HOMS GOVERNORATE, Syrian Arab Republic – Pregnant and post-partum refugees who fled Syria years ago are finding themselves displaced once more, this time by escalating violence in Lebanon. Many are experiencing fatigue and distress as they make their way back to their home country.
“Losing shelter breaks the spirit before the body,” Nahida Tabaa, a counsellor, told UNFPA, the United Nations Population Fund, which is the UN’s sexual and reproductive health agency.
UNFPA supports a mobile clinic run by the Syrian Family Planning Association (SFPA) at Joussieh, a border crossing between Syria and Lebanon. The clinic’s gynaecologist, Dr. Rahaf, sees between 70 and 120 women per day as Lebanese refugees and Syrian returnees pass through.
Exhaustion etched on their faces
Nearly 200,000 people have crossed the border from Lebanon into Syria since 28 February. About 5 per cent are Lebanese nationals, and 95 per cent are Syrian returnees.
Sarab, 30, is one of those returnees. Previously displaced from Raqaa, Syria, she had found peace in southern Lebanon – until the recent violence erupted, forcing her to flee while five months pregnant.
Before the hostilities, she had been receiving treatment for gestational hypertension. "I fled my home to escape the shelling, but in the chaos of fear and displacement, I forgot my medicine,” she told UNFPA.
Sarab and her four children first took shelter in a Beirut school, which had been turned into a refuge for displaced families. From there, they endured a gruelling overland journey to Joussieh.
By then, Sarab was suffering from a range of alarming symptoms: Extreme fatigue, dizziness, contractions, severe abdominal pain and bleeding. She was brought to Dr. Rahaf’s clinic, where an ultrasound revealed that her fetus no longer had a heartbeat.
She was brought to Dr. Rahaf’s clinic, where an ultrasound revealed that her fetus no longer had a heartbeat.
To prevent sepsis, Sarab received urgent medical care and was transferred to the nearest specialized hospital for stillbirth treatment.
“The signs of exhaustion were etched on Sarab’s face,” Dr. Rahaf said.
At the clinic, Dr. Rahaf has witnessed numerous cases of pregnancy complications and fragile newborns. “This is the heavy price of displacement that women pay with their health and the lives of their children,” she said.
Eman, too, is a Syrian returnee. She also fled the violence in Lebanon and crossed through the border at Joussieh. At 38 years old, Eman is already the mother of 10 children and is eight months pregnant with her eleventh.
She arrived at the mobile clinic with extreme exhaustion and severe shortness of breath. “I could no longer catch my breath from the weight of my pregnancy and the toll of the road,” she told UNFPA.
An emergency ultrasound revealed that she had excessive amniotic fluid, a condition that can lead to preterm labour or other complications. She, like Sarab, was referred to the nearest specialized medical facility.
Eman was fortunate her condition was diagnosed when it was. “Rapid interventions in cases of emergencies for displaced mothers can save both their lives and their babies,” said Dr. Rahaf.
Emotional strain taking a toll
But it was not only physical complications the mobile clinic was seeing. Women are also experiencing stress and trauma. “Our role goes beyond medical exams to rebuild the trust and psychological safety of these women,” Ms. Tabaa, the counsellor, said.
Abeer, 27, fled Israeli strikes in southern Lebanon. She gave birth while her family was displaced in Zahlé, and they continued onward to Syria, their home country.
“We tasted every bitterness imaginable just to reach safely,” Abeer said. Now breastfeeding a newborn, she is feeling the strain of uncertainty, worried about finding shelter and having ready access to healthcare.
“Our role goes beyond medical exams to rebuild the trust and psychological safety of these women.”
Ms. Tabaa says providing care to the mothers of newborns is essential, not only for the women but for their families. “Providing psychological safety for the mother is the first step in ensuring the infant's health,” she explained.
The mobile clinic provides psychological first aid as well as other support for post-partum women such as contraceptive services and dignity kits containing hygiene supplies including soap, underwear and sanitary napkins.
Jawahar, 23, too, is returning to Syria from a long stay as a refugee in Lebanon. She traveled to the Joussieh crossing with her husband and their one year old. She, too, is pregnant. At the medical point, she received an ultrasound, prenatal vitamins and support for anxiety.
“I feel relieved just by speaking out,” she said. “I am grateful to have reached my country safely.”
