Iraq: Creating a safe place for Syrian mothers to give birth

Mohammad, nine days old, with his mother Seva

IRAQ 2017 © Sacha Myers/MSF

Midwife Abla Ali despaired as she crouched on the floor of the tent. The baby's shoulder was stuck and the mother had been in labor for hours. Abla had no equipment or extra support, just her bare hands. She summoned all her strength and eventually pulled the small baby into the world.

The year was 2013 and Abla had just arrived in Domiz refugee camp in northern Iraq. She fled Syria with her family when fighting started in their city. A neighbor's house was bombed, killing everyone inside. Abla says her family felt lucky to be alive, yet life was still hard in the camp.

"There were no basic services in the camp—no toilets, no water," recalls Abla. "It was cold, and it was raining, and it was so hard to look inside a tent and know we had to stay there. We tried to cope with it. One of my sisters cried for a month because she couldn't cope and she wanted to go home, even if it meant she would die in Damascus."

Abla had trained as a midwife in Syria and started to work in the camp straight away. She helped women give birth in their tents because it was too far to travel to the nearest hospital. Abla says it was manageable unless there was a complicated birth."I was always really worried when a woman got into trouble during birth, like when the baby's shoulder got stuck," Abla explains. "I just had to try my best with what I had and hope the baby survived. Sometimes after a difficult birth I couldn't move my hands and arms because of the effort of delivering the baby.”  

Over the past few years, a lot has changed in Domiz refugee camp, now home to more than 30,000 Syrian refugees. Life is still hard, but conditions have improved. The tents have been replaced with basic concrete houses clad with iron sheets, makeshift cafes serve steaming plates of Syrian food, and carpet shops display their wares along dusty roads.

And women no longer give birth on the floor of their tents. Doctors Without Borders/Médecins Sans Frontières (MSF) built a maternity clinic where women from the camp can safely deliver their babies and access care before and after they give birth. Over the past four years, MSF medical staff have delivered more than 3,400 babies and provided more than 27,400 gynecological consultations.

Twenty-nine-year-old Shorash was the first mother to deliver at the clinic. She gave the midwives who delivered her baby the honor of choosing her name: Isla. Since then, Shorash has also given birth to baby Shifa at the facility.

“I heard about the maternity unit from my neighbors, and someone from MSF visited us and informed us there would be a new unit,” Shorash says. “The services here are really good, and they take care of us.”

“They visited me and did tests and monitoring before, during, and after delivery. It was important for me because I wanted to know the baby was okay. The most important thing about the maternity center is that everything is free.” 

Alba started working at the clinic first as a midwife, and then as a sexual reproductive health supervisor. She’s also just given birth to her own baby at the clinic. “We provide a good service for women—the full package of care from the beginning of the pregnancy until after the birth,” she says. “Women feel more comfortable here because the staff are from the camp, and the staff are Syrian.” The clinic also works with the Dohuk Directorate of Health, which provides vaccinations at the clinic.

“The best part of being a midwife is the appreciation from the mothers,” Abla says. “They stop me in the camp when I pass and they say to their children: ‘This is Abla, she’s a good midwife and she delivered you.’ ”

IRAQ 2017 © MSF/Sacha Myers

MSF launched the sexual reproductive health and maternity project in Domiz Refugee Camp in 2013. We initially provided prenatal care, antenatal care, and family planning services. In 2014, the project was expanded to a full maternity unit with a 24-hour delivery room, triage, and gynecological consultations.

MSF completed the project in Domiz refugee camp in November 2017 and has handed over the maternity unit to the Dohuk Directorate of Health. We will continue to work across Iraq and currently have projects in the governorates of Erbil, Diyala, Ninawa, Kirkuk, Salaheddin, Anbar, and Baghdad.

MSF offers neutral and impartial medical assistance regardless of race, religion, gender, or political affiliation. To ensure our independence, MSF does not accept funding from any government or international agency for our programs in Iraq.