Women’s health in the Syrian diaspora: lack of awareness of family planning

 

(C) Firas Al-Mashhedi – Syrian families fleeing Tel-Marak

 

By Nisreen Anabli

Soumaya pointed at her baby boy in a picture. He passed away few months ago in a hospital in Gaziantep in Turkey. He had a malignant disease. Says the 31-year-old Syrian refugee: “I have four girls. He was my only boy. I lost him a little while ago.”

Eyed was the youngest of Soumaya’s five kids. Soumaya moved to Turkey in 2013 as a Syrian refugee.

Despite poverty, Soumaya seems ready and keen to have another child, a baby boy. She thinks this will compensate for the loss of the only boy she had. Soumaya’s family already consists of six members. They all live in one bedroom attached to a tiny kitchen and one washroom in .Yet, they still believe, as do many other Syrians, that “bringing kids to life will bring fortune and sustenance to the family.”

Um Zeyad (mother of Zeyad), 29 years, one of Soumaya’s neighbors, is mother to five kids. Three of them were born in Syria before the conflict; the rest were born in Turkey. When we asked Um Zeyad how she could manage to support such a big family, she said she would recycle her kids’ clothes, and pass them all the way to the youngest, or adjust and fix them to suit their sizes.  Um Zeyad’s family also receive help from welfare associations. Um Zeyad blames her husband on having the two last kids in Turkey. “Since we got married, his dream was to have a big family,” she added.

Most Syrian refugees face extreme conditions in the countries of asylum, from extreme poverty to unemployment and displacement.  Despite this, the Syrian diaspora has experienced a very high percentage of newborns since the beginning of the crisis. According to the Turkish Ministry of Family and Social Affairs’ statistics, the number of Syrