating teeth that were forcibly removed during his imprisonment.

We are in Médecins Sans Frontières/Doctors Without Borders’ surgical rehabilitation hospital in Amman, where Abdul is currently receiving surgical treatment for injuries he sustained in Syria over a year ago.

“When I was released, I decided I wanted to assist those in danger, those who were being wounded in the fighting. I worked as a volunteer in a field hospital in Deraa, in southern Syria. Here, we used to warn the community about impending attacks, and go to their aid when the attacks were over – bringing them back to the hospital for treatment. It was important that people did not try to reach the hospital themselves during an attack, as they would be most definitely be hit.

“One day, we received word that a taxi driver was hit in the neck by a sniper and was bleeding heavily. My colleague and I went to go to him, but it was very dangerous. My friend told me to stay behind, as I am married with five children, and he was single. He went on to reach the taxi driver, and was shot dead. I reached them and tried to bring them back to the hospital… as I was entering the building a MIG was flying overhead and suddenly there was a massive explosion, and the next thing I remember was seeing many injured and dead around me. I tried to get up, but realised that I too was hit in my left leg and bleeding heavily. Eighteen people in the hospital died that day.”

imageA women and her daughter who have just crossed the border into Iraqi Kurdistan. Her husband stayed in Syria, although if things get worse he too will flee. Image: Diala Ghassan/MSF

Reconstructive surgical programme

A year and a half later this story is still very raw, and Abdul is unable to hide his grief. He gets visibly upset when he recounts the day his friend and colleague died trying to assist others. He shows me the phone his friend had with him when he died, which he now keeps with him at all times. The last call his friend made was to his mother.

On the day of the explosion Abdul was transferred to the Jordanian border where he received some immediate medical care. After a few months, he heard about Médecins Sans Frontières’ reconstructive surgical programme and was admitted for surgery on his left leg and arm. To date he has had six operations. It is not yet clear how many more surgeries he will need before he is discharged from the programme completely.

Indiscriminate violence

Set up in 2006 to focus on treating wounded patients from Iraq, this programme has now expanded considerably to treat patients from all over the region. With the escalation of violence in Syria over the last two years, our doctors here are treating more and more Syrian patients who require multiple, complex surgeries.

The nature of the injuries they are seeing among Syrian patients has changed: “In the beginning we were seeing more gunshot wounds, and injuries associated with torture,” says Dr. Sharif, the project coordinator, “Now we are treating more shrapnel wounds and burns. These are injuries more related to indiscriminate violence – bombings and explosions.”

imageThe Médecins Sans Frontières medical team check on a man who fainted the minute he arrived to the transition area after walking for several hours to cross the border between Syria and Iraq under harsh conditions including a temperature which reaches 50 degrees. Image: Diala Ghassan/MSF

Psycho-social help

As Abdul recounts his story, I see other patients in the ward listening respectfully and intently; they too have suffered brutal violence and tragedy. But in this hospital, they now have a chance of recovery. More than 400 patients are currently enrolled in the programme. Thanks to the generosity of donors around the world all the treatment, which includes post-operative physiotherapy and mental health counselling, is provided for free.

As I prepare to leave, I thank Adbul for sharing his story. ‘Do you know what the best thing about this hospital is?” he asks. “The psycho-social help I am getting. When I arrived, I did not think I needed any support. I was angry with everyone and everything – those I left behind in Syria, my wife, my children. I was so angry. I feel that I can now cope with what has happened to me and those I love. This was the help I really needed.”

*not his real name

Jane-Ann McKenna has recently returned from a field visit to Jordan and Iraqi Kurdistan where she conducted a humanitarian assessment of Syrian refugees’ needs in neighbouring countries.

In 2012 Médecins Sans Frontières teams performed 1,165 reconstructive surgeries in the Amman hospital. The project also provided physiotherapy and psycho-social support to thousands of patients. To donate, visit or call 1800 905 509.

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