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Manchester researchers offer help to families displaced by Syria conflict

It is not just at home where our research and teaching helps communities, but in places where it is needed most.

The armed conflict in Syria broke out in 2011 and has caused the largest humanitarian crisis since the second world war. The lives of more than 8 million children have been put in danger, their worlds turned upside down by witnessing violence and death.

Experiencing the traumatic events of war leaves children at a high risk of behavioural and developmental problems, and can have long-lasting consequences.

Research Associate Aala El-Khani recognised the urgent need to find strategies that would help parents in refugee camps cope with their own emotional difficulties in order to help them support their children’s mental health needs.

Aala, whose parents are from Syria and has relatives in the country, began her PhD at Manchester in 2011.

"I initially started my PhD on a different topic, but as the events in Syria unfolded, and with my background in parent training, as well as having two young children myself, I began to wonder what it must be like to parent children in war and refugee situations and how could families in that context be supported through training and advice", says Aala.

Travelling to refugee camps

Researcher Aala El-Khani interviewing a Syrian parent in a refugee camp
Researcher Aala El-Khani interviewing a Syrian parent in a refugee camp

During her PhD, Aala visited three refugee camps housing Syrian refugees. While there she conducted focus groups and interviews with parents and professionals involved in humanitarian support.

The extreme conditions meant that parents were focusing on practical things like collecting clean water but felt they were not coping with their children who they saw showing sadness, anxiety, anger and aggression. Parents expressed guilt and felt they were failing their children.

This phase of the research started to give a better understanding of the parenting needs of people living in refugee camps and the requirement to provide them with psychological first aid to help them better care for their children.

Distributing psychological first aid inside bread parcels

Having identified a significant and urgent need for families to access parenting support, Aala and colleagues had to develop a system of getting information to people living in the conflict zone.

Humanitarian agencies were already stretched providing basic daily essentials to refugees, such as clean water, food and medicines.

Working with the established NGO Watan, they discussed how to reach as many families as possible, at low cost. It was suggested that one way to distribute written information rapidly and to a very large number of families was alongside the routine distribution of bread from bakeries set up as a relief supply route to displaced families. The Bread Wrapper Study was born.

Parenting information packed inside a bread delivery for refugees
Parenting information, questionnaires and pens packed inside a bread delivery for refugees

A two-page parenting information leaflet was developed, with bite-size coping strategies and parenting advice. It asked caregivers to think about what they were experiencing and what could they do to help themselves.

It asked them to think what their child might be experiencing and what they could do to help the child by, for example, providing warmth and support, giving praise, encouraging play, maintaining a routine and spending time together.

A brief questionnaire was also included so parents could give feedback on how useful they found the information and what further support they needed.

The leaflet and questionnaire, along with a pen, were packed with the bread and distributed to 3,000 families within two days using Watan’s charity arm. The questionnaires were returned via the same channel then taken back to the UK for analysis.
The impact

"We were surprised at how much interest parents had in the leaflets, their willingness to respond and the value they took from the brief advice”, says Aala.

60% of questionnaires were completed and returned by parents, with the majority of caregivers rating the overall usefulness of the leaflet as either ‘quite a lot’ or ‘a great deal’.

The majority of the 400 additional comments written on the questionnaires were incredibly encouraging, including one which said "Thank you for not forgetting about us and our children”.

"(The leaflet) is great if we follow it accordingly. It has relaxed us and shown us what to do. We can reduce anxiety and fears in our children and make them feel safer"

Feedback from Syrian refugee parent

"To our knowledge this is the first time this approach has been used to reach out to provide parents with basic parenting skills information in conflict zones. The questionnaire feedback showed that the  approach to delivering psychological first aid has great potential as a means of getting psychological support to parents in complex humanitarian situations", says Aala.

The approach has been commended by various charity organisations and the leaflet has been adapted to meet the needs of refugees now living in Europe. It has been translated into English, Arabic, Swedish, French, Italian and Greek and adopted by a number of humanitarian agencies across Europe and North America.

Going forward, the team hopes their research will be deployed on a much larger scale to promote a better understanding of the needs of all people caught up in crisis.

They are using feedback from the Bread Wrapper Study to develop a parent training programme tailored for displaced families and are continuing to develop and evaluate culturally appropriate and evidence-based materials for rapid distribution.

Engaging the public

As well as the work in Syria, Aala and colleagues in the Faculty's Parenting and Families Research Group have been engaging the public closer to home by putting their research in the spotlight in order to draw interest and support for the Syrian refugee crisis.

"By doing this we are building an understanding within communities of what life as a refugee is like, so that they will be more accepting places to live in", says Aala.

The team has put on exhibitions at Z-arts in Hulme in June 2015 and #JourneysFest at The Manchester Museum in October 2016, featuring artwork by children in refugee camps and a documentary film Departing: Arrivals made with independent film maker Hafsah Naib.

The film shows interviews with parents talking about their journey with their children from the warzone to the UK.


The exhibitions, which have attracted several hundred visitors, highlight the enormous challenges faced by those caring for children in the Syrian conflict and also showed how we can help support parents to protect themselves and their children from further psychological distress.

"The exhibition is an extremely powerful reminder of the innocence of children caught in the conflict and the urgent need to support and care for them"

Visitor to the exhibition, 2015

Read more about our research into parenting in humanitarian and conflict situations.