Syrian Exodus: Health, Help, Hypocrisy

The invaluable and hard-hitting Women Under Seige project, which documents male sexual violence in conflict zones worldwide, has produced a striking article on Syria's rape crisis. Shockingly, Syrian women and girls fleeing sexual violence in their own country are encountering further abuse, appropriation and exploitation once they have left.

Trigger warning: this feature contains links to reports on and testimonies of sexual violence

A humanitarian crisis has many layers and many consequences. Each violent rupture aggravates the inequalities that existed there before, creating new divisions which tear societies apart and cause trauma which affects the generations that follow. Each new phase of civil war drains essential resources and weakens the basic infrastructure of society further, creating flashpoints of instability and violation. Individuals' fundamental rights and freedoms are disturbed by the justified fear, the overt threat and the obscene reality of violence.

Sexual violence has been a prominent feature of the ongoing crisis in Syria. In a powerful, informative report for the Guardian on the brutal civil war there Mark Tran writes, "Sexual violence occurs in every humanitarian crisis, notably during the Balkan wars and in conflicts in parts of Africa, and Syria is no exception." Meanwhile, the invaluable and hard-hitting Women Under Seige project, which documents male sexual violence in conflict zones worldwide, has produced a striking article on Syria's rape crisis.

Shockingly, Syrian women and girls fleeing sexual violence in their own country are encountering further abuse, appropriation and exploitation once they have left. A report from Standpoint magazine makes this clear: "Many of the women and girls have fled their homes after experiencing atrocities involving multiple rapes and sexual torture by armed men."

It continues:

The scandal of Zaatari [the largest refugee camp for Syrians, in Jordan, close to the border with Syria] and other refugee camps and dwellings is that these vulnerable, traumatised women and girls are not being adequately protected from sexual exploitation and forced marriage by those mandated to keep them from further harm.

A recently published article by the International Rescue Committee found that female Syrian refugees are not safe from sexual and domestic violence in Zaatari and other camps, and that reports of forced marriage of women and girls are increasing. A child protection group found that the women and girls in the camp identified rape and kidnapping as a primary reason that families fled from Syria, but that sexual violence was rarely reported.

Sexual exploitation at Zaatari is so widespread that a number of camp inhabitants are operating informal monitoring groups and have caught out several "marriage brokers" who infiltrated the camp posing as workers. These individuals are merely escorted off the camp if reported.

Indeed, a number of UN officials and aid workers I met at Zaatari and in other camps and settlements in Jordan and Lebanon tell me it is known that prostitution and trafficking of women, both at the border and within the camp exist, but to date no formal investigation has been commissioned into these criminal activities.

It is jarring, then, to receive a long and seemingly thoughtful article which has just been produced by the World Health Organisation about healthcare for Syrian refugees in Jordan, in the Zaatari camp and beyond. The article, Syrians Flee Violence and Disrupted Health Services to Jordan, barely mentions endemic sexual violence and its health consequences and does not convey adequately the deep psychological trauma and sexually exploitative environment of the camps. It skims over the brutality of its subject and couches its health issues in pastel terms while delivering a veiled threat in a quote from the UN agencies' April 2013 public appeal to those involved to resolve the crisis, that "We are precariously suspending some humanitarian support."

On the topic of the abuse of Syrian women and girls both within and beyond the country's borders the article only says blandly that, "staff also offer refugee women the chance to learn more about their health in general and provide counselling to those who have suffered domestic violence or sexual violence," as though these things are rare and incidental rather than endemic and central. Later it quotes a WHO public health expert referring mildly and generally to a "vulnerable population of children, the elderly, women and pregnant women [whose need for help] is great when they arrive here because some of them have been without health services for a long time."

What euphemisms, what superficiality, what patronage. The article addresses health issues as if some of them were not a consequence of the widespread sexual violence and gendered subjugation which have caused many of Syria's women and girls to flee in the first place. It also reports on sexual and reproductive issues in a manner so bland that it does not come near to reflecting women's blatant inequality. Instead, it gives a sanitised, clinical version which casually notes "a high fertility rate - an average of five children per family - among Syrian refugees, particularly those from rural areas" and maintains a strange, fragmentary disconnect. There is a gap between citing the health issues it reports and pulling into consideration the recent gendered violence or ongoing inequality and lack of status that caused some of the issues.

To return to the WHO article, there is much that is both valuable and urgent, not least the statistics which show the scale of Syrians' departure from their country, where food, water, healthcare and energy are "increasingly scarce." 1.4million women, children and men have fled to neighbouring countries so far and that number is increasing all the time. Of those, more than half a million have sought refuge in Jordan, with more arriving every day: the article cites figures of 1500-3000 people coming daily in April 2013. It estimates that by the end of the year there will be 1.2million Syrian refugees in Jordan, the majority of whom will not be in camps but living within communities and possibly isolated from access to healthcare and other services. Of those 1.2million, there will be an estimated 30,000 pregnant women.

