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(Brussels) – Delays in registration and limited implementation of temporary protection policies in Turkey mean that many Syrian refugees are left without effective protection or access to jobs and services that they desperately need, Human Rights Watch said today. As long as Turkey remains burdened by overwhelming numbers of refugees and unable to provide sufficient protection and security for all, the European Union should not be sending Syrian refugees back to Turkey.

“As Turkey is host to over two million Syrian refugees it is hardly surprising that many are not getting the support they desperately need to maintain livelihoods,” said Stephanie Gee, fellow in the refugee rights program at Human Rights Watch. “The EU is morally, and indeed legally, obliged to share some of the refugee burden by not sending Syrian refugees back to Turkey without assessing their asylum claims.”

A migrant child stands in a tent on the side of a highway near Edirne, Turkey where hundreds of mostly Syrian migrants have had to wait as Turkish police prevent their bid to cross the border with Greece.  © 2015 Osman Orsal / Reuters

An agreement, which went into effect in March 2016, between the EU and Turkey provides that many Syrian asylum seekers in Greece could be returned to Turkey without EU evaluation of their original protection claims concerning conditions in their home countries because Turkey is a “safe third country” or “first country of asylum” for them. “Safe” for the purposes of this analysis means more than being safe from war or persecution. It means that an individual refugee has protected rights in line with the Refugee Convention, including the rights to work, health care, and education.

The laws and policies governing Syrian refugees’ lives in Turkey, however, do not grant them full refugee rights, and the protections these laws and policies do extend have yet to be fully realized. As a result, many Syrians in Turkey still cannot access education, health care, and lawful employment. Furthermore, delays of up to six months in registration for temporary protection mean that some refugees are unable to get basic services and live in fear of being forced to live in a camp or deported.

Human Rights Watch has previously documented how Turkish pushbacks at the Syrian border constitute refoulement – being returned to a country where their lives or freedom would be threatened – and has repeatedly called for the EU to recognize how both relevant policies and circumstances on the ground in Turkey mean it should not be considered legally “safe” for returns. New legal analysis and research demonstrate in detail why the quality of protection in Turkey for Syrians does not rise to the level required for “safe third country” or “first country of asylum” returns.

In March and April, Human Rights Watch interviewed 67 Syrian refugee adults and children living in Turkey. These interviews, along with information from nongovernmental groups and public reports, revealed that many refugees face months-long delays in registering for temporary protection, leaving them unable to enroll their children in school or get health care.

One 21-year-old Syrian man said he went five times to two different police stations before he was even able to make an appointment – for a date three months later – to apply for registration. Others said officials imposed requirements for registration that were not specified in the regulation, such as a rental agreement with a landlord.

“Truly, it isn’t safe for us here – we fled death, but have come to a place where we have no life,” said “Mahmoud” (not his real name), a 29-year-old former journalist from Hama who has only been able to find occasional employment freelancing or working small jobs. He said he was grateful Turkey had allowed him to stay in the country, but he did not feel his temporary protection status offered real stability. “I just want to be in any place that respects rights, where I can ask for them and be truly assured that I have them – nothing more,” he said. “We just want to live, and for the law to protect us.”

The Turkish government says it has spent US$10 billion on hosting Syrian refugees since 2011, and now spends about US$500 million monthly. In the past two years, Turkey has also issued regulations that allow Syrian refugees to remain in the country lawfully, use public education and health care systems, and apply for work permits. Under the EU-Turkey deal, the EU has promised Turkey at least €3 billion to help host the refugees, of which it has disbursed €180 million so far. However, these measures have yet to make a significant impact on many Syrian refugees.

Turkey has registered more than 2.7 million Syrian refugees since 2011, although some of them may have since left the country. Almost 300,000 live in 26 state-run camps near the border, according to Turkish officials; the other nearly 90 percent live in towns and cities.

While Turkey signed the 1951 Refugee Convention and its 1967 Protocol, it limited its application to European refugees, excluding all others from its protection. A 2013 law established a system of “international protection” for non-European asylum seekers that brings Turkish refugee law closer to the convention’s provisions. The law also provided for a temporary protection regime, which was fleshed out in an October 2014 regulation. The regulation governs rights and benefits for most Syrian refugees in Turkey, but it could be terminated at will by the Council of Ministers. If that happened, beneficiaries would lose the guarantee that they could remain in the country legally.

