Ratiba and her husband arrived by motorcycle to the Doctors Without Borders/Médecins Sans Frontières (MSF) supported hospital in Idlib governorate, northwestern Syria. She was in labor. The couple have three other children, all born in the 11 years since the war began. They are displaced and live in a tent, struggling to make ends meet. Like thousands of other pregnant and lactating women in Syria, Ratiba was diagnosed with malnutrition and suffered from continuous dizziness, hypertension, and fatigue throughout her pregnancy.
Northwestern Syria is home to some four million people, including 2.7 million internally displaced, 80 percent of whom are women or children. Throughout the war in Syria, MSF has witnessed the additional consequences the conflict has had on women. Many live in precarious conditions and suffer from food insecurity. Existing challenges—such as gender-based violence—further compound women’s vulnerabilities. “Even the normal stages in a woman’s life, such as menstruation, pregnancy, or breastfeeding, become a complex burden,” said, Teresa Graceffa, MSF medical coordinator in Syria.
Mental health consequences
Access to health care is a huge challenge due to insecurity, long distances to reach health facilities, and the cost of services and transportation. "A woman coming from afar recently gave birth near the entrance of an MSF-supported hospital,” said Caroline Masunda, MSF medical referent in Syria. She was waiting for enough money to pay for transportation, as there was no ambulance available. This is concerning as late arrivals for delivery could lead to medical complications for both the mother and the baby."
Eleven years of war have also taken a toll on women’s mental health, and many are struggling with anxiety, depression, or post-traumatic stress disorder. Most women and adolescent girls who receive psychological support in MSF facilities say that their distress 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 presented [with] symptoms of depression,” says Soumaya*, an MSF health promoter “She was so overwhelmed with sadness that she could no longer breastfeed her newborn child.”