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Muzoon was fourteen years old when her family made the wrenching decision to leave their home in Syria. War had begun. Peaceful protests were met with shootings. Next, bombs were flying overhead. Even still, Muzoon wanted to stay. What would become of her in a refugee camp? Would there be a school there? Would she ever be able to go home again? In this inspiring memoir, Muzoon shares how she grew up as a refugee. And how she spoke up for what she needed: A chance to learn. A chance to make a difference. Muzoon wasn't just fighting for herself - she wanted to help other refugee kids, too. And she shows how one stubborn, determined girl can change the world.

Background There is limited evidence regarding the ways in which displacement disrupts social norms, expectations and trajectories for adolescent girls and young women and the resulting impacts on their risks of violence. This knowledge gap is especially marked with regards to Syrian adolescent girls and young women seeking refuge in Turkey. We explored risks of gender-based violence against Syrian adolescent girls and young women in Turkey and examined how these risks were shaped by their displacement. Methods Data were collected in August 2016 in Izmir, Turkey through five sex-specific focus group discussions with Syrian adolescents and young people (aged 15–25 years) and two mixed gender focus group discussions with Syrian adults (18 years and older). Group discussions covered the issues facing Syrian adolescents and young women in Turkey, and how these were influenced by their displacement. Discussions in Arabic were audio-recorded, transcribed and translated into English. Data were coded inductively, and analysed thematically. Results Syrian adolescent girls and young women expressed an increased sense of vulnerability to violence since their displacement. Due to financial strains and limited educational opportunities, they were often encouraged by parents to work or marry, both of which they perceived to increase the risks of violence. In contrast, some adults suggested that marriage could protect adolescent girls and young women from risks of violence associated with working. Being alone outside the home was viewed as risky by all participants due to pervasive sexual, verbal and physical harassment, aggression, and even kidnapping attempts. To limit these risks, many parents reported keeping adolescent girls and young women at home, or ensuring that they were accompanied by male relatives when in public. Conclusions Syrian adolescent girls and young women face multiple risks of violence following displacement related to altered social trajectories. Some family-based strategies to protect young women from violence could reinforce restrictive gender norms and increase risks of violence. Interventions to address violence should include providing safe spaces, access to education and safe transport for young women, and financial support for families as well as community-based interventions to address the daily risks of sexual harassment in public spaces.

Background The war in Syria caused the forced displacement of millions of Syrians to neighboring countries. Lebanon is the host country with the largest overall number of Syrian refugees per capita. Adolescent refugee girls experience a unique level of vulnerability during human emergencies and are at increased risk of suffering from poor sexual and reproductive health (SRH) outcomes. We conducted an exploratory qualitative study to learn about the SRH perceptions and experiences of refugee adolescent girls living in Bourj Hammoud, an urban setting in Lebanon. Methods We employed a qualitative design with eight focus group discussions (FGDs) conducted with 40 Syrian Arab and Syrian Kurdish adolescent girls between January and March 2020. Every FGD consisted of five participants aged 13 to 17 years. A semi-structured guide was used covering multiple themes: menstruation, puberty, SRH awareness, and sexual harassment. FGDs were transcribed and analyzed using thematic analysis. Findings The participants discussed adolescent girls’ health and named six elements of good health, such as healthy activities and self-protection. The majority of the FGD participants reported a lack of awareness about menstruation when they experienced it for the first time and the social stigma associated with menstruation. When defining puberty, they indicated its social link to a girl’s readiness for marriage and her need to become cautious about sexual harassment. Most FGD participants had very poor knowledge of the female reproductive system. Mothers were the most approached persons to receive information on SRH issues; however, the girls indicated a wish to receive advice from specialists in a comfortable and private atmosphere. All the girls reported that either they themselves, or an acquaintance, had experienced some type of sexual harassment. The girls rarely reported those incidents due to fear of being blamed or subjected to mobility restrictions, or forced to drop out of school. Conclusions The findings show the refugee girls need for satisfactory knowledge on SRH issues and interventions to prevent sexual and gender-based violence that take into consideration the complexity of urban settings. Plain language summary After almost 10 years of war, Syria’s neighboring countries are hosting millions of Syrians who were forcibly displaced. Most prominent among these countries is Lebanon. Adolescent refugee girls are exposed to precarious conditions, which make them more prone to sexual and reproductive health (SRH) problems. This qualitative study was performed in Bourj Hammoud, an urban setting in Lebanon, in order to explore Syrian refugee adolescent girls’ SRH perceptions and experiences. The agenda of the International Conference on Population and Development (ICPD) in addition to the Inter-Agency Field Manual on Reproductive Health in Humanitarian Settings (IAFM) and its Adolescent Sexual and Reproductive Health Toolkit for Humanitarian Settings issued by the Inter-Agency Working Group on Reproductive Health in Crises (IAWG) formed the framework of this study. Focus group discussions were performed with 40 Syrian Arab and Syrian Kurdish adolescent girls, each group consisting of five participants aged 13 to 17 years. Different themes were discussed within the groups including menstruation, puberty, and sexual harassment. The participants talked about the social stigma related to menstruation and the social link between puberty, a girl’s readiness for marriage, and her need to be careful about sexual harassment. Most of the girls had insufficient information about the female reproductive system. The girls consulted their mothers to learn about SRH issues; however, they expressed a wish to receive well-informed advice from specialists in a safe atmosphere. All the girls reported incidents of sexual harassment, which happened either to them or to other girls they know; however, they were discouraged to report them because they feared other consequences, such as being blamed or not being allowed to go to school anymore. The outcomes of the study show the girls’ urgent need to have adequate information about SRH issues and appropriate interventions to prevent sexual and gender-based violence within complex urban settings.