In January 2016, Turkey issued a new regulation allowing Syrian temporary protection beneficiaries to apply for work permits, but subject to certain residency criteria and only if they can find an employer willing to sponsor them. As a result of the limitations, adult refugees that Human Rights Watch interviewed were either ineligible to apply, lacked information about the policy, or could not find a sponsoring employer. Among the Syrian refugees interviewed, 24 adults were eligible for work permits and another 24 were not, and none had applied or heard of anyone who had.

Human Rights Watch has documented how these types of difficulties put Syrian refugee families in Turkey at risk of poverty and child labor. They also put Syrian workers at risk of exploitation. One woman said she was paid half of what her Turkish co-workers received and that sometimes her employers halved even that small amount. She also described instances of physical abuse of Syrian workers by managers.

In April, a UN World Food Programme assessment of 1,562 Syrian households in southeastern Turkey found that 93 percent of those interviewed were living below the national poverty line. The report found that limited access to stable employment was strongly linked to food insecurity.

The majority of Syrian children in Turkey remain unable to attend school. In November 2015, Human Rights Watch published a report documenting the reasons Syrian refugees have not been able to go to school in Turkey. The government has taken admirable steps to address these gaps and has pledged to enroll 450,000 Syrian children by the end of this year. However, the Education Minister recently acknowledged that “only 325,000 Syrians in Turkey are attending school out of more than 756,000 school-age refugees in Turkey.” The number of school-age children may be even higher, as there are now nearly 940,000 Syrian children aged 5 to 17 registered in Turkey, though some may have left.

International donors should support the Turkish government in efforts to improve the realization of basic rights for Syrian refugees who have fled to Turkey. In the meantime, the European Asylum Support Office (EASO) and Greece should consider all asylum applications of Syrians who have come through Turkey on their merits, as they should not be considered inadmissible on the grounds that Turkey is a “safe third country” or “first country of asylum” for all Syrians.

“Turkey already hosts over two million refugees, many of whom are struggling to survive and do not see their rights fulfilled as refugees,” Gee said. “Instead of trying to pass the buck and violating their own standards, EU governments should play their part in global responsibility-sharing and give Syrian asylum seekers a chance to make their claims.”

Legal Framework

Turkey signed the 1951 Refugee Convention and its 1967 Protocol, but it is the only country in the world to have expressly declared a geographical limitation, excluding non-Europeans from its protections. In 2013, Turkey passed the Law on Foreigners and International Protection, bringing its treatment of non-European asylum seekers more closely in line with the convention’s provisions. The law also provided for a temporary protection mechanism for situations of “mass influx,” which was fleshed out and formally extended to Syrian refugees in the October 2014 regulation.

Syrian refugees in Turkey largely fall into three categories: those with renewable residency permits, which require a valid entry stamp and a fee of more than 1,000 Turkish lira [US$344] for the first year, with additional fees thereafter; temporary protection beneficiaries who have been registered at no cost under the October 2014 temporary protection regulation; and unregistered people without explicit legal status. The vast majority fall under the second category, and references to the 2.7 million refugees registered in Turkey indicate people with temporary protection status. Syrians are barred from applying for other forms of international protection under the 2013 Law, as long as they are covered by the temporary protection regulation.

Under the EU-Turkey deal, there are two legal principles that can be used by Greece to return asylum seekers to Turkey without examining their asylum claims on their merits. One is “first country of asylum,” under which they can be returned to a country if they already have accessible and sufficient protection there as defined in Article 35 of the EU Asylum Procedures Directive (APD), and “safe third country,” as defined in Article 38, meaning they can be returned to a country where they could have requested and received refugee status.

A “safe third country” must offer the individual applicant the chance to request and receive refugee status in line with the Refugee Convention’s provisions. Even if Turkey’s 2013 Law created an international protection system that allows individual asylum seekers to receive “conditional refugee status” and protections in line with the convention, Syrians are excluded from it because the temporary protection regulation that governs their status is explicitly outside the scope of that system. Therefore, Turkey cannot legally be considered a “safe third country” for Syrian refugees.

Whether Turkey presents a relevant “first country of asylum” for Syrians depends on slightly different criteria: the person must either be recognized in that country as a refugee or have “sufficient protection” there, including protection from refoulement – being returned to a country where their lives or freedom would be threatened. Since Syrians are not recognized as refugees in Turkey, they must enjoy “sufficient protection” in practice there for this concept to apply.

