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Abeer Alharthi, MSN, RN, PhD Student

The human cost of war: A nurse’s reflection on the tragedy of forced migration from the Zaatari Camp

By: Abeer Alharthi, MSN, RN, PhD Student
Abeer Alharthi, MSN, RN, PhD Student
Abeer Alharthi, MSN, RN, PhD Student

As the doors to the primary health center (PHC) swung open, the triage room overflowed with Syrian refugees, their eyes fixed on the healthcare staff, yearning for attention and aid. My green vest, embroidered with the words “King Salman Humanitarian Aid & Relief Center,” was a symbol of hope as I walked through the crowded halls. Syrian refugees have endured one of the worst humanitarian crises to this day. In that PHC, they were finally given the chance to be treated as human beings in agony. This reflection will explore the impact of forced migration through the lens of a healthcare professional hoping to bring awareness to the often-overlooked humanitarian crisis that accompanies every major conflict. In this post, I reflect on my experience as a nurse caring for Syrian refugees at the Zaatari refugee camp in Jordan.

What happened to the Syrian people?

The Syrian conflict is an ongoing civil war that began in 2011 and led approximately 5.4 million Syrian people to flee their country seeking safety and refuge across the Middle East, North Africa, and Southern Europe. The World Health Organization (WHO) has identified Syrian refugees residing at the Zaatari camp, which houses about 80,000 Syrian refugees in Jordan’s northern desert region, as being at great risk for disease morbidity and mortality due to poor living conditions, lack of access to healthcare services, and unhealthy lifestyle habits. Refugees frequently face a range of stressors and challenges that can significantly affect their health, including trauma, loss, social isolation, and economic hardship.

The journey to Zaatari

I had the opportunity to work in a primary health center supported by King Salman Humanitarian Aid & Relief Center (KSrelief), a humanitarian organization based in Saudi Arabia, and provide healthcare services to Syrian refugees along with a highly dedicated staff including Saudi and Syrian healthcare professionals. Working at the Zaatari refugee camp was a challenging, yet rewarding experience. I was shocked by the dire conditions that Syrian refugees endured at the camp. The limited resources available, combined with the high levels of stress and trauma experienced by refugees, had an accumulative effect on their health leading to the development of a range of chronic and acute health issues that need to be addressed immediately to prevent further deterioration of their health. Vitamin deficiency complications, psychiatric illnesses, and cardiometabolic diseases were among the health issues that Syrian refugees were suffering from, which is consistent with prior literature. These diseases were being exacerbated by the stressful and crowded conditions at the camp, as well as by the lack of access to healthy food, exercise facilities, and smoking cessation programs.

While the PHC staff are working diligently with KSrelief to meet refugees’ needs, there is still a massive gap in adequate and well-equipped health centers that provide specialized services within proximity to the refugee community. This will facilitate access to necessary care and reduce the burden of time required for refugees to reach these facilities. Additionally, it can make it easier for healthcare providers to monitor and manage the health of the refugee community, and it facilitates the referral process if specialized care is required. This also includes improving access to screening and health promotion programs, providing education and awareness about healthy lifestyles, and improving the overall living conditions at the refugee camps.

To address the needs of Syrian refugees, we need to address the determinants of health including the social, economic, and environmental factors that contribute to communicable and noncommunicable diseases. The cooperation between local and international humanitarian aid organizations is crucial in addressing the health of refugee populations residing in temporary settlements. By addressing issues such as housing, access to healthcare, nutrition, education, and employment, humanitarian organizations can help improve health outcomes and promote greater resilience and well-being among this vulnerable population.

Respecting culture

While working at the center, a small event occurred that stuck with me. An elderly patient, who was receiving treatment for asthma while sitting in bed, witnessed me disagreeing with a nurse. The nurse herself is a Syrian refugee, and as a token of appreciation, she gave me some chocolate. However, I hesitated to accept it, insisting that she should enjoy it herself as I was concerned that she might not have had anything to eat that day. The patient, who was observing this interaction, reminded me of the Arab culture that places a great emphasis on hospitality and generosity, which are considered fundamental traits of the Arab identity. He said, “My daughter, we are Arabs, and it is disrespectful to refuse a gift from an Arab.” I quickly apologized and took the chocolate.

This interaction made me reflect on the way we communicate and show our compassion to refugees as healthcare professionals. While it is important to acknowledge the suffering, compassion must be delivered with dignity and respect. Refugees’ cultural backgrounds and social virtues must be honored, as it helps promote their self-worth.

Until they return home

As we drove through the camp, I couldn’t help but feel a sense of sadness and despair at the conditions that the refugees were living in. The identical pre-built shelters make me wonder how anyone could feel safe or secure living in them. I can see the magnitude of this crisis written on the faces of children and refugee families.

Working side-by-side with individuals who have gone through tremendous trauma and faced great loss has revealed the remarkable courage many of them possess. I was touched by the resilience and determination of the refugees I met and worked with. The situation in the camp is far from ideal, but with the help of humanitarian aid such as KSrelief, we can empower refugees to lead a life of optimum health and wellness…until they can return home.

A call to action

As a PhD student, I am passionate about using my research to promote the health and well-being of refugees and displaced populations affected by disasters and conflicts. My dissertation work focuses on understanding the unique health needs and challenges of displaced populations and developing interventions to improve their health outcomes. Through my work, I hope to advance our understanding of the social, economic, and political factors that contribute to poor health outcomes among refugees, and to develop effective strategies to address these challenges.

By involving refugees as active participants in my research, I can gain a better understanding of their experiences and needs and develop interventions that are culturally appropriate and responsive to their unique contexts. I urge my fellow nurses and researchers to engage in this critical work and become advocates for the health and well-being of refugees. By utilizing our expertise, we can engage in research, offer healthcare services, and extend our support to advocacy efforts that aim to enhance the health and human rights of refugees. Collectively, we can contribute to improving the lives of displaced communities across the globe.


Al-Rousan T, Schwabkey Z, Jirmanus L, Nelson BD. Health needs and priorities of Syrian refugees in camps and urban settings in Jordan: Perspectives of refugees and health care providers. Article. East Mediterr Health J. 2018;24(3):243-53. doi:10.26719/2018.24.3.243

UN Refugee Agency. Syrian Arab Republic. unhcr.org/syrian-arab-republic.html

World Refugee Day: Caring for the forcibly displaced. Lancet. 2014;383(9935):2100. doi:10.1016/S0140-6736(14)61014-X

The views and opinions expressed by My Nurse Influencer contributors are those of the author and do not necessarily reflect the opinions or recommendations of the American Nurses Association, the Editorial Advisory Board members, or the Publisher, Editors and staff of American Nurse Journal. These are opinion pieces and are not peer reviewed.

2 Comments. Leave new

  • Erika Cleborne-Bérubé
    May 8, 2023 3:44 am

    Dear Abeer,
    Thank you for sharing your experience. It mirrors my own experience of the challenges of working in refugee camp situations in various camps across Greece in 2016-2019. As you say, the research is sorely needed! Please get in touch if you need insights from other nurses or from other camps.

    All the best with your work

  • Fahad Odayani
    April 27, 2023 5:50 pm

    Thank you Abeer for your endeavor. As per the UN Refugee Agency, there are over 100 million refugees almost half of which are children and 22% of the refugees are settled in low-income countries that could prevent them from accessing proper healthcare.

    I wish you the best and I hope you get the chance to expand your studies into demographics of Europe with the Ukrainian crisis, Africa with the Sudan crisis, South America and Asia.


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