Tag: international psychology

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Instigators of group conflict & genocide

Staub (2012) identifies multiple instigators in group conflict and genocide. First is difficult life conditions which includes “severe economic problems, great political disorganization with a society, or great, rapid social changes and their combinations” (Staub, 2012, p.3). Difficult life conditions disrupt and exacerbate connections with others, self-identity, and safety and security. The social impacts of this may lead to a desperate attempt to identify with a group. Often these groups create a bond and identity through devaluing other groups and scapegoating others. This can give rise to ideologies which aim for changes which will improve the difficult life conditions, but do so in ostracizing and blaming others. While it is possible for these group initiatives to be positive and constructive, most often this pattern can elevate negatively, leading to mass violence against the “other.”

Another instigator is the “[c]onflict between groups, especially identity groups” (Staub, 2012, p.3). Disagreement and devaluing of other groups can lead them into conflict with one another, and as they become increasingly violent, this can spur on acts of genocide. Basic needs and resources can be a part of this, but the devaluation of other groups is still often combined with this. Ideologies of superiority justify actions against another group. Additionally, groups that have been devalued, are different from the mainstream, or are less privileged may begin demanding equal rights which can give rise to violent action. In the past, territorial conquest and colonization have been accomplished through violent means, including genocide. When group conflict escalates to war, genocide becomes further justified by one of the groups towards the other.

Reference

Staub, E. (2012). The roots and prevention of genocide and related mass violence. Chapter 2 in Anstey, M., Meerts, P. & Zartman, I. W. (eds). The slippery slope to genocide: Reducing identity conflicts and preventing mass murder. New York: Oxford University Press.

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The role of bystanders in group conflict

Staub (1999) investigates how bystanders can both normalize and perpetuate violence in group conflict but can also provide interventions which can end such violence. Bystanders can be internal, as in within the country or group, or external, such as in humanitarian aid organizations or other nations. In either case, my understanding is that bystanders are ones who bear witness to the conflict, but may not be directly involved in it, at least for a time. Passive bystanders are explicitly described by Staub (1999), but active bystanders are not named, although there are descriptions of active bystander interventions.

The involvement of other external bystander states are most often passive, unless they see an opportunity for self-gain in their involvement, such as in relation to “power, wealth, or influence. They have not seen themselves as moral agents with responsibility for the welfare of people outside their borders” (Staub, 1999, p.316). Furthermore, it is not uncommon for some countries to “actively support perpetrators” (Staub, 1999, p.308).

Internal bystanders also tend to remain passive (Staub, 1999), and while this might apply to much of the bystander population, I can think of many examples where internal bystanders have become active and attempted to intervene through various methods, such as both peaceful and violent protests. However, passive bystanders further create divide between groups, by the repeated messages by one group or government reinforcing the scapegoating of another group. Over time, these become ingrained beliefs in the civilian population – “it distances them from and leads them to increasing devalue victims. It diminishes their capacity to empathize with those in distress and their sense of guilt about their inaction. In the end, they go along with and frequently even support persecution and violence…” (Staub, 1999, p.308).

A current conflict showing many examples of the role of bystanders is the Syrian Civil War. The war has endured since 2011, and its length may have been significantly affected due to bystanders. It is a complicated war with many different sides triangulated against one another. The Assad governmental regime, the rebel groups opposing it, ISIS, the Kurds, Shia Muslim militias, and Hezbollah are the primary internal groups in conflict (BBC, 2017).  President al-Assad is himself from a minority group in Syria, the Alawites, and since coming to power he has systemically and actively encouraged discrimination towards many of Syria’s other ethnicities and religions. Thus, divisions were created between groups, as Staub (1999) identifies as part of the initial stages towards group conflict. When some protested this discrimination in Syria, the government took violent action, and conflict escalated quickly. Furthermore, Staub (1999) points out several cultural risk-factors contributing towards capacity for group conflict, and according to Hofstede Insights (n.d.), Syria has a number of these factors, including high power distance – which is tolerant of authoritarian systems, and high uncertainty avoidance. Another factor which perpetuates conflict is trauma, which can be imparted on multiple generations, and may make traumatized individuals more likely to have feelings of insecurity and react to real or perceived persecution with “defensive aggression” (Staub, 1999, p.310). Syrians have experienced high rates of individual and collective trauma, both in the internally and externally displaced, from not just the conflict, but also forced labor, human trafficking, and discrimination and violence by host communities where refugees seek asylum (Gerson, 2018).

Syria’s rise of internal active bystanders are comprised of several capacities, from armed militia rebel groups resisting and fighting back against the human rights violations of the government on civilians, and also groups like the White Helmets who avoid any active conflict, but take dangerous risks in order to rescue and provide medical care to those injured in attacks from both sides. Passive bystanders might include those civilians who have aligned themselves to the Assad regime, such as other Alawites, Christians, and the wealthy, and those in fear that the fall of the government would allow terrorist groups such as ISIS to take over (Christian Science Monitor, 2011). Both violent active and passive bystanders could be perpetuating the conflict through an overall increase in retaliatory violence on both sides, and in upholding discriminatory, divisive beliefs and institutions about the “other.”

External active bystanders have been many, and likely are the largest contributors to the ongoing conflict. Supporters of the Syrian government include Russia and Iran (BBC, 2017). Russia has carried out air strikes and provided political backing on behalf of the Assad regime at the UN (BBC, 2017), and this seems to be highly motivated by their own self-interest in being a major source of power in the Middle East and is concerned that regime changes could create even further instability – and a loss of Russian power, in addition to the benefits of their naval base and $5 billion in weapon sales to Syria (Calamur, 2013).

External bystanders on the side of the rebels include Turkey, the Gulf Arab states, and the U.S. (BBC, 2017). Under the Obama administration, the U.S. intervened by suppling some arms and troops to the rebels, but these were comparatively minimal (Gerson, 2018). While the U.S. claimed it was becoming an active bystander based on the human rights abuses by the Syrian government, it limited its aid because of hopes to make a nuclear deal with Iran, who supports the Syrian government. Under President Trump, the U.S. troops with withdrawn from Syria and ended all support to the rebels. It has been speculated that this decision was largely motivated by Trump’s intention to be on Russia’s ‘good’ side, with Russia backing the Syrian government.

There are many more examples and instances of how the war in Syria has been accelerated and worsened through complicated international bystanders, and also from within through internal bystanders. All of these examples are much too complex to lay out in full within this assignment, but I do hope this gives an overview of how Staub’s (1999) roles of bystanders in group conflicts has had a significant impact on the Syrian civil war.

