Student Voices Aug. 31 2017

Reflections From Jordan: A Call for Reform

The longer I’m here, the less I know.

This is the most honest realization that I can share with you because when you come to a refugee camp equipped with a partial master’s degree and the best of intentions—you really do feel like you can change the world.

But then you sit down and hear people’s stories—stories of incredible hardship and need, stories of long journeys, lost homes, and possible indefinite family separation. These are the same people that you have been reading about for months and years, and you realize that you don’t have an answer for them. You realize how truly complex a complex emergency is and how small you are in the scheme of it all.

Amman, Jordan, Middle East, Syrian Refugee Initiative, Mailman School of Public HealthThis summer, I have been working in Amman, Jordan, with the Mailman School’s Program on Forced Migration and Health to learn about the impact of family separation on Syrian Refugees. Together, my colleagues and I conducted over 80 qualitative interviews with refugees across the country to learn about their experiences.

Syrian refugees here have access to certain rights, but only if they are registered with United Nations High Commissioner for Refugees (UNHCR). Out of 1.4 million, only 657,000 Jordanian refugees are registered and even then resources are limited and there is still a great deal of unmet need. Many refugees have been displaced for years and they lack access to basics like food, money for rent, and healthcare. I am increasingly aware of the many hoops that refugees have to step through to get what they need to survive—and live with dignity.

Even something seemingly as simple as getting registered, and applying for services like food stamps and resettlement can be complicated and perplexing. Many refugees are confused as to why they may not be eligible for certain services, or how to even apply. Humanitarian agencies are overwhelmed and can be unresponsive. Part of me understands and respects that the existing process is in place for a reason, but the another part keeps thinking that we must do better.

Amman, Jordan, Middle East, Syrian Refugee Initiative, Mailman School of Public HealthMy teammates and I, who live and work together, often come home and debrief about what we’ve been seeing and experiencing. For hours we go around talking about our participants’ experiences and try to come up with solutions. Is it more money? Better policies? Better organization? More decentralization? A complete re-structuring? Who should take on a bigger role?

Historically, the humanitarian system has been set up for short-term emergencies where basic human needs are met. Increasingly, crises are protracted and we have to adjust to meet longer-term needs. A clear example of this, which my team and I have observed while conducting interviews, is that many refugees lack access to secondary and tertiary healthcare. This includes medications for chronic disease like diabetes and hypertension, important surgeries such as those for tonsillitis and kidney stones, and even treatment for illnesses like cancer. Without an end to the Syrian crisis in sight, and other crises emerging, we have to find a way to better meet these refugees’ long-term needs. But how? Here’s where the more personal questions come in:

What can I do?

How can I be useful?

Where do I place myself to create the most positive change?

The answer isn’t simple, but humanitarians like Dr. Paul Spiegel, director of the Johns Hopkins Center for Refugee Disaster Response, and Dr. Francesco Checci, an epidemiologist at the London School of Hygiene and Tropical Medicine, have been advocating for an overhaul to the existing system. Changing that system involves a shift from short-term techniques to long-term approaches with revised leadership and a focus on efficient, effective, and sustainable interventions.

As part of the future generation of humanitarian responders—still a little green and wide-eyed—I don’t see any option but to overhaul how we’re approaching things now. I am looking forward to working with my peers at Mailman this fall and learning from the experiences of Syrian refugees to find durable response solutions for those in the future.

Hannah Chandler is a second-year MPH student in the Heilbrunn Department of Population and Family Health and part of the Program on Forced Migration and Health. She graduated from Azusa Pacific University in 2015 before joining the Johns Hopkins Center for Health Security as a Research Assistant.

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