Located on one square kilometre in central Beirut, Shatila is home to an estimated 14,000 people, although the true number may be more than twice that. The camp is not policed by the Lebanese authorities and most residents have limited access to housing, employment, electricity and water. Established in 1949 to accommodate Palestinian refugees, Shatila now has a population that is more than half Syrian.

Syrian refugees seeking mental health services from Médecins Sans Frontières (MSF) in Shatila are suffering less from the acute trauma of war than from shifts in family dynamics and relationships caused by their displacement.

MSF has encountered an increasing number of Syrian women who have experienced domestic and sexual violence. Supported by counsellors, they told their stories, bearing witness to the psychological and emotional challenges that women in their community face and overcome. We hear first from a midwife, and then from several of the women and their counsellors.

‘I want to look like a lady!’

“Is it a boy or a girl?’ This is the first question at every ultrasound. If a lady is expecting a girl it may cause tension with her family, so we always say we don’t know. I tell her our priority is the health of the baby; I show her its body, point out the feet, hand, face; I let her listen to its heart. I still feel joy each time I deliver a baby, but it can be very hard. Once, I saw a Syrian refugee aged 12 pregnant with her second baby. It is normal for them to become mothers very young. Here is D, now 16, married in Syria at 14; this is her first baby, a girl. When you draw me, don’t draw me in these baggy trousers. I want to look like a lady! (MSF midwife)

‘Vendors offer food in exchange for sex’

A good memory of Syria? The night I finished my uni exams. We all went to the public park to have a BBQ and chill. Look, I have photos, I can show you. Here in Lebanon, the best times here have also been in the park when my husband and I take our children there to play. But this rarely happens as I can’t go out unaccompanied, and my husband must look for work. Most days I just stay in the room with the children. It’s been almost five weeks since my last day out. When we don’t have enough money for food, I’ll go to the market in the evening to gather vegetables from the bins. The vendors often offer fresh food in exchange for sex. But I won’t do that. I may have nothing here, but back home I was decent and respected; I had a job, a good home, neighbours, friends. It’s hard to accept that life is gone. (Syrian refugee)



I remind her she is resilient. I say it will be like jumping into water: the cold of this new hostile environment shocks at first but, gradually, you grow accustomed to the discomfort until it is easier to bear. Good memories sustain us when things are hard. I say to dedicate a specific time every day to remember the places and people you have lost: to think about them, to look at photos. But in order to make the most of the present, it is important to accept the reality that you cannot go back to the past. (MSF counsellor)

‘She was having terrifying flashbacks’

Metaphors can seem reductive, but I do think they can help us to process by thinking about things in a different way. Sometimes I say that coming to terms with trauma is like opening a packed wardrobe. When you open the door a tangled mess pours out at you; you must sort through it before it can be carefully folded away. M was imprisoned for one month in an Isis camp. She told me how she saw many horrifying things: people being slaughtered, women being raped. She was pregnant and, after three days of neglecting the labour pains, they took her to an Isis hospital. In order to force her to deliver quickly, they beat her and they even lied and said her unborn child was already dead. She lost that child, but when she came to MSF, she was pregnant again. She was having terrifying flashbacks of the previous delivery and was convinced that this pregnancy would be the same. I had to help her to see the things she feared were now in her past. We showed her many births here, so she could accept that this is not like the Isis hospital and our doctors will be kind. In the end, M delivered a healthy baby naturally. (MSF counsellor)

‘I watched my family die and could do nothing’

When the bomb fell on our home, it trapped my legs. I couldn’t do anything; I watched my family die in front of my eyes. My mother, sister, my two children, dying and I did nothing. Even before the crisis, financially we were not comfortable. So they never had what they needed, I could never give them what they deserved. (Syrian refugee)

I try to help T to let go of this guilt, to see that her family would understand she did everything she could. We’re still working on the difference between forgetting and moving on. She now has another son and she said to me that God had given her back some of what she lost. (MSF counsellor)

‘My employer raped me every day for five months’

There are 11 in my family, so I was sent out to work at the age of 13. I worked in a warehouse just outside Shatila, sorting clothes. My employer was a 45-year-old man. One night when I was working alone, he raped me. This became a pattern. He raped me every day for five months. I could not say anything because I didn’t want my family to suffer the scandal. But, eventually, my older sister noticed the bruises and I told her everything. She brought me to MSF. (Syrian refugee)

When N came to MSF we discovered that she was pregnant. With her sister’s support she decided to have a late abortion, at great personal risk. This is such a common story. Rape victims stay silent because of the social taboo about such things. If a pregnancy results from the rape they may attempt to terminate it secretly themselves, with drugs or a hard fall. If they come to us, we can offer them counselling. If they are pregnant, we can help them to leave the camp and stay in a women’s shelter where they can give birth without their community’s condemnation. The men involved in these rapes are never punished, they never get what they deserve. (MSF counsellor)

‘They took my daughter’

My six-year-old daughter was kidnapped on her way back from the camp kindergarten. My husband is in prison for debt, so I have to raise the children alone. I don’t have time to walk them home from school. Two boys, 18 and 16, approached her and said that if she came with them they would give her some money and sweets. They took her to a­­n abandoned building, took off her clothes and showed her porn movies. She’s not going to get back to the way she was. She gets stressed whenever she sees little boys. She throws her toys, runs to her bed, covers her face and tells me she wants to sleep. (Syrian refugee)

We see these things often in the camp, and I’ve heard this happens not just to young girls, but also to boys. Today we had another six-year-old girl brought to us. She was raped by a 50-year-old man. There had been some form of penetration and he told her that, if she comes back the next day, she will get some sweets. And for all that we see, there are many, many, many cases that never reach us. The worst things happen behind closed doors. (MSF counsellor)

‘If Isis men saw a beautiful woman, they would rape her’

When the war started, I wanted to join my husband in Lebanon. But I became trapped in a refugee camp in Syria. If Isis men saw a beautiful woman there, they would take her and rape her. So I was very afraid and spent one month hiding in the tent all day and all night. When I finally arrived at Shatila, my husband no longer trusted me. He knew that many women were raped and so he was asking many questions about how I managed to come here safely. When he realised that I had been faithful to him, we could be a family again. He still gets angry quickly, but he says it is not my fault. It’s only because he is frustrated at the situation here. I have three children now. This baby is only 20 days old. I am content to just be with my family and feel safe – but I want my children to have the chance for more. (Syrian refugee)

It is difficult to treat a sickness of the spirit when you cannot change the conditions that are causing it. Even just working in here can be difficult. When I need a break from it all, I come up to the terrace on the roof of our clinic. Look there, you see what looks like tear tracks down the buildings? This is from their water tanks, because the only wells here are salty. And you can see how many dovecots and birds – people feed them! Strange, when they themselves have so little. But perhaps they find in this a form of freedom. (MSF counsellor)