While 98% of a target population of 90,000 newly arrived refugees at Zaatari camp aged up to 30 years have been immunised against measles and UN organisations plan to extend this one project to Syrians across Jordan, there is an urgent need for common drugs used to treat diabetes, hypertension and heart disease as well as a paucity of anaesthetics and antibiotics which could save lives. In addition, provision must be made in terms of expertise, medicines and equipment to tackle injuries which are a direct result of the violence and not of chronic disease. Also, there is a need for trained professionals to tackle the psychological trauma of survivors.

In its depiction of women, the article is strangely conservative. It cites as a case study from Zaatari camp one woman, who at only 22 is pregnant and already has two small daughters by her husband. The article includes an utterly infuriating, clichéd and gratuitous detail about her appearance: "Najjar...was clad in a black headscarf." This woman's appearance is immaterial as she is a person, not a object, yet the overall image fits with a time-honoured cliché of the Middle Eastern woman as seen by Western eyes: black-veiled, put-upon, virtuously married young, permanently pregnant.

At the end of April - the most recent figures available for this June article - there were 120,000 people at Zaatari camp, with 10-13 births daily. The United Nations Population Fund has established clinics to provide "primary healthcare and reproductive health services" including contraception, antenatal and postnatal care and advice about reproductive health.

And that is all the article has to say about that.

The article does not point out what is obvious and terrible: that some of the pregnancies are the result of rapes; that those rapes have other health consequences including infection and serious internal injury as well as extreme trauma; that women are staying silent about having survived male sexual violence because of the stigma of being a victim and the knowledge that women who survive sexual violence are punished by those around them including their families; that rape, exploitation, being trafficked, being prostituted, being bought and sold, used and abused are common within the camps and within refugee communities themselves; and that some of the contraceptives offered to women will be for use within the context of that rape and abuse.

What's happening to the women and children of Syria is tragic but also classic. The abuse of females, the hatred and opportunism of perpetrators, the tacit acceptance of bystanders, the passivity of onlookers even when their job is to prevent abuse and punish abusers, the stigmatisation of victims and the impunity of abusers - all are endemic globally.

In every violent change, those who were already the most disempowered are the ones who most at risk. Women are expected to keep families together and maintain peace and protection at a daily level but have few resources to do so, no authority to make broad changes and little meaningful respect, influence or power with which to direct events, protect themselves or gain justice against abuse. At the same time as having all the work associated with children, home, family, we are targets of male violence from sexual harassment to rape, kidnapping for rape, trafficking, violation for money, euphemistically named abuses such as forced 'marriage', 'child marriage' and so on (in the case of Syria, Women for Refugee Women have reported on pertinent cases here). We also suffer from extreme inequality, exploitation and double standards within our own families: the usage of our menial labour, nurturing labour and sexual labour and the entire language of control, 'shame', 'honour', 'virtue' and other sick euphemisms used to enforce women's subjugation and keep us silent and afraid.

In Syria and elsewhere, our needs are considered trivial and our rights ignored, our suffering silenced by the stigma of being a rape victim or an abuse survivor - a truly perverse transference, where the victim serves the perpetrator's sentence. When we tell the truth, we are called liars. When we react, we are called over-reactors. When we speak up, we are called troublemakers. When we can bring ourselves to describe what happened we are said to be exaggerating or mistaken. When we tell the world that we have been attacked, we are attacked again; when we talk about abuse we are abused again. Everyone colludes misogynistically in wiping the surfaces clean: shutting up the victim, refusing to punish the perpetrators, making the whole thing go away.

Societies all over the world, West to East, North to South, rich and poor, where people's skin is white, pink, red, yellow or black, in peace and at war, cannot face up to the reality of male violence, exploitation and abuse: how normal it is, how ubiquitous and common; how multifaceted; how damaging; how well-supported in mainstream culture, language, politics and law; how it crosses all other social divisions; how corrupt and hypocritical; how devastating and how deeply embedded in every world culture. The power, dominance and control which are used to abuse and exploit us in violent and non-violent ways alike is barely acknowledged or only glancingly referred to; and the complex consequences in terms of psychological trauma, physical trauma, social stigma and much more are regarded as inconveniences or ignored as if they don't exist.

UN organisations' eyes may be on Syria and the neighbouring countries of Iraq, Jordan, Lebanon and Turkey as the international community reports and cogitates. But my own eyes and those of many women's human rights advocates are on the UN, watching to see how they monitor, confirm, openly condemn and unequivocally tackle not just immediate and urgent health problems arising in refugee camps but the far more pernicious disease of sexual violence.


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