In informal tented settlements throughout Irbid governorate in northern Jordan, Syrian refugees are preparing themselves for the tenth winter away from their homeland. The worn-out tents covered with plastic sheets were once a temporary solution. This year, the harsh winter and the COVID-19 pandemic have made their living conditions increasingly challenging and their financial burdens even harder to bear.
The Hawara region, a rural area in Irbid, where many Syrian refugees live, is one of the areas covered by the Médecins Sans Frontières/Doctors Without Borders (MSF) home-visit teams. The teams are part of the non-communicable diseases (NCDs) project, which has been running in Jordan since 2014.
Every year, winter in this region brings troubles to refugees living in poor conditions. The children are exposed to the cold and the risk of severe burns caused by the basic gas heaters that families are using.
“Even if heaters are available, they are still primitive and expensive. If some families manage to secure a gas cylinder for heating, they [often] get stolen. Also, the heaters produce smoke and fire, and the area has no nearby hospitals,” says Khalid, a Syrian refugee and a father of seven.
In front of their tents, Khalid’s children play with the neighbour’s kids, happily running and jumping barefoot, unaware of their parents’ concerns over the complications that come with winter. “No matter what we do, rain gets into the tents and we find ourselves stuck in mud, using our hands to push the water out,” says Khalid.
The arrival of COVID-19 has had a significant impact on the lives of Syrian refugees in Hawara. Most refugees in the region work as day labourers on local farms. However, a four-day lockdown in mid-November, put in place to stem the spread of the virus, resulted in many of them losing their modest daily income, which is around 4-5 JOD (US $5-7).
Many Syrian refugees in this region suffer from non-communicable diseases (NCDs), such as diabetes, high blood pressure, respiratory conditions and heart disease that require long-term medication and follow-up. For those living with NCDs, they have been more affected by the pandemic, as their economic situation is further strained and they are more vulnerable to health complications if they contract COVID-19.
Responding to the chronic illnesses and medical needs of Syrian refugees and vulnerable Jordanians, MSF opened an NCD project in northern Jordan in 2014. The project provides free-of-charge medical treatment and follow-up consultations. As of December, 3,699 patients are receiving life-saving care through the project.
“Many patients with NCDs face financial difficulties, which also affect their mental health,” says Ali Abo Saqer, MSF nursing team supervisor in Irbid.
MSF’s home-visit teams extend these essential NCD care services to patients who are unable to visit the clinics due to mobility constraints and the severity of their illness. The teams provide a range of services, including psychosocial support, physiotherapy and health awareness sessions.
“Increasing patient knowledge about NCDs can save their lives. We conduct awareness sessions to increase their knowledge of the different illnesses and teach them the best daily practices that they can follow,” says Amani Al-Qawasmi, an MSF health promoter in Irbid.
MSF has adapted its medical activities during the COVID-19 pandemic to ensure that medical treatment and clinical follow-up for NCD patients enrolled in the project. MSF teams are following strict infection prevention and control measures when providing medical care to patients. Medical teams try to provide consultations to patients by phone, but, when the patient’s needs make it necessary, the teams also make home visits and hold consultations in the clinic.
“I received helpful advice in case of any relapse – I was using the oxygen concentrator for 16 hours a day, but now I use it for only two hours. I’m able to walk again; just short distances at a time,” says Abu Madian, a 51-year-old patient enrolled in MSF’s home-visit service.