Lute Maekaeka Kazembe

In January, a snowstorm hit most of Jordan. Seeing the street and cars covered with snow was surreal. I had arrived in Jordan when it was hot, and fast forward only two months here I was looking out at snow! Winter in Jordan can be unexpectedly cold, with temperatures going down to -5°C. And while lovely to look at, the cold weather is extremely difficult for vulnerable families. Over 750,000 refugees live in Jordan. Most are Syrian, fleeing the crisis which began more than 10 years ago. For people struggling to survive, the cold winter exacerbates the challenging conditions in which they live. Heating is expensive and mostly unaffordable.

Just before Christmas last year, I joined the Medair health team on a field visit to Irbid, about four hours north of Amman. The view during the drive was spectacular, with picturesque green fields on rolling hills. Irbid has a large farming community that produces most of the vegetables and fruits found in Amman’s stores. The scenery evoked memories of travelling around Zambia, my home country. Displayed along the roadside were corn, tomatoes, vegetables, and fruits, just like in Zambia. As my colleague Arin drove, we shared stories about roasting corn over the fire and how much both of our sons enjoyed fresh corn.

In Irbid, we met Ruba, a Case Management Officer. Ruba took us to a large field on a hillside, with a tent set in the middle. Rugs covered the bare ground, and curtains partitioned the tent into sections. Inside, we met Ahmad and his family.

Ahmad and his family of six are Syrian refugees. The youngest child, Islam, is 18 months old. Islam has a skin and lung disease, causing severe ulcers, breathing problems and generalized paralysis. She depends on oxygen, is fed intravenously, and needs constant care. As Syrian refugees, Ahmad and his wife do not have the permits required to enable them to work. The family depends on a monthly food voucher from UNHCR. However, this is not sufficient for all their needs and the health care for Islam. When I met them, Ahmad had recently received cash from Medair to pay hospital bills.

This visit was a final assessment, meaning our work with Ahmad’s family had come to an end. Ruba and Ahmad discussed options for further support with other development agencies. As we left, I sensed Ruba’s sadness that this was the last visit, but I also saw her resolve to do her best to refer Islam to another organisation for support.

“I am going to call UNHCR and another organisation for them to follow up on this case. I will keep on asking until they come here,” she said determinedly.

Looking out at the wintry morning in Amman, I thought of Ahmad and his family. I thought of how beautiful that hillside must look covered in snow and that it would look like the traditional Christmas cards of a scenic ‘winter wonderland’. But for Ahmad and his family, this winter will not bring joy.

There are 26 million refugees in the world. Ahmad and his family are the real people behind these numbers.

Ten years after the start of the Syria crisis, more than 700,000 refugees remain displaced in Jordan. Families fled from Syria, leaving homes where generations had established their lives. Displacement has created immense economic, social, emotional, and physical challenges for families. Many feel hopeless without mental strategies to cope. Medair’s social protection programme provides unconditional cash transfers to vulnerable Jordanian families and refugees. Social protection officers give mental health and psychosocial support, assisting families to develop positive coping mechanisms and life skills.

For two Syrian mothers, having tools to manage mental health was essential for improving their well-being. Zara, a widow, is a Syrian refugee who came to Jordan in 2012 with her four children. Like most refugees in Jordan, she lived in an urban area and not in a camp. The only support she received was a food voucher. Despondent and worried about her children’s safety, health, and well-being, Zara cried every day. In 2021, Zara was referred to Medair, which contacted her. After an assessment, Zara was enrolled in Medair’s social protection programme. She received cash for five months. Zara was paired with a social protection officer, Amneh, and together they set life goals, developed coping tools, and built her self-esteem.

While the cash that Zara received was invaluable, Zara longed to work, be successful, be positive, and stop crying. Zara wanted to be free from her overwhelming anxiety and depression. Amneh helped her create a case plan and referred her to external services. Zara did not understand the physical and emotional impact of poor mental health on a person, and refused a referral to see a psychiatrist. However, she felt comfortable working with Amneh on techniques for deep breathing and positive thinking to control her anxiety. When her sessions with Amneh ended, she explained that Amneh had felt like her support and her family. She felt changed. Today, Zara has a job and works three days a week.

Like Zara, Noura came to Jordan in 2012, fleeing Syria with her family and her young daughter. For Noura, a young Syrian refugee and a mother, receiving psychosocial support led to a major change in her life. Noura and her family enrolled in Medair’s social protection programme, receiving cash assistance for five months. Amneh, Medair’s Social Protection Officer, assessed the family’s needs, working with them to set goals and develop coping mechanisms. Medair’s cash assistance allowed the family to buy food, pay utility bills, and buy medication for the father who has a medical condition.

When Amneh began working with the family and first visited their home, Noura was very shy. Her daughter found the first two sessions with the social protection officer frightening, as she was unaccustomed to strangers. Noura had lived in Jordan for almost 10 years and lacked the confidence to leave her home, go outdoors, or meet other people. Amneh noticed that this affected her daughter. When they worked on goal setting, Noura’s first task was to take her daughter to the park.

Amneh, Medair Social Protection Officer, talking to Noura (far left) and her family during an assessment visit at their home in Amman, Jordan

(Photo: Lute Kazembe)

Noura and her daughter playing during an assessment visit at their home in Amman, Jordan (Photo: Lute Kazembe)

As Amneh worked with the family, Noura began improving her skills. She has since started training and is determined to complete her education. She hopes her daughter will also finish her education in the future. Amneh reflects on working with Noura, saying that Noura is almost unrecognizable and looks more confident. She adds, “The people we work with have a lot of problems, stress, often live in poor conditions, and a lot have lost their family. They need to know how to reduce their tension. They need the skills to live.”

Noura explaining the activities she is involved in because she is confident after psychosocial support services (Photo: Lute Kazembe)

Zara and Noura are two of the many cases in Jordan where people may not understand the emotional and psychological challenges caused by their experiences, especially as refugees or members of vulnerable families. These cases continually remind Medair staff of the cruelties of poverty, displacement, and conflict.

Ali Almaany, Medair’s Social Protection Project Manager, explains, “Problems are like an iceberg. They [people] don’t see the long-term effect of the negative coping mechanisms.”

COVID-19 exacerbated existing inequities, and the protracted nature of the Syria crisis has left many in limbo, uprooted from their homes and facing considerable uncertainty. Medair provides complementary services that address multi-dimensional needs. Medair’s programming in Jordan has expanded over the years, meeting growing needs with a holistic approach to health, while acknowledging that an individual’s overall well-being requires more than access to health care alone.

Names have been changed to protect identity. Photographs by Lute Kazembe.