UNHCR, the United Nations refugee agency, has indicated that having “sufficient protection” must mean an individual will be granted “a right of legal stay and be accorded standards of treatment commensurate with [the Refugee Convention] and international human rights standards,” including for “living, work rights, health care, and education.” UNHCR has also stated that “[a]ccession to and compliance with the 1951 Convention and/or the 1967 Protocol are essential” to consider, and that “the capacity of States to provide protection in practice should be taken into consideration, particularly if they are already hosting large refugee populations.”

The analysis of Turkey’s legal and policy framework presented here, illustrated by accounts of Syrian refugees, shows that Turkey fails to meet these standards.

Furthermore, in May, Human Rights Watch documented brutality and pushbacks at the Turkey-Syria border, where Turkish border guards have killed at least five Syrian asylum seekers attempting to reach safety and seriously injured at least 14. These actions amount to refoulement under international law.

EU asylum applications are assessed in two stages. First, authorities decide if a person’s claim is “admissible” – whether they are required to consider it by law. This is the stage at which safe third country or first country of asylum assessments may be made. Second, if a claim is found admissible, authorities consider the claim on its “merits” – whether the protection claim itself based on conditions in the person’s home country is valid.

While Greek asylum law previously mandated the consideration of “safe third country” criteria when considering returning a person to a “first country of asylum,” Greece swiftly amended its asylum procedure on April 1, with the passage of Law 4375/2016, to drop that requirement. Asylum seekers can be returned to Turkey as long as they are found to have “sufficient protection” there, although that term is not defined in the law. Greece still considers the claims for some vulnerable categories of asylum seekers on their merits, such as unaccompanied children or pregnant women, and those denied admissibility have a right to appeal to a Greek appeals board.

On April 7, Turkey amended the Temporary Protection Regulation to provide that Syrians returned from Greece “may” have their status reinstated at their request. However, this measure is not enough to establish that all returned Syrians will be offered “sufficient protection” in Turkey. Any examination of that question should keep in mind that Turkey’s accession to the Refugee Convention does not extend any protection to Syrians; the temporary protection regime falls outside the international protection system under Turkey’s migration law; and Turkey’s capacity in practice to meet Syrian refugees’ rights is demonstrably limited. Until the relevant legal framework and regulations are amended to address the gaps in access to basic services and protection and this results in changes in practice, EU governments should not consider Turkey as qualifying as a “first country of asylum” for the purposes of admissibility decisions in the EU.

Long Delays in Registration

Human Rights Watch found that in both Istanbul and Izmir, Syrian refugees faced months-long delays in registering for temporary protection and in receiving official identification cards, known as a kimlik (“identification” in Turkish). The card is required to enroll children in public schools and get primary health care and work permits.

Nongovernmental groups working with Syrian refugees say that these delays are in part the result of a new “pre-registration and screening” phase that the Directorate General of Migration Management (DGMM) added to the temporary protection procedure in March. Capacity constraints may also be causing delays. One employee of an international aid group in the southeast told Human Rights Watch that registration has operated in fits and starts; in Gaziantep, the process was effectively stalled until recently, with at least a two-month delay in appointments now. In Istanbul, another group representative said appointments were delayed three to six months in districts with many Syrians.

DGMM told Human Rights Watch that Syrians may be issued a 30-day valid “pre-registration form” that allows them to stay lawfully in the country while they wait for their applications to be processed. However, the representative of a nongovernmental group operating across Turkey said that this form cannot be used to get services, so those with the “pre-registration paper” must rely on limited charitable and aid group assistance.

In Izmir, Human Rights Watch witnessed a newly arrived Syrian family attempting to register for temporary protection at the appropriate police station. An officer told them to return in two weeks to make an appointment, which would be for several months later.

An aid worker that serves a community of Syrian agricultural workers in a small town outside Izmir, Torbalı, said that most refugees there lacked IDs as a result of the registration backlog. While aid workers are able to provide for some basic needs, he said, skin diseases and malnutrition were common, and there were no educational services and no transportation available to the nearest public schools.

Ali, 21, said that registering for temporary protection in Istanbul was a months-long ordeal:

I went to the police station in Fatih [a neighborhood of Istanbul] last October to get the kimlik. It was so crowded, they told me to come back the next day. I did, waited for hours, and still didn’t get an appointment. I heard from others that the Taksim [a different neighborhood] police station also does registrations, so I went there. They said come back next week, so I did. They said come back two days from now, so I did. They said come next week. So I gave up. I finally tried again in February, and I received an appointment for [mid-May].

