An overview of the demographic characteristics of the study sample of Syrian refugee adolescent girls is provided in Table 1.
When asked to indicate what their story was mainly about, the adolescent girls gave diverse responses noting that their stories touched on the themes of education, safety and financial security, with some girls indicating a combination of themes (Figure 1). Visual inspection of the triad indicates greatest density of responses at the security item, with a noted grouping at education as well. There are obvious patterns indicating responses that pick up on a combination of items, especially the combination of education and security and the central location indicating a combination of security-education-financial security as well.
A Description of Unmet Needs
Among the 188 girls in the study aged 13-17, there were 104 (55%) who specifically mentioned some form of unmet need. Participants indicated needs associated with all of the levels in Maslow’s hierarchy, but in varying degrees and with important sub-categories.
Basic Needs
Basic needs are defined as the prepotent biological and physiological needs of human organisms, including: food, hydration, shelter, warmth, sanitation and sleep30. Thirty-eight of the 188 stories (20%) spoke specifically about an unmet need at this level, or about one in four (27%) of the 104 adolescents who discussed any unmet needs.
Unmet needs for housing and sanitation that were identified by the Syrian girls were primarily related to the conditions in refugee camps and informal tented settlements. Many girls described crowded dwellings, with many family members or multiple families living in a single tent. This is depicted in the statement:
“We used to live with our father in a house, now we live with a nation in a tent.” [ID507]
The conditions are further described as inappropriate and uncomfortable, with limited access to basic resources such as clean water for hydration and sanitation for themselves and their children, for example:
“...The tent is inappropriate, it’s too hot, and I live with my two little kids in one room, and it’s full with mice and snakes and insects… We are paying the rent of a small tent, and there is no water, neither water for drinking nor water for cleaning, we go to far places to get water, and it is too hot, my kids are getting too many times sick because of this problem.” [ID253]
“Here we pay for everything, we pay for water, we might even have to pay for the air that we breath some day, my husband can't get us enough money, he's overwhelmed by the amount of money that he has to raise. I once even got sick and suffered a lot, being a foreigner is hard.” [ID868]
In some cases, girls viewed marriage as a means to achieve financial stability to meet at least basic needs:
“We don’t have money for food. I want to get married to have a better life. We need money. I need to get married to be able to get what I need.” [ID820]
Safety Needs
Safety needs relate to personal security, stability, protection, law, and freedom from fear30, 31. There were 46 adolescent girls who mentioned unmet safety needs in their narratives. This was 25% of all the 188 girls in our study, and 44% of the 104 adolescent girls who spoke about any unmet needs at all. These deprivations were unmet needs for access to healthcare in cases of medical need, fear and insecurity associated with domestic violence, need for safe transportation, limited child protection and lack of access to formal paperwork or registration.
Unmet needs for healthcare were consistently discussed by the girls and from their perspective represent threats to individual safety. Girls stated that in some cases, they would attempt to travel back to Syria to access healthcare, even at risk to their own safety. These sample quotations highlight the safety issues associated with unmet needs for healthcare specifically:
“I went to a hospital here, but no one helped us. I spent three days in the hospital in Saida [Lebanon], and no one helped us. The medical expenses were very high, and you are aware of our situation here. I went back to Syria to be treated.” [ID1501]
“... We do not have any medical care. Since going to a hospital costs a lot, if anyone was sick we don’t seek any medical help. The situation is not safe.” [ID1238]
Domestic violence is an additional safety concern and was specifically identified by 10 of the 188 participants. These stories commonly associated violence with being married at a young age, for example:
“I was 15 years old when I got married. I didn’t get engaged, and I didn’t do a wedding. We were married in four days only. Problems started immediately. I lived with him for 20 days only. He used to beat me, ...” [ID271]
Safety needs also relate to the safety of the participants’ children. In some cases, the young mothers would sacrifice their own safety for the wellbeing of their children.
“I had a daughter and he still beats me… I endured our abusive relationship for two years. I was patient for my daughter’s sake.” [ID432]
Both married and unmarried Syrian girls mentioned feeling unsafe in their communities due to fear of violence towards them:
“And here in the camp there is no safety, after it’s dark we can’t go out, and I’m under the 18 years, and if whatever happened to my kids, even if my kid dies, I can’t go out before my husband is back I don’t feel safe going out alone, after it is dark there is no safety.” [ID253]
The safety needs identified are further exacerbated by a lack of formal paperwork and registration, which can impede movement and access to services, work and schooling. Again, girls spoke about putting themselves at risk by trying to travel back to Syria to renew papers:
“Our papers need renewal and a guarantor. We tried to go to Syria in order to renew our papers there, but we were unable to go, since our permits are expired and the borders are closed.” [ID665]
When girls were asked what is important for Syrian girls in Lebanon, from their own and their parents’ perspectives, girls list safety and happiness among those things most important (Figure 2).