References

BBC. (April 7, 2017). Syria war: A brief guide to who’s fighting whom. BBC News. https://www.bbc.com/news/world-middle-east-39528673

Calamur, K. (August 28, 2013). Who are Syria’s friends and why are they supporting Assad? NPR. https://www.npr.org/sections/parallels/2013/08/28/216385513/who-are-syrias-friends-and-why-are-they-supporting-assad

Christian Science Monitor. (September 14, 2011). Why many Syrians still support Assad. https://www.csmonitor.com/World/Middle-East/2011/0914/Why-many-Syrians-still-support-Assad

Hofstede Insights. (n.d.). Country comparison: Syria. https://www.hofstede-insights.com/country-comparison/syria/

Gerson, M. (April 2, 2018). Would you trust America? The Washington Post.  https://www.washingtonpost.com/opinions/would-you-trust-america/2018/04/02/5fc5b854-369e-11e8-8fd2-49fe3c675a89_story.html

Staub, E. (1999). The origins and prevention of genocide, mass killing, and other collective violence.  Peace and Conflict: Journal of Peace Psychology, 5, 303-336.

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Tech in Human Mobility / International Psychologists’ Role in Addressing Human Rights Abuses

Thompson and Atkins (2010) write about how technology has both helped and hindered in human mobility.  One issue they discuss is how there are no negative impacts towards brain drain due to Information and Communication Technologies, but rather, that it provides people who do move from their home countries to share knowledge and skills back home that they gain abroad.  While I believe in many cases this may be true, I believe that it is also equally possible that people abroad do not share knowledge and skills back to their home countries, and continue the cycle of brain drain from deprived areas.  One way to address this is to promote acculturation services worldwide which advocate an integration model, encouraging people to acculture to their new country, but also to value their home cultures.  This may assist people in continuing to want to find ways to support and assist their countries of origin, even if it is no longer feasible for them to continue to live there. Corporations and educational institutions who host migrated workers could, in the global interest, provide incentives for these people to share, or to bring back after a period of time, knowledge and skills to their home countries. IPs can help to advocate and research these scenarios to create a win-win-win situation, with both countries, the organization, and the individual gaining something of value from doing this.

In his 2003 TED talk, Wade Davis shares several points of importance to indigenous people’s rights and to International Psychology.  His data is staggering on the amount of language, and with it, cultural knowledge, that is lost every day. He stressed the importance of how knowledge is relative to culture and the environment, using the example of how there are 17 varieties of ayahuasca, but “modern” Westernized eyes can’t distinguish between the individual plants.  However, the indigenous peoples of the Amazon know the difference because each plant sings in a different key in the moonlight.  In this instance, not only can we not distinguish the plants, but our entire method of understanding differences between plants is upturned.  Our worldview does not permit such methods of identification as scientific, and therefore it is discredited.  But yet, these people have this knowledge, and they have gained it through their own means.  This type of scenario could be difficult when International Psychologists must significantly challenge their worldview.  Davis also talks about how change and new technology don’t inherently threaten the ethnosphere – cultures change and adapt and develop new technologies all the time, but that doesn’t necessarily destroy the culture itself.  What DOES threaten it, however, is the force of power and domination by some cultures over others.  This is expressed politically, through genocide, through ethnocide, loss of environmental resources and homelands such as through aggressive deforestation or forced relocation of peoples (ie. Native Americans onto reservations), and other means.  Ethnocide can be accomplished by strategically killing off key members of a culture, or also through the forced assimilation and marginalization of a people into the dominant culture (ie. Aborigine children separated from their families and forced into English schools and forbidden to speak their native tongue or practice any aboriginal traditions).  IPs can also help to address these types of issues by preserving knowledge and culture through researching lesser known cultures or minority peoples, and advocating for their rights both directly, and indirectly through increasing awareness of the culture among the mainstream dominant cultures.  

While there are quite a few organizations and people working diligently to assist people who have suffered from human rights violations, I believe there is still a long way to go in this area, and I believe this is one of the most important functions we as IPs can help to improve. 

References

Cooke, M. (2002). The effects of personal characteristics on migration from prairie cities to first nations. Canadian Ethnic Studies, 34(2), 40-62.

Thompson, L. F., & Atkins, S. G. (2010). Technology, mobility, and poverty reduction. In The psychology of global mobility (pp. 301-322). Springer, New York, NY.

Wade Davis: Dreams from endangered cultures. TED2003. http://www.ted.com/talks/wade_davis_on_endangered_cultures.html 

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Cultural Demographics of Syria

Syria is a middle-income developing country which has been ravished over the last 9 years by civil war. Because of the war and the mass number of civilian refugees and internally displaced persons, it is nearly impossible to calculate the current demographics within the country.  Most of the information I have been able to gather is based on pre-2011 data. 

Religious beliefs are often closely connected to individuals’ ethnic identities in Syria.  About 75% of the population is Sunni Muslim (BBC, 2011). The remaining 25% is split between Christians, Alawites, Druze and Ismailis.  There are also groups of Gypsy peoples, such as the Bedouin and Roma. Additionally, prior to the war, refugees from Iraq and Palestine and migrants from Lebanon, Armenia, and Israel, resided in Syria, though most have now left (Minority Rights Group International, 2011).

The Kurds comprise the largest ethnic minority with 10-15% of the population (BBC, 2011), and are concentrated around Northern and Northeastern Syria. Many Kurds were marginalized in Turkey and Iraq and so had moved into Syria prior to the civil war. However, with the civil war, many Kurds accused the Syrian government of discrimination and refusing them basic social, political, and cultural rights.  Kurdish protestors can expect to be jailed, and their political party is banned.

Alawites are Shia Muslim, and are the largest religious minority in Syria, accounting for 8-15% of the population (BBC, 2011). Despite being a minority, they control the most power.  President Bashar ad-Assad is Alawite, and most of his top government officials are also. Despite this, the Alawite community as a whole has been taken advantage of because of this, being coerced into being “thugs” which are used to intimidate, beat, and kill protestors of the regime.

Syrian Christians observe the Greek Catholic and Greek Orthodox denominations and have most of their populations focused in the major cities (BBC, 2011). Christians in Syria, despite being a significant minority, have a high amount of religious tolerance, worshiping freely and holding some high positions in government. Christians in Syria have mostly not been active in the protests, out of fear that the Islamic government would deny them religious freedom. They have been more visible in support of the regime. 

Ismailis are made up of about 200,000 people in Syria and are a branch of Shia Muslim with about 15 million followers worldwide (BBC, 2011). They are most concentrated around the city of Salamia. They reportedly fall on both sides of the civil war – some pro-regime, and others against it. 