Ali said he needed to bring his landlord with him to get that appointment. “The landlord requirement is new,” he said. “It started earlier this year.” Tamer, a 28-year-old Syrian also living in Istanbul, said: “I haven’t applied for the kimlik yet because I’ve been staying with a friend, so I have no rental contract, which is required. If I try to go without the rental contract, I need to pay a broker.” There is no requirement in the temporary protection regulation itself to provide a landlord or rental contract.

Four Syrian refugees said they were able to circumvent delays by paying 125-150 lira [approximately US$42-50] to independent brokers to negotiate earlier registration. “To get my kimlik, I had to call one of these brokers and pay 150 lira,” said Mohammed, 26. “I was in a hurry so I didn’t even consider going without the broker; everyone told me it would take many months.”

Jemaa, 23, said of his family-of-four: “When we first went to register, they said it would be a two or three-month wait. We paid 125 lira, and we all got a kimlik right away.” Rama, 19, said she paid a broker to facilitate her registration process because she was pregnant and otherwise might have needed to pay even more exorbitant amounts for crucial neonatal and maternal care during her pregnancy and delivery.

These registration delays have a direct impact on Syrian refugees’ stability and safety. Several refugees said they believed that being unregistered might lead to a forced move into a refugee camp or deportation. In April, Amnesty International reported large-scale deportations of Syrians in Hatay province, where those returned were primarily unregistered refugees or refugees apprehended without their IDs.

Delays are also preventing many Syrian refugees from accessing education and health care, adding to gaps in services and protections that exist even for individuals who have valid registration.

Technical Complications Affecting Registration

Temporary protection beneficiaries, like all legally resident foreign nationals in Turkey, are assigned “foreign identification numbers” (FINs) that facilitate their access to government services. All legitimate FINs are supposed to begin with the digits 99. However, government agencies that registered Syrians ad hoc before the temporary protection regulation went into force issued numbers that began with 98, in a placeholder system.

Due to technical requirements of Turkey’s registration system, 98-numbers cannot be incorporated into the existing government service infrastructure, which affects school enrollment and hospital care. There is a mechanism to convert a 98-number to a 99-number online, but several refugees said technical glitches had prevented the conversion for some or all members of their families. Furthermore, while all registered refugees were supposed to receive proper 99-numbers following the publication of the temporary protection regulation in October 2014, seven refugees who had registered after that date – some as recently as March – showed a Human Rights Watch researcher IDs with 98-numbers.

Work Permits

In January, Turkey issued a new regulation allowing Syrian temporary protection beneficiaries to apply for work permits. The announcement was initially met with praise from international observers. However, the Turkish government disclosed in late March that only 2,000 applications had been submitted, or .074 percent of Turkey’s 2.7 million registered Syrians, and did not say how many had been granted.

Human Rights Watch has found that the new work permit regulation has yet to make any impact on Syrian refugees’ labor rights and protections. Many refugees remain vulnerable to exploitation and live in dire circumstances.

Under the new regulation, Syrians with temporary protection status may only apply if they have been registered in the province where they want to work for at least six months, and the employer must provide a contract, sponsor the application, and ensure that Syrians make up no more than 10 percent of its workforce. An international group in Gaziantep said that the switch from the 98-number to 99 restarts the six-month clock, and that these “technical problems,” in addition to misinformation among potential employers and employees, had discouraged Syrians from applying.

Among Syrian refugee families Human Rights Watch interviewed in March and April, 24 adults were eligible for work permits under the terms of the new regulation. None had applied, however, because they had no information on the requirements, feared their employers would not allow it, or could not find an employer willing to sponsor them. Another 24 were ineligible because they were not registered or had not been registered long enough or in the right place. None of the 48 had even heard of anyone receiving or applying for a work permit under the new regulation.

“Noor,” a 21-year-old woman from Qamishli who had been working in a garment factory in Istanbul for 10 months, said: “We’ve never heard anything about work permits for Syrians. Our workplaces don’t require them. But we know nothing about our own rights; my mother stays at home, we are at work all day. No one tells us anything.” Meanwhile, she said, she and other Syrians have experienced abuse and exploitation. While the gross monthly minimum wage in Turkey is 1,647 lira (about US$560), Noor has been promised a salary of 900 lira [US$305] per month, which she does not always receive:

If I take off one hour, they don’t pay me at all. Sometimes they pay me only half a month’s pay for a full month’s work, and keep promising to pay me later, but never do.… Turkish coworkers who work on the same machinery as me get paid two times what I am making. Sometimes they ask me, ‘How can you bear getting paid so little?’

