Imagine Not Being Able to Call the Midwife

Head of Programmes at CanDo International, Dina Prior, talks to us about some of the biggest issues facing people living in war-torn communities.

My midwife moment

When I was pregnant with my first child, I was in Washington DC preparing my organisation’s response to the Ebola crisis. As is usual in the US, I had been seeing an OB-GYN (a doctor who specializes in women’s health) throughout my pregnancy, as midwives only make up a small part of the healthcare system. I’d been working day and night and got really sick, so my mum persuaded me to come home to the UK.

I worried for the health of my baby but in the UK I was immediately assigned a midwife and I couldn’t believe how quickly she put me at ease. She was there for me through what turned out to be a fairly traumatic birth – at one point I passed out and my son’s heartbeat couldn’t be detected. But that wasn’t the end of the story. I saw the midwife continually over the next weeks – in fact, she was always popping in to see me while I was in hospital, supporting me with the things that people think come naturally, like breastfeeding and caring for my baby.

I’ve worked with medics for over 16 years, but I never knew the half of what these angels did, or the pressure they are under, especially during the delivery.

Planning for families in camps

When I first visited Atmeh camp, it wasn’t really a camp at all – 20 or so families had gathered and had built shelters under the trees; they had been making their way to Turkey (like thousands of others fleeing the war) but the border had been closed. Fast forward seven years and Atmeh is home to over 250,000 Syrians. For women going through pregnancy and giving birth in Atmeh, and throughout the country, their story couldn’t be more different to mine.

The healthcare system in Syria has been decimated. Women don’t have many choices when it comes to how they will have their baby, often having them in a tent or other temporary shelter – with no support from a qualified midwife. The sense of security that I took for granted when I was pregnant doesn’t exist for them – they don’t have anyone to guide them through their pregnancy, they can’t make an appointment to see a doctor if they fall ill, they can’t pick up a phone in the middle of the night and call for an ambulance if they go into labour.

Naturally, myself and the women in my antenatal group worried about everything from what pain control to use and whether we would need stitches, to mood lighting and birthing balls. Women in Syria haven’t stopped worrying about the smaller details, but in a country where the maternal mortality rate has increased by nearly 40% since the start of the war, they are also having to worry about whether or not they will survive the delivery and see their child.

The complications of war

Like the US, midwifery isn’t a big part of Syria’s healthcare system – pregnant women rely on the support of an OB-GYN, or in rural cases a traditional birth attendant, or at least they did. Since war broke out, it is estimated that over half of Syria’s doctors have fled. So in many cases, women give birth alone.

The support structures may have disappeared, but the need for them has not. As is the trend in war-torn countries, early marriages and a breakdown of reproductive health care services are compounding the problem. Where women do have access to OB-GYNs, they are being scheduled in for C-sections to make the flow of births manageable for the still-diminishing population of medical staff. This ‘C-section first’ approach brings its own set of troubles; it is almost impossible for women in camps to recover well, lack of access to clean water, personal care items and medicine means that infections are inevitable.

Introducing trained midwives into camps like Atmeh could be the difference between life and death. Learn more about the work that Hand in Hand for Aid and Development is doing to train midwives here

About Dina

Dina has worked in 28 countries across the globe, often at the front lines of conflicts. Dedicated to supporting first responders, her career has focused on assisting people and communities in most need by providing the ability to become self-reliant. With particular experience in health care, mental health and women and children, Dina has worked her magic across the Middle East, Africa, Asia and Europe over the past 18 years.

Hand in Hand for Aid and Development is a UK registered Syria charity that has been at the forefront of providing humanitarian aid in Syria since the beginning of the conflict in 2011.

Established by a group of British-Syrians, looking for how to help Syria, the charity has grown to become one of the leading humanitarian actors serving Syrian communities in Syria and neighbouring countries.

CanDo is a small, dynamic start-up and registered charity building and mobilising a global movement because we believe passionately that we are all humanitarians. We are on a mission to enable local humanitarians to provide life-saving healthcare in communities devastated by war.