Jordan
Patrina McCauley
HMC510: Health Care Models Across the Globe
CSU-Global
Dr. Evelyn Shinn
November 20, 2013

Jordan
The Middle East is one of the most tumultuous regions on the planet and the impact of political instability spreads beyond the borders of countries in turmoil. Countries, like Jordan, that are not in conflict experience strain on economic and social systems due to refugees from neighboring countries seeking safety (Johnson, 2010). The duration of Middle Eastern conflicts has left Jordan, in particular, with long standing systems of care in place for refugees from Palestine, Iraq and now Syria (Dudley, 2012). The growth rate of a refugee camp can be startling, growing from hundreds to thousands and even hundreds of thousands of people during the course of a conflict (Kaufmann, 2013). For instance the refugee camp Za'atari’s population went from hundreds of refugees to fifteen thousand residents in the first few months and within a year to over one hundred thousand people (Remnick, 2013). The impact of the region’s instability can be assessed in many ways including demographic changes, strain services and strain on resources in countries taking refugees.
The demographics of refugee populations are often different from the general population of the home country. In the majority of cases refugees are more predominantly female (Kauffman, 2013). The impact of a predominately female refugee population comes with additional challenges because women are second class citizens lacking many civil rights and social opportunities compared to their male counterparts in the same country (Al-Modall, 2012). During conflicts women face rape, increased domestic violence, are married off at young ages to provide refugee families with needed funds, and can become trapped in their host country with children if the marriage does not work, to name a few specific complications (Al-Modall, 2012; Khawaja et al, 2008; Wolfe, 2013; Macdougall, 2011). The social challenges for these women include barriers that become opportunities for health education including: needs for family planning, increasing the breastfeeding of children, mental health issues including post traumatic stress disease (PTSD), and other comorbid diseases (Madanat et al, 2007; Morris 2009; Mateen, 2012; Khader, 2012). The camps present an opportunity to work on social and health issues impacting women and also refugee children in the Middle East, but it takes a lot of resources to accomplish these health interventions.
The strain on social services that refugees create is also an important issue. Refugees in the Middle East, specifically Syrians, are not like refugees in other areas of the world because they are accustom to seeking services (Gavlak, 2013). The strain on health care and other services due to volume of people involved affects both cities and populations inside the camps despite refugees fleeing their home countries in part due to lack of services (Gavlak, 2013; Kaufmann, 2013). Only about thirty percent of refugees end up settling in the camps while the rest live in the towns and cities (Kaufmann, 2013). The World Health Organization (WHO) focuses support and resources on non-camp refugees to keep the over burdened health system from collapsing (Gavlak, 2013). Jordan invests in developing health services in the cities (Johnson, 2010). Gaps in care and services in camps can be compounded by the size of the camps per Kaufman who found “the camp has become so large, and its resources are so minimal, that most of the refugees do not live within walking distance of schools or medical facilities” (2013, pg 18). The services needed by stressed refugees after fleeing their homes for safety, health and to have a future are important to the stability of the camps.
Refugees coming to the camps come with very little money or resources. The strains on resources in host countries include scarce water supplies, medications, and financial resources