The supervisors yell at us, call us names, and treat us like animals. When the electricity in the factory went out, they yelled at us for not working through the outage. One time my supervisor threw scissors at me. I’ve seen the managers hit Syrian guys in the face at work, and I’ve never seen them treat the Turkish employees like that.

A nongovernmental group in Istanbul said the work permit application can be submitted to the Ministry of Labor and Social Security online, but the potential employer must be the one to apply. This requirement has led some observers to raise concerns that employers lack the incentive to comply with the regulation or that they might demand a fee from the potential employee for sponsorship since it can lead to higher wages and require employers to provide greater labor protections. The regulation has a narrow exception for self-employment, but the terms are not explicitly defined.

Ali, a 27-year-old from Palmyra who has been working as an informal real estate broker and taking commissions to find people apartment rentals, said he believed employers were unwilling to sponsor work permits under the new regulation: “I don’t want to work for a Turkish employer because they take advantage of us. I worked four months without pay before I started out on my own. But I’ve never heard of any Syrian getting a work permit. Nobody has it.… Employers don’t want to give it to them.”

Two Syrian refugees who were technically eligible to apply for work permits said they believed it would cost a lot of money to obtain one, although the regulation does not mention fees. “Ahmed,” 40, said he and his teenage sons work 12-hour shifts, and he knows he is being exploited: “There’s a Turkish guy who works with me at the bakery, doing the same work, but he gets paid [almost twice as much as me].” Yet, he did not believe a work permit was an option for him: “I’ve heard of work permits, but I’ve heard it costs a lot of money to get one.” Some Syrians have been able to apply for work permits by paying someone to assist with the paperwork. The perception that work permits are expensive may be a significant deterrent to the application process as well.

Finally, the new work permits do not cover seasonal agricultural workers, such as the refugees in Torbalı. While this means they are not required to have work permits, it also means they are not covered by the labor protections the regulation provides.

Access to Education

In November, Human Rights Watch released a report documenting the barriers preventing the majority of Syrian refugee children living outside of refugee camps from attending school, despite regulatory changes allowing them to do so in principle. Those barriers included economic hardship and child labor, bullying, language barriers, bureaucratic hurdles, and non-compliance with the relevant regulation at the local school or provincial level.

In the 2014-2015 school year, about 212,000 Syrian children, including those in camps, were enrolled in formal education in Turkey. Laudable efforts by the National Education Ministry and its partners had brought that number up to 325,000 as of April 2016, however, a huge gap remains. According to the government’s figures, nearly 940,000 Syrians ages 5 to 17 are registered in Turkey, though some may have left the country.

Human Rights Watch interviewed 16 Syrian families in March and April whose children were not in school. They described the same problems discussed in the November 2015 report, with the additional complication of delayed registration for some families.

Batool, 42, has three school-age children: a 15-year-old daughter, Rawan, and 12-year-old twins, Mahmoud and Joud. She said that her husband, who worked in construction in Syria, had been unable to find steady work in Turkey. In the meantime, Rawan and Mahmoud work at a garment factory to support their family. But delays in temporary protection registration and bureaucratic glitches also contributed to keeping them out of school. Batool said:

We applied for the kimlik after we arrived [in August 2015] and just had our interview [in late March]. They gave us temporary registration papers instead of actual cards, but they have registration numbers on them. But when we asked an NGO to help us register for school with them, for some reason these papers weren’t accepted.

Batool said her daughter Rawan is acutely aware of what she is missing and cried every day when she first arrived in Turkey because she wanted to be back in school. Rawan said: “My friends have the old kimliks, and they were allowed to start school.… That’s my bad luck, I guess. My life is filled with bad luck. I was in school until I left Syria, and I had just started tenth grade. I loved everything about school, but especially studying math and English.… It’s like we put our dreams in balloons and just let them all fly away. We can’t make any of them stay and come true.”

“Rana,” 15, has been out of school since her arrival from Syria in 2013, because she has been working to support her family:

This is my second factory since I started working three years ago. I arrived in Turkey on a Saturday and was working at a factory by Monday. I twisted my foot while crossing the border, and still I had to work [standing] on it as soon as I arrived. Every day, I cried at work, working 8:30 a.m. until 9 p.m. I was so tired, and they were always scolding me.… I should be in ninth grade now. I miss going to school a lot.