The Druze reside mostly in Southern Syria, and number between 500,000 – 700,000 (BBC, 2011). They follow a religion based on Ismailism. The Druze have a history of being revolutionaries, and a major Lebanese Druze leader scolded the community for not being more active in the protests in Syria.  This was countered by the government regime actively seeking their support. 

Syrian Gypsies are much harder to calculate their population, as some are nomadic, but are estimated to number around 250,000 – 300,000 (Williams, 2001).  They consist of Bedouin peoples, who traditionally are nomadic herders, whose religious beliefs are a mix of pre-Islamic indigenous beliefs and modern Islam. Roma, Nawari, and Dom are other Syrian Gypsy groups.  

The primary languages spoken in Syria include Arabic (the official language), Kurdish (Kimanji dialect, Armenian, Aramaic, Circassian, and Turkish (Minority Rights Group International, 2011). The CIA World Factbook lists the following estimated population spread of Syria as of 2017: 

0-14 years: 31.62% (male 2,923,814/female 2,777,073)

15-24 years: 19.54% (male 1,790,360/female 1,732,694)

25-54 years: 39.22% (male 3,522,653/female 3,547,540)

55-64 years: 5.41% (male 482,576/female 493,085)

65 years and over: 4.21% (male 342,407/female 416,347

The economy has declined by about 70% since the onset of the war in 2011 (CIA World Factbook, 2017). More than half the population live in poverty, and a quarter live in extreme poverty, and an unemployment rate of nearly 50%, as of 2013 (Syrian Centre for Policy Research, 2013). Services have become extremely limited, with schools and healthcare facilities being targets of bombing by the government.

Human rights violations are a constant concern in Syria.  Working as an international psychologist, the challenges to help Syria are many and complex. The priority would be finding a way to have the government end the civil war and the attacks on civilians.  Following this, infrastructure within the country will need to be rebuilt.  Addressing the mental health concerns, including war trauma, for residents as well as refugees is also of a high priority. 

References

BBC. (December 9, 2011). Guide: Syria’s diverse minorities. BBC News. Retrieved from http://www.bbc.com/news/world-middle-east-16108755

CIA World Factbook. (2017). Syria. Retrieved from https://www.cia.gov/library/publications/the-world-factbook/geos/sy.html

Minority Rights Group International. (October, 2011). World directory of minorities and indigenous peoples – Syria. UNHCR.  Retrieved from http://www.refworld.org/docid/4954ce5ac.html

Syrian Centre for Policy Research. (October, 2013). Syria: War on development: socioeconomic monitoring report of Syria, second quarterly report (April – June 2013). United Nations Development Program. Retrieved from http://www.undp.org/content/undp/en/home/librarypage/crisis-prevention-and-recovery/syria-war-on-development–socioeconomic-monitoring-report-of-syr.html

Williams, A. (2001).  The Gypsies of Syria. Dom Research Center, 1(4). Retrieved from http://www.domresearchcenter.com/journal/14/syria4.html

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Humanitarianism Papers, Docs, and Essays

Providing Mental Health Services in Humanitarian Aid to Syria

Syria has been engaged in a devastating civil war, between multiple groups including the government regime, civilian militias, and terrorist groups for almost a decade (Hassan, Kirmayer, Mekki-Berrada, et al., 2015). This has been devastating to the population of Syria, destroying infrastructure, historical places, schools, hospitals, and demolishing whole communities. Prior to the war, Syria’s health system was already lacking, despite improvements to life expectancy and overall health (Hendrickx, Woodward, Fuhr, et al., 2019). Mental health services were extremely limited. Only 2% of the health budget was allocated for mental health, primarily for in-patient hospital settings. Community mental health settings were exceedingly rare, as was the availability of counselors, psychiatrists, psychologists, social workers, and other mental health professionals. Additionally, the system faced problems due to “inequity, poor transparency, lack of standardized quality care, inadequate numbers of health staff, and uneven distribution of services in the regions due to an uncontrolled expansion of private services” (Hendrickx, Woodward, Fuhr, et al., 2019, p.1) for general healthcare. The government military has deliberately attacked health clinics and hospitals, including psychiatric hospitals, creating an even larger disparity in access to mental health services (Hendrickx, Woodward, Fuhr, et al., 2019). This means the majority of MHPSS services are delivered within Syria by humanitarian organizations, both national and international.

Since the onset of the Syrian Civil War in 2011, more than half of all Syrians have been forcibly displaced, split nearly evenly between internally displaced persons and international refugees (Hendrickx, Woodward, Fuhr, et al., 2019). There are also many non-displaced persons within Syria who are in need of humanitarian assistance and mental health and psychosocial support (MHPSS). It is common for Syrians to be displaced multiple times as the conflicts zones continue to shift, and more than half of those displaced are children (Hassan, Kirmayer, Mekki-Berrada, et al., 2015). Known risk factors contributing to mental illness have been experienced by Syrians as a result of the conflict, such as “exposure to traumatic events, forced displacement and ongoing stressors such as unemployment, impoverishment, social dislocation and loss of social support” (Hendrickx, Woodward, Fuhr, et al., 2019, p. 1). Human rights violations towards civilians are rampant within Syria, “including massacres, murder, execution without due process, torture, hostage-taking, enforced disappearance, rape and sexual violence, as well as recruiting and using children in hostile situations” (Hassan, Kirmayer, Mekki-Berrada, et al., 2015, p. 12). The Universal Declaration of Human Rights and International Human Rights Law (Weissbrodt & De La Vega, 2007) have been completely disregarded within Syria since the outbreak of the conflict.

One aspect that is particularly challenging for humanitarian organizations is the disregard for their protection – and even specified targeting – by actors in the conflict (Hassan, Kirmayer, Mekki-Berrada, et al., 2015). About 4.8 million people live in remote or difficult to access areas, and another 440,000 are trapped in active conflict zones at any one time, further complicating the ability of humanitarian organizations to deliver aid, supplies, or services.

A systemic review of the literature on the burden and access to mental health services in Syria and neighboring countries (Hendrickx, Woodward, Fuhr, et al., 2019) found large variations in rates of mental illness, such as between 16 to 80% for post traumatic stress disorder, 11 to 49% for depression, and 49 to 55% for anxiety. The most common risk factors for mental illness were being exposed to traumatic events and a history or family history of mental illness. The largest obstacles commonly reported to receiving mental health care were financial and socio-cultural. Gaps in the research were pronounced in the interventions used and the burden of mental illness primarily for those living within Syria.  Access to care and barriers were also in need of further research, as well as evaluation of psychosocial programs and interventions. Furthermore, a common problem found amongst the studies reviewed was that MHPSS interventions had not been validated with the Syrian population and had not been adapted to cultural symptoms or expressions of distress. Barriers to services were found to be “cost, language, cultural understanding, limited availability and quality of services, poor quality of services, low knowledge of mental disorder symptoms, lack of awareness of MHPSS services, and stigma and discrimination” (Hendrickx, Woodward, Fuhr, et al., 2019, p.9).

