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Doctors Worldwide (YYD) Community Centers for Refugees and Vulnerable Host Communities to provide Psycho-Social Support and Protection Services - Need Assessment of Covid-19 Pandemic Impact in Istanbul especially for Afghan Groups

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There are approximately 3,7 million Syrians under temporary protection in Turkey. Although some Syrians have different legal statuses, it is known that there is a population of more than 4 million, which can be considered under the definition of "refugee" by the international community in Turkey.

According to February 2019 data presented for refugees by United Nations High Commissioner for Refugees (UNHCR), a total of 368, 400 people, including about 170,000 Afghans, 142,000 Iraqis, 39,000 Iranians, 5,700 Somalian, and 11,700 other nationalities are living in Turkey with international protection requests other than Syrians.1 According to the Turkish Republic Ministry of the Interior, the majority of 130,496 refugees crossing the sea and land borders into Greece were non-Syrian asylum seekers. When YYD takes into consideration these groups in Turkey with Syrians demanding international protection, the picture of refugee density in Turkey becomes more significant.

After the first Covid-19 case detected in Turkey on 10th of March 2020, with an increase of cases day by day, strict measures have been taken such as movement restrictions, travel bans, isolation, and temporary suspension of public and government services, face masks, hygiene, disinfectant, etc. measures and restrictions on physical distance and prevention measures have been gradually lifted on 1st of June 2020. COVID-19 pandemic measures worsened the financial situation of the host communities and foreigners covering each group, increased the needs of each cash support and livelihoods in Turkey. Especially in the focus group, isolation, inability to reach physiological needs, stress, and anxiety were observed, during the COVID-19 pandemic precautions. The inability to leave the home environment increased violence, oppression, and domestic problems in this period. The perception of domestic trust due to the crowded multiple-family residence has decreased. It has led to an increase in the symptoms of obsessive-compulsive disorder due to depression, anxiety, and unconscious precautionary processes in adult beneficiaries. Behavioral disorders (nail-biting, finger sucking, trichotillomania, anger burst, lying, urinary incontinence, encopresis), childhood depression and fears, anger problems, sleep problems, and night terror symptoms also increased in child beneficiaries.

During the pandemic, the importance of mental health-oriented case management and protection oriented case management has increased day by day. Many cases in areas such as violence, travel permission, and attendance to education have reached the Community Centers of YYD, intervention, and follow- up have been carried out in the 2.5-month period, which is the pandemic prevention period. Emphasis was placed on group dynamic-focused support activities by increasing the support mechanisms, raising the level of knowledge, and ensuring an increase in well-being through group sharing during the 4 weeks period in protection-focused group sessions. Enhancing protection awareness and psycho-social support activities that, blends the support group principles, is a first. The service deficit in this regard is due to a lack of dominance in conservation issues and a lack of activities that emphasize the long-term healing effect of the group. The language barrier, the cultural vulnerability of public stakeholders, and the lack of access to the rights, laws, and enforcement mechanisms of focus groups have increased the importance of the provision of protection services.

Efforts have been carried out to obtain information about protection case management and support mechanisms, to obtain consultancy about the protection case management, to accompany the action, to facilitate access to services, to meet certain protection results, and to improve the protection environment.

Physical abuse/violence, sexual abuse, psychological or emotional abuse, neglect, exploitation, psychosocial problems; resources, opportunities or services to the divestment of rights and access to services, the need for advocacy, restriction on freedom of movement in the case of constraint oriented action has led to process. YYD aims to contribute to the creation of an area where all asylum seekers and immigrants can reach basic rights and services and live-in harmony with the local community. It is essential to increase cooperation and coordination with relevant institutions at national and regional levels and to instill awareness of protection for vulnerable migrants.

People displaced by war, conflict, and humanitarian crises are more affected by global epidemics and similar disasters, and their living conditions are getting more difficult. Difficulties in accessing information, especially due to the language barrier, exacerbated already existing difficulties in accessing livelihoods, made financial difficulties inevitable and increased vulnerability. Additional health risks of living and working in crowds; shelter, food, access to psychosocial support services and hygiene conditions to deficiencies in, the disruption of basic rights and access to services and facilities, including physical barriers to access to healthcare units are the main causes of most of the problems in this period. During the pandemic, it is predicted that the inability of migrant’s children to leave the home environment, the loss of visible and accessible opportunities with the school attendance follow up, and the limitation of access to assistance mechanisms can lead to an increase in cases of abuse (especially physical and sexual abuse). Another content that can support the data is the increase in gender-based violence that occurred during the pandemic when social isolation and the process of seeking help were disrupted. According to the data of the Istanbul Police Department, domestic violence cases reported in March 2020 increased by 38.2% compared to last year.

With 20 years of experience in line with the purpose and mission of YYD in Turkey living in temporary protection, stateless, the authority issued by Directorate General of Migration Management certified pre-registration and international protection status and/or the owner of the reference persons Covid19 within the scope of the measures, isolation, based on the needs that arise in the period; YYD focused on meeting the basic needs of hygiene, support for special health need , prevention studies focused on protection, protecting the physical and mental health of children, failure of the vaccine system and raising awareness about Covid-19.