Running Head: HEALTH AMONG SYRIAN REFUGEES 1

Health Among Syrian Refugees

Samantha Moussari

Professor Kathy S. Faw RN, MSN

Bon Secours Memorial College of Nursing

NUR 3113

October 28, 2016

I pledge.
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Syrian Refugees Scholarly Paper

The current political crisis occurring in Syria has killed and endangered over 11 million

people causing the survivors to become refugees. Discussed in this paper are the various Syrian

refugees living in camps, caravans, and urban areas located in countries foreign to them, which

makes them an extremely vulnerable population. The social determinants of health for this

population are acute and chronic illness, lack of education, and mental illness. The interventions

taking place to address the health needs of this population include: agencies working to provide

assistance with the cost of health care, physicians addressing health education, and medical

teams assessing mental needs. The goals for addressing social barriers of health for this

population are discussed by Healthy People 2020.

Social Determinants of Health

The social determinants of health depicted in the literature on the Syrians are barriers of

health services, education, and social support. The conditions of Syrian refugees revealed acute

and chronic illnesses, lack of education, and psychological issues. According to an article in the

International Journal for Equity in Health, the refugees receive insufficient healthcare because of

the pressure put on the host country’s health systems. Nora Alghothani, Yousef Alghothani, and

Atassi (2012) explain that the most prevalent acute illnesses are “upper respiratory infections,

gastroenteritis, conjunctivitis, hepatitis A, skin rashes” and “urinary infections” (p. 86). Upper

respiratory infections are influenced by poor living circumstances such as living in close quarters

and the extreme prevalence of tobacco use among adults. Chronic conditions that are

predominant in this population include diabetes, hypertension, and chronic obstructive

pulmonary disease. These acute and chronic conditions are prime because national agencies and

host countries lack the resources to provide free healthcare, and the refugees lack the means to
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afford the cost of healthcare. For each medical visit, refugees are required to pay for a portion of

their consultations and received medications. Additional causes for these poor conditions

include the providers’ lack of adequate medication and equipment, long wait times for scheduled

appointments, and transportation issues.

Educational restrictions on healthcare are the second issue addressed for this population.

According to Nora Alghothani, Yousef Alghothani, and Atassi (2012), Syrians lack education on

“health awareness and preventative measures including good hygiene, smoking cessation,

adequate nutrition, exercise, medical compliance acknowledgment and acceptance of psychiatric

conditions” (p. 87). These primary prevention methods are not being utilized with this

population, which causes a disease process or furthers a disease process. Poor nutrition,

smoking, and poor hygiene are a large reason why the Syrian refugee population is more

vulnerable to health and mental illness.

Psychological issues are the third social determinant of health discussed with this

population. Basheti, Qunaibi, and Malas explain that more than half of all Syrian refugees are

suffering from fear, insomnia, hopelessness, and terror. Some of these mental illnesses and

feelings originate from their living circumstances and socioeconomic status. For example, the

refugees living in camps have a higher report of mental illness than those living in caravans. The

propensity for mental illness in camps may be due to the higher concentration of acute illnesses,

such as the flu, infections, and diarrhea, found in camp areas. Many psychological issues

originated when the Syrians had to flee their country to escape war zones.

Evidence-based Interventions addressing Health Needs

The Syrian refugee population is extremely vulnerable with much of their care left in the

hands of others. For this reason, national agencies assist with the cost of health care, physicians
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volunteer to educate, and medical teams coordinate care to be delivered for mental illness.

Although there are many agencies worldwide contributing to the refugees, the researchers

Doocy, Lyles, Akhu-Zaheya, Burton, and Burnham identify the Ministry of Health, UNHCR

(United Nations High Commissioner for Refugees), and NGOs (non-governmental organization)

for contributing to the cost of healthcare. However, these organizations are unable to pay the full

cost of healthcare for refugees so they are beginning to put more effort and money into health

promotional programs. These programs are targeted to detect risk of illness and provide control

measures for refugees with hypertension, diabetes, and cardiovascular disease. These agencies

are also encouraging healthcare facilities to follow standard protocols, so refugees can better

understand how to care for simple conditions on their own. Together, these agencies are

working to promote the Millennium Development Goal’s that strive for global partnership and

the combatting of diseases.

