learning & Surveying compassion in Jordan

In Amman the buildings are dense, piled on top of each other, no spaces in between – evidence of a city that grew out of necessity. During the day the sight can be overwhelming, but at sunset the repetitive architecture reflects back a pink light that captures the city and you can feel a collective sigh of relief run through the narrow unsidewalked streets.

Sunset in Amman 

I am in Amman conducting a study on self-compassion and the mental health of displaced Syrians living in Jordan. Jordan has provided safety to Palestinians, Iraqis, Syrians, and others fleeing danger in their homelands. Although it has not always done so perfectly, it’s powerful to stand on a soil that has borne the weight of so many stories of loss, pain, and strength. As a first generation Syrian American, bearing witness to the war that upturned people’s lives, separated them from family, and destroyed their homes is important to me. I feel a responsibility to understand how these experiences impacted the health and well-being of those who lived through them and to share that globally with my peers and mentors who have the resources to provide support.

I arrived at UCSD as a first year medical student, eager to find an avenue to do the work I cared for. I was excited to be connected with Dr. Wael Al-Delaimy, Professor at the Herbert Wertheim School of Public Health, who conducts research with refugee populations in Jordan and in San Diego. Dr. Wael has previously studied resilience in refugee communities and I was interested in further exploring what additional tools individuals use to withstand severe trauma. At the time, I was taking an elective class on self-compassion and was surprised by how powerful it can be on one’s health. I found that there was no literature on the role of self-compassion in communities that have experienced displacement and suggested the topic to Dr. Al-Delaimy. Together, we designed a cross-sectional survey study that uses four validated tools which assess traumatic exposure, mental health, self-compassion, and resilience. I spent the spring doing literature review, designing the study, and obtaining IRB approval.

The city of Amman is on a hill so there are stairs everywhere!

Dr. Al-Delaimy also connected me to Dr. Rana Dajani, the founder of We Love Reading, an organization that promotes reading aloud to children in underserved communities in Jordan. Dr. Dajani and Lina, the Program Coordinator at We Love Reading, both very familiar with the displaced populations living in Jordan, were able to provide me with a lot of insight on how to best conduct the study. Learning from community members themselves was a critical part of my experience this summer. It was something I was continuously reminded of as I met more and more amazing people along my journey that offered their support. Meeting with Dr. Dajani and Lina before leaving for Jordan gave me a good idea of what our work would look like, but as I would soon find out, being in the field is so different from talking about being in the field.

Lina from We Love Reading was an amazing mentor to me! Us on the balcony of the We Love Reading office. 

Making the decision to go to Jordan was not easy, given that COVID continues to be a concern worldwide. Ultimately, because I am vaccinated, the vaccine rate in Amman is relatively high, and I had the support of the school and our community partners in Jordan, it felt safe to travel. I took precautions throughout the trip by getting tested, wearing a mask, and encouraging study participants and volunteers to wear masks. However, I still want to note the immense privilege that it is to be able to travel during this time (and any time).

Explaining the study to participants. 

Before arriving in Jordan, I was anxious about how successful I would be in outreaching to community organizations where I could survey. When I arrived, Lina provided me with a list of a few organizations I could start with. I nervously began to make phone calls, arranging meetings with organization directors to explain my project. The community organizations were so incredibly generous with their time and ideas as they helped me plan data collection days, recruit participants, and bridge the research to the community. I was motivated by their excitement for the research topic and their willingness to help. What surprised me even more was how one community organization would lead me to a new one. While collecting data, I would often meet a participant or a volunteer that would show interest in the project and would offer to take me to another organization that might be interested in collaborating.

Dr. Al Delaimey and I with community leaders, Rua and Farris (local medical students), and Dr. Al Delaimey’s kids after data collection at a community organization.

On a typical data collection day, I would get up at 8:30 AM, have an Arabic coffee with my Aunt (I am lucky to have family in Jordan and was able to stay with them), and take a Careem (the Jordanian version of Uber) to the We Love Reading office. At the office, I would check in with Lina, make copies of the surveys I would be distributing that day (endless thanks to Farris and Azeez who helped me with all the printing), and pick up the children’s books I would gift participants. Then, I would take another Careem to the organization I was stationed at that day (I took aalllooottt of Careems during my time in Amman! Taking a Careem felt safe, the app was really easy to use, and I had a lot of great conversations with the drivers I met!). At the organization, I would explain the study to potential participants, obtain their consent and give them the survey. Many of those that I surveyed needed help with reading or writing, so, in these cases, I had the opportunity to conduct the survey via interview. Although this was a slower form of data collection, these interviews allowed me to connect with the participants and understand their needs in a way that reading a survey does not allow me to do. In these interviews, I learned about the severe unemployment (due to laws barring Syrian refugees from many work opportunities), the heavy impact of COVID, and absolute lack of access to healthcare. However, I also learned that life in some ways, regardless how difficult it is, must continue, as people shared with me graduation or wedding photos and laughed with me about their kids. At the end of every day I was always surprised by how much laughter there was. I suppose this is a form of self-compassion – to allow yourself to laugh even in the midst of adversity.

One of the largest logistical challenges I faced was outreaching to men in the community. Most of the community organizations in Amman are women-run and primarily serve women and children. Additionally, organizations are open during working hours, during which men in this community are often at work or are out in search of it. I was lucky to meet Ali, a volunteer at an organization who happened to be present on a day I was there collecting data. Ali is part of the refugee community in Amman and has served his community as a health and well-being instructor for many years. Ali became a good friend, as he helped me outreach to men that may be interested in participating in the research. Beyond that, Ali taught me about compassion – he would often say that every action of kindness put out into the world undoubtedly returns to the giver in some form or another, so he gave endlessly. I am grateful for the support he gave to this project and I pray that his generosity returns to him in double.

A fish meal I shared with Ali and other friends on one of my last days in Amman! 

Thanks to people like Ali, Ruaa and Farris, the 2 wonderful Jordanian medical students who helped me collect data, and the participants who shared their stories with me, my understanding of compassion was constantly being challenged while working on this project. It was incredibly difficult to ask the participants I met about the traumatic experiences they faced as a result of displacement and the impact it had on them and their families. How could people share so much of their lives,pain, and hopes with me when I offer so little in return? How could I be a witness to this suffering and do so little about it? I reflected on the role of a researcher as an observer. Compassion, on the other hand, requires that we recognize suffering and take action. How could I, as a researcher, exhibit compassion? What does it mean to extract data from someone’s lived experiences when, regardless of my intention, this data will likely not directly serve those it belongs to? I don’t have the answers to these questions, but one experience I had in Jordan gives me something to cling to as a learning researcher. After interviewing an uncle (a term of respect in Arabic when referring to an elder) about his experiences, he thanked me. I was taken aback – you are the one who shared so much with me. “Thank you for getting us out of the house and giving us a place to talk about how we are feeling.” This was a reminder to me that compassion isn’t always a grand action- sometimes it’s just being present, asking questions, and listening. This is certainly not enough – but it is a start, as I continue to learn what the role of a researcher in a community can be.

I am grateful for all the people I met in Jordan who exist every day in the presence of adversity, but still welcomed me with warmth and shared with me their stories. I take these stories on as a responsibility and, although whatever I do with them will never be enough, I hope the outcome is meaningful and a beginning.

Thank you to Ali, Ruaa, Farris, Khala Samira, Hasan, Khala Manal, Khala Rasmeyeh, Sundos, Muna, Lina, Farris, Azeez, Dr. Al-Delaimy, Dr. Dajani, Adel, Ameh Samar, and so many more. See you soon inshallah.

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