Enab Baladi – Shams al-Din Matoun

The hands of Hebatuallah are shaking as she gives a lesson to her students in the classroom. The 23-year-old teacher suffers from an accelerated heartbeat and shortness of breath. These symptoms have been accompanying her continuously for 40 days, coinciding with a military escalation campaign witnessed in the northwestern region of Syria by the regime forces and key ally Russia.

Hebatuallah told Enab Baladi that she was confirmed by a cardiologist and internal medicine specialist that there was no organic cause for the condition she was experiencing, noting that the doctor assured her that the increase in tension and her constant anxiety that resulted from her fear of a repeat of the bombing that targeted a place close to her place of residence is the direct cause of her suffering.

Idlib, its countryside, and western Aleppo witnessed a military escalation last October, which resulted in the killing of more than 70 people, the injury of 349 others, and the damage of more than 40 health facilities, 27 schools, and 20 water networks.

According to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), the escalation affected more than 2,300 sites and led to the displacement of more than 120,000 people. It is the largest escalation in northwestern Syria since 2019, added the UN agency

The bombing on the last stronghold of the Syrian opposition has left psychological and physical effects on people who lived through states of terror and shock and who witnessed massacres committed by regime forces and Russia, forced displacement, “brutal” bloody scenes, and bombing that did not spare anyone.

The rescue Syria Civil Defense (The White Helmets) agency considered that the escalation in the region came within the context of a systematic policy aimed at striking stability there, spreading terror among safe civilians and preventing them from living their normal lives, describing October as a bloody month for the people of northern Syria.

Illness and fear

Hebatuallah explained that she was now terrified by any strong sound she heard, even the sound of a door closing or a speeding motorcycle passing by, thinking it was the sound of a new bombing.

As for Ruqaya Abdullah, 54, from the town of Sarmin, east of Idlib, she suffers from high blood pressure and tremors in her reddened eyes from lack of sleep as a result of her constant anxiety due to the premonition of the bombing that the city might be exposed to at any moment.

Abdullah told Enab Baladi that she had not suffered from any signs of blood pressure throughout her life, pointing out that she had lived through harsher days during the past years, as the bombing was more severe and the situation was worse, but the intensity of the bombing after a relative calm was the reason for her suffering.

“We no longer have the energy to go through harsh events again. A while ago, I was planning to marry off my son, and now I fear for him to leave the house,” Abdullah added with a sigh.

The woman began to suffer from high blood pressure and needed medication continuously. It was also discovered after her condition was diagnosed that she had colon spasms, which could lead her to develop a permanent disease known as irritable bowel syndrome.

“Psychosomatic disorders”

Internal physician Uday al-Khatib told Enab Baladi that these disorders are classified as psychosomatic and result from constant emotional pressure due to the problems and burdens of daily life and feelings of fear and anxiety.

It is known in medical terms as “psychosomatic problems,” as it focuses specifically on the unity of body and soul and the mutual influences between them. It is also a psychological condition that leads to physical symptoms, often without any medical explanation, and can affect almost any part of the body.

Al-Khatib said that treatment in such cases is two-fold: the first depends on chemical medications, and the second depends mainly on psychological treatment and removing the causes that resulted in the disorder, such as fear and anxiety.

The physician added that the state of instability prevailing in the region reduces the chances of treatment and thus causes the illness to continue.

Children are victims too

The level of comprehension of Miral, a second-grade primary school student, has declined significantly, as she remains absent-minded all the time, and she has begun to refuse to go to school, especially after the suspension of school hours several times since the beginning of the school year, which recently coincided with the bombing campaign that was launched by regime forces.

Miral’s family returned to live again in Sarmin last October after being displaced at least twice as a result of repeated bombings on the city.

The child’s mother told Enab Baladi that Miral suffers from nightmares during her sleep, which has become intermittent, and she sometimes suffers from involuntary urination.

“My daughter asks me before she sleeps, ‘Do we feel pain if the house falls on top of us as a result of the bombing?’” the woman said while trying to hold back her tears.

Miral also suffered from jaundice, as the child’s state of fear was a major factor in her psychological and physical illnesses, according to what her mother reported from the doctor who diagnosed the child’s condition.

For his part, pediatrician Ahmed Hamdan told Enab Baladi that young people are more vulnerable to illnesses in which fear is a contributing factor to the symptoms, causing problems with sleep and attention.

Children may appear restless and irritable, in addition to having stomach pain, headache, high fever, and jaundice. These are all medical issues that children become more susceptible to when they are exposed to severe panic or constant tension.

The pediatrician explained that the child may not be able to express these feelings well, so he resorts to bouts of crying or repression, which is more dangerous and is reflected in his body as a disease.

The reality of the conflict in Syria affected all segments of society, including women and children. They were the first victims since the start of the Syrian revolution in 2011, and the war left its effects on their bodies, personalities, behavior, and psychology.

Reports from children’s and humanitarian organizations confirm that the conditions of war in Syria, including killing, bombing, and displacement, have destroyed children’s sense of security and pose major threats to their psychological health and development, especially since most of them witnessed, heard, or lived through at least one traumatic event.

UNICEF reported in March 2022 that the war in Syria continues to leave psychological scars on children and that a third of Syrian children show signs of psychological distress, such as anxiety, sadness, fatigue, and frequent sleep disturbances.