Needs for Love and Belonging
Belonging and love needs are characterized by motivations for social wellbeing, belongingness, affection and love from family, friends, community groups or within romantic relationships30, 31. There were 51 girls who expressed specific unmet needs for belongingness and love, representing 27% of the overall sample and approximately half (49%) of girls who expressed any unmet needs at all. Many girls spoke about disturbed relationships and a loss of a sense of love and belongingness as a result of displacement. These needs were related to separation from family and friends by distance or borders, as well as feeling unsafe in public in Lebanon. Many of the girls discussed experiences of social isolation as they were often unable to safely go out, socialize or build new friendships. For example one girl explains the multiple sources of social isolation and how this made her feel:
“...My sister got married and I was left alone. It felt very lonely. Not one day would pass that I wouldn’t cry and hate my life. Shortly afterward, my mother left too and I was completely alone and it felt horrible.” [ID1417]
Another participant details how the migration from Syria changed her loving relationships and the way her situation over time made her choose to get engaged even though she was uncertain about it:
“I'm a woman who used to love my life in Syria, the love, the care, anyone would listen, anyone would help. We came here to Lebanon and we lost hope, trust and love. Each person wanted to solve their own problems, no one had the patience for other people's problems, I got engaged but not because I love him but just because I'm at an age where I should find the partner of my life. I can't seem to be happy or comfortable with him, there’s no harmony. but I only imagine the consequences if I leave him, society will judge me, it won't be accepted, I don't know if we'll ever live in harmony. I can't leave him now.” [ID938]
Marriage appears to have improved some girls’ love and belonging although this is balanced by experiences of intimate partner and domestic violence and extreme unhappiness in marriage situations. See, for example, this set of disparate marriage relationship experiences that were shared by participants:
“I decided to try to work and study at the same time...The curriculum started, but I only attended for 3 weeks. The principal interfered in what we had to wear, and he decided that girls and boys shouldn’t socialize together. I didn’t attend my classes anymore and continued to work. I liked my work and the people I worked with. The best thing that happened to me was that I met my husband here. His family is my family now.” [ID1545]
“I was forced into getting married, and I couldn’t get along with my husband. I was a teenager, and I was so young. I didn’t understand what marriage is. I couldn’t get along with them, neither with my husband nor with my parents in law.” [ID432]
The quality of social relationships are hindered by negative aspects of the girls’ living environments, emotional stress and, in some cases, physical abuse and sexual violence. This is in a context of very limited or lack of peer and family psychological or social supports in Lebanon compared to their lives in Syria:
“Sitting and being trapped inside the house is not a good situation. You feel the atmosphere is sickening. It is such a big difference from our life in Syria. We were living in big homes, a cleaner atmosphere, cleaner water and lots of differences. Even the social relations or social environment in Syria was a lot better; you were with your family, your uncle’s family, your friends – anywhere you go you would find people around you. But here, if you become sick, no one will come to your door. No one will even feel for you or notice.” [ID355].
