Refugee Families affected by economic crisis

The Direct Targeted Group

It comprises of 300 women and adolescent girls of following nationalities, Palestinian refugees from Lebanon (PRL), Palestinian refugees from Syria (PRS), Lebanese and Syrian and prioritizing elderly females and those with disabilities who were categorized as most vulnerable individuals among these circumstances, and who were in immense need for being provided by basic needs and being referred to any additional needed services such as, providing them by a psychosocial support due the negative psychological impact they suffered from the armed clashes and random bombardment.

Context Analysis and Background

Since the end of July 2023, the aggression of the armed clashes in En El Hilweh camp has been extending and causing displacement, trauma, injuries, deaths and instabilities. Stray missiles and bullets as well as random bombardments have been unstoppably damaging houses and resources, menacing people’s lives and resulting in continuous waves of displacement from the camp to emergency centers during the two rounds of armed clashes throughout August and September 2023.

The destructive bombardments, the random missiles, and the not responded calls of mercy have led to the displacement of more than 2568 families from their houses to mosques, UNRWA schools which turned into emergency centers, warehouses, gatherings and the more fortunate ones resorted to their relatives in Saida where around 70% of them were women, adolescent girls and children including persons with disabilities.

It was evident how miserable the circumstances that the displaced people were going through, whether in emergency centers or being hostedby the absence of basic needs, as they had left their houses empty-handed since the commencement of the armed hostilities. What exacerbated the situation was the inability of individuals to return to their houses after losing them, either partially or completely, notwithstanding the announcement of the ceasefire.

Accordingly, due to the unexpectedly eruption of the second round of clashes without prior alert, displaced women and adolescent girls fled out of their houses with their clothing they put on as a result of the shock and unconsciousness of what was happening around them, as their only concern was striving for their survival and protecting the children. Additionally, the psychological situation exacerbated among the female groups, as they are emotional by nature, as a result of what they have witnessed and gone through of armed clashes, trauma, trepidation of losing a family member, constant anxiety, and displacement. Therefore, they became more aggressive toward each other, venting their anger through screaming and beating. What made it worsen is that some of the displaced women were suffering psychological pressure beforehand, and its intensity exceeded the normal pace.

Intervention in emergency centers and for hosted families

Since the general atmosphere can be best summarized by terror, anxiety and disappointment in the light of what the families have witnessed of bombardments and injuries, adult females were in immense need for releasing their negative energy, expressing their feelings and setting their thoughts free. Thus, an expeditious intervention was necessary to find an effective and appropriate solution suitable for each case, so these following activities were conducted in homes and in displacement centers:

• Identification and Reporting: After visits that took place in displacement centers and homes, 300 vulnerable women and adolescent girls are identified, and priority was given to the elderly and personswith disabilities, who are most vulnerable to being affected by conflict and irresponsible armed clashes. The assessment is carried outby case studies to monitor the risks facing them and determine the extent of this risk, whether it is low, medium or high, where several cases have been reported including: post-trauma stress disorder, panic attacks, tantrums, isolation, eating disorders, sleep disturbances, anxiety, aggressive reflexes. After classifying the type of risk, intervention is made according to the appropriate need, including psychological first aid, psychosocial support, individual sessions, referral to specialists or psychiatrists, or submission to an asylum,
• Psychological First Aid: For the purpose of releasing stress, reducing anxiety, ensuring their comfortability, and avoiding aggressive attitudes or internal fights among families, we have planned and worked on conducting PFA activities to 300 adult females to assist them in the immediate aftermath of an emergency the moment they have arrived at the emergency centers or displaced in relatives’ homes to overcome what they are going through, reduce initial distress caused by the armed clashes and displacement, and to foster adaptation to the recent situation.
• Psychosocial Support Activities: Conducting PSS activities for all adult females, 20 groups 15 females in each, classified based on age and focusing on integrating and involving elderly and persons with disabilities as priority,where various activities were covered on psychological debriefing such as: anger, emotional management, risk management and psychological stress, so they release the negative energy and thoughts, alleviate stress and anxiety, and promote positive thinking that assist them in adapting, as 10 sessions were conducted to each group.
• PSS Individual sessions: All adult females were undergone to PSS individual sessions in order to determine the specific mental state for each one, where several cases were identified including: depression, apprehension, psychological pressure and stress and assist them to spoke up freely in a comforting and confidential environment and provide them any additional necessary and urgent services they would be needed for helping them dealing with their personal topics and achieving psychologically health lives.
• Focused PSS: Taking into consideration women’s wellbeing, psychologist was in charge of conducting psychosocial therapy group such as: art therapy, venting, and enhancing positive thoughtsfor 180 women and girls referred from PSS activities and individual sessions to initiate their sense of belonging and improve their social life.
• Awareness Sessions: acquiring awareness sessions are essential especially in those circumstances displaced females were going through as it assists them to successfully deal with significant life changing and challenges and develops the ability to manage their emotions, health and relationships. Accordingly, to help displaced females make informed decision, solve problems, communicate effectively and take care of their health, awareness sessions were conducted on solving problems, accepting other’s opinions, conflict resolution, effective communication, behavior control for all adult females emphasizing in including elderly and persons with disabilities. Additionally, raising awareness of them on reproductive and mental health, cyber and domestic violence, GBV, and abuse.
• Referral System: Some services are required for those who needed it beyond the PFA, so based on cases that were followed by case management worker, it was essential to activate the referral system to committed a support for all these cases, as 180 cases were referred to psychologist, 7 high risk cases to a psychiatrist, 1 hemiplegia case for physical therapy, 5 pregnant and 7 breastfeeding women to gynecologist, all adult females were referred to medical services, and a mental illness case to an asylum.
• Follow up Support: On purpose of ensuring a sustainable well-being, enhancing comfortability, reducing distress and fostering coping in the place of displacement for all displaced adult females in shelters and homes, wehave conducted a regular follow-up by visits or calls on daily basis for those who received PFA and who were referred to any further needed services.

