Tuesday, May 7, 2013


Born in exile: Syrian women give birth in refugee camp

Pregnant Syrian women say they never imagined giving birth inside a refugee camp in Jordan where they battle heat and dust and strive to get enough drinking water.

ZAATARI, Jordan — In a tent hospital bed, a Syrian woman who was four months pregnant when she fled her country's civil war cradles one of the newest residents of this dust-swept refugee camp: Her newborn son, just delivered by cesarean.

Around a dozen babies are born every day in Zaatari camp, which is home to 120,000 Syrians and counting — and there's only one, overworked Moroccan doctor performing C-sections.

Still, the clinic where he operates and several other field hospitals here performing regular births are a moment of quality care for women dealing with pregnancy on top of the trauma suffered in their homeland and the hardship of exile in a rough camp.

"Thank God, we have clean facilities and safe instruments in such a refugee camp," the woman, Umm Raad, said this week in the maternity ward of the Moroccan field hospital, holding her hour-old baby, Abdullah. Like other women in the camp she asked to be identified by her nickname for fear of repercussions against her family still in Syria.

Over 10 months, Zaatari near the border with Syria has catapulted from a barren patch of desert to effectively become Jordan's fifth largest city, and it's still rapidly growing. They are only a portion of the more than half million Syrian refugees in Jordan, the rest of whom live in towns and cities around the country, with 1,500-3,000 more crossing in from Syria every day.

The United Nations and other international agencies are racing to try to provide them with medical services — including for pregnant women or women with newborn children.
"There are 10 to 13 births taking place every day in the Zaatari camp alone," said Muna Idris, the assistant representative to Jordan for the U.N. Population Fund, known by the acronym UNFPA. "We're expecting that number to increase as the number of refugees in the camp increases."

By the end of the year, she estimated, there will be 1.2 million refugees in Jordan — "of that number there will be 30,000 who are pregnant."

More than a quarter of the population at Zaatari are women of childbearing age, a significant portion of whom fled here with their children, but not their husbands, who remained behind to deal with businesses, protect homes or even fight in the rebellion against President Bashar Assad's regime.

In the camp, housed in tents or trailers, they find themselves dealing with the bitter cold in the winter and burning dust storms in the spring and summer — as well as the daily struggle of living with few resources except international rations. Many of the women talk of the burdens of collecting water from the camp's communal facilities and walking long distances for clinic visits, then waiting long hours in the sun for their turn — usually with young children in tow.

Um Mohamed, a 29-year-old woman now in the ninth month of her pregnancy, arrived in the camp with her four children last month from Daraa, the southern Syrian town just across the border from Zaatari and a raging battle zone.

"I find it difficult having to do so many things by myself," she said. "My husband is still inside Syria and my children are very young."

She says she's lucky to be staying with a relative in a camp trailer. "But often we find ourselves without water. And we certainly have no money," she lamented.

Hanging over her is the worry of giving birth in indefinite exile.

"This child of mine and the others born here are not born in their own country, their own home. What will their futures be?"

There are several tent hospitals at the camp run by a number of countries, including Jordan, France and the United Arab Emirates, providing a variety of health services to the refugees. Serious medical conditions are treated in nearby Jordanian hospitals.

All the clinics carry out regular births. A comprehensive number of births since Zaatari was set up in July was not available. Just two of the clinics — the Moroccan hospital set up in August and another run by the French agency Gyn√©cologie Sans Fronti√®res — have delivered nearly 600 babies, according to UNFPA's humanitarian affairs specialist, Shible Sahbani.

More than 280 children were born in the camp during just six weeks this year, according to the six weekly camp reports by the U.N. refugee agency that are available on its website.

The Moroccan hospital, run by the North African country's military, is the only facility in the camp that performs C-sections. It has delivered 196 babies — 153 of them C-sections, sometimes up to five a day, the staff said. The facility has 47 specialists but only one gynecologist, who performs all the cesareans, and only one anesthesiologist.

"It gets so hectic at the field hospital on certain days," one doctor at the clinic said. "All the other field hospitals inside the camp refer and send all their patients requiring C-sections to us. This makes many of us at the Moroccan hospital have to work sometimes 18 hours a day."

"Even though the doctors here face great pressures and a heavy work load, we feel at the end of the day that we are really serving humanity," he said. The doctor spoke on condition of anonymity in line with military rules.

The Moroccan hospital consists of about 15 khaki beige colored tents. In one of them, with a large Velcro flap door, is the operating room where the C-sections are carried out, stocked with an oxygen machine, monitors for mother and baby, the hospital bed, a drip, lights and medical instruments to perform the surgery lying on a table. The newborn is initially put in a nearby incubator, while the mother is taken to a tent that serves as the maternity ward.

The facility is likely better than those in parts of Syria hit hardest by more than two years of warfare. "People are increasingly coming down to Jordan because of the deterioration in access to services in Syria, whether health services, water, food or shelter," said Idris.

Um Murad, who delivered her baby girl Judy a week ago at Zaatari, said the hardest part was not having her family around to help in the birth and with the newborn. Judy developed a fever, then jaundice and after a frantic search finally a place was found for her at a hospital in the nearby Jordanian town of Mafraq.

"Back home in Syria, it would be normal for my mother and close relatives to be at my side during the delivery of my baby," Um Murad said. "There were no relatives here to help me."

Visiting the new mother, one of her neighbors, Um Ahmed, said the birth in a refugee camp seals the baby's fate. "You're born inside a refugee camp and you are registered as a refugee. That says it all. It's never the same as being born in freedom in your own country," she said.

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