The 2018 Semi-Annual report from the Syrian Arab Red Crescent Society (SARC) shows little detail on the provisions or specifications of psychosocial support or mental health services. However, they do mention that a significant number of trainings were given on the topic of psychosocial support, numbering 15, tied for the third most numerous training category with disaster management, following first aid and community health trainings. The document also reports that psychosocial support was an included service within the thirteen community centers established in conjunction with the UNHCR in the humanitarian support project. It notes there were 22,803 beneficiaries of these psychosocial services, which also included services for children with special needs, direct support, and awareness sessions and recreational activities. In addition, SARC serves 334 shelters across Syria, which provide services to 12,000 families, and include psychosocial support activities.

The International Medical Corps is also providing psychosocial services in Syria as part of their humanitarian aid in the region. They are working on multiple projects and call for additional support in several areas. First, they seek to scale up sustainable and comprehensive MHPSS services within Syria and surrounding countries who have Syrian refugee populations. They also are training doctors and nurses in mental health and improving the training of mental health professionals within Syria to address the needs currently but also in the future. Additionally, they are “[i]nvolving affected Syrians in community outreach and in learning basic psychosocial support skills, which can strengthen community support and help establish links to formal mental health care services” (International Medical Corps, 2015). They also apply the IASC guidelines to coordinate MHPSS groups, which communicate and collaborate programs and services, advocate to donors, share resources and tools, and map current humanitarian MHPSS efforts (Hijazi & Weissbecker, 2017).

Much of the lack of support for psychological services in Syria is likely to be related to the stigma around mental illness found in many Middle Eastern societies.  While there is very little research on mental health in Syria prior to the war, we can draw assumptions from what we know of the responses of refugees towards mental health and in cultural assumptions from surrounding countries with similar cultural makeups. Syrians consist of a diversity of backgrounds and identities and are considered Arabs – though “this is a term based on the spoken language, not ethnicity” (Hassan, Kirmayer, Mekki-Berrada, et al., 2015, p.10). There has been an increasing emphasis placed on tribal affiliation since the beginning of the war, which helps establish identity, community, and a structure of leadership within groups in a fragmented country. Multiple ethnic groups have been marginalized and oppressed, the largest of these being the Kurdish, which has seen a resurgence and reclaiming of cultural identity in recent years. Prior to the conflict, there were also significant amounts of refugees residing within Syria, mostly from Iraq and Palestine.

For mental health professionals working with Syrians, there should be caution when diagnosing mental illnesses, as high rates of daily stressors may cause them to show increased symptoms for a period of time, although this is not necessarily indicative of a mental disorder (Hassan, Kirmayer, Mekki-Berrada, et al., 2015). Similar to other populations affected by war-related trauma, Syrian refugees have most commonly shown to have emotional category disorders, such as post traumatic stress, anxiety disorders, depression, and prolonged grief. Interventions which focus on non-clinical aspects such as safety, living conditions, identity, community, social roles, and building hope may have significant results in addressing mental health concerns as well (Hassan, Kirmayer, Mekki-Berrada, et al., 2015).

Syrians traditionally have used their family and friends for high levels of support and for coping with difficult situations (Hassan, Kirmayer, Mekki-Berrada, et al., 2015). As many of these social circles have been drastically disrupted from the war, helping Syrians establish a sense of community support would be highly important. Other coping mechanisms for Syrian individuals have been reported to including praying, listening to music, watching TV, drawing, withdrawal, and smoking. Negative coping mechanisms should be watched for and sought to be decreased, while increasing positive coping mechanisms. Men may struggle to admit any “weakness” as is the cultural norm and may benefit from the use of collective activities. Women’s roles, routines, and social networks are also impacted, and they may need ways to engage in active coping and develop new routines and social networks. Many adolescents restrict themselves from sharing their emotional difficulties with their parents, because they do not want to cause them more stress or suffering in addition to the war.  Some parents report “increasingly resorting to maladaptive coping strategies, such as beating their children or being overprotective” (Hassan, Kirmayer, Mekki-Berrada, et al., 2015, p. 17). As a result of losing caregivers or family members, family structure and the roles for individuals and between genders may have changed and cause tension within the family, and conflict with traditional norms and gender roles. Sexual violence can be exceptionally troubling to individuals, as it can result in further consequences such as being ostracized.

Domestic violence has increased since the conflict, with stress for men being the reported cause (Hassan, Kirmayer, Mekki-Berrada, et al., 2015). Use of evidence based treatment for men to reduce aggressions such as anger management and parenting classes can be used by counselors, although it should be noted these have not been adapted to the Syrian context. In providing services to victims of abuse, counselors should be mindful of the risks for stigmatization and further abuse which may occur at victims seeking counseling or being encouraged to leave their partners. Helping victims identify supportive and safe individuals in their social network can be helpful as part of treatment.

Another consideration is the increase in early marriage for girls as a result of the conflict (Hassan, Kirmayer, Mekki-Berrada, et al., 2015). This is used as a coping mechanism which is seen as a way to provide protection and secure the future of girls at a time when many families are facing poverty, insecurity, uncertainty and the loss or absence of male family members. Early marriage can stall or end girls’ education, increase the risk of health problems and domestic violence, and cause feelings of stress and abandonment by parents for girls.

Counselors working with Syrian survivors of torture have reported that clients typically have multiple emotional and psychological symptoms, in addition to financial and legal issues (Hassan, Kirmayer, Mekki-Berrada, et al., 2015).  LGBTQI+ individuals in Syria face severe discrimination, and same-sex acts are illegal. Since the conflict, LGBTQI+ individuals are  especially vulnerable to being abused or exploited, in addition to high levels of stress and stigma. Elder Syrians are also at increased risk for psychological problems, especially those with health conditions or who have limited support networks; many have lost family members and friends due to death or displacement because of the conflict. Individuals with disabilities or chronic health conditions also show above-average levels of psychological distress. It is common for older adults and those with disabilities to be concerned about being a burden on their caretakers, feel powerless, and have fear about being separated from their families and losing access to health and social supports as a result of the conflict.