Purpose The purpose of this study was to uncover and describe the barriers to education as experienced by Syrian refugee girls in the Za'atri Syrian Refugee Camp in Jordan. Design A qualitative nonexperimental design utilizing focus group discussions (FGDs), individual interviews, and participant and nonparticipant observation was used for this study. Four FGDs were facilitated in three dropout education centers (nonformal school) in the Za'atri Syrian Refugee Camp. Data were collected over a period of 5 months from December 2017 to April 2018. Methods Using an FGD format, the United Nations Human Rights ABC module in the Arabic language was used to educate, to empower with knowledge and skills, and to elicit participants’ responses to perceived barriers to exercising their universal human rights, especially their right to education. Data were collected using a demographic tool, digitally recorded FGDs, an observation notebook, a flip chart, and a detailed interview schedule. Fifteen in‐depth, individual, 1½‐hr interviews of self‐selected participants were conducted. Narrative statement and content analysis were used to analyze the data for each FGD. A constant comparative method was used to compare and verify codes, categories, and themes within and between groups. Findings The complex interplay of patriarchy, tradition, and religious practices, combined with the added vulnerabilities of protracted warfare displacement, prevent Syrian girls from being their own agents, prevent their access to education, and expose them to even greater health risks through coercion into early marriage. Several themes explained the process by which the interactive nature of patriarchy, traditional cultural, and religious practice influenced the girls’ right to education and their right to make their own decisions about marriage. These are (a) gender role and the social position of girls in the family, (b) gender role and the cultural disvaluing of girls’ education, (c) economic survival priorities and child labor, and (d) the intersection of environmental stressors with preservation of family honor as motivators for early marriage. Repeated exposure to threats and physical abuse seem to be the mechanisms that reinforce the girls’ perceived gender‐based vulnerabilities, submissiveness, and educational truancy. Conclusions Syrian refugee girls seem to consistently face conflicts and daily adverse experiences that pose serious physical and psychological risks to their health with potentially far‐reaching negative health consequences. Gender‐based physical and psychological threats and abuses, along with the coercive practice of early marriage, while viewed as a way of protecting them, put Syrian refugee girls at greater health risk, psychological threat, and social and economic challenge. Evidence on refugees who experienced violence shows that they are more likely to experience post‐traumatic stress disorder (PTSD), dissociative disorders, depression, and anxiety, along with a host of life‐threatening physical comorbidities. Clinical Relevance Syrian refugee girls are at high risk for gender‐based abuse and violence. Nurses can play an important role in reducing the health risks associated with gender‐based abuse by assessing clients for symptoms of physical and psychological abuse, including symptoms of PTSD, depression, anxiety, and suicidal ideation. Maternal and child health assessment and health‐promoting interventions should be included in the healthcare plan. Understanding the sociopolitical conditions, as well as the cultural and religious backgrounds, that shape the lived experiences of displaced girls is also essential for offering a congruent, culturally sensitive plan of care and for creating targeted and relevant educational and treatment intervention strategies and referrals.

