"I got married seven years ago, and until now I have not had any children. In the last few years, I once went to a public hospital to find out the reason behind my infertility. I was unable to communicate with the doctor because the translator refused to translate for me under the pretext of work pressure," said Taj, 28, a resident of the southern Turkish city of Gaziantep to Rozana, describing her suffering because of the language barrier.
Taj is not the only one suffering from the lack of access to services available to Syrian refugees in Turkey, who are estimated at 3.6 million. There are hundreds of people who lack access to information and therefore cannot benefit from the services provided by the United Nations High Commissioner for Refugees (UNHCR).
Rozana conducted a survey to find out to what extent the refugees within the target group of the UNHCR programme have access to the services provided by the UN body’s official contacts and partners inside Syria, while trying to figure out to what extent they are aware of the services they can enjoy.
Reasons for the lack of access to services!
In this survey, we conducted a random questionnaire among 438 people (131 women, 304 men and three who preferred not to disclose their gender) to find out the extent to which information on free services offered to Syrians by the UN and its affiliated bodies, such as health, education, social assistance, psychological support, interpretation services and access to the formal labour market.
We tried to identify the gaps that prevent Syrians from accessing services in order to inform the relevant authorities to ensure the necessary access and circulation of information among the refugees.
Absence of information
According to the survey, most of the respondents did not know about the mechanism of communication with the UN body, or the location of the UN-supported health, psychological or legal centres, and had never benefited from its services before.
When 30-year-old Ruba needed psychological support after leaving Syria, she contacted an organisation that provides free psychological support in partnership with the United Nations, to which she was introduced by an acquaintance.
UNHCR confirms that a refugee with a Temporary Protection ID Card can access primary care clinics and public hospitals that provide psychological support in the city where he/she lives in order to benefit from psychological assistance.
If no psychiatric service is available in the hospital or there is no doctor available, the refugee can be referred to another hospital or city accordingly, and the cost of this health care and treatment is covered by the temporary protection insurance.
UNHCR's partner organisations may have psychologists providing psychological support in the region where the refugee resides. Please find a list of these organizations in the link below.
Syrian refugees who want to learn Turkish language in order to be integrated in society, complain about some UN education centres in the vicinity of their residences and their neglect of the refugees.
Maysa, 36, who is a mother of three children and a resident in Gaziantep province, told Rozana: "I went to two (UN-supported) organisations to enrol in Turkish language classes, along with my children. Every time I go there, they get my phone number to contact me later when the courses start. I waited for a long time and I did not get any call. After seven years spent in Turkey, I was not able to reach a centre that would accept me and my children to learn the language.”
She added: "I cannot learn the language in a private centre because the costs are very high and incompatible with our financial situation. My husband is the only breadwinner and his monthly salary does not exceed 2,000 Turkish Lira.”
According to the survey, 48.5 percent of the respondents had never benefited from UNHCR services in Turkey, and 15.5 percent received such services, while 41.8 percent encountered problems in accessing the available services due to the absence of an adequate response from the relevant workers’ part.
When can the refugees have access to UNHCR services?
Syrians who are not registered with the Turkish government cannot benefit from any services or assistance in Turkey. This includes access to health and education services, social assistance and employment opportunities, except for emergency services, which are available for free despite the non-availability of a temporary protection card. In case the person goes to private hospitals and clinics, he/she will have to pay the fees according to the UN.
Syrians who do not have a temporary protection card and do not benefit from all the free services provided by UNHCR can get information on the regions to register in by calling the Aliens Centre on (157) and then move to and register in that region, according to the Refugees Association's website.
The mistreatment of some Syrian by translators in public hospitals, or their reluctance to do translation work for unclear reasons, has prompted many people to seek treatment in private centres.
Nadia Haj Hussein, a resident of Gaziantep, told Rozana: "We choose to go to a private doctor because language is a major barrier to get medical treatment in public hospitals."
She added that “the translators in the hospitals do not answer to anyone, sometimes because of their arrogance... I do not know why, although their job is to translate what people need.”
As for Samer, 32, whose wife suffers from a fungal disease, his monthly salary cannot not allow him to take her to a private hospital for treatment; however, the mistreatment he received, as he describes, from the translator in a public hospital pushed him to go to a private hospital and borrow money to treat his wife.
"In a public hospital, the translator only assisted me when I paid him a sum of money, is that fair?" Samer told Rozana.
The survey indicates that 40.9 percent of participants received a free translation service of average quality, 30.9 percent received a good translation service, 28.2 percent received a poor translation service and 80 percent did not know that UNHCR provides a free translation service.
Many Syrian refugees have asked, via the survey, for imposing tighter supervision measures over translators, especially in public hospitals.
In these cases, UNHCR provided a translation assistance hotline (68 48 444) and indicated that an interpreter can be requested from UNHCR's partner organisations in the city where the refugee resides.
The hotline operates from 9am to 5am from Monday to Thursday and on Fridays from 9am to 4pm, with advice available in Arabic, Persian, Turkish, English and other languages, or you can contact UNHCR by email at (email@example.com).
How do organisations communicate with refugees?
Syrians in Turkey use several applications to access information, but the Facebook application is the most used means to access medical services, according to 71.2 percent of interviewees.
