LONDON: Some walked out of Syria’s Sednayah prison unable to remember their own names. After years inside what rights groups described as a “human slaughterhouse,” survivors of the country’s most notorious prison emerged in late 2024 unsure whether their families were alive or whether their homes were still standing.
As Syria struggles to piece itself back together, so too do its survivors. But the country keeps uncovering new wounds.
On May 19, Syria’s National Commission for Missing Persons received a report that human remains had been discovered in the Ish Al-Warwar neighborhood in the Barzeh district of rural Damascus, state news agency SANA reported.
People gather with independence-era Syrian flags and pictures of 23 locals who died in Sednaya and other Assad-regime prisons during a memorial vigil for them by the monument to the Great Syrian Revolt at Al-Seyouf Square in Jaramana in the Damascus countryside on the city's outskirts on December 21, 2024. (AFP/File)
The Barzeh Media Office said the remains of between 15 and 20 bodies were found near Tishreen Military Hospital, buried irregularly beneath rocks — another grim chapter in a reckoning with no clear end.
That reckoning began in earnest on Dec. 8, 2024, when longtime ruler Bashar Assad fled Damascus as a rebel offensive swept into the Syrian capital, triggering the mass release of more than 20,000 prisoners — among them survivors of Sednayah.
But the suffering did not end when the prison gates were thrown open. Many of those released were political prisoners who continue to grapple with devastating physical and psychological scars and face a critical shortage of support.
A drone view taken on December 19, 2024, shows Seydnaya prison, which was known as a slaughterhouse under Syria's Bashar al-Assad rule. (Reuters)
As Syria navigates a fragile transition, a largely invisible crisis is taking hold beneath the surface. Years of systematic violence against civilians have left deep psychological wounds. Among those suffering most are survivors of political detention and torture.
A July 2025 World Health Organization report noted that one in 10 people in Syria are living with a mild to moderate mental health condition, while one in 30 are probably suffering from more severe conditions that can have a crippling effect on daily life.
Yet Syria’s mental health system is severely under-resourced.
Before the civil war broke out in March 2011, the country had about 100 psychiatrists for a population of 21.9 million, according to a July 2025 study published in the journal Conflict and Health. During the 14-year conflict, that figure fell to fewer than 75 psychiatrists nationwide.
People searching for their missing relatives look at posters on a wall at the Damascus Hospital, also known as the Mujtahid Hospital, where some freed detainees and bodies recovered from the Saydnaya prison were transported, in the Syrian capital on December 14, 2024. (AFP/File)
For those released from detention, freedom has rarely meant relief. Many return home to find family members have been killed, their houses destroyed, spouses unwilling to reconcile, or children who have grown up barely remembering them.
They also face profound challenges reintegrating into society, finding employment and reconnecting with loved ones. Rates of depression, anxiety and post-traumatic stress disorder are high.
In Homs, one of the governorates hardest hit by the fighting and still plagued by sporadic violence, the US-based medical nonprofit MedGlobal established the Homs Recovery Center to provide special support for detention and torture survivors.
“A lot of released detainees did not know where to go — some couldn’t remember where their families were, others were in very poor health,” Dr. Hala Kseibi, MedGlobal’s Homs area coordinator, told Arab News.
File photo showing members of the Association of Former Detainees in Damascus meeting to establish a platform to help document missing persons cases. (ADMSP PHOTO)
Working from a database compiled through the Homs National Hospital and the Association of Former Detainees in Damascus, MedGlobal estimates that about 800 former detainees are living in Homs.
“There was an initiative at the Homs National Hospital to receive these individuals and assess their physical and mental health,” Kseibi said. “The psychologists and social workers were shocked by how bad the situation was. It was worse than they had imagined.”
That shock prompted action. One Homs-based mental health professional approached Dr. Zaher Sahloul, MedGlobal’s president, who connected with Dr. Ahmed Radwan, attending psychiatrist and medical director at the Gateway Foundation in Illinois, and Dr. Stephen Weine, professor of psychiatry at the University of Illinois College of Medicine.
A Syrian national flag flutters above a hospital that has been turned into an observation post for the Syrian Army in the city Qusayr, 15 kilometers from Homs in restive central Syria, on May 7, 2012. (AFP/File)
Radwan, originally from Homs, brought clinical expertise and an intimate knowledge of the city’s culture and community. Weine contributed decades of experience developing mental health programs in conflict zones.
“Together, they began developing the program,” Kseibi said. “They met with the young volunteers at the Homs National Hospital and formed a team of social workers, psychologists, and psychiatrists.”
The profile of who they serve reflects the scale of what the Assad years took from ordinary Syrians.