Children constitute more than 50% of displaced Syrians, and more than 75% of these are under age 12 (Hassan, Kirmayer, Mekki-Berrada, et al., 2015). It is not uncommon for children to become separated from their families, witness acts of destruction and death, be at risk for sexual exploitation, human trafficking, physical abuse, recruited as child soldiers, and be unable to access basic services. Children have exhibited abnormally high levels of behavioral and emotional problems, with clinical levels of anxiety at around 50%. “Problems include: fears, difficulties sleeping, sadness, grieving and depression (including withdrawal from friends and family), aggression or temper tantrums (shouting, crying and throwing or breaking things), nervousness, hyperactivity and tension, speech problems or mutism, and somatic symptoms. Violent and war-related play, regression and behavioral problems are also reported among children” (Hassan, Kirmayer, Mekki-Berrada, et al., 2015, p. 20). Most children have been forced to stop schooling as a result of the conflict. Roles for children may have also shifted, taking on adult responsibilities and concerns due to loss or injury to caregivers. Evidence from Syrian refugees shows that with positive support from families, communities, and service providers, over time emotional and behavioral problems are reduced. Interestingly, the International Medical Corps has shown high rates for children using mental health services within Syria (69%), likely due to the otherwise lack of outlets for socializing and activities (Hijazi & Weissbecker, 2017).

For international humanitarian mental health providers, it is important to understand the Syrian cultural contexts and models of illness and distress to provide improved communication and appropriate interventions with clients. It is recommended to avoid labeling and diagnostics when possible as this “can be especially alienating and stigmatizing for survivors of violence and injustince” (Hassan, Kirmayer, Mekki-Berrada, et al., 2015, p. 22). Models of counseling should emphasize building rapport and a therapeutic alliance, and be open to exploring multiple avenues of support such as “both formal and informal medical systems, religious or community resources and strategies” (Hassan, Kirmayer, Mekki-Berrada, et al., 2015, p.22).

Mental health is not discussed or understood broadly in Syrian culture, and any ideas of psychological states carry negative connotations (Hassan, Kirmayer, Mekki-Berrada, et al., 2015). Suffering is seen as just a part of life does not require psychological care unless it is debilitating. Usually, clients will report physical complaints rather than psychological ones. “Most Arabic and Syrian idioms of distress do not separate somatic experience and psychological symptoms, because body and soul are interlinked in explanatory models of illness” (Hassan, Kirmayer, Mekki-Berrada, et al., 2015, p. 22). The use of images or metaphors may be seen by international counselors as a lack of awareness, communication, or even as psychosis. However, by working with the client to understand the meaning of their expressions it can be determined what their psychological symptoms are within their cultural framework.

With the above cultural considerations of mental health in mind for Syrians, humanitarian organizations can plan interventions and aid to address both short- and long-term assistance in a multi-layered approach. The IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings (IASC, 2007) identify how MHPSS services can be coordinated and integrated throughout multiple aspects of a humanitarian operation. This includes recruiting staff and volunteers who understand the local culture, so in implementing any MHPSS service, the above information should be utilized so that all members of the team understand how to properly work with and interpret meaning from Syrian clients. This is also useful in developing a train-the-trainer model for teaching Syrian lay counselors, and while they may innately understand the local culture, it will be important for their supervisors and teams of international origin to accurately relay and understand information.

Areas of concern which present significant difficulty within Syria include the protection and human rights standards (IASC, 2007). International humanitarian organizations attempting to provide services in Syria should prepare in advance for a strategy to how they can best protect clients from human rights abuses, which are rampant in Syria currently. There may be active opposition to their aid and protections by the Syrian government, and so humanitarian actors should be well versed in International Humanitarian Law and International Human Rights Law (International Committee of the Red Cross Factsheet, 2003) and what extend their funds and resources will allow them to actively protect clients. The rebuilding of an internal network of mental health support, targeting stigma, building awareness, and strengthening the infrastructure to improve the accessibility, quality, and availability of mental health services within Syria should constitute part of long-term goal planning for humanitarian organizations (Hijazi & Weissbecker, 2017).

References

Hassan, G, Kirmayer, LJ, Mekki-Berrada A., Quosh, C., el Chammay, R., Deville-Stoetzel, J.B., Youssef, A., Jefee-Bahloul, H., Barkeel-Oteo, A.,Coutts, A., Song, S. & Ventevogel, P. (2015). Culture, context and the mental health and psychosocial wellbeing of Syrians:

A review for mental health and psychosocial support staff working with Syrians affected by armed conflict. Geneva: UNHCR.

Hendrickx, M., Woodward, A., Fuhr, D.C., Sondorp, E., & Roberts, B. (2019). The burden of mental disorders and access to mental health and psychosocial support services in Syria and among Syrian refugees in neighboring countries: a systematic review. Journal of Public Health (Oxford, England). Advance online publication. https://doi.org/10.1093/pubmed/fdz097

Hijazi, Z, and Weissbecker, I. (2017). Syria crisis: Addressing regional mental health needs and gaps in the context of the Syria crisis.  International Medical Corps. Retrieved from https://internationalmedicalcorps.org/wp-content/uploads/2017/07/Syria-Crisis-Addressing-Mental-Health.pdf

Inter-Agency Standing Committee (IASC). (2007). IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings. Geneva: IASC. Retrieved from http://www.humanitarianinfo.org/iasc/content/products

International Committee of the Red Cross. (2003). Factsheet: International humanitarian law and international human rights law: Similarities and differences. 

International Medical Corps. (March 16, 2015). Ongoing war creates invisible mental health crisis for Syrian people. Retrieved from https://internationalmedicalcorps.org/press-release/ongoing-war-creates-invisible-mental-health-crisis-for-syrian-people/

Syrian Arab Red Crescent Society (SARC). (2018). Semi Annual Report 2018. Retrieved from http://sarc.sy/semi-annual-2018-report/

Weissbrodt, D. & De La Vega, C. (2007). Overview and history of international human rights. In         International Human Rights Law: An Introduction (p.14-26). Philadelphia, PA:        University of Pennsylvania Press.

Categories
Humanitarianism Presentations and Videos

Culturally Sensitive Mental Health in International Humanitarian Crises

A presentation designed to be a potential workshop for mental health professionals who already have significant training in their field, and some awareness of working in humanitarian contexts. Maybe they have worked as a volunteer in the U.S. and are looking at volunteering abroad. This is an outline to considerations of working with both clients and staff in diverse communities in culturally sensitive ways.

