It was when a bullet shattered the window of his son's bedroom that Abu knew it was time to leave Syria.
The languages teacher together with his wife and five children left behind his comfortable middle-class home in Homs, close to the Lebanese border, and boarded a bus for Jordan.
On arriving in the city of Amman, the family were first put up by friends before renting an apartment on the outskirts of the capital.
Due to Jordanian law, Abu – now a refugee - is not allowed to work so has to rely on the assistance of family, friends and organisations to live and support his wife and his children who are all under the age of 18. The psychological and emotional impact of being terrified into leaving their once safe home has also taken its toll.
"My children had terrible nightmares," explained Abu, who has a degree from the University of Homs, via a translator for the humanitarian organisation CARE International. “My daughter was so scared she did not want me to leave the apartment. She screamed and locked the door, because she feared I would never return.”
"My youngest son would not come close to the window. However, the refugees who are arriving now are even worse off than we are. There are no jobs in Syria anymore, so they have had no income for many months, they have lost all their assets and experienced the worst violence - one cannot imagine.”
As Abu points out, there are vast differences in each refugee’s individual situation, both financially and in terms of the horrors and fears they might have experienced.
However there are 15 million refugees worldwide who have one thing in common. They have all experienced trauma.
“It is the story of millions of displaced people and each person has their own story of trauma,” said US-based psychologist Jason Evans Mihalko, who works with refugees and asylum seekers. “It is something that nearly all refugees experience.”
"There are a myriad of reasons why people become refugees - poverty, political turmoil, violence. If it wasn’t going on they probably wouldn’t seek to leave their home country, and leaving their country is traumatic in itself. Displacement from family, traditions, culture and language.”
"All I have worked with have expressed a great deal of sadness and a wish to be able to be back in their country but with such a conflicting feeling that if they go back they will die. There’s a profound sense of loss and hopelessness.”
Each refugee will be affected by their individual experience to varying degrees and some will cope better than others. Of them a small percentage would be diagnosed as suffering from mental illness as a result.
On fleeing their homes, refugees typically end up in camps in bordering countries. Or they enter another country illegally or legally on a short-term visa. They can end up overstaying a visa, being too afraid to return home and then make an application for asylum.
While waiting for a decision on their application they are called asylum seekers. A refugee is someone who has left their country and proved they need protection under international law.
Consultant psychiatrist and psychotherapist for charity Freedom from Torture, William Hopkins clarified that the reaction of Abu’s family is not unusual for refugees.
“There are themes around feelings of security for all displaced people,” he said. “They might be quite anxious, or depressed or suffering from post-traumatic stress disorder because they’ve fled countries like Syria due to the violence or the threat of violence. They may be getting flashbacks or nightmares, severe anxiety or panic attacks.”
In camps there can be a whole new set of problems, including a high risk of exploitation, violence, lack of privacy and the stress of living without basic facilities, said William. “There is a lack of safety and uncertainty over the future. They don’t know what’s going to happen to them and also experience a lack of control and helplessness.
"A lot of things are done for them in camps. They don’t have a lot of say about what food they’re going to get, when they’re going to get it and what the toileting facilities are going to be. This can create apathy and a lack of motivation. They also have to deal with a loss of role. These people had some sort of role or status in their country of origin which is stripped away.”
"They no longer can be the parent who can provide for or support their family, they’ve lost their job, lost their money. They can feel undermined and inferior and can’t get the things they need for their children.”
For those refugees like Abu who settle in towns, cities and countries away from the camps, living conditions may or may not be better. Some find apartments or houses, others make do with tents or basic hostels.
Psychologist Jason Evans Mihalko said: “When they are resettled, they often feel very cut off from things which are familiar in their country where they speak the language. They may not understand the local culture and customs and the local culture may not understand them. That is extremely difficult and complicated. When someone is following the tenets of their faith and what feels appropriate for them, in a country which doesn’t understand that, it’s confusing and scary.”
Part of how people cope with the trauma of displacement is by recreating the structure of their previous life, explained Jason. “That’s basically what trauma is – something unpredictable which makes the world feel intensely unsafe. To try to control and manage that unpredictability, people will follow very traditional cultures, and seek to be around like-minded people– other refugees from their culture - to feel safe. It’s a way of recreating the comforts and familiarity of home. In the case of Muslim dress - traditions that their mothers and grandmothers followed and having that sense of predictability and identity.”
Most refugees stay around their region of displacement. Eighty per cent of the world’s refugees are hosted by developing countries. The UK had 23,499 applications for asylum last year and 0.27 per cent of the country’s population are refugees.
William said: “Often these are quite educated people who’ve had a good quality of life in the country they’ve come from. They’ve been economically quite stable so they’ve had a house, an income, a car.”
"They come to the UK and they’re living in awful accommodation –it might be a shared room. They have a minimal amount of money to live on.There’s no way they would have come here for economic reasons. The reason they’ve come here is because they’ve feared for their life. They can have all the problems of leaving their family behind, of leaving the wider community with all their integrated and stable relationships.”
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"They come to a country where in some cases they’re not particularly liked or wanted. There are language difficulties. They’re going to have to start again at the bottom and their qualifications might not be accepted. It’s not a pleasurable thing – not something they do willingly.There’s some confusion between asylum and immigration.”
Angelina Jalonen, therapeutic case work services manager for the Refugee Council, said asylum seekers who make it to the UK can feel“worthless” because they are not allowed to work while making their case to the Home Office. She told of a family from Syria who owned a pharmacy. They had sold everything to raise £60,000 to make their way to the UK and were finding life extremely difficult because they now had nothing and were not permitted to work to rebuild their lives.
She explained: “Their accommodation was quite appalling and they felt very degraded – not worthy as human beings. The son was always on the phone trying to ring someone almost in a panic. He said he was trying to reach his friend [back in Syria]. There was this anxiety of how many friends were remaining.”
William revealed that refugees who have managed to escape their countries often feel very guilty about the people they’ve left behind. He explained: “Reliving the story and experiences can help them integrate some of the fears and anxieties they’ve experienced and help them untangle some of the psychological problems such as guilt due to leaving people behind."
Angelina stated that she’s inspired by the resilience of some of the refugees she sees who have the most harrowing stories. They may have been tortured, abused or raped which is widespread in war zones.
“When you hear some narratives you wonder how they have coped so far and what has kept them going,” she said. “I think sometimes we focus too much on physical things. We should look at who is this person? What was this person before adversity or before tragedy struck? What was going on in this person’s life? Yes they may be free physically but they’re not free emotionally.”
A remarkable video series depicting the extraordinary challenges faced by aid workers and refugees in Zaatari will be shown exclusively on Yahoo UK starting on Tuesday November 12. See the trailer for the series here.
To find out more about the work of the United Nations High Commission for Refugees click on the link below