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A Syrian refugee girl begs for money on a sidewalk outside a hospital in Beirut, Lebanon.
A Syrian refugee girl begs for money on a sidewalk outside a hospital in Beirut, Lebanon. Photograph: Hassan Ammar/AP
A Syrian refugee girl begs for money on a sidewalk outside a hospital in Beirut, Lebanon. Photograph: Hassan Ammar/AP

'It never seemed to be enough': treating the mental health of refugees

This article is more than 7 years old

One aid worker in the refugee camps of Lebanon fears that needs are still growing while funds run low

“I just stopped my father from killing himself. Please help me.”

The call came through at eight in the evening. The man’ voice was trembling, but I could distinguish his Syrian accent clearly.

“There’s something wrong with him,” the man cried. “He tried to jump off the balcony. He has been seeing things that are not there.

“We are so scared, please do something. I was told that you can help.”

At that time I was working as a mental health area manager with International Medical Corps in north Lebanon. During those days, the phone never stopped ringing.

I sat with the refugees on the thin mattresses and I removed my shoes before entering out of respect for their makeshift homes. I drank the strong black Arabic coffee that they offered me – it was too strong for me and I had already had a cup in every tent that I had visited that day.

It didn’t matter, though. What mattered to me was showing the refugees that what they had to offer me – even if it was a cup of coffee – was something I would value.

At the end of the day, with these visits behind me, I would often lie in my bed exhausted but unable to fall asleep because of all the different thoughts running through my mind.

Most often it was the thought that no matter how much we were doing, it never seemed to be enough.

There was always more to be done, more people still in need. The more we got the word out that we were helping people in the area, the more people came looking for help. We were constantly reminded of our limitations, but it did not stop us trying. We worked over-time. We took phone calls at all times of the day and night.

We helped the young and the old, male and female. We supported refugees from Syria, Palestine and Iraq, as well as those vulnerable Lebanese they lived alongside. We treated some at our medical centres and others in their own homes. We treated people for depression, post-traumatic stress disorder and schizophrenia. Anyone who had a psychosocial need was welcome.

It finally got to the stage where we had to start putting people on waiting lists in order to keep providing quality care and apologising for the delays. The team had to downsize because funds began running low, but the need did not slow. Time and medication were limited, the distances to travel great and the need for mental health services vast.

It is one of the things that nagged at me endlessly as a manager – that the available resources were decreasing, but the need only seemed to be increasing. The decisions about how and where to cut costs kept me awake at night – I was always hoping that fresh donations could be raised, that our programmes could grow, that the desperate need of these vulnerable people would be properly recognised and our services would be given a new lease of life.

Often I had to remind my team – and myself – that we were doing the best we could. I think it’s a common issue for humanitarian workers, and at times we all lost sight of that. Nobody came out here asking to be the hero, the one person who would present the ultimate solution, but we each did our part – we did everything we could possibly do.

Sometimes, that had to be enough.

“We are so scared. I was told that you can help.”

It was at eight o’clock, and we responded straight away to that harrowing call – making sure that the family could keep an eye on their father before we got there. He was assessed, given medication and provided with support through the therapy sessions that followed. Eventually, he would get better. His family also received support – we explained to them what had happened and how they could help in their loved one’s recovery.

This was a positive outcome to a tough problem, in circumstances where often the options all look bleak. A success story to hold tight.

Yet sometimes I still can’t sleep. We helped many, but there are still so many more that need our support. No matter how much we chip away every day, that need persists. Sometimes, I can’t help but feeling that all of our efforts were just a drop in the ocean.

I am permanently changed as a result of this experience – and I do not mean this metaphorically. An experience like this alters your brain, your entire physical being.

I will never think about refugee camps or mental health needs in the same way. What’s more, I’ll never think about myself in the same way.

Mary Dahdah is mental health area manager at International Medical Corps in Lebanon.

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