“To die is better for me”, social suffering among Syrian refugees at a noncommunicable disease clinic in Jordan: a qualitative study
Open accessAbstract
Background: The conflict in Syria has required humanitarian agencies to implement primary-level services for non-communicable diseases (NCDs) in Jordan, given the high NCD burden amongst Syrian refugees; and to integrate mental health and psychosocial support into NCD services given their comorbidity and treatment interactions. However, no studies have explored the mental health needs of Syrian NCD patients. This paper aims to examine the interaction between physical and mental health of patients with NCDs at a Médecins Sans Frontières (MSF) clinic in Irbid, Jordan, in the context of social suffering. Methods: This qualitative study involved sixteen semi-structured interviews with Syrian refugee and Jordanian patients and two focus groups with Syrian refugees attending MSF’s NCD services in Irbid, and eighteen semi-structured interviews with MSF clinical, managerial and administrative staff. These were conducted by research staff in August 2017 in Irbid, Amman and via Skype. Thematic analysis was used. Results: Respondents describe immense suffering and clearly perceived the interconnectedness of their physical wellbeing, mental health and social circumstances, in keeping with Kleinman’s theory of social suffering. There was a ‘disconnect’ between staff and patients’ perceptions of the potential role of the NCD and mental health service in alleviating this suffering. Possible explanations identified included respondent’s low expectations of the ability of the service to impact on the root causes of their suffering, normalisation of distress, the prevailing biomedical view of mental ill-health among national clinicians and patients, and humanitarian actors’ own cultural standpoints. Conclusion: Syrian and Jordanian NCD patients recognise the psychological dimensions of their illness but may not utilize clinic-based humanitarian mental health and psychosocial support services. Humanitarian agencies must engage with NCD patients to elicit their needs and design culturally relevant services.
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Integrating traditional practices and community support is crucial in their adaptive processes and effective coping, and emphasizes the importance of culturally relevant interventions in the mental health care of South Sudanese refugees.
“Integrating traditional practices and community support is crucial in their adaptive processes and effective coping, and emphasizes the importance of culturally relevant interventions in the mental health care of South Sudanese refugees (Adaku 2016;Eltayeb 2017;Maconick 2020).”
From Exploring trauma and resilience of Urban South Sudanese refugees in Sudan (2024) · cites this paper as Maconick 2020
The Conclusions (page not supplied) call for culturally relevant care that draws on pre-existing coping mechanisms, and the Discussion suggests peer support and community-based services. But the study concerns Syrian refugees in Jordan; it does not establish that integrating traditional practices and community support is crucial to effective coping among South Sudanese refugees. (LLM, conf=0.88)
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Self-citation
- Authors
- Maconick, L., Ansbro, É., Ellithy, S., Jobanputra, K., Tarawneh, M., & Roberts, B.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- Médecins Sans Frontières (JO)
- Médecins Sans Frontières (GB)
- Ministry of Health (JO)
- Corresponding author
- Ansbro, Éimhín
- Venue
- Conflict and Health
- Published
- 2020-09-01
- Volume
- 14
- Issue
- 1
- Pages
- 63-63
- ISSN
- 1752-1505 (ISSN-L)
- PMC
- PMC7465779
- OpenAlex
- W3082024539
- Cited by
- 34
- References
- 54
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 9 · 2023: 8 · 2022: 3 · 2021: 6
- FWCI
- 1.70
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Conflict and Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Médecins Sans Frontières
- Topics
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Health Sciences › Health Professions › General Health Professions › Health and Conflict Studies
- Social Sciences › Health › Migration, Racism, and Human Rights
- Keywords
- Syrian refugees, non-communicable diseases, social suffering, mental health, psychosocial support, humanitarian health services, refugee mental health, biomedical model of mental illness, Médecins Sans Frontières, Irbid, Jordan
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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