The Syrian Civil War has been one of the major world events of the past decade, resulting in millions of deaths and mass destruction, in addition to creating one of the biggest refugee crises in recent history. Canada in particular has received tens of thousands of Syrian refugees. The website for Immigration, Refugees and Citizenship Canada (IRCC) states that “Canada resettled more than 25,000 Syrian refugees between November 4, 2015 and February 29, 2016.” As of October 31, 2020, that number currently sits at 44,620 resettled refugees in total.

As big as that number seems, it is only a tiny fraction of the total number of refugees. About 13 million people have been displaced to places within and outside of Syria — more than half of Syria’s population.

In a recent U of T study, occupational therapists Sumaira Khan and Zahra Kanji, alongside their co-writers, explored the experiences of Syrian refugee youth throughout their migration journey to Canada and assess their occupational transitions — that is, changes in their daily activities and social roles — as a result of their resettlement to Canada.

What is occupational therapy?

According to the Canadian Association of Occupational Therapists, occupational therapy is “a type of health care that helps to solve the problems that interfere with a person’s ability to do the things that are important to them.” Khan and Kanji set out to explore the ways in which the occupations — routine daily activities — of Syrian refugee youth were impacted as a result of the environmental, cultural, and social changes created by their forced displacement.

“We really view [sic] that the everyday occupations or activities that a person does is essential to their well being and to who they are as a person,” Kanji said during an interview with The Varsity. This idea, they said, is central to what they are taught and what they practice as occupational therapists.

Kanji added that, within their field, the term “occupation” can include a variety of things, ranging from day-to-day activities like work and school to recreation and self-care habits.

Generating data through storytelling

In order to gather data for their study, Khan and Kanji conducted two interviews each with four Syrian refugees, aged 19 and 20, who had arrived in Canada between 2017–2019. For privacy, the participants were referred to only by their first names: Raafat, Nour, Mohammad, and Miriam. The interviews were structured so that the participants could share their experiences and the evolution of their social roles and occupations throughout their migration journey.

The researchers used an approach introduced to them by one of their research supervisors, Professor Jane Davis of the Department of Occupational Science and Occupational Therapy at the Temerty Faculty of Medicine. The strategy consists of creating what’s called an “occupational life course timeline” — a graphical representation of the events and occupations going on at different points in one’s life.

“It’s not been used as much in research; that’s why we wanted to include this,” Khan said. They conducted online interviews in which one of the researchers drew the timeline as the participants told their stories. After that, they sent the timelines to the participants to reflect on before conducting a second round of interviews, where the timelines served as visual aids.

“That process did elicit a lot of great conversations because the participants were able to actually see their journey evolve,” Khan noted.

Creating meaning out of subjective narratives

Both Khan and Kanji emphasized the role that their own experiences and biases played in generating and analyzing their data. Khan talked about the “interpretivist paradigm,” saying that both her and Kanji feel that the data itself and its interpretation are closely linked.

To ensure the quality of their research data, Khan and Kanji made sure to use as many sources as they could to generate their data, including the occupational life course timelines, information from multiple interviews, and careful analysis of the interviews to extract meaning and themes.

Kanji said that they used a narrative inquiry approach to use the participants’ stories to understand the meanings they drew from their own experiences. The researchers transcribed the interviews and broke them down to identify key aspects of the participants’ narratives and put them all into thematic groups. Four key themes emerged from their analysis: family, autonomy, community participation, and integration into society.

An important aspect of the researchers’ findings was that these themes were fluid and the roles of the participants within each of them changed based on external context. For instance, a major shift in context for many participants happened when the civil war started in 2011. After 2011, the siblings Raafat and Nour couldn’t participate in their community the way they used to before the war, and were forced to flee to Lebanon with their family and establish their lives in a new society as refugees.

Mohammad, who was 10 years old when the war began, said he lost his childhood as he was forced to drop out of school and stop playing with friends on the streets at a very young age. A common point among all of the participants’ narratives was taking on responsibilities and roles while they were still young — like taking odd jobs at a young age to support their families, or becoming cultural navigators as they moved to a new country.

Another aspect that the researchers discovered in the participants’ narratives was a disruption of traditional gender roles as they settled into their new lives in Canada. While Nour would have previously been expected to solely be a caretaker and get married at a relatively young age, she found opportunities to challenge those roles when she arrived in Canada. She found it easier to pursue higher education and acquire more autonomy. These cultural shifts also manifested within her family as the men in the family started contributing to household work — a role traditionally reserved for women.

Social, economic, and environmental barriers

“When it comes to occupational possibilities, Canada — as great as the opportunities are — isn’t perfect,” Khan noted. Some of the participants described experiencing marginalization as refugees in Canada due to factors like limited English proficiency, a lack of education as a result of their circumstances, and financial difficulties.

While this might be a general issue affecting all immigrants and refugees, the IRCC reported that Syrian refugees accessed settlement services — such as language assessment and training, employment services, and crisis counselling —  at a higher rate than non-Syrian refugees who arrived in Canada during the same period. This suggests that Syrians are more affected by issues of marginalization because they have limited resources to navigate their new society.

Although government services like the ones detailed above have had a positive reception among those who are able to receive them, systemic barriers such as a lack of available childcare or a shortage of accessible English Sign Language classes prevents mothers of young children or people who are hearing-impared — a common ailment among refugees, according to research — from accessing these government services.

Lack of access to language services can have largely negative effects on refugee families since, according to a 2018 study, language barriers are one of the key factors that affect people’s ability to find employment.

Adapting and moving forward

One of the key takeaways that both researchers highlighted was the resilience that all the participants showed throughout their stories. They noted that the young refugees had to grow up quickly and adapt to their new environments, needing to quickly acquire new skills essential to their survival. “[They were] only in their mid-teens when they moved to Canada with a wealth of experience like cultural knowledge, cultural capital, and life experiences,” Khan emphasized.

Khan and Kanji noted that it’s important to look at the experiences of refugees through the lens of occupational therapy in order to delve deeper into their day-to-day experiences and gain more understanding. “Something we did see in our interviews was that when the participants did arrive with their families, obviously immediate needs were met, but there was a gap with regards to how to navigate their surroundings,” Khan said.

Despite the difficulties that they faced in Canada, the participants demonstrated a drive to succeed and give back to their communities. For Mohammad, this has meant volunteering as a translator at the same resettlement agency that supported his family. For Raafat and Nour, it has meant an aspiration to pursue medicine.

In her interviews, Nour said her desire to return to Syria as a doctor came from seeing the war firsthand. “I saw a lot of people dying [with] my eyes. And I just wanna go back and help them,” she said. “I wanna do everything [for] free… I’m not interested in money. I care about helping people.”