Categories
Humanitarianism

Aspects of international humanitarian law, refugee law, & human rights law relevant to mental health delivery in diverse settings

The Sphere project is a manual assembled and updated by multiple international groups and humanitarian aid organizations, with “concrete measurable benchmarks” (The Sphere Project, 2011) to outline quality, accountability, and values for humanitarian agencies, developed after mistakes from humanitarian groups during the Rwandan genocide. The Sphere has been updated to include four primary essential rights for all, and to guide the actions of humanitarians.  These are:

  1. Enhance the safety, dignity and rights of people, and avoid exposing them to harm.
  2. Ensure people’s access to assistance according to need and without discrimination.
  3. Assist people to recover from the physical and psychological effects of threatened or actual violence, coercion or deliberate deprivation.
  4. Help people claim their rights (Sphere Handbook, 2018, p.33)

In a TEDGlobal talk with António Guterres (2015), the impacts on Syrian refugees and on the communities they are fleeing to are discussed through the lens of how global policies affect human rights and suffering. The needs of Syrian refugees are exacerbated when surrounding countries taking them in, like Lebanon and Jordan, do not have the resources and also do not qualify for additional funding from sources such as the World Bank, as they are middle-income countries. These countries are then unable to provide enough support for the refugees.

As a global community, we should be supporting these countries as the front lines of defense and in supporting our collective international humanitarian commitment to refugees. Additionally, we should not be limiting how many refugees we can take in each country, as it is our duty to adjust our own society to meet the need.  Fear over security causes leaders to make harmful statements, such as Trump stating he would not allow any Muslim refugees in the US. However, statements like these actually provide fodder and support for terrorists, particularly Muslims who already reside in the US who are then ostracized and see themselves as needing to assert themselves and fight back against such statements, and so join terrorist groups. Refugees endure severe suffering, or else they would not be refugees in the first place – but then continue to be exposed to the worst conditions, unable to work, dependent on social support but often ineligible for it, health conditions and lack of medical care, and tensions with locals. 

              In the Nobel Prize acceptance speech by Medicins Sans Frontiers (MSF), also known as Doctors without Borders (Orbinski, 2000), they state “[h]umanitarian action is more than simple generosity, simple charity. It aims to build spaces of normalcy in the midst of what is profoundly abnormal. More than offering material assistance, we aim to enable individuals to regain their rights and dignity as human beings…Our action and our voice is an act of indignation, a refusal to accept an active or passive assault on the other.”

They also state “[h]umanitarianism occurs where the political has failed or is in crisis. We act not to assume political responsibility, but firstly to relieve the inhuman suffering of that failure. The act must be free of political influence, and the political must recognize its responsibility to ensure that the humanitarian can exist” (Orbinski, 2000). The responsibility for addressing the suffering of humans lies, ultimately, with political systems and countries. The needs for humanitarian organizations exist because these systems either fail to provide adequate interventions and support or are the instigators of human suffering in the first place. “Humanitarianism is not a tool to end war or to create peace. It is a citizens’ response to political failure. It is an immediate, short term act that cannot erase the long-term necessity of political responsibility” (Orbinski, 2000)

Additionally, ”[h]umanitarian action requires a framework in which to act. In conflict, this framework is international humanitarian law. It establishes rights for victims and humanitarian organizations. It fixes the responsibility of states to ensure respect of these rights, and to sanction their violations as war crimes. Today this framework is clearly dysfunctional. Access to victims of conflict is often refused. Humanitarian assistance is even used as a tool of war by belligerents. And more seriously, we are seeing the militarization of humanitarian action by the international community” (Orbinski, 2000).

The speech (Orbinski, 2000) also addresses how language shapes our view. Aside from natural disasters, humanitarian aid is not existing without the responsibility of another for a crime – and usually a crime on a massive scale, which causes significant human suffering. We tend to downplay the roles and responsibilities that actors have when we discuss the situation as a humanitarian emergency, removing it from it’s context.  At the same time, those providing humanitarian aid should refrain from politicizing or allow their preference of who to help rely on which side of a conflict one is on. The speech by MSF acknowledges that their humanitarian work exists within societal, cultural and political contexts, while at the same time working to clarify its purpose and goals outside of such, in terms of human rights and other essential rights, such as environmental ones, and to resist the urge to polarize peoples, systems, and governments as good or bad. As part of maintaining this, MSF remains an independent organization, and resists funding or oversight by any militarized group, which it views as being impossible to remain impartial.

I personally see the standards of MSF (Orbinski, 2000) as being important and applicable to using mental health care in humanitarian aid across diverse settings and peoples. Acknowledging that biases exist, and to choose to work on them in our own personal spaces with peers, mentors, and our own therapists, while aiming to approach each individual that we work with as a human being with an inherent right to dignity, worth, value, and deserving of empathy and care, regardless of their behaviors or actions. This aligns with the principles of Sphere (2018), and can be guides for how to approach care with refugees.

References

Orbinski, J. (2000). There is no such thing as military humanitarianism. Peace Magazine; Winter 2000. Retrieved from http://www.peacemagazine.org/archive/v16n1p08.htm

TEDGlobal (2015). António Guterres: Refugees have the right to be protected. Retrieved from https://www.ted.com/talks/antonio_guterres_refugees_have_the_right_to_be_protected

The Sphere Handbook: Humanitarian Charter and Minimum Standards in Humanitarian Response. (2018). Retrieved from https://www.developmentbookshelf.com/doi/book/10.3362/9781908176707. DOI: 10.3362/9781908176707

The Sphere Project (2011). Introducing the Sphere Handbook 2011 . Retrieved from http://www.youtube.com/watch?v=zpXxVg-Cv8A&feature=related.

Categories
Humanitarianism

STRENGTHS PM+ for Syrian Refugees

A FAQ and introduction to a culturally-sensitive mental health program to address problems of daily living, stress, anxiety, depression and PTSD by trained peer mentors.

Categories
Humanitarianism

The Syrian White Helmets

The Syrian Civil Defense, more widely known as the Syrian White Helmets, are an organization of volunteers within Syria and in parts of Turkey. The group is made of up of “[f]ormer bakers, tailors, engineers, pharmacists, painters, carpenters, students and many more professions besides” (White Helmets, n.d., par.5). They primarily operate in opposition-held areas of Syria It was formed in 2014, but began with grassroots movements of volunteer rescue teams in 2012 (Aikins, 2014) with the escalation of the Syrian Civil War after a failed ceasefire which had been implemented by the UN (BBC, 2012). It was the beginnings of The White Helmets which drew the world’s hearts towards the conflict in Syria – the image of Omran, the five year old covered in blood and dust sitting alone in the ambulance; the video of an infant being desperately pulled from the rubble of a bombed building (Malsin, n.d.).

The group’s humanitarian framework comes from international humanitarian law from the Geneva Convention, and guided by philosophy from the Quran (The White Helmets, n.d.). Their motto, from the Quran, is “to save a life is to save all of humanity” (The White Helmets, n.d., par. 7), and they ascribe to the international humanitarian laws principles of Humanity, Solidarity, and Impartiality. They have been nominated three times for the Nobel Peace Prize and have had a Netflix documentary made about them. Their organizational structure is run by a democratically elected council and led by Raed al Saleh.

