Community-based child protection with Palestinian refugees in South Lebanon: Engendering hope and safety

Introduction

The aim of this article is to show the impact of an intensive social work intervention on a problem-saturated multi-generational refugee community which relies on community/voluntary engagement and family cooperation rather than strong State-centred child protection frameworks or consistent statutory/state-regulated responses. Quantitative measures of hope were chosen to contribute to the evaluation process because of the role hope can play in strengthening refugee communities resilience and social well-being. Engendering hope is also an important component of the approach used by Foundation Terre des hommes Lausanne (Tdh), an international non-governmental organisation (INGO). Tdh social workers use a child-focused, participatory and strengths-based child protection framework.

The importance, and challenge, of engendering hope with refugees through helping relationships to increase social well-being has been given some attention in the literature already. This has mainly focused on the role of hope as key to overcoming adversity in relation to pre-migration experiences, post-traumatic stress disorder (PTSD), adaptation and post-migratory stressors (Goodman, 2004; Hardgrove, 2009; Hosin, 2001; Luster et al., 2009; Miles, 2000; Yohani, 2010). Hope building in particular is reported as a key component of healing for those who have experienced trauma, loss and despair (Brohl, 1996; Goodman, 2004; Wessells, 1999; Yohani, 2010) and is therefore an important part of a protective environment for children. The importance of providing ongoing support to refugee children and families to increase social well-being is increasingly being recognised, especially within refugee camps and in the early years of adaption (Ellis et al., 2008; Kia-Keating and Ellis, 2007; Montgomery, 2008; Yohani, 2010). Yet the Palestinian refugee context, with camps established in Lebanon and neighbouring countries since 1948, draws attention to the long-term needs of refugees when trauma is transferred to, and re-lived by, new generations who are born as refugees (Khamis, 2005).

The politically charged and protracted situation for Palestinian refugees which continues to exert new trauma and despair each day presents certain challenges for the hope building, especially with vulnerable families living so close to their homeland and site of continued conflict. Day-to-day life in the Palestinian refugee camps and ‘illegal gatherings’ in South Lebanon are shaped by unequal rights, marginalisation and chronic socioeconomic disadvantage alongside significant political and military instability (Halabi, 2004; Makhoul et al., 2003). Illegal gatherings are locations frequently adjacent or in the near vicinity of Palestinian refugee camps which have been established to accommodate the overflow of population due to the boundaries of the camp having not been changed since their creation in 1948 or 1967. Land used for gatherings is not approved for housing and can be government or privately owned. Conditions in gatherings are often poor and housing construction precarious. Illegal gatherings are under constant threat to be dismantled.

The political consciousness of Palestinians is inseparable from ‘a collective hope’ regarding the ‘right to return’ to the Palestinian homeland and consequently a Palestinian nation. For generations, Palestinian children have been born as refugees in a context of statelessness, despair and ongoing insecurity about where they belong and whether they are safe. Because of this, the collective hope of the ‘right to return’ can take precedence over immediate and personal hopes or ambitions (e.g. related to relationships, education, family or employment) which are placed on hold until the larger hope is realised. This has significant consequences for hope building and social well-being both on personal and social levels. The right to return’s presence in the lexicon and daily consciousness of Palestinian refugees sits at the heart of what the future ‘will’ look like and consequently permeates how children are socialised and people manage their lives, relationships, possessions and politics. Vicarious hope can be seen to function where parents hope for things for their children which they do not believe they will experience themselves such as the right to return, full inclusion as citizens, better access to health, education and employment. The symbiotic relationship of despair and hope cannot be separated from initiatives and humanitarian aid projects that aim to increase social well-being and child protection.