According to Nora Alghothani, Yousef Alghothani, and Atassi, the physician volunteers

provided attention to clinical issues and the overall goal for the improvement of the refugees’

health status. The physicians spent half of their time with a patient on their clinical condition

and the other half on education. Volunteers educate the refugees on the need for cleanliness,

smoking cessation, physical activity, and an adequate diet. The physicians also educate the

people of the host country about the Syrians’ cultural differences, in order to make crossing paths

easier and their clinical issues more easily understood. Nora Alghothani, Yousef Alghothani,

and Atassi (2012) describe that a “structured humanitarian medical mission is an important

component of global healthcare and can positively impact all parties involved” (p. 88). In their

article, the physicians discussed are working together to fulfill the Millennium Development

Goal’s: environmental sustainability and the combating of disease.

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Basheti, Qunaibi, and Malas explain the Syrian refugees’ psychological perspective of

their current living situations and how they are aimed to be fixed. The psychological needs of

the refugees are now being included in the assessment at healthcare visits. A treatment technique

being used to help with mental illness among this population is called narrative exposure

therapy. This therapy works by allowing refugees to tell their stories, which helps to relinquish

anxiety and fears associated with the traumatic war stress they encountered. Also, standards are

now being reevaluated so that they are satisfactory for those living in camps as well. Addressing

the psychological aspect of this vulnerable population is vital, for they endured extreme

traumatic stress prior to their exposure to yet another challenging lifestyle. The refugees’

psychological diseases, such as depression and anxiety, are addressed with the Millennium

Development Goal’s plan to combat disease and ensure environmental sustainability.

Global Approach in Addressing “Health for All”

Healthy People 2020’s main goal to help this vulnerable population is to eliminate

preventable disease, disability, injury, and premature death. This goal shows that the refugees’

acute and chronic illnesses are being addressed by global agencies. The physicians and medical

volunteers are also working towards eradicating diseases and premature death by educating the

refugees on their acute diseases and how to prevent these diseases in the future. Secondly,

Healthy People 2020 is focused on creating social and physical environments that promote good

health for all. This issue is being addressed by assessing the Syrians’ acute and mental illnesses.

Providing these people with the opportunity to tell their story promotes social acceptance and

relief from stress. Although sweeping standards are not fully acceptable for these people,

agencies worldwide are working to promote better health for the Syrian refugees.

Conclusion
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The Syrian refugees are in an environment that forces them to face acute and chronic

illness, lack of education, and mental disease. Their health and mental health are at stake

because of their socioeconomic status, close living quarters (overpopulation), air pollutants, and

warzone induced traumatic stress. Interventions established to move away from those issues

include: global health agencies working together to provide substantial healthcare, physicians

educating patients on their health needs, and medical teams providing care for psychological

issues. The Millennium Development Goals and Healthy People 2020 are pursuing solutions to

address these issues and help improve the lives of Syrian refugees.
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References

Alghothani, N., Alghothani, Y., & Atassi, B. (2012). Evaluation of a short-term medical mission

to Syrian refugee camps in Turkey. Avicenna Journal of Medicine, 2(4), 84-88.

doi:10.4103/2231-0770.110738

Basheti, I. A., Qunaibi, E. A., & Malas, R. (2015). Psychological impact of life as refugees: A

pilot study on a Syrian camp in Jordan. Tropical Journal of Pharmaceutical Research,

14(9), 1596-9827. Retrieved from http://www.bioline.org.br/pdf?pr15222

Doocy, S., Lyles, E., Akhu-Zaheya, L., Burton, A., Burnham, G. (2016). Health service access

and utilization among Syrian refugees in Jordan. Internation Journal for Equity in

Health, 15(1), 108. doi:10.1186/s12939-016-0399-4

Sahlool, Z., Sankri-Tarbichi, A. G., & Kherallah, M. (2012). Evaluation report of health care

services at the Syrian refugee camps in Turkey. Avicenna Journal of Medicine, 2(2), 25-

28. doi:10.4103/2231-0770.99148