They have nearly 3000 volunteers and have rescued more than 115,000 individuals from the rubble after air raid attacks (Syria Civil Defense, n.d.). They have 221 female volunteers and openly state that they seek to include women in their work alongside male volunteers, and also in services specific to women such as maternal health clinics (The White Helmets, n.d.), as is culturally acceptable. 252 volunteers have been killed, and more than 500 injured (The White Helmets, n.d.). More than half of those killed have been in “double tap” attacks, where there is an initial attack, then a second attack after rescuers arrive to help, to specifically target them. Additionally, in 2018, about 100 White Helmet volunteers along with their families were emergency evacuated by a rescue group from Israel after becoming trapped by the Syrian military (BBC, 2018).  800 volunteers and their families had been planned for, but nearly half did not make it for the one-time rescue operation.

One of the founders of the organization, from Britain, James Le Mesurier, had created another nonprofit, called Mayday Rescue, in order to fundraise, provide equipment, and train the White Helmets in urban search and rescue (Yee, 2019).  He was found dead in Turkey in 2019 under suspicious circumstances following multiple disinformation campaigns against him by the Russian Foreign Ministry, claiming that both he and the White Helmets were actually a terrorist organization linked with al-Qaeda (Yee, 2019). Others, likely fueled by this propaganda, speculate that the White Helmets are propaganda themselves for the interests of the US and NATO (Kakade, 2016). However, the claims that the White Helmets are linked with terrorist organizations and have staged mass casualty events have been thoroughly discredited as a clear ploy by the Russian and Syrian governments (Palma, 2016, Solon, 2017).

The primary goals of the group exist within the physical and cultural space of Syria, comprised of Syrians. Their ultimate aim is to provide emergency humanitarian relief in the Syrian Civil War to anyone who is suffering, and they are known for their dangerous attempts at saving lives at any cost (James, 2014). Their actions are to act as first responders following airstrikes in Syria, providing “emergency evacuation, urban search and rescue, firefighting, community engagement, and medical response” (Asif & Asif, 2018, p. 27). Additionally, they have developed an emergency plan to prevent the spreading of COVID-19 in Syria and go door-to-door to raise awareness, while also disinfecting public areas including camps and buildings, coordinating with medical professionals in setting up quarantine facilities, and training specialized teams on how to safely evacuate COVID-infected individuals to hospitals (The White Helmets, n.d.).

An important cultural consideration of humanitarian work is the effect that outside international aid has towards the local community. The White Helmets have been much more successful than Doctors Without Borders AKA MSF, most likely due to this discrepancy of trust (Asif & Asif, 2018). An outsider can create a feeling of shame, as if one is being pitied by the international community and is hopeless to help themselves, while a culturally native individual represents strength, solidarity, trust, and resiliency. “Thus, the clinical encounter between the native population and the foreign doctor becomes a microcosm of colonial rule, one that is characterized by confrontation and distrust” (Asif & Asif, 2018, p.27). The White Helmets are also committed to the long-term rebuilding of Syria as they are Syrians themselves, and want to ensure the peace, safety, and welfare of Syrian communities in infrastructure, and social, physical, and emotional health. It is because of these culturally-relevant investments and actions that it has been recommended to increase trauma-informed psychological care training for the volunteers, as they are in a unique position to deliver such services in the immediate and long term within Syria (Lester, 2018).

While the group was founded by international backers, its approximately 3000 volunteer members are Syrians themselves (Daley, 2016). As such, they have not ever been involved in another conflict, so can only be judged on their capacity within the one context they are serving. Additionally, they appear to be culturally sensitive in that they operate within the Syrian context.  However, this does not always mean that all Syrian cultures are equally respected, although the group strives for impartiality. There have been some criticisms of their ability to do so, stating that they are opposed to the government regime, and actually are encouraging the Syrian Civil War to continue through taking sides in the conflict and continuing to accept funding from Western backers (Moore, 2019). However, evidence and support of this opinion is scarce. That being said, it is understandable that the group would be largely opposed to the governmental regime, who has been criticized heavily for their attacks on their own civilians and human rights abuses (Amnesty International, n.d.). Despite this, The White Helmets claim that they have saved lives on all sides of the conflict, including government soldiers (The White Helmets, n.d.).

Below is the information directly from the Syria Civil Defense web page on “What We Do” (n.d.)

We are a humanitarian organisation dedicated to helping communities to prepare for, respond to and rebuild after attacks in our beloved Syria.

We are best known for our search and rescue services following bombings but we provide a range of services inline with the internationally recognised activities of civil defense.

We work according to the guidelines for civil defence organisations across the world, as well as in accordance with International Humanitarian Law. As defined in Protocol I (Article 61) of the Geneva Conventions of 1949, we pledge to provide the services listed at paragraph 5:

  1. Warning the civilian population of attacks and dangers
  2. Urban Search and Rescue
  3. Evacuation of the civilian population from areas into which fighting is encroaching
  4. The provision of medical services – including first aid – at the point of injury
  5. Fire-fighting
  6. Management of emergency shelters
  7. Detection and marking of danger areas (such as areas with unexploded ordnance)
  8. Provision of emergency accommodation and supplies
  9. Emergency repair of indispensable public utilities
  10. Decontamination and similar protective measures
  11. Assistance in the preservation of objects essential for survival
  12. Emergency assistance in the restoration and maintenance of order in distressed areas
  13. Emergency disposal of the dead
  14. Management of blackout measures
  15. Complementary activities needed to carry out any of the tasks mentioned above.

As outlined in the Protocol I (Article 61) of the Geneva Conventions of 1949 we provide these services for the following purposes:

  • To protect the civilian population against the dangers arising from hostilities or other disasters
  • To speed recovery from the immediate effects of such events To provide the conditions necessary for survival of the civilian population.

While civil defence organizations are protected under the international humanitarian law applicable to all civilians and civilian objects in general, the Additional Protocol I to the Geneva Conventions, adopted in 1977, makes protection specific for civil defence.

Additionally, the White Helmets web page (n.d.) makes it clear that the organization is committed to helping rebuild physically and mentally in rebuilding communities following the end of the Civil War. One point that I found somewhat confusing is the utilization of two different web pages for the organization. It appears the White Helmets web page (n.d.) is aimed more towards generating support and fundraising, while the Syria Civil Defense website (n.d.) has more information about the organization itself and press releases.