Within academic literature, hope has been described as an ‘overall perception that one’s goals can be met’ (see Snyder et al., 1991, for review) or ‘to believe that something positive, which does not presently apply to one’s life, could still materialise’ (Miles, 2000: 138). Although under-researched, hope is considered an important concept when working with refugee children particularly in response to despair, linked with concepts of resilience and coping (Goodman, 2004; Hosin, 2001; Lazarus, 1999; Luster et al., 2009; Miles, 2000; Snyder et al., 1997). Even in contexts of poverty, insecurity and inequality, such as the Palestinian refugee camps in Lebanon, there are still important protective factors present for children such as high self-esteem, doing well at school, family relationships, religion and faith which bring emotional and social benefits, peer networks and community belonging. These can all be drawn upon to encourage ‘hopeful thinking’. ‘Hopeful thinking’, which is related to notions of perceived competence and control, is associated with increased health and well-being outcomes, especially when children face health or social problems (Snyder et al., 1997). Research on hope with vulnerable young people reveals the importance of a sense of connection (O’Leary and Robb, 2009), self-agency and futuristic aspiration (Robb et al., 2010). Hope can lead to actions which seek to improve unsatisfactory situations to increase social well-being drawing on a strengths-based framework, whereas hopelessness is associated with giving up, inactivity or despair (Goodman, 2004; Miles, 2000).

There has been limited research on the levels and nature of hope in refugee children (Miles, 2000), especially those receiving support from a community-based intervention. However, there is evidence to suggest that intervention from adults can be important for engendering and encouraging hope in children (Bronfenbrenner and Morris, 1998; Luster et al., 2009; Yohani, 2010). While previous studies exploring the role and nature of hope in refugee children have predominantly used qualitative methodologies (Goodman, 2004; Hosin, 2001; Luster et al., 2009; Miles, 2000), quantitative measures have also been developed to identify ‘hopeful’ attitudes and behaviours in children across a wide variety of contexts (Snyder et al., 1997). These measures were used as part of a wider evaluation of Tdh’s community-based child protection project to identify whether or not engagement with social workers in child-focused and participatory protective activities led to increased ratings of personal hopefulness, resilience and coping. The results from these measures, complemented by a single case study from the project, will now be presented.

Methods

Research context

Conditions in the Palestinian refugee camps and gatherings are marked by overcrowding, poor sanitation, poor socioeconomic conditions, limited access to health, education and social services and a lack of employment opportunities (Abbas et al., 1997; Laithy et al., 2008; Suleiman, 1997; United Nations Relief Works Agency (UNRWA), 2014).The three camps involved in this research are some of the oldest in Lebanon and are home to over 65,000 people, almost half of whom are under 26 years old (UNRWA, 2014). See Table 1 for further details about the three camps.

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Table 1.

Details of camps.

	Camp 1	Camp 2	Camp 3
Registered refugees	22,789	11,254	31,478
Number of schools	4	4	4 (including 1 secondary school)
Number of health clinics	1	1	1
Proportion of population 0–12 years	22%	20%	22%
Proportion of population 13–15 years	26%	27%	27%

The context in which children grow up in these camps and gatherings is characterised by unequal rights, chronic socioeconomic disadvantage, continued volatility within internal politics, trauma and emergencies, Lebanese political instability and a residual threat of war with Israel. This creates precarious conditions for a stable protective environment for children.

Unsurprisingly, many child protection risks arise in this environment which increase levels of hopelessness and despair, including school dropout, child labour linked to financial exploitation and abuse, poor physical health, poor mental health, sexual and psychological abuse, exposure to conflict and violence, problematic use of alcohol and drugs, and lack of social space and recreational activities for both children and youths (especially girls) (Bahani et al., 2009; Khader et al., 2009; Khamis, 2005; Peltonen and Punamaki, 2010; Makhoul et al., 2003; Reed et al., 2012). While there are some formal legislative and professional frameworks of child protection in Lebanon and related services, these are rarely operationalised within the refugee camps as governance and provision of services are maintained by several Palestinian groups and the UNRWA. Few child protection frameworks and direct intervention services exist which go beyond consciousness-raising apart from limited health and education services or the provision of basic cash subsidies (Suleiman, 1997; UNRWA, 2012).

Bahani et al. (2009) found limited awareness of child protection generally in the camps, no professional frameworks and little or no knowledge of the Lebanese Legislation (Law 422) or related services to protect children from abuse and violence. Generally, there was little faith in the capacity of Lebanese Authorities or local Palestinian power structures, such as Popular Committees, Community Committees and school directors to intervene in child protection matters with very few examples of positive intervention. None of the internal Palestinian structures of governance in the three camps had an official focal point or practice orientation for responding to child protection risks reported or identified by them. Children and youth had no forum to raise their concerns, and it was found that there was little or no coordination or networking among child protection actors in camps and gatherings. Local organisations working with children, such as Vocational Training Centres and Scouts, had little or no training in even basic child protection.