The mental health coordinator of the Union of Medical Care and Relief Organizations (UOSSM), Muhammad Ajoum, told Rozana that the organisation supports refugees by means of mental health centres in (Kilis, Istanbul and Reyhanli) and physiotherapy centres in (Kilis, Gaziantep and Reyhanli).
The UOSSM cooperates with several organisations such as the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), Doctors Without Borders (MSF) and others, and supports Syrians in Syria and Turkey, according to the organisation's Facebook page.
Regarding the Syrians’ access to these free services, Ajoum explained that the organisation’s services are promoted by networking with service providers located in the targeted state, either Turkish government agencies such as the Shunem Centre (a centre that provides support for abused women with translation services), the Turkish Red Crescent, or other service providers through concluding agreements between the two parties.
The organisation's services are introduced by distributing brochures to beneficiaries in the centres, in addition to online promotion through the Facebook page or the organisation's official website, as well as Arabic audio-visual media in Turkey, according to Ajoum.
Regarding the difficulties that hinder the organisation in reaching beneficiaries, the mental health coordinator explains that during the outbreak of the coronavirus, consultations are done online or via mobile phone in light of the lockdown decisions to combat the pandemic.
Ajoum noted that the organisation is also working on holding awareness sessions via Facebook to introduce the work of its centres and how to reach them, especially for the new arrivals in the region.
He indicated that the United Nations supports government agencies to coordinate activities in support of refugees, as it supports the livelihood program to empower women in Kilis, in addition to support programs consecrated to children activities.
Criticisms regarding services’ promotion
Syrian journalist Husam Al-Agha told Rozana that "most people do not know the difference between the United Nations and its services and medical or relief services provided by other local or international organisations, and the reason can be attributed to the UNHCR’s failure to reach all Syrian refugees in Turkey."
Al-Agha continued: "What should happen is to intensify awareness campaigns regarding the services provided by the United Nations High Commissioner for Refugees, which implies realizing activities on the ground with them, perhaps by visiting the refugees’ homes and maintain permanent contact with them, and then by informing them that the services provided by the Turkish government are under the UN supervision and support, with the assistance of the European Union."
What is the role of UNHCR in Turkey?
The UNHCR in Turkey says on its website that “the Turkish government leads the response to protect and assist refugees and asylum seekers in Turkey, and the United Nations provides direct operational support, capacity building and technical advice to the Turkish authorities, as well as coordinating the efforts of United Nations agencies and its partners to support Turkey's refugee response and avoid aid gaps."
The United Nations stresses that registration with the Turkish government bodies is an important right and requirement for foreigners seeking international protection in Turkey, as it is the legal basis for their stay in the country and gives them access to services, including access to health, education, social assistance, psychological support, translation services and official access to the labour market.
The UN refugee agency notes that holders of the Temporary Protection Card, which starts with the number 99, are eligible to receive all assistance provided by the Turkish authorities, including medical assistance and medicines within the state in which they reside.
The costs of medical services at all levels, including public health centres (“Toplum Sağlığı Merkezi" in Turkish), family care centres, government and university hospitals, are included on an equal basis with Turkish citizens.
The UN body provides advice and assistance to people with serious medical conditions, as well as counselling on educational activities, legal aid, assistance with the help of a psychologist and a therapist, in addition to counselling on accessing services and inquiring about rights for people with special needs.
UNHCR and its partner organisations also provide translation services for medical and legal procedures, a home visit for social and financial aid, as well as assistance in writing petitions on behalf of the refugee, including applications to government bodies, such as the Social Assistance and Solidarity Foundations (SASF), the directorate of migration management in the concerned state, and Directorate General of Migration Management in Turkey, in addition to courts and lawyers’ associations.
To get assistance, you can contact the UNHCR via its assistance hotline at (4444868) or by sending an e-mail to this address: (firstname.lastname@example.org).
What does the temporary protection regime provide for refugees?
The temporary protection system guarantees to its holders a set of rights, services and aid, including health and education services, social aid, psychological support, and access to the labour market, according to the United Nations.
Syrians who are granted temporary protection can benefit from the services offered by the health centres established for immigrants, which in turn ensure Arabic-speaking staff in all states. Information about these centres can be obtained from the website of the Ministry of Health or from the Health Directorate office in the city where the refugee lives.
In the absence of health centres for immigrants, the Syrian refugees can go to public health centres in the city, which provide free primary health services.
If the refugee does not have an official referral from government health institutions, he/she has to pay the expenses in private hospitals or clinics.
Parties associated with the United Nations
In Turkey, there are several organization partnering with the United Nations and provide assistance to refugees, such as the Association for Solidarity with Asylum Seekers and Migrants (ASAM), which covers psychosocial and legal counselling, health and reproductive counselling, and educational and social activities, and has 72 offices in 46 provinces all over Turkey.
The Human Resource Development Foundation (HRDF), which works to establish and strengthen a rights-based reception system to support refugees, and other institutions in the link here.
Regarding the file of providing the refugees with job opportunities in Turkey, the United Nations points out to the possibility of communicating with its partners that provide support related to livelihood resources, including the ACTED in Mersin, the Support to Life (STL) in Istanbul, Habitat - Housing in Istanbul, and Concern in Sanliurfa, as well as the Chamber of Commerce of Gaziantep), and provides the addresses of these bodies.
This Journalistic material was produced with the support of Journalists for Human Rights (JHR) and funded by Global Affairs Canada.