ATTITUDES

This KAP assessment tells us what people know about COVID-19, how they feel and their actions to prevent the disease. It identifies knowledge gaps, beliefs, or misperceptions that can facilitate people’s understanding and behaviour. It also assesses what community would like to know more about COVID-19 and how they prefer to contact TRCS to ask questions or share feedback. Knowing what information people have heard already, how they reacted to it and why they might be resistant to change can help develop targeted messaging and engage in dialogue with communities to promote positive behaviour. The findings of KAP assessment can guide adjustments to ongoing interventions and improve the quality and accessibility of services for the communities.

Attitude refers to communities’ feelings towards the subject, in this case COVID-19, as well as their perceptions, beliefs, or any preconceived ideas that they may have towards the disease.

HOW DANGEROUS DO YOU THINK THE CORONAVIRUS IS?

The majority of survey respondents view COVID-19 as ‘’very dangerous’’ (81.4%), while few think COVID-19 is “more or less” dangerous (15.6%), or not dangerous at all (2.4%). Findings in the previous KAP assessment showed a slightly higher result with greater number of people regarding COVID-19 as ‘’very dangerous’’ (84.0%) and a smaller number of people (12.9%) considering the disease to be ‘’more or less’’ dangerous.

The following responses were reported under the "Other" category: it varies from one person to another depending on the person's health condition/age, it is not as dangerous as it was earlier, "Normal"/medium, "Terribly" dangerous, dangerous. Three "I don't know" answers were also reported.

Similar to the survey results, a majority of the FGD participants perceived COVID-19 as deadly and highly contagious, and that no drug or treatment was available yet to treat the disease. The virus first transmitted from China and then spread across other countries they said. Participants in most locations, except a few in Kilis, believed COVID-19 was real.

If a person gets infected with Coronavirus or have recovered in your community, are they treated differently or discriminated because of it?

When asked if a person who is infected or has recovered from COVID-19 would face discrimination, 14.9% of the host population answered ‘’Yes’’ compared to 5.3% of the refugee respondents. This suggests that stigmatisation of COVID-19 is higher among the host population than among refugee communities. Stigmatisation was also reported higher among the host population in the previous assessment (21.7%) compared to refugees (8.7%), however, overall, there has been a decrease in those saying people would be discriminated against during the second round.

If yes or to some extent, which the following groups are being discriminated in your community because of the Coronavirus?

According to those who said discrimination would occur (1,028 respondents), people who had, or previously had had, COVID -19 (57.1%) were felt to be the most discriminated against, followed by people suspected of having COVID-19 (50.9%). Again, these responses were significantly higher among the host population (41.5% and 39.0% respectively) compared to refugees (15.3% and 11.7% respectively). The findings were similar in the first round of surveys with responses for these two options marginally lower among the host population (39.9% and 38.2%) and higher among refugees (19.9% and 16.7% respectively) the first time around. Older people, health workers, Syrians, refugees, and poor people were also recognised as being stigmatised.

Responses under ‘’Other’’ included: it varies in different communities, those in hospitals, those who do not follow restrictions/measures, youth, those who do not know enough about the virus, those who fear the virus, people who hide being sick, people who developed symptoms. Ten ‘’I don't know’’ responses were reported.

FGD participants, especially those from the host community, reported that the COVID-19 outbreak has prompted discrimination towards those who are infected or have recovered from the disease in the community. Although these responses were slightly less than in the first round KAP assessment, participants said that people would still stay away from those who have recovered from the disease for fear of also becoming infected. People who have already recovered from COVID-19 are still considered to be potential carriers of the disease. Participants also said that people tend to hide the disease due to the fear of being stigmatised. According to local respondents in Kocaeli, refugees are more exposed to such discrimination. Participants in Adana, İzmir and Kayseri said that they tried to support those who had been infected remotely as much as possible.

‘’Even if the test results are negative, people who had once contracted the virus are discriminated against. They are not welcomed to engage in social activities. People would distance themselves when he or she entered crowded spaces,’’ said participants in Gaziantep.

‘’People may want to hide the fact that they contracted the virus as they fear the reactions of the community,’’ said a participant from the local community in Kocaeli.

An FGD participant from the host community in Konya said: ‘‘We had a Syrian neighbour who contracted the virus. This spread fear and stigma in the neighbourhood. But this would be different if he or she was Turkish. I think, this is a very bad thing’’.

Refugee respondents said that discrimination also happened at workplaces and gave examples where people lost jobs after they had been infected. They also feared that they would not be admitted to hospital or provided treatment if they went there and had experienced problems with the landlords of their homes.

‘’If we get infected with COVID, we are afraid we will not be admitted by the hospitals, and there is also the fear of losing employment,’’ said refugee respondents in Adana.

In Kilis, Ankara and Sanliurfa, respondents from the host communities said that people believe refugees cannot maintain proper hygiene due to their poor economic conditions, lacking cash to buy hygiene products and living in crowded homes, and so are at higher risk of infection.

What worries or concerns you the most about the Coronavirus?

Less than two-thirds of survey respondents (62.4%) reported being worried that their family might become infected with COVID-19. This was a new option added to this second round of the assessment and results as one of the major concerns among both refugees (32.4%) and local people (29.9%). In the previous assessment, fear of becoming infected with COVID-19 was the highest number of response (67.1%), which, however, resulted as the second top in this round (53.5%). Fears of having lost employment (7.9%), losing employment (6.9%) or paying rent/bills (7.3%), being unable to afford food for the household (4.4%) were all slightly higher among refugees than local people. Concerns related to employment were also higher for men than women.

These findings were similar to the FGDs where participants reported that their greatest fear was if they or their family members would become infected by COVID-19, particularly those who are older. They are also worried about the treatment for COVID-19, and not recovering from the disease if infected. Respondents said that people in the community were concerned about losing employment in case they contracted the disease as well as not being able to find employment due to the COVID-19 situation. Households with low income and poor financial conditions are already facing challenges to afford hygiene materials or food for families and children.

“We are afraid of losing our job and facing financial difficulties if we contract the disease," said a refugee respondent in Bursa.

'’I am worried about becoming unemployed. I see many people at my workplace who have been dismissed after contracting coronavirus,’’ said a respondent from the local community in Hatay.

Respondents also feared going to the hospital, using public transport, or the death of a family member due to the disease. They are worried that they could become infected or infect one of their family members, as they were going to their workplaces regularly.

‘’I am afraid of visiting hospital because it is very crowded there," a refugee participant in Bursa said.

Respondents were also worried about getting infected through contact with people who did not take preventive measures or did not show any symptoms. Many participants in Mardin said that they were afraid of going into quarantine if suspected of being infected with the disease.

FGD participants reported that parents were most concerned about the future of their children and how their children’s education was being impacted by COVID-19 as they were not going to school due to the pandemic. Some said they feared pre-lockdown ‘panic buying’ which could create a shortage of food supplies or hygiene materials in the market. They said that people were also worried about how long this pandemic would persist and the future uncertainties.