Research methods and tools

While the wider evaluation drew on a number of different quantitative and qualitative data sources, this article reports on results from a validated ‘hope’ instrument for 8- to 16-year-olds (Snyder et al., 1997) used to assess children’s self-efficiency, self-agency and ability to see a pathway to solve problems and achieve goals. This measure was selected because it is relatively short and simple to administer while also having been validated for Arabic-speaking communities and widely used around the world in different contexts to measure hope in children (Abdel-Khaleka and Snyder, 2007). Translation to Arabic involved back-translation techniques and an engagement with compatible meanings across languages and cultures (Abdel-Khaleka and Snyder, 2007). The tool was trialled in the refugee camps prior to use, and all of the social workers received training on how to administer the tool and ensure high data quality. While hope is a loaded concept in the Palestinian context, as previously discussed, the measures used directed children and young people to consider the personal nature of hope as it pertains to increasing their own social well-being.

Two types of the hope instrument were administered: one for children aged 5–14 years (6 items with a 6-option scale, minimum score = 6, maximum = 36) and one for youths aged over 15 years (6 items with an 8-option scale, minimum score = 8, maximum = 48). Total scores were created by adding together scores from each statement. This tool was administered by a social worker at the beginning and end of their intervention resulting in a pre- and post-intervention measurement of hope (Figure 1).

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Figure 1.

Instrument questions.

While the original ‘hope’ tool was validated to measure two sub-scales within the one tool (agency sub-scale and pathways sub-scale), a principal component analysis (PCA) of these data indicated that the scale is reliable at measuring only one overall component. This is supported by a very high Cronbach’s alpha score of .93 which indicates high internal reliability for the tool as a whole. Higher total scores therefore represent higher levels of hope, reflecting a perceived capacity to initiate and sustain action towards a desired goal which improves social well-being and produce routes to these goals, embodying both agentic and pathways thinking (Snyder et al., 1997).

Results

Overview of all cases

A total of 888 ‘cases’, which refers to the aggregated number of individual children’s (0–18 years) case files, were opened across the 2 years of the project, resulting in an excess of 5900 family visits and contact with 3882 individuals when taking into account the wider family involved with each child. The hope tool was used with a sub-sample of 222 children referred for direct social work intervention during two, 3-month periods across the 2 years.

Child protection risks identified during assessment

It is important to highlight that the measurement of hope was used with children who had been referred to Tdh because of a child protection concern, rather than with the general population of children in the Palestinian refugee camp. In total, 316 child protection risks were recorded across 222 cases as identified by the social workers working in the camps and gatherings. These included school dropout, child labour, problematic substance use, health problems, poverty, family conflict, neglect, and physical, sexual or emotional abuse, which reflected the risks found in the scoping assessment completed by Tdh. While school dropout was the most common reason for referral, initial and further assessments often found a whole range of more complex child protection concerns including child physical and sexual abuse. It was in regard to these assessed needs the intervention was focused and for which the role of hope in building resilience and increasing social well-being was central.

Hope

The mean level of hope across all camps and gatherings at the first assessment for children was 17.28 (standard deviation [SD] = 5.49; n = 122) and for youth was 28.41 (SD = 8.62; n = 100), and at case closure the mean level had increased to 23.91 (SD = 4.57; n = 122) for children and 35.26 (SD = 6.47; n = 100) for youth (see Figure 2), indicating an improvement during the period of intervention. A paired sample t-test was conducted separately for children and youths to compare mean total scores at assessment and case closure, to see whether the change evident in Figure 2 was statistically significant. This showed a high level of statistical significance for both children (t = −13.65; p < .001) and youths (t = −10.34; p < .001). Although children recorded a higher increase in levels of positive change than youth, they started at a lower level.

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Figure 2.

Mean level of hope pre- and post-Tdh intervention.

