Life after torture: Syria’s battle to mend its people and its healthcare

When eight-year-old Shoaib* was freed from Sednaya prison in Damascus, Syria, the outside world was unrecognisable to him. Jailed at just three months old, alongside his mother, young Shoaib was unable to identify birds or even the sun.

“My child is unfamiliar with a biscuit, juice, a bird, or even a toy to play with. He cannot read or write. He doesn’t know his family or his father. He has witnessed me, his mother, subjected to physical and sexual abuse,” Shoaib’s mother told TRT World.

Shoaib’s story is one of thousands. According to a report released by the Syrian Centre for Human Rights (SCHR) last month, a total of 5298 children were detained or forcibly disappeared since 2011 and a total of 30,293 children lost their lives.

He was imprisoned alongside his mother, who was charged with speaking out against the regime. Although she was not directly involved in the protests, her arrest was prompted by the involvement of other family members in the demonstrations.

Rape and daily torture

Similar horrors befell 31-year-old Nour al Hussein*, who was also locked up in the Sednaya prison. She was arrested five years ago for participating in demonstrations calling for freedom and the fall of the Assad regime, then led by Bashar al Assad.

“Armed men took me to Sednaya prison blindfolded, where I along with other inmates were subjected to harassment, rape, and daily torture without mercy. We were also forced to watch mass executions in the main square of the prison, to spread terror in our souls and the rest of the prisoners and detainees,” she told TRT World.

Al Hussein added that she was beaten with sticks and subjected to electric shocks so that she confessed to fabricated charges of transporting weapons to anti-Assad forces. When she refused, she was thrown into solitary confinement for 15 days. From the adjacent room, the stench of death and corpses was inescapable.

“When I came out of the prison on December 8, I came to know that my husband had married another woman and left for Türkiye with my children. I haven’t been able to see them to date and this has just increased my suffering and illness,” she said.

Shoaib, his mother and Nour al Hussein are just a few of the countless Syrians emerging from prisons with physical and psychological scars.

After years of brutal civil war and the fall of Bashar al Assad’s regime, Syria is grappling with the herculean task of rebuilding not just its physical infrastructure but also the shattered lives of its people—scars that will take years to heal.

A healthcare system in ruins

Syria’s healthcare system, once a source of regional pride, today lies in tatters.

According to a 2023 report by the World Health Organisation (WHO), over 50 percent of the country’s healthcare facilities are either non-functional or severely damaged. Essential medicines remain scarce, due to the destruction of pharmaceutical companies during the war, and government funding cuts that have forced many hospitals and facilities to shut down.

While the mass exodus of medical professionals during the conflict has left the country critically short-staffed. By 2015, more than half of Syria’s 30,000 doctors had fled the country, and the situation has only worsened.

While limited medical resources address physical injuries, the country is woefully unprepared to deal with the mental health crisis brewing in its aftermath. Years of torture, starvation, and isolation have left tens of thousands deeply traumatised.

Many recently freed detainees from notorious prisons like Sednaya are unable to return to normal life. They recount horrific torture, endless days in darkness, and the inescapable trauma of watching fellow prisoners die.

Jamal, 43, spent four years in Sednaya. He described enduring physical and mental torture, including being forced to sleep beside a fellow inmate’s corpse for two days.

“I was often stripped naked and beaten up by the prison guards. This was a regular torture. We were also kept hungry and not allowed to sleep inside the prison. The worst part was enduring cold and then getting punished if we stepped out into the sun,” he told TRT World.

Jamal contracted tuberculosis during his time in prison and the guards would often withhold his medication. Now free, he is haunted by insomnia and deep psychological wounds.

Fear and isolation

Walaa al Ballan, a psychological counseling specialist from Aleppo, explained that the patients she is seeing who are being released from prison are in a state of shock. Some even suffer from claustrophobia and insist on be treated in an open space.

“The survivors suffer from many psychological problems, which are manifested in their constant feeling of fear and isolation, as a result of the state of dispersion and loss they experience after their release,” she told TRT World.

She emphasised that it’s Syrian women who have faced the most difficult humanitarian conditions in the regime’s detention centres. Enduring daily violence, sexual harassment that often ended in rape, and torture that often led to death.

Other vulnerable groups to psychological illnesses are those who have lost family members, survivors of detention, displaced persons, women, and children who suffer from repeated trauma. Front-line workers, such as volunteers in rescue teams, are also exposed to great psychological pressure.

The most common psychological illnesses are obsessive-compulsive disorder, panic attacks, and anxiety. In addition, people also suffer from depression and post-traumatic stress disorder.

The impact of war extends beyond prisons. Bilal, 33, became paralysed after a missile strike in Idlib last year. He was living in a makeshift camp when the attack destroyed his life.

“There was a time when I wanted to study and become a doctor. But the war has left me traumatised. First I lost my wife and then I am left paralysed now. I don’t know what to do further in life,” he told TRT World.

Social stigma

Al Ballan noted that mental health stigma remains a significant barrier to recovery. Misconceptions that mental illness expresses a weak personality or lack of will, which makes people feel ashamed or afraid to admit to having mental problems.

Over 13 years of conflict in Syria have prioritised emergency healthcare over mental health, resulting in a severe shortage of mental health services, particularly in the northwest, where violence continues.

A 2022 report by the Syrian American Medical Society found that less than one percent of healthcare facilities in Syria offer mental health support. With few trained psychologists or psychiatrists in the country, the burden falls on overwhelmed general practitioners.

The World Health Organisation estimates that nearly one million people in the region are affected by some form of mental health disorder. While some international organisations have stepped in to offer support to tackle the growing mental health crisis, it is far from enough.

Groups like Medecins Sans Frontieres (MSF) and the International Rescue Committee (IRC) have been providing basic healthcare services in camps for internally displaced people, but these efforts are stretched thin. Targeted mental health support and rehabilitation programmes to address psychological trauma are urgently needed to build resilience, and provide holistic care for displaced populations and long-term prisoners.

The United Nations Office for the Coordination of Humanitarian Affairs reports that, so far this year, only 25 percent of the $4.1 billion required for the humanitarian response plan in northwest Syria has been secured.

The health sector is facing a funding deficit of $471 million, with just about 10 per cent of its needs being met, according to MSF. It warns that this funding gap puts critical health services at risk, with mental health care being the most likely to be sidelined.

Syria’s path to recovery is fraught with challenges, not only in rebuilding its shattered medical infrastructure but also in addressing the deep psychological wounds inflicted by years of war.

For individuals like Shoaib, his mother, and Nour al Hussein, who remain gripped by fear, shock, and trauma from their imprisonment, the future appears bleak.

Despite receiving treatment, their recovery is uncertain, highlighting the immense psychological burden on Syria’s next generation. Without urgent intervention and international support, the country risks leaving its people trapped in an endless cycle of trauma and despair.

*Names changed to protect identity