It is worth to be mention that to alleviate the burden on the displaced mother and bring joy to her heart as her feeling of terror, trepidation, anxiety, stress and incapability to afford baby’s needs exacerbated, we organized a celebration to welcome her newborn baby at the emergency center on Saturday 23rd of September, a day after her birth, and providing her with health care and basic supplies, such as milk, baby bottle, baby board, diapers, and clothes. In addition to providing her with psychosocial sessions to avoid her subjection to a postpartum depression.

Furthermore,in terms of achieving dignity and warmth for the most vulnerable displaced women and adolescent girls, and as a result of abrupt of eruption of the armed clashes that forced families fleeing their homes without taking clothes with them to put on or change, we were responsible for providing 220 pieces of cotton clothes and pairs of shoes, and coordinating with local community to avoid duplication as we followed these step:

• Needs Assessment: Since day one of displacement whether in shelters or homes, a comprehensive needs assessment is carried out to all displaced families in order to meet their needs, with a focus on women and girls group and for what they are in desperate need of as it becomes clear that one of their needs is to be provided with appropriate clothing and comfortable shoes.
• Sourcing and Procurement:It is critical to determine trustworthy and good-natured suppliers who can provide high-quality cotton clothes and comfortable shoes while taking into account the region’s weather conditions and the women’s background and culture to find suitable clothing and shoes that suit, while also being eco-friendly.
• Distribution: We cooperate with school officials and gatherings committees to set up specific distribution points close by and suitable for all displaced women, to facilitate and ensure their accessible for their needs.
• Coordination with Local Community Organization: To preclude recurrence and overlapping of services for displaced women during the period of displacement, to regulatethe ease of access for these services, and to ensure the implementation of it, it was necessary to make coordination with local community organization.

After the ceasefire and with the deployment of the security forces in Ain El Hilweh camp, displaced women and girls returned to their homes, but with a psychological readiness for what they would witness of tremendous devastation to their camp due to the support they received on psychological level to confront the grave challenges. Despite the return of the displaced females, they are still among our targets in psychosocial support sessions. In addition to continuous follow-up of previously referred cases during period of displacement.

Case Study

Code: Nablus 034

Age: 22 years

Nationality: Palestinian

Number of Children: 2

Case summary:

She is 22 years old woman who gets married early at age of 16 years, and has 2 children ,2 and 4 years old. She suffers from family problems, as she is abused by her careless husband. Therefore, she suffers from psychological problems such as: depression and severe psychological pressure, as well as suffers from a domestic violence. The woman is currently displaced to Nablus school that was taken as emergency center due the armed clashes, where she feels vulnerable and alone and no longer has the ability to withstand the pressure.

Economic situation:

The economic situation of the family is dire due to her husband’s unemployment and her inability to work for lacking of a safe place that could leave her children in.

Social Situation:

Her social relationship with her husband is miserable where she cannot communicate with him positively. He is careless for his family, and insults her regularly in public, while her relation with her children is built up on caring and loving as she considers them her source of strength.

Furthermore, her relation with her family is disconnected since she got married with no any sign of communication between them, as she puts the blame on them for her situation, while her relation with her husband’s family is described as good, as her husband’s mother takes care of her and makes her feel the tenderness and motherhood that she was deprived of, as she says.

About the case:

The woman feels that she is powerless, alone and has no breadwinner, and that the whole world has abandoned her, especially her family who in her opinion sold her to get rid of. She has no siblings, so she considers her children to be her source of strength and her only hope to stay survived.

The case now is living as displaced person in a room, in the school she resorted to out of terror. She goes through psychological pressure and fatigue with no friend or companion as her husband’s family stayed in the camp. She says that last week she couldn’t sleep nor eat out of fear of what she has witnessed of bombardment, stray missiles, death, and bullets. She fled to the shelter solely due to her great fear for her children and the trauma her children were subjected to, when they saw the masked armed men in their neighborhood, so she could make sure that they are being protected.

Intervention Method:

- Registering her and giving her psychological first aid

- Conducting Individual psychological support sessions (12 sessions)

- Integrating the case with a women’s group to get to know each other and make friends

-Conducting Awareness sessions on: anger management, communication, emotion management, violence, communicating with children, personal hygiene, risk management, how to say no, self-esteem.

- Integrating her into Psychosocial support activities as she is participated in 6 art therapy sessions and 8 breathing yoga sessions to get relaxation and feeling positively.

- Referred her to the psychologist for following her up and strengthening her personality

- Opening a case management file to reduce the risk and empower.

Data Collection:

Personally by the case itself

Recommendations:

Following up the case after she returns to the camp

Integrating her into psychological support activities

Following up the case by the psychologist

Home visits to strengthen her relationship with her mother-in-law and to support her, as well as communicate with her husband to help her get comfortability.

Links:

• Naba'a Website