Bivariate analysis was completed on the hope change scores to identify the factors which significantly impact this change using key variables such as gender, age, number of contacts, length of intervention, change in health score, pre-intervention hope score and post-intervention hope score. A weak but significant correlation was found for both children and youths between change in hope score and number of contacts with a social worker (r = –.33, p < .001; r = –.33, p < .001). The more direct contacts with a social worker, the higher the total hope score. A stronger and significant correlation was also found for both children and youths between pre-intervention hope score and change in hope score (r = −.65, p < .001; r = −.67, p < .001). Those who started with the lowest scores showed the most positive increase in total hope scores. Age was also found to have a weak but significant correlation with change in total hope score for children, but not youths (r = .21, p < .001). Younger children recorded more positive change than older children. Post-intervention hope score was also found to have a moderate and significant correlation with change in hope score (r = −.41, p < .001). Children with the highest post-intervention hope scores showed the most change.

When these explanatory variables were put into a multiple regression model (using enter method and list-wise exclusion of missing cases), three predictors of change in hope score were identified for children: camp (ref category) or gathering (β = −3.421; p < .01; n = 120), number of contacts (β = −2.47; p < .05; n = 120) and pre-health score (β = −.573; p = .053; n = 120). However, this model only had an R of .445 and an R² of .198, indicating that these variables only account for 20 percent of the variance of change in hope score for children. When pre-intervention hope score (β = .638; p < .0001; n = 122) was put into the model, all other variables became insignificant, and with pre-intervention hope scores remaining in the model alone the R increased to .647 and the R² to .419. However, this suggests that other factors not captured by the variables above also contribute to the change in hope scores for children.

Two predictors of change in hope scores were identified for youth: number of contacts (β = −.295; p < .01; n = 100) and pre-intervention health score (β = −.573; p = .001; n = 100). However, this model only had an R of .401 and an R² of .161, indicating that these variables only account for 16 percent of the variance of change in hope scores for youth. When pre-intervention hope scores (β = .485; p < .0001; n = 122) were put into the model, pre-intervention health scores became insignificant, and with pre-intervention hope scores remaining in the model with number of contacts (β = −.195; p < .01; n = 100), the R increased to .706 and the R² to .498. This suggests that other factors, not captured by the above variables, also contributed to the change in hope score for youth.

Comparison group

In regard to levels of hope, given the small number of youths in the comparison group, only 16 responses on the child instrument were analysed. While hope scores for the intervention group increased over time, hope scores for the comparison group significantly decreased over the same time period (t = 2.19; p < .05). This is illustrated in Figure 3, showing that the comparison group had slightly higher hope scores to begin with than the Tdh serviced group, but this was reversed when measured again at a later period.

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Figure 3.

Changes in mean hope scores over time.

Case study

In October 2009, Nadia (13-year-old female) was referred to the service because she had stopped attending school. During the first home visit, Nadia was highly resistant to returning to school. Observation revealed she was very stressed, with chunks of hair falling out over recent weeks. It emerged that two of her younger siblings were also close to dropping out. Their father died 2 years earlier and their mother was struggling to gain enough income to support her four children (the eldest child being 20 years old and severely disabled).

Observations over time showed that the children rarely spoke and were quite isolated. Needs of the family were discussed with the mother. Problems included extreme poverty, poor living conditions and the fact the disabled sibling required 24-hour care. It was revealed that Nadia is often the main carer.

Tdh offered some help to improve the living conditions of the home by providing furniture and ensuring safe electric wiring. The children were reluctant to leave the house but the social worker persisted, calling often on the family for short visits, and gradually a trusting relationship was established. The two youngest of the children returned to school and Tdh supported this with some resources for their studies.

Nadia, however, remained resistant to school or to engage in any activities outside the home. Nadia revealed she felt responsible for the daily care and support of her disabled older sibling. Tdh examined ways to encourage Nadia to engage in other activities, such as vocational training. This required working with the whole family, particularly supporting the mother to encourage Nadia to visit some vocational centres and ensuring responsibility for the disabled sibling is shared. Relatives and neighbours agreed to provide some care when the rest of the family are out, for example.

In July 2010, Nadia undertook a hairdressing course and was happy to engage the researcher in conversation about her wishes for her future as a hairdresser. This marked a significant change from previous visits when she was withdrawn and would not make eye contact.