Like many Syrian children in the workforce, Rana has faced wage exploitation: “I only made 300 lira [US$103] a month at first, but now I earn 1,000 lira [about US$340],” a wage that is still well below the gross monthly minimum wage of 1,647 lira [about US$560].

“Ahmed,” 40, has lived in Turkey with his family for three-and-a-half-years since fleeing his hometown, Hasaka. “We registered and received kimliks as soon as they started giving them out,” he said. He works night shifts in a bakery, earning 1,000 lira [US$344] per month, which is not enough to support his family of five in Istanbul. “Of course it’s important for my children to go to school – but it’s also important for us to survive, so they have to work instead. My 15 and 14-year-old sons work in garment factories. They get paid, but not always what they’re promised. They were both in school in Syria until we left.”

Samira, a Syrian woman from Damascus, has five children between 9 and 17. Only her 9-year-old daughter is enrolled in school. She said her 17-year-old and 14-year-old sons work to support the family, but have faced exploitation and abuse:

My sons quit their factory jobs two days ago. The older one worked a month and a half without getting paid. It wasn’t the first time he wasn’t paid. He once worked for nine months without pay, and when he went with a group of Syrian coworkers to confront his management, his employer sent some men to beat him up. He’s been traumatized ever since. He’s a grown boy, but he’s not a tough guy and it was really scary for him.

Enrolling her daughters in public school, Samira explained, involved a complex bureaucratic process, including multiple interviews and tests to determine her eldest daughter’s grade placement: “She was so discouraged by the whole process that she wanted to give up. Finally, they said she would be placed in 11th grade. When she arrived at school for her first day, she was told to join the 9th grade class. She was so upset she only attended for one day and quit.”

Samira’s 13-year-old daughter attended classes in the 7th grade until one of the school staff slapped the girl in the face “because she was in the schoolyard when she was supposed to be in class.” Her mother said: “She never went back to school after that day. A nongovernmental organization tried to mediate and arranged for a discussion with the director, but my daughter was so traumatized and uncomfortable and afraid, she refused to go back.”

The seasonal agricultural workers in Torbalı whom Human Rights Watch interviewed said that none of the children among the 1,500 Syrians in the area at the time were able to attend school. Aziz, a 42-year-old father-of-eight from Ras al-Ayn, said: “The children went to school for one month, when a bus would come and pick them up. But the bus stopped coming, so the kids stopped going. They sit all day at home now, and if there’s a job for them in the fields, they work.” An aid worker in Torbalı said that local authorities provided the bus to “show off” that they were providing educational services to these children and confirmed that the service stopped after a short time.

Maysaa, 13, said she arrived in Torbalı from Deir al-Zour in May 2015, and that she has not been able to attend school since: “I don’t work; I sit at home helping my mom in the tent. I really wish I could go back to school. Life here is not nice…I don’t have friends, and everything is hard.” Her father, Abd al-Karim, said: “When I first left Syria, we originally left her behind because she was studying. But in February 2015 [she fled to Turkey because] her school was closed because of the fighting nearby and she hasn’t been in school since.”

Access to Health Care

The temporary protection regulation also gives registered Syrian refugees access to free primary health care through public hospitals and providers. However, as this regulation implies, those who have not registered cannot get adequate care beyond the emergency level unless they can afford private treatment.

In Izmir, Human Rights Watch observed a recently arrived Syrian family attempt to get medical help for their 6-year-old son, “Shadi.” The family said Shadi had broken his arm during a dangerous border crossing attempt from Syria, and they had taken him to a hospital in Qamishli, Syria, to set the bone. He still had pain after successfully crossing the border several days later, however, so his family took him to an emergency room at a public hospital in Izmir. An x-ray revealed that the bone had not been set correctly and would require immediate surgery to avoid long-term damage. However, hospital staff told Shadi’s family that such a surgery would not be considered an emergency service, and he would need a temporary protection ID to receive treatment. The local police station told them he would not be able to receive the ID for several months.

“Hassan,” 28, said that difficulties getting maternal health care due to delays in registration ultimately played a role in his family’s desperate decision to attempt a boat journey across the Aegean Sea in early April, which ended when the Turkish Coast Guard intercepted the boat: “My wife gave birth here in Turkey, and the hospital wouldn’t take her unless I paid because we didn’t have a kimlik. We tried to get a kimlik, but you have to wait for 10 hours outside just to get an appointment. What am I supposed to do here? This is not a home.”

