Sindrom Kehancuran Manusia sendiri adalah istilah yang diciptakan oleh ahli neuropsikologi medis Mohammad Khalid Hamza dari Syrian American Medical Society pada tahun 2016. Dilansir dari laporan khusus VOA tentang pengungsi Suriah, istilah ini dicetuskan oleh Hamza lantaran melihat dan meneliti bagaimana trauma yang dimiliki oleh korban konflik Suriah begitu besar hingga istilah PTSD pun tidak cukup menggambarkan trauma dan kerusakan mental yang dialami korban.

But Katouh did not do that. She illustrated her characters’ personalities in very practical and poignant ways. As Long as the Lemon Trees Grow as YA fiction? I love every character in this book.I was affected by every single one of them. I'm ready to sacrifice myself for them. They deserve the best in the whole world. Layla was so bright and so full of life she was the shining light in the darkest times. Ahmed Lamar and Yousef were the bravest kids ever i admired their courage and strength . Kenean was so sweet and determined and brave his love for his country and his siblings was really admirable<33Tak mengherankan jika kemudian Salama pun acap kali mengalami berbagai masalah mental. Ia mulai berhalusinasi, kesulitan tidur, hingga bisa tiba-tiba terdiam dengan tatapan kosong. Khawf (dalam bahasa Arab berarti rasa takut) pun hadir dalam manifestasinya terhadap trauma besar yang ia alami. Trauma yang melebihi PTSD dan kini punya istilah sendiri, Human Devastation Syndrome atau Sindrom Kehancuran Manusia. I had to write Salama’s character three times, to be able to flesh it out even more,” she says, explaining that her characters were not intended as purely tragic beings: "It wasn't fair to the people who had suffered... They are not just their suffering." And it is one! All the characters in this book love their given and chosen families fearlessly and this is a powerful aspect of this book. Seperti yang sudah Koutuh coba elaborasi sebelumnya mengenai sindrom kehancuran manusia, ia menyadari bahwa tidak semua orang bisa bertahan waras dengan situasi konflik berkepanjangan di Suriah. Nyawa dan kesehatan mental menjadi taruhannya. Karena itu, bagi mereka yang memutuskan untuk mencari suaka, keluar dari Suriah untuk menyelamatkan nyawa diri sendiri dan orang terdekat tidak digambarkan Koutuh sebagai sebuah tindakan pengecut.

A searing story of war, loss, family and love, of seeking grace in madness and hope in tragedy, As Long as the Lemon Trees Grow is a phenomenal tale, a piercing keen for the Syria that was and the Syria that is. An absolute must read." - Sabaa Tahir, #1 NYT bestselling author of An Ember in the Ashes These stories have happened. And are still happening as you read these words." (from the author's note) Ia juga merasa bersalah tiap kali ada pasien yang harus kehilangan nyawa dalam pengawasannya. Rasa bersalah ini semakin kuat apalagi semenjak ada seorang anak laki-laki yang ia “biarkan” meninggal karena mengalami pendarahan dalam. Salama Kassab was a pharmacy student when the cries for freedom broke out in Syria. She still had her parents and her big brother; she still had her home. She had a normal teenager's life.

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It feels so surreal to see the words that I wrote five years ago be translated into a book that people all over the world are reading,” Katouh tells Middle East Eye. Hope and resistance