While Nadia was still attending training in hairdressing in January 2011, Nadia (now 14 years old) expressed worries about her future once the course was finished. A local hairdresser offered her work but for very low wages. The social worker facilitated a meeting with the vocational training centre and the employer. An agreement was reached that Nadia would attend another year of training and would work 2 days a week for the employer for an agreed fee.

The case study shows how the Tdh social worker engaged in hope-building activities with Nadia through a combination of psycho-social support, responsive care planning, increasing family communication, provision of resources and advocacy. The helping relationship with the social worker facilitated a greater engagement by Nadia in meeting her goals and increasing her own social well-being. Over time, Nadia was able to share her hopes and fears with the social worker and actively participate in the solving of identified problems with the social worker and support from her family.

Discussion

The hope tool used measures a child’s capacity to initiate and sustain action towards a desired goal which would increase social well-being and to produce routes towards these goals. This is critical in the Palestinian refugee context which is characterised by immediate social and economic barriers and a long-term context of national statelessness and powerlessness. Hope or despair regarding school achievements, future employment or family life is all set within a larger context of insecurity – in relation to their length of stay in a camp or gathering, the types and amounts of services which may or may not be provided for them and the ongoing internal and external conflicts which impact family and community life. It was recognised by Tdh that changing levels of hope and the perceived ability to make changes in life needed to take into account a complex community identity. As shown through the case study, this was done by working hard to involve a wide range of community members in protecting children and increasing their personal well-being within and alongside the case management approach.

While the data indicate some improvement in hope following engagement with Tdh social workers, there are some limitations to the findings of this research. The hope scale is based on the premise that children are ‘goal directed’ and that their goal-related thoughts can be understood according to two interrelated components: agency and pathways. The tool has been developed in a ‘Western’ context based on Western understanding of ‘goal directedness’, which may not manifest in the same ways in the Palestinian/Lebanese context, although the tool has been validated for use with Arabic-speaking populations. The tool was therefore complemented by the collection of qualitative data through individual case studies to help interpret the results, as highlighted by the case study presented above. There was also a risk that participants may react favourably to questions at the post-intervention collection of data to please the social workers, for example. However, this was mitigated by different workers collecting post-intervention data rather than participants’ regular social worker along with the sometimes significant gap between pre- and post-measures (which would make it difficult for participants to remember their initial responses). In addition, families were randomly visited by the lead researcher while the tool was administered to ensure appropriate use.

In addition, the effective sample size for this study was quite small due to the difficulties of drawing together a large comparison group from communities where Tdh did not work. While there were statistically significant differences between the group not receiving assistance and the children in receipt of Tdh services, the comparison group was quite small. Therefore, it is difficult to use this as evidence for the changes being wholly attributable to Tdh intervention, and the data do suggest there were other factors which contributed to the increase in hope not captured by these data. This research captures a snapshot in time and measures associations rather than causal relationships. However, the widespread change for those receiving Tdh intervention does indicate that change is partly related to the project’s support.

Intervention from a supporting and helpful adult is certainly associated with increased levels of hope and well-being in the literature. Caregivers and caring professionals can play an important role in building or maintaining hope when children are recovering from trauma or adjusting to a changed life (Frank and Frank, 1991; Herth, 1990; Jevne, 1993; Luster et al., 2009; Yohani, 2010). Positive development is said to take place when a child engages in increasingly more complex activities on a regular basis with one or more persons with whom the child develops a strong mutual emotional attachment (Bronfenbrenner and Morris, 1998). Farran et al. (1995) conceptualise hope as multidimensional and view this connection as the relational aspect of hope. In their seminal work on children and hope, Snyder et al. (1997) also outline how adults can raise hope in children by teaching goal formation, modelling problem-solving and inspiring agentic thought which contributes to overall levels of well-being. These studies and literature provide a foundation for the importance of adult relationships during challenging experiences, such as those which Palestinian refugee children in Lebanon continue to experience, although research indicates that such relationships need to be hope focused.