Lebanon hosts over one million refugees displaced from Syria as a result of the armed conflict—of whom, approximately 15% are adolescents aged between 12 and 17 years of age. Many female adolescent migrants report a decrease in quality of life and an increase in family tensions. This study sought to investigate the emotional well-being of adolescent Syrian girls in Lebanon. We hypothesized that married girls may experience additional hardships and thus greater feelings of dissatisfaction in daily life, given their young marriage and responsibilities at home. This study was part of a large mixed-methods study on the experiences of Syrian refugee girls in Lebanon (n = 1422). Using line-by-line coding and thematic analysis, 188 first-person narratives from Syrian girls were analysed. Our results highlight poor emotional well-being among married and unmarried girls, with sadness, fear and anger commonly mentioned. Some participants expressed feelings of hope, happiness, gratefulness and empowerment. Unmarried girls (n = 111) were more likely to associate their shared stories with negative feelings such as sadness (47% vs. 22%), disappointment (30% vs. 19%), and frustration (32% vs. 22%) than were married girls (n = 77). Four themes emerged as important determinants: access to education, perceived safety, peer support, and longing for life back in Syria. Continued efforts to improve emotional well-being for married and unmarried refugee girls are needed in Lebanon, in particular those that address the nuances for these groups.

Although the influx of Syrian refugees in Jordan initially attracted considerable international humanitarian support, funding has declined recently, and labour market restrictions have tightened. Adolescents in Azraq refugee camp face particular challenges due to its unique characteristics, including strong surveillance and security measures and a remote desert location, which affords only limited mobility and income-generating opportunities. Instead of offering protection and security for displaced Syrians, the camp has become a ‘violent space’. This article explores the experiences of younger (10–12 years) and older (15–17 years) adolescent girls and boys in Azraq camp. It provides insights into their gendered experiences in four capability domains—education, voice and agency, bodily integrity and freedom from violence, and psychosocial wellbeing—highlighting key vulnerabilities that need to be addressed to deliver the Leave No One Behind agenda. The findings suggest that when planning programmes and services, the government, international community and civil society actors working with adolescent refugees in Azraq need to take into consideration spatial dimensions of vulnerability. Such efforts should ensure that programmes are designed and implemented in an inclusive and accessible way so that male and female adolescents in specific camp settings can overcome the constraints that they uniquely face.

This paper aims to analyze the representation of Post-traumatic Stress Disorder (PTSD) in Zoulfa Katouh’s novel, As Long as the Lemon Trees Grow (2022). Katouh, a Canadian-Syrian author who specializes in drug sciences, sets her debut novel against the backdrop of the war in Syria in the aftermath of the Arab Spring. The protagonist, Salama, a teenage girl pursuing an undergraduate degree in pharmacy, faces the harrowing realities of war and volunteers as a surgical assistant amidst the chaos of bombings and sniper attacks. As a result of the war, Salama tragically loses almost all her family members, and in response to her fear and anxiety, creates a hallucinatory male figure named Khawf. Khawf, which is the Arabic word for fear, serves as a manifestation of Salama’s PTSD and a symbolic representation of her traumatic experience, blurring the lines between reality and imagination and highlighting the psychological toll of living in a war-torn zone. Hence, this paper explores the nature of PTSD, as depicted in the novel, and examines how Salama’s sense of responsibility toward injured civilians and her feelings of guilt toward those she could not save influence her psyche, leading her to avoid and repress memories, unleashing her hallucinations and defense mechanisms. The theoretical framework of this study is primarily shaped by Anke Ehlers’s research on mental defeat and alienation in victims of political trauma, Horowitz’s stress response theory, and Stanley Lyndon and Philip Corlett’s exploration of hallucinations as perceptual disturbances in cases of PTSD. Finally, this paper aims to present a deeper understanding of the psychological trauma inflicted by war and the complexities of human defense mechanisms in the face of adversity by analyzing Katouh’s portrayal of PTSD symptoms that Salama, the protagonist, suffers immensely.

Gender bias in textbooks (GBIT) is a low-profile education issue, given the 72,000,000 children who still have no access to schooling, but this article argues that GBIT is: (1) an important, (2) near-universal, (3) remarkably uniform, (4) quite persistent but (5) virtually invisible obstacle on the road to gender equality in education—an obstacle camouflaged by taken-for-granted stereotypes about gender roles. Specifically, GBIT: (1) is important because (a) textbooks occupy ~80% of classroom time, and (b) it may contribute to lowering girls’ achievements, especially in weak schools in poor countries; (2) has been found worldwide to varying degrees (except, perhaps, Sweden in recent years); (3) involves nearly identical patterns of under-representation of females, plus stereotypes of both genders’ occupational and household roles that overwhelmingly underplay women’s rising worldly importance; (4) is decreasing very slowly, according to “second generation” re-studies; and (5) remains obscured by the “hidden-in-plain-sight” system of gender stratification and roles. Case studies from Syria, India, Romania, China and the US document these points. Other case studies from Sweden and Latin America describe government initiatives to reduce GBIT, with differing levels of success. Totally revising textbooks (and curricula) to eliminate this bias is quite unlikely, partly because it is very costly. The article concludes by presenting inexpensive alternate methods that can combat GBIT.