Lack of feelings of love or belonging are also exacerbated for Syrian girls in Lebanon due to prevailing societal discrimination that hinder their integration:
“I would cry a lot, especially from the insults. “You, Syrians, are coming to rob us” or “You, Syrians, are coming to torture us”. These curses and insults bother me a lot, and I’d feel choked, then I’d cry. I was going through a huge psychological pressure, and I wasn’t feeling comfortable.” [ID1501]
Esteem Needs
Esteem needs, as described by Abraham Maslow, involve human motivation for a stable and generally positive evaluation of ourselves, a sense of independence, status, and personal achievement30. This level of the hierarchy was the least represented among the unmet needs expressed by the girl participants. There were only 13 examples of specific mention of unmet esteem needs, representing 7% of the 188 total participants and 13% among the 104 who noted any unmet needs at all. Expressed esteem needs were principally related to the effects of discrimination the girls feel as foreigners in Lebanon and the influence that lack of access to education and income generating opportunities has on their sense of self. One participant explicitly states that harassment or “bullying” affects her self-esteem and the esteem of other Syrian migrants. Others describe the feeling they get because of being “Syrian” in Lebanon:
“I hope that Lebanon treats Syrian better because we are all brothers and sisters. I also hope that the bullying stops as it affects our self-esteem.” [ID348]
“Of course our life was better there...if you're Syrian, they are disgusted by the word, when you say "Syrian" it's just as if you mentioned something "filthy", they treat you like an animal here, they don't give you any sort of value.” [ID614]
Participants expressed needs for opportunities for education and opportunities for income generation, recognizing their links with personal financial stability, independence and feeling respected. Education remains largely inaccessible for many migrant Syrian girls in Lebanon due to the high costs of schooling, safety concerns, and lack of formal accreditation for Syrian students in Lebanese schools45. Many girls have wanted to continue their education but most have been unable to and this is affecting their sense of self:
“I want to tell the story of how the situation in Lebanon and Syria is different, and how it has affected us for the worse, especially in our education. We were very hopeful of becoming recognized members in the community, but now, we do not have that hope anymore.” [ID141]
Self-Actualization Needs
Individuals ideally have opportunities for personal growth, fulfillment and finding personal meaning in life. Thirty participants spoke about specific unmet self-actualization needs, representing 16% of the overall sample and about a third (29%) of the participants who expressed any form of need. The concerns expressed were largely related to achieving personal goals in education, finding employment to support their livelihood, and long-term personal safety. Discussion of career aspirations were often accompanied by recognition that these ambitions may not be possible:
“My dream is to finish my education and become a doctor one day, but my dream's been killed.” [ID663]
“We are not comfortable at all, our futures have been destroyed and they remain a mystery. I hope that an opportunity will come where I can properly study because I love education and I want to become someone important in society.” [ID558]
“I think girls should continue their education. After she finishes her education, then she can think about marriage. She would be working and have completed her education and would have a better financial status.” [ID1498]
The narratives also reflect the girls’ feelings that their lives have lost significant meaning and an ongoing desire for improvement to the situation and a better future:
“My life [in Syria] had a lot of meaning, I had a lot of beautiful things. But not anymore.” [ID1500]
“I hope every girl gets to live her life, a life of her choice, following the right path. I hope that we could someday go back to Syria, so that we could live our lives, that every Syrian girl could live her life without suffering, I have suffered a lot.” [ID688]
Multiple Needs and the Intersections with Marriage and Time Since Migration
Adolescent girls commonly spoke about more than one type of unmet need. Indeed, in 63% of cases, girls expressed multiple needs, which existed across the more basic stages (physiological and safety) as well as the higher stages of the hierarchy (belonging, esteem and self-actualization). In particular, unmet safety needs were frequently expressed in conjunction with other unmet needs with 45% of the girls speaking about safety and physiological needs, and 40% speaking about safety and needs for belongingness/love.
Unmet needs for belongingness and love varied based on the number of years spent in Lebanon as well as by marital status. Among the girl participants who migrated less than three years before the date of the survey, 13% expressed love and belongingness needs. This was 31% among those participants who had displaced in the 4-5 years before the survey. The frequency of these kinds of needs also varied between married and unmarried adolescent girls, with 67% of married girls and 28% of unmarried girls reporting needs for love and belonging. Some of the married girls indicated that marriage helped them meet needs for love and belonging, while others said that they had hoped marriage would help but that it did not. Some participants indicated that marriage and motherhood gave them some freedom, purpose and happiness, while others said that they were exposed to abuse and were unhappy in their marital situations.
When the group of participants was separated by marital status and the quantitative/ternary plot data examined, there were some similarities but also differences in response pattern. For example, when the girls were asked what was needed to improve the life of Syrian girls in Lebanon, both groups had average responses that were quite central but low in the plot. This indicates consideration of all three response items “basic necessities to survive”, “programs and services” and “girls need more respect”, but overall slightly less tendency towards answering that girls need programs and services. Married girls did tend to respond on average more towards “basic necessities to survive” than the unmarried girls and these differences were statistically significant (Figure 3).
Recognition of Local Efforts to Address Unmet Needs
The participants in this study recognized formal and informal supports to address unmet needs. They spoke about organizations working to address needs at all levels of Maslow’s Hierarchy. For instance, while gaps do exist, NGOs are providing some access to shelter, food, clean water and basic health services. For some, there are safe spaces to socialize, opportunities for education and occupational outlets. The participants provide specific examples:
“ABAAD (Resource Centre for Gender Equality) provided us with these activities which allowed us to express our potential to some extent.” [ID1500]
“We had to move to Lebanon because of the war, and I began work in a hair salon. At the moment, I am working with an NGO that takes care of camps, and if the association’s plan works, they promised to equip me with whatever I need to open my own hair salon.” [ID534]
“The UN is helping with food but rent is impossible and my daughter and husband need medical care.” [ID1213]