Remember Omran, that bloodied and dusty five-year-old in the ambulance whose image wrecked our hearts all over the world? In 2017, the Syrian government media released new photos and videos of him, along with statements by the boy’s father that the family was pro-regime and that the child had been used by the rebel forces as fake propaganda (Specia & Samaan, 2017). This is just another example of how the truth around the White Helmets, and the war in Syria as a whole, is constantly being twisted and changed, making it difficult to know the truth (Haddad, 2016). Social media exacerbates this, with clearly differing messages posted to different sites, aimed at different followers, and between Arabic and English (Lynch, Freelon, & Aday, 2014). This is a common modern tactic in civil wars and human-causes acts of humanitarian crises, the post-truth age (Harsin, 2018).

Overall, it appears the White Helmets are a legitimate organization working diligently within a high-risk area to serve the Syrian community.  They provide an invaluable service that international organizations have struggled to do. Despite the conflict being ongoing, the organization has been successful in its mission, and seems to have the ability to continue doing so, despite the direct attacks on their lives and through the media to discredit them and attempt to eliminate their funding. That being said, Asif and Asif (2018) recommend that the White Helmets increase their indigenous independence by eliminating Western funding. While I understand this position, I think that there is always a struggle for organizations to have enough funding, so to get it from any source possible may be necessary in order to complete their mission.

I find the Syrian White Helmets to be incredibly inspiring personally and would like to see other models for indigenous humanitarian organizations given research and support around the world. I would like to see the larger international aid organizations focus their resources and funding towards supporting local, grassroots movements such as the White Helmets.  I think this is done in some capacity already, but I think there is much room for improvement.

References

Aikins, M. (2014). Whoever saves a life. Medium. Retrieved from https://medium.com/matter/whoever-saves-a-life-1aaea20b782#.kelvvhn3f

Al Asaad, S. (2018). The White Helmet myth: A soft war propaganda. Op-Ed. MEHR News Agency. Retrieved from https://en.mehrnews.com/news/132739/The-White-Helmet-myth-A-soft-war-propaganda

Amnesty International. (n.d.). Syria. Retrieved from https://www.amnestyusa.org/countries/syria/

Asif, S.M. & Asif, S. (2018). Doctors with borders: The White Helmets and radical political medicine. In: Weber AS, Verjee MA, editors. Proceedings of the 1st International Conference on Medical Humanities in the Middle East [Internet]; 2018 Nov 17-18: Doha, Qatar: Innovations in Global Health Professions Education; 2019 March. p. 27-29. https://dx.doi.org/10.20421/ighpe2019.01.09

Atlantic Council. (2017). Breaking Aleppo. Retrieved from http://www.publications.atlanticcouncil.org/breakingaleppo/

BBC. (June 12, 2012). Syria in civil war, says UN official Herve Ladsous. BBC News. Retrieved from https://www.bbc.com/news/world-middle-east-18417952

BBC. (July 22, 2018). Syria conflict: White Helmets evacuated by Israel. BBC News. Retrieved from https://www.bbc.com/news/world-middle-east-44915099

Daley, B. (October 7, 2016). Who are Syria’s White Helmets, and why are they so controversial?. The Conversation. Retrieved from https://theconversation.com/who-are-syrias-white-helmets-and-why-are-they-so-controversial-66580

Haddad, B. (2016). The debate over Syria has reached a dead end. The Nation. Retrieved from https://www.thenation.com/article/archive/the-debate-over-syria-has-reached-a-dead-end/

Harsin, J.  (2018). Post-Truth and Critical Communication Studies. Oxford Research Encyclopedia of Communication. Oxford University Press.

James, L. (2014). The most dangerous job in the world. New Internationalist. Retrieved from https://newint.org/features/web-exclusive/2014/10/10/syria-civil-defense-volunteers/

Kakade, S. (2016). White Helmets: Heroes or propaganda?. Ruggles Media. Retrieved from https://camd.northeastern.edu/rugglesmedia/2016/09/26/white-helmets-heroes-or-propaganda/

Lester, N. (2018) Introducing a Trauma-Informed Practice Framework to Provide Support in Conflict-Affected Countries. The RUSI Journal, 163(6), 28-41. DOI:10.1080/03071847.2018.1562016

Lynch, M., Freelon, D., and Aday, S. (2014). Syria’s socially mediated civil war. United States Institute of Peace. Retrieved from https://www.usip.org/publications/2014/01/syrias-socially-mediated-civil-war

Malsin, J. (n.d.). The White Helmets of Syria. Time. Retrieved from https://time.com/syria-white-helmets/

Moore, T. (2019). The White Helmets: Unneutral in the Syrian conflict. Kent State University Undergraduate Symposium on Research, Scholarship and Creative Activity. Retrieved from https://oaks.kent.edu/ugresearch/2019/white-helmets-unneutral-syrian-conflict

Palma, B. (December 15, 2016). Are the Syrian ‘White Helmets’ Rescue Organization Terrorists?. Snopes Fact Check. Retrieved from https://www.snopes.com/fact-check/syrian-rescue-organization-the-white-helmets-are-terrorists/

Solon, O. (December 18, 2017). How Syria’s White Helmets became victims of an online propaganda machine. The Guardian.  Retrieved from https://www.theguardian.com/world/2017/dec/18/syria-white-helmets-conspiracy-theories

South China Morning Post [username]. Syrian conflict: who are the White Helmets? . YouTube. Retrieved from https://www.youtube.com/watch?v=mnhkH6lYJxM&t=13s

Specia, M. and Samaan, M. (June 6, 2017). Syrian boy who became image of civil war reappears. The New York Times. Retrieved from https://www.nytimes.com/2017/06/06/world/middleeast/omran-daqneesh-syria-aleppo.html

Syria Civil Defense. (n.d.). ”Who we are” and “What we do.” Retrieved from https://www.syriacivildefence.org/en/

The Syria Campaign. (2017). Killing the truth: How Russia is fuelling a disinformation campaign to cover up war crimes in Syria. Retrieved from https://thesyriacampaign.org/wp-content/uploads/2017/12/KillingtheTruth.pdf

The White Helmets. (n.d.). Retrieved from https://www.whitehelmets.org/en/

Wright, R. (July 23, 2018). The White Helmets – Syria’s noble rescuers – have to be rescued by Israel. The New Yorker. Retrieved from https://www.newyorker.com/news/news-desk/the-white-helmets-syrias-noble-rescuers-have-to-be-rescued-by-israel

Yee, V. (November 11, 2019). James Le Mesurier, backer of Syrian White Helmets, is found dead in Turkey. The New York Times. Retrieved from https://www.nytimes.com/2019/11/11/world/middleeast/james-le-mesurier-white-helmets-dead.html