INNUMBERS:
• 24,200 prisoners released on Dec. 8, 2024
• 800 detention survivors identified in Homs governorate
(Sources: SNHR, MedGlobal)
According to a February report by MedGlobal, the typical participant is a married man in his late 30s to early 40s, although a small percentage are women. About 82 percent are married and one in 10 are now separated from their spouses.
Most, or about 86 percent, have only an elementary-level education, and 58 percent are currently unemployed. Many also lack identification documents, complicating access to work and basic services.
The program takes a step-module approach. Each participant begins with a full psychosocial assessment covering mental health, chronic illness and torture history. Based on that evaluation, they are referred either to group therapy, a psychiatrist, or both.
“Group therapy is a seven-session program,” Kseibi said. “The goal is for participants to support one another. Peer support is incredibly important, more so than medication.”
Infographic generated by Gemini (Google AI)
After completing group therapy, about 80 percent of participants show improvement and require no further intervention, according to Kseibi. The remaining 20 percent are referred for psychiatric care.
“The structure is not one-size-fits-all,” Kseibi said. “It’s tailored. Some go through group therapy first, then the psychiatrist. Others go to the psychiatrist first, then group therapy. Some do both simultaneously.
“For example, if someone isn’t comfortable sharing in the group setting, we make sure the program adapts to each person’s needs.”
The depth of what participants have survived makes that flexibility essential. On average, they spent 5.5 years in detention. During that time, many endured torture, severe beatings, malnutrition, chronic illness and untreated conditions including tuberculosis.
The focus on therapy over pills shapes MedGlobal’s approach.
A MedGlobal on the leg of a patient, who suffered injuries during the fight against the Assad regime. (Supplied)
“We believe in medication, of course,” Kseibi said. “But we believe even more strongly that it shouldn’t be the primary focus. Medication suppresses the problems and the pain without resolving the root cause.”
The program’s biggest obstacle has not been funding or infrastructure, but human resources.
“Mental health as a field suffers from a weak workforce,” Kseibi said. “Even most graduates come out without real practical experience, and a large percentage of mental health practitioners default to medication.”
To close that gap, volunteer psychiatrists from the US run a twice-weekly educational program for the Homs team, covering specific topics and case discussions.
Team members also collaborate with the University of Illinois Chicago and will receive certificates from the university after two years. Staff completed four months of training before the program launched and before meeting any detainees.
“This isn’t a one-off training — it’s an ongoing commitment,” Kseibi said. “We’re building the team while simultaneously serving the released detainees.”
In Syria, stigma around mental health has long kept people from seeking care. But in Homs, MedGlobal found an unexpected opening.
During the war, WHO-led Mental Health Gap Action workshops gradually shifted community attitudes toward accepting mental health support. Former detainees, Kseibi said, largely see themselves not as patients but as survivors of something historic.
The program’s outreach strategy reinforces that framing deliberately — never leading with clinical language.
“When we reach out, we don’t mention mental health,” Kseibi said. “We say something like: ‘We got your number from such-and-such organization, and they told us you’re a former detainee.’
“When the person says yes, we ask: ‘We’ve noticed that many former detainees experience constant anger, stress, and difficulty sleeping — are you dealing with any of that?’ And they say: ‘Actually, yes — how did you know? I’ve been like this at home.’
Former Sednaya detainees Mohammed Najib (L) and Omar al-Masri describe their experiences as they revisit a cell at a facility which was used as a jail for the Tishreen Military Hospital, currently out of service, in Damascus, Syria, on January 10, 2025. (AFP)
“When we address their problem instead of framing them as psychiatric patients, they immediately feel understood, so they come, and they stay.”
The dropout rate is low, and when people do leave, it is rarely because of discomfort or stigma. Finances are the more common barrier.
“Participants say: ‘If I come to you, I will lose a day of work, and I can’t afford that,’” Kseibi said. “Transportation is another issue, as a large portion of our beneficiaries are from rural Homs, not the city, and getting there, especially in winter, is difficult.
As part of its campaign, MedGloban has recruited volunteer psychiatrists from the US to run a twice-weekly educational program for Syria's Homs province. (Supplied)
“MedGlobal addresses this with a transportation stipend of about $5 per visit, and medications are provided free of charge.”
But for every person MedGlobal reaches in Homs, hundreds more across Syria remain without support. The offensive that unlocked Sednayah did not end the nation’s suffering. Sporadic violence and displacement continue to generate new trauma, even as older wounds go untreated.
Syria’s interim government faces a reconstruction challenge that extends far beyond roads and buildings. A small mental health workforce gutted over 14 years of war must be rebuilt at the precise moment when demand is highest.