Four refugee families said they had successfully accessed non-emergency health services, including hospitals and pharmacies, free because they had temporary protection IDs. However, even among those Human Rights Watch interviewed who were registered, there were gaps in health care.

In Torbalı, two Syrian women who had kimliks said they had difficulties getting gynecological care. Both said they can’t get supplies to manage their periods or afford to buy them. Widha, 20, said: “My period pain is really bad and prevents me from being able to stand up. There aren’t enough sanitary napkins to go around and we can’t buy new ones, plus the pain is so bad that I can’t work when I’m on my period. I went to the hospital once because it was so bad. They did some tests but gave me nothing, not even regular painkillers.”

Yazi, 25, had given birth six months prior to her interview, and said her difficult experience at the hospital during childbirth made her reluctant to seek further help for related health issues:

I have had persistent pain since childbirth in my back and abdomen, especially when I am on my period. But I haven’t gone to the doctor because I feel uncomfortable.… When I went to the hospital to give birth, I took a translator with me but they made her leave the room.… I was in a lot of pain and couldn’t communicate with anyone. Then no one checked on me and I was calling out, and they shushed me. I was frightened. I called out, and no one responded.

The Directorate General of Migration Management told Human Rights Watch that translation support for health care is meant to be available for Syrians free of charge, but acknowledged there are currently gaps in translation services.

Restrictions on Movement

Syrian refugees, even those registered under temporary protection, also face restrictions on their movement across Turkey. The temporary protection regulation allows authorities to require beneficiaries to live in a specific “province, temporary accommodation center, or a certain place” (Art. 33), but in its initial implementation, no restrictions were placed on Syrians who wished to move from one province to another. In August 2015, the government issued written instructions to provincial authorities, ordering measures to limit and control the movement of Syrians inside the country. Enforcement was initially ad hoc, but has since become more widespread, and temporary protection beneficiaries are now required to obtain permission from local migration authorities to leave the province where they are living.

Without such permission, refugees may be prohibited from boarding planes or buying bus tickets to a different province. Some observers have noted that the new measures may be an attempt to control the population to limit leaving the country, in line with the EU’s expectations under the EU-Turkey deal.

Three Syrian refugees interviewed by Human Rights Watch mentioned concerns about these restrictions. Ali, 27, said: “Turkey has been really good to Syrians, but the closed borders and limitations on free movement are a real problem.” He did not know what the requirements were for permission to travel and believed it was granted and denied arbitrarily, adding, “I just wish I could move a little within the country.”

Similarly, Mohammed, 29, said these new restrictions affected his sense of security in his temporary protection status:

I never feel safe or stable here. We don’t know what will happen next to us. Every day we hear about problems for Syrians related to their status here…There are limitations on movement everywhere. It’s unbearable…Maybe I can leave Istanbul, but that doesn’t mean I can come back, it depends on my travel permission. Just because I get it in one direction doesn’t mean I will get it in the other…I want to be somewhere where there is rule of law and rights. We don’t have that here.

The Migration Directorate told Human Rights Watch that the primary reason for the travel permit requirement is to “provide rights and services more efficiently.” However, the written instruction governing this policy also references the need to curb “attempted illegal crossing by Syrians to third countries.”

While Turkey is entitled under international law to place some restrictions on lawful residents’ movement in certain circumstances, freedom of movement is an important Refugee Convention right, and Turkey should ensure any such restrictions are justified and legitimate in scope, as they affect refugees’ abilities to have stable lives and may constrain their access to employment and educational opportunities.


In March and April, a Human Rights Watch researcher interviewed 67 Syrian adults and children living in Istanbul, Izmir, and Torbalı. The interviewed families were identified through nongovernmental group referrals and contacts within the Syrian refugee community of each city. Human Rights Watch conducted all interviews in safe and private places, in Arabic, with the assistance of a female interpreter. All interviewees received an explanation of the nature of the research and the intentions concerning the information gathered. Human Rights Watch has withheld identification of individuals and agencies that requested anonymity. Human Rights Watch also consulted local and international nongovernmental groups, public reports, and official statements. Human Rights Watch shared a summary of its findings with Turkish migration authorities and received an official written response on June 10, 2016, which has been referenced where relevant.

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