"To die is better for me", social suffering among Syrian refugees at a noncommunicable disease clinic in Jordan: a qualitative study.
Journal
Conflict and HealthAbstract
Background: The conflict in Syria has required humanitarian agencies to implement primary-level services for non-communicable diseases (NCDs) in Jordan, given the high NCD burden amongst Syrian refugees; and to integrate mental health and psychosocial support into NCD services given their comorbidity and treatment interactions. However, no studies have explored the mental health needs of Syrian NCD patients. This paper aims to examine the interaction between physical and mental health of patients with NCDs at a Médecins Sans Frontières (MSF) clinic in Irbid, Jordan, in the context of social suffering. Methods: This qualitative study involved sixteen semi-structured interviews with Syrian refugee and Jordanian patients and two focus groups with Syrian refugees attending MSF's NCD services in Irbid, and eighteen semi-structured interviews with MSF clinical, managerial and administrative staff. These were conducted by research staff in August 2017 in Irbid, Amman and via Skype. Thematic analysis was used. Results: Respondents describe immense suffering and clearly perceived the interconnectedness of their physical wellbeing, mental health and social circumstances, in keeping with Kleinman's theory of social suffering. There was a 'disconnect' between staff and patients' perceptions of the potential role of the NCD and mental health service in alleviating this suffering. Possible explanations identified included respondent's low expectations of the ability of the service to impact on the root causes of their suffering, normalisation of distress, the prevailing biomedical view of mental ill-health among national clinicians and patients, and humanitarian actors' own cultural standpoints. Conclusion: Syrian and Jordanian NCD patients recognise the psychological dimensions of their illness but may not utilize clinic-based humanitarian mental health and psychosocial support services. Humanitarian agencies must engage with NCD patients to elicit their needs and design culturally relevant services.Publisher
BMCPubMed ID
32905304Type
ArticleLanguage
enISSN
1752-1505ae974a485f413a2113503eed53cd6c53
10.1186/s13031-020-00309-6
Scopus Count
Collections
Related articles
- Cardiovascular disease risk and prevention amongst Syrian refugees: mixed methods study of Médecins Sans Frontières programme in Jordan.
- Authors: Collins DRJ, Jobanputra K, Frost T, Muhammed S, Ward A, Shafei AA, Fardous T, Gabashneh S, Heneghan C
- Issue date: 2017
- "What's happening in Syria even affects the rocks": a qualitative study of the Syrian refugee experience accessing noncommunicable disease services in Jordan.
- Authors: McNatt ZZ, Freels PE, Chandler H, Fawad M, Qarmout S, Al-Oraibi AS, Boothby N
- Issue date: 2019
- Delivering a primary-level non-communicable disease programme for Syrian refugees and the host population in Jordan: a descriptive costing study.
- Authors: Ansbro É, Garry S, Karir V, Reddy A, Jobanputra K, Fardous T, Sadique Z
- Issue date: 2020 Oct 1
- Prevalence of non-communicable diseases and access to care among non-camp Syrian refugees in northern Jordan.
- Authors: Rehr M, Shoaib M, Ellithy S, Okour S, Ariti C, Ait-Bouziad I, van den Bosch P, Deprade A, Altarawneh M, Shafei A, Gabashneh S, Lenglet A
- Issue date: 2018
- Host country responses to non-communicable diseases amongst Syrian refugees: a review.
- Authors: Akik C, Ghattas H, Mesmar S, Rabkin M, El-Sadr WM, Fouad FM
- Issue date: 2019