Cordaid recently started providing psychosocial support to displaced families in Northern Iraq. “Only now, after ISIL and after having found refuge, do psychological and psychiatric problems come to the surface”, says Hala Saba Jameel, Cordaid’s Health program manager in Northern Iraq.
(Displaced Yazidi family members at the Cordaid supported primary health care centre in Seje. October 2018 © Albert van Hal / Cordaid)
You escaped ISIL and its trail of atrocities. You, and your near ones who survived, found refuge in a place which is a 4 hours drive away from your hometown, Sinjar. The last couple of years, you tried to go back several times. Only to see that your home is still uninhabitable or gone. That the area is still insecure and nearly no one has returned. Income opportunities are non-existent. Your kids can’t grow up here.
This is the typical situation of the thousands of Yazidi people that fled to Seje, a village in Kurdistan Iraq, not far from the city of Duhok. Many of them are squatting in unfinished buildings.
Most Yazidi refugees in Seje, a village near Duhok, fled from the Sinjar area.
Combining medical care and psychosocial support in one centre
A year and a half ago, Cordaid started providing essential health care services to the large community of displaced families and the host population. It is part of Cordaid’s health program in Northern Iraq.
We knew that on top of medical care, the displaced Yazidi population needed mental care and psychosocial support. We knew that all the displaced in Seje – women, children and men – had experienced or narrowly escaped a series of deeply traumatic events. The ISIL siege of Sinjar in 2014. The Sinjar massacre of 2000 Yazidi people. Yazidi women and girls being forced into ISIL slavery. The exodus and hibernation on Mount Sinjar of thousands of refugees. The subsequent battle for the hometown of the Yazidi community.
This is why, since August, Cordaid added a component of psychosocial support in it’s primary health care center in Seje. Hala Saba Jameel, Cordaid’s Health program manager in Northern Iraq, recruited a social worker who fits the job. “She is a Yazidi from Sinjar herself”, Hala explains, “knows what the displaced went through and speaks the same language. For a social worker that is essential.” Hala herself, an expert in matters of gender based violence, taught the social worker to have a keen eye – and ear – for cases of abuse and harassment among the women and children that visit her.
After the rush of crisis
The past months there have been weekly psychosocial support sessions on the premises of Cordaid’s health center in Seje. About 20 displaced Yazidi persons attend these sessions, which are sometimes supervised by Hala.
Because of the war men are jobless. They project their frustrations on their wives and become abusive.
Hala Saba Sameel
“Trauma and deep depression are all too common among the people who visit us”, she says. “They lost family members, they lost their homes, their jobs. Only now, after the rush of crisis and after having found refuge in Seje, do psychological and psychiatric problems come to the surface. We see kids that have become unmanageable. Some of them have epileptic fits because of what they went through. Some women have suicidal thoughts.”
Women carry a lot of extra weight
On top of loss, exclusion, displacement and poverty, Yazidi women carry a heavy extra burden. “We know that ISIL sexually abused many Yazidi women in horrific ways. It is a very delicate and painful topic. So far, none of the women who visit us shared stories of rape”, Hala explains. Which doesn’t mean it hasn’t happened. Or that they aren’t confronted with other forms of abuse. On the contrary.
If women are victims of rape, we can refer them to Erbil, where – with support from Cordaid – the ministry of Health recently opened a centre for the clinical management of rape.
Hala Saba Sameel
“Unfortunately, harassment, intimidation and sexual abuse are not only weapons of war”, Hala continues. “Most often they are part of domestic abuse. I can say that nearly all if not all of the women who visit us are victims of abuse. Often, the perpetrators are their husbands. Because of the war men are jobless, frustrated and hurt that they cannot support their families. They project this frustration on their wives and become psychologically or sexually abusive. They do not allow their women to work and earn an income. And as women are not entitled to inherit, they do not have any form of property or resource. The majority of women married while still being a child. That makes it even more difficult for them to stand up to these forms of abuse.”
The vicious circle of not going to school
Most displaced Yazidi kids do not go to school. “It’s too expensive”, says Hala. “Men seek jobs as daily workers. With some luck they earn a few dollars as cleaners, or in construction works in nearby cities. It’s a lottery. Their income doesn’t allow them to pay the 20 dollars a month for the bus fare to school. So the girls stay at home and the boys are forced to work. And history repeats itself. Most mothers were forced to marry as a child because their parents were poor, school was too expensive and there were no alternatives.”
Addressing needs and referring to specialized services
As much as possible – and with limited means at hand – Cordaid tries to solve problems from A-Z. “Problems of the displaced Yazidi community abound and are interrelated”, Hala says. “We listen to their stories and address their needs as much as we can. In group sessions we discuss all sorts of things, from hygiene promotion, to abuse or the pitfall of early marriage. We provide individual psychosocial assistance to women and children that need more support. Basic medical needs can be dealt with at our centre.”
Often, people feel a barrier to come to the centre and share their problems, whether they be psychological, sexual, financial or legal. By visiting them, we can diminish that barrier.
Hala Saba Sameel
Severe cases, like displaced persons who need chemo therapy or dialyses, are referred to the hospital in Duhok. “In case women are victims of rape, we can refer them to Erbil, where – with support from Cordaid – the ministry of Health recently opened a centre for the clinical management of rape”, Hala explains. “We also refer to legal service providers, for example if people need ID cards or certificates. In case psychiatric support is needed, we also refer them to the hospital in Duhok. But needs are overwhelming and Duhok – a city of 330.000 inhabitants – only has 5 psychiatrists. In Seje we have recruited a general practitioner who can provide basic mental healthcare services. But she is not a psychiatrist.”
Providing psychosocial support inside people’s homes
To meet more needs, Cordaid is in the process of recruiting a permanent social worker in Seje. “At the moment our social worker comes once a week to Seje. This is not enough”, explains Hala. “We now look at possibilities to offer fulltime employment. This would allow her to extend psychosocial support and visit people in their homes and shelters. Often, people feel a barrier to come to the centre and share their problems, whether they be psychological, sexual, financial or legal. By visiting them, we can diminish that barrier.”
Cordaid is also in the process of recruiting a specialist in family medicine from Duhok, to visit Seje once or twice a week, to better address mental health needs.
No family, no home, no income
15 young displaced Yazidi women – between the ages of 18 and 35 – haven’t come to Cordaid’s psychosocial support sessions yet. But they are very much on the radar of our team in Seje. Hala: “They are on their own, have no family whatsoever, no home and no income. They survive thanks to what people give them, clothes and food. They are reclusive, live on their own in cold, open, unfinished buildings. We don’t know their stories. Some have come for medical care to our centre, but they are too reticent or afraid to ask for more help. Hopefully, soon, we will be able to give them the assistance they need. These are the kind of persons our social worker will definitely try to reach out to.”