Experiencing menstruation, pregnancy or breastfeeding in Syria

The war in Syria did not prevent nur be a midwife. She was born in Aleppo, is 32 years old and is currently working on Doctors Without Borders projects in Idlib, in the northwest of the country, an area that is home to four million people. Of that total, almost three million are internally displaced and the 80% of them are women and children. Every day Nur cares for dozens of women like Ratiba, a displaced mother with four children, three of whom were born during the Syrian conflictwho raises her children in a tent and struggles to make ends meet.

Nur explains to RTVE.es in a video call that thousands of women in Syria, during their pregnancy, are diagnosed with malnutrition and suffer “continuous dizziness, tension problems and a lot of fatigue.” She does not want to focus on her success story, why despite the war she managed to study, train and work. She had to interrupt her studies for three years and her instability has led her to move from one place to another throughout the country, but now He has settled in Idlib where his work is increasingly essential. She stops to give examples of what women suffer every day in a country where the war does not stop. It lists the great challenges they face for health care and the multiple consequences that further aggravate the vulnerability of women, such as gender violence and early marriage.

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In fact, she tells the story of Ratiba and, right away, assures that she is not the only one suffering from this situation. Throughout this year she has witnessed how women, like the rest of the population, have been directly affected by the conflict and its consequences. “Even the normal stages of a woman’s life, such as menstruation, pregnancy or breastfeeding, become a heavy burden for them,” says Teresa Graceffa, MSF medical coordinator in Syria.

Even the normal stages of a woman’s life, such as menstruation, pregnancy or breastfeeding, become a heavy burden for them

“Many deliveries are complicated both for the mother and for the little ones”

Many people in Syria live in precarious conditions and suffer from food insecurity. In addition, insecurity complicates transfers to medical centers and the cost of services and transportation. “Most women they can’t come because they don’t have enough money to pay for transportation and there are no ambulances,” recalls Nur. “This causes many deliveries to become complicated for both the mother and the little ones,” she adds.

A grandmother holds her granddaughter in a hospital co-managed by MSF in north-western Syria MSF / Abd Almajed Alkarh

Last year in this region, MSF treated an average of 50 deliveries and 600 consultations per day, but their efforts are not enough to alleviate the enormous needs created over eleven years of conflict, nor to cover the void left by the closure of numerous health centers and programs in the last year. “I am concerned that many organizations are closing projects and this directly harms women,” she says. “We need help, a lot of help,” says Nur, who warns that the needs continue to grow, the fragile health system in northwest Syria faces structural challenges and funding gaps remain a huge challenge.

most women they can’t come because they don’t have enough money to pay for transportation and there are no ambulances

Also, these Eleven years of conflict have undermined the mental health of women. “We are dealing with anxiety, depression and post-traumatic disorders,” he says. “We not only heal physical pain, but psychological pain as well,” she adds. His needs take a backseat. They cannot buy medicine or attend to their own demands as women.

We not only cure physical pain, but also psychological

“The war has killed my heart”, assures the young midwife. For this reason, Doctors Without Borders affirm that her anguish is directly or indirectly related to the conflict. “I recently referred a 25-year-old displaced mother of five to a mental health specialist because she was showing symptoms of depression; she was overwhelmed with sadness not being able to continue to breastfeed their newborn child”, says Sumaya, an MSF health promoter.

MSF has been providing sexual and reproductive health services to women in northwest Syria for ten years, including prenatal, postnatal and newborn care; delivery assistance, including caesarean sections; gynecological consultations, family planning and mental health support. In 2021, more than 18,000 Parthians in Aleppo and Idlib governorates and were made more than 200,000 sexual and reproductive health consultations in hospitalshealth centers and mobile clinics, co-managed or supported by the organization.

Sexual and reproductive health is no longer a priority

Under these circumstances, the normal stages of a woman’s life, such as menstruation, pregnancy or breastfeeding, become a huge burden for them. They live in huts with shared bathrooms and this puts their hygiene at risk. They do not receive aid with specific products for them. “Many don’t have access to pads or can’t afford the pills,” Nur argues. The winters are very harsh and makeshift housing does not help. Also, she remembers that they have no privacy. “Before the war, we women could take care of ourselves, now everything is focused on survival,” says Nur.

Before the war women could take care of ourselves, now everything is focused on survival

In IDP camps, women often express concern about the reduced availability of maternal and child care services. “Every time we go to the hospital in the area, we see less staff working, and most services are usually suspended,” says Fatima, a mother of seven who recently suffered a miscarriage. “I found out that they have closed the hospital where my daughter was born,” she adds.

Nur tells the story of a patient who was pregnant, felt pain and out of modesty did not notify her husband because they lived with her brother-in-law’s family. Finally, it turned out that she was having an abortion and it was already late when they brought her to the clinic. “This is due to cultural codes and there are topics such as pregnancy that are still taboo”he argues.

She explains that the war has changed the roles of women: “They have more responsibilities, but it has taken away more strength and comfort.” In the last year, MSF has seen several health centers and programs reduce their activities or close due to lack of funding. Additionally, during the conflict, hundreds of medical facilities have been damaged or destroyed. Many toilets have died or have fled the country. Often there are no medicines or essential medical supplies. All of this has negatively impacted access to essential services for pregnant women, girls and newborns.

Humanitarian response falls short of needs, and it is imperative to increase funding for vital activities in the country, including sexual and reproductive health services. “Women in northwestern Syria need long-term, quality sexual and reproductive health services to give them a chance to lead a healthy life,” says Dr. Faysal Omargeneral coordinator of MSF in Syria. “Clearly now is not the time to let them down.”

A woman washes dishes using a water tank in a camp in northwestern Syria. MSF / Abd Almajed Alkarh


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George Holan

George Holan is chief editor at Plainsmen Post and has articles published in many notable publications in the last decade.

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