NeuCare Project

This project will encounter a lack of neurodevelopment graduate programs for training professionals who tend to children in the refugee camps in Palestine and Jordan. Such programs are scarce, if not non-existent, despite the concerning implications that emerge from the current tragic social and political context.

The UNRWA has cautioned in several emergency calls in 2018 and 2019 that the refugee situation has negative effects on mental health. According to scientific research, refugees are at a higher risk for suffering physical and mental illness as compared to the general population (Abdullahi et al., 2018; Bogic, Njoku, & Priebe, 2015; Kirmayer et al., 2011; Munyandamutsa et al., 2012). Health consequences are even more exacerbated in the case of children (Fazel et al,. 2012; Reed et al., 2012). Children who live in refugee camps live in poor conditions and are of low socioeconomic status. As a result of these situations, children may develop different mental health problems such as neurodevelopmental disorders (Abdullahi et al., 2017; Turley & Obrzut, 2012; Zaydeh et al, 2016). These neurodevelopmental problems are not only related to exposure to traumatic events and violence, but also to malnourishment (Fasfous, Peralta-Ramírez y Pérez-García, 2013; Khamis, 2005; Thabet, Abed, and Vostanis, 2004). The effects and consequences of these neurodevelopmental problems occur in childhood and may be maintained throughout one’s life, affecting academic performance, professional status, and mental health during adulthood (Shonkoff, 2011, 2012).

The global figures demonstrate the magnitude of this problem. According to the United Nations High Commissioner for Refugees´ (UNHCR) report (2018), more than 68.5 million people were displaced worldwide due to persecution, conflict, violence or human rights violations. Of these individuals, 40 million were internally displaced and 25.4 million were refugees. However, considering the number of refugees in regions both outside and inside Europe, the problem is especially pronounced in the Middle East region, especially Palestine and Jordan. In this region, there is a large number of refugees and they represent a high percentage of the total population in these countries (Gonzalez-Ubeda, 2017).

An analysis of the social and health needs in Palestine and Jordan highlighted that a high percentage of the population in each[1] country are refugees:

    • Palestine: There are more than 2 million people living in refugee camps in Palestine. According to the last census conducted by the Palestinian Central Bureau of Statistics in 2017, 39% of the Palestinian refugees are children under 15 years old.
    • Jordan: there are 700,000 Syrians and 2 million Palestinian refugees living in Jordan (almost 40% of the total population).

Detecting and addressing neurodevelopmental issues in children due to the refugee crisis is currently a pressing problem in both countries because there is not a just resolution of the question of Palestine refugees and Syria is currently an unsuitable place to return. This problem had been recognized by the UNRWA in a statement made last year announcing “refugees must be protected from the most severe impacts of hostilities and violence through the provision of mental health and psychosocial assistance and monitoring, reporting and advocacy” (Strategic Priority 2 of the occupied Palestinian territory Emergency Appeals 2019). In terms of child development risks, Palestinian refugees are not distinct from other protracted refugee situations such as those in Syria. In addition to the short-term consequences, the aforementioned long-term effects are even more drastic. As a result of neurodevelopmental impairments sustained during childhood, some adults will not be able to develop to the best of their capacity. Due to a large number of refugee children and the impact of neurodevelopmental issues later on in adult life, different interventions are urgently needed. Furthermore, these needs would remain even if there were a positive change in the global refugee situation.

Professionals working in Palestine and Jordan face the problem of neurodevelopmental impairment in the refugee camps. However, in these two countries, there are very few master’s programs (M.A.) focused on refugee populations (i.e., German Jordanian University offers a Master Programme in Social Work related to refugees). Worldwide, there are currently around 25 M.A. programs that target involuntary migrations. Nonetheless, all of them share a very similar approach to the problem. All existing M.A. programs emanate from a legal, anthropological, and/or political perspective focussed on human rights. Some of them also tend to the psychopathological and psychosocial consequences of being a refugee. Nevertheless, until recently, none of the M.A. programs take a neuroscientific or neuropsychological perspective to assess and rehabilitate alterations linked to neurodevelopment in refugee children, in spite of the fact that neurodevelopmental issues are common among this population. From our point of view -both preventive and palliative- assessing and treating neurodevelopmental problems could have an important impact on the future individual, social, and economic development of these two countries and the Middle East region. It is also important to consider that most M.A. programs are imparted in the USA or well-developed European countries (UK, Belgium). Thus, high tuition fees make it very difficult for students and professionals from Middle Eastern countries to access and afford training. Our high education program seeks to overcome such difficulties, training natives on basic and applied neuroscientific knowledge that will lead to improvements in the neurodevelopment of children, and thus to the society as a whole.

Due to the lack of specific M.A. programs in Palestine and Jordan, there are hardly any professionals with neuropsychological training to detect problems related to neurodevelopment. In addition, professionals do not have enough adapted and validated tools to carry out a broad assessment of neurodevelopment in Arab children (Fasfous, 2012; Fasfous et al, 2017).

In summary, despite the high prevalence of neurodevelopmental disorders among refugee children, there is a lack of services and the quality of current intervention programs is often poor. This problem could be explained by the need for high academic programs, specific programs that focus on capacity building, and the limited number of instruments and tests that are available in Arabic for neuropsychological assessment. The implementation of a graduate training program through this project would be a great advancement in resolving the detected problem.

Abdullahi, I., Leonard, H., Cherian, S., Mutch, R., Glasson, E. J., de Klerk, N., & Downs, J. (2018). The risk of neurodevelopmental disabilities in children of immigrant and refugee parents: current knowledge and directions for future research. Review-Journal of Autism and Developmental Disorders, 5(1), 29-42.

McKell, C., & Hankir, A. (2018). Barriers to the treatment of mental health problems for Palestinian people in refugee camps in Jordan: a cross-sectional study. The Lancet, 391, S8.[2]

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