The results highlight some key implications for those adults seeking to improve levels of hope for children living in refugee camps. It appears that foundation characteristics prior to intervention have significant implications for determining levels of change in hope rather than specific characteristics of the intervention. The greatest levels of change in hope were with those who had the lowest levels to start with. This can also be seen in the case study. These results are particularly encouraging because it appears that it is possible to raise hope in situations which seem most hopeless, thereby enhancing confidence in children’s ability to make changes which will increase well-being. Increased hope which supports resilience and strategies of coping also helps boost the protective environment for children at a personal level. The multi-objectives of the project therefore meant increased levels of protection for the most vulnerable at a micro-level, while also supporting increased protection at a macro-level through engagement with other child protection actors. This ecological approach is particularly important in response to serious child abuse, such as sexual abuse, which can shatter personal resilience while being incredibly sensitive to raise within the community (Drumm et al., 2004).

The results show that the second objective of the project, to strengthen existing child protection networks at a structural level across the community and general awareness of child protection, is essential alongside direct social work intervention with individual children. While universal services such as health and education are important in identifying children who need early intervention and support, these services are limited in the three camps. Therefore, child protection networks need to include wider members of the community such as religious and political leaders, those who lead community groups or associations. Increasing trust both at a micro- and macro-level with a range of actors and groups is therefore felt as vital for supporting this process (O’Leary, 2011). A defining feature of the intervention in refugee camps characterised by complex military and political contexts was the need to engage with all stakeholders in a transparent manner that built relationships of trust towards a practical commitment to work in partnership on child protection concerns. In addition, the project sought to engage with religious and cultural processes which protect children and are often ignored or misunderstood by ‘outsiders’, especially those from the West (Hutchinson et al., 2014). While this increased the challenge and complexity of some protection work, the outcomes negotiated provided greater stability for children in the long term.

Results also show more positive change for younger children than older children, and for children a more positive change than youth, although they started at a lower level. Youth changes were far more modest indicating the lack of options available for young people in the refugee camps. Unemployment levels are particularly high, for example, and there are many restrictions placed on Palestinian refugees in regard to the jobs they can do outside the camps resulting in few options of employment outside of the camps (UNRWA, 2014). These findings also support strategies for early intervention to increase hope and agentic thinking before children and young people are fully confronted with the structural challenges and inequality they will face as they grow. The case study also shows the key role social workers played in engendering hope by helping the young person to tackle some of the structural disadvantages in place. Further research that specifically focused on youth would likely give a clearer definitive understanding of Palestinian young people.

Finally, the case study in particular draws attention to some of the key aspects of hope building and its role in increasing social well-being with Palestinian refugee children in Lebanon experiencing high levels of poverty and structural disadvantage. In such contexts, despair and hopelessness are often based on knowledge of personal powerlessness and of how difficult it is to achieve personal goals or protect oneself in the face of huge structural barriers. Hope building therefore needs to take into account both the personal and structural contexts, providing avenues for both personal and structural transformation. Helping adults have a key role to play in hope building in these contexts through enabling children to express their hopes and fears, supporting problem-solving activities, opening up communication with family members and the wider community, accessing resources and advocating for their interests with others. Hope building can also support the process of increasing social well-being through supporting a more positive outlook on future aspirations and providing the motivation to develop plans to achieve such aspirations. While the results of this study relate specifically to Palestinian refugee children in Lebanon, they offer some promise to working with similar groups. This could be especially relevant for work with Syrian refugees, many of who are in Lebanon and surrounding countries. At the time of writing this article, the Syrian crisis was entering its fifth year with no reasonable prospect of resolution in the near future. Knowledge from this research could be tested with other populations for its applicability.

Conclusion

Implementing tools to measure subjective concepts such as hope are complex, especially in real life/action research in a developing world context where it is not always possible to achieve rigorous samples, sufficient control groups and exceptional data quality. Despite these challenges, this study does highlight the importance of proactive working with children to foster hope that increases a personal engagement with safety and well-being even in the most socially exclusive conditions. The hope tool and case study do highlight the importance of such concepts and how meaningful they can be in the everyday life of children. The structural inequalities faced by Palestinian families in Lebanon are not conductive for facilitating hopefulness or confidence in their ability to exercise individual or collective agency (Bahani et al., 2009; Makhoul et al., 2003). This makes increasing personal hope while engaging the community to challenge structural inequalities an even more important part of not only protecting children but also supporting them to be active participants in maximising their own well-being and a sense of safety.