Child protection and mental health during conflict intersects with a variety of adverse conflict-related factors, and intervention outcomes in the field are often difficult to predict. Using the casefiles of 376 school children registered in a Mental Health and Psychosocial Support (MHPSS) project in the Northwest governorate of Idleb in Syria, this study aimed to determine (i) the rates of various protection concerns (potential mental health conditions, psychosocial deprivation issues, and social, behavioural and emotional issues) for students enrolled in this project, (ii) whether the rates of any of the protection concerns varied between children and adolescents, or between boys and girls, and (iii) which of the identified demographic and protection sector factors predicted the presence of potential mental health conditions and MHPSS intervention outcomes. MHPSS interventions (including individual MHPSS sessions tailored for children in conflict, resilience building activities, tutoring, peer building activities, community awareness, and other tailored services) were implemented at schools operated by the UK-based organization, Syria Relief. The variables tested included demographic variables of age group (208 children, aged 4–9 years; 168 adolescents, aged 10–14 years) and gender (211 males, 165 females), and 23 protection sector variables including 11 potential mental health problems (anxiety, attention deficit hyperactivity disorder, conduct disorder, autism, epilepsy, motor tics, depression, post-traumatic-stress disorder, social phobia, specific phobia, learning disability), 7 psychosocial deprivation (PSD) variables (war injury, child labour, loss of caregiver, neglect, domestic abuse, displacement, poverty), and 5 social, behavioural and emotional (SBE) variables (low/abnormal socialization, emotional issue, peer issues/being bullied, peer issues/being aggressive, educational decline). Within the sample, 73.7% were found with a probable mental health problem, with 30.6% showing signs of anxiety, 36.2% of depression and 26.6% showing signs of post-traumatic-stress disorder. Additionally, 74.5% of the sample had at least one form of PSD present (42.6% were displaced, 39.6% suffered from abject poverty), and 64.9% had a reported SBE concern. Children were more likely to have a potential mental health concern, especially autism and PTSD, and poor socialization; while adolescents were more likely to engage in child labour, experience abject poverty, exhibit aggressive behaviour, and educational decline. Male gender was associated with child labour and aggressive behaviour while female gender was associated with the presence of potential mental health problems, especially depression, and loss of caregiver, and poor socialisation. Odds ratios (ORs) indicated significant negative impact of the presence of SBE concerns (any), 4.45 (95% CI: 1.68–12.7), emotional issue, 11.02 (95% CI: 2.76–74.49), low/abnormal socialization, 8.37 (95% CI, 2–57.71), and displacement, 2.91 (95% CI, 1.21–7.48) on the child’s mental health. MHPSS intervention outcomes were categorized as case improvement, decline, or incomplete/limited information available; with case improvement noted for 63.6% of the sample, decline noted for 14.4%, and incomplete treatment/limited follow-up noted for 22.1% of the sample. Additional analysis of predictors of treatment success found that child labour was significantly associated with a lack of treatment success, OR 0.24 (95% CI, 0.07–0.92). These findings provide important insights into the complex tailoring needs that protection and MHPSS field projects require.

Beginning in the 1850s, the Ottoman Empire’s educational landscape expanded and diversified. During this era of imperial reforms, discourses around education increasingly focused on the importance of female education. This article uses census material from Tripoli in today’s Lebanon to explore the experiences of students in the wake of these shifts. It examines literacy rates across different social and religious groups and the extent to which educational decisions parents made were biased by gender and class. The analysis reveals that the rate of Muslim boys’ literacy was high even before new schools opened starting in the 1850s. As for the post-reform developments, it shows that although around a quarter of propertied families decided to send their sons and daughters to school, a considerable proportion of Muslim and Christian families privileged sons alone. Still, reforms allowed a number of groups in the generations between 1860 and 1910 to achieve higher rates of literacy, including Muslim and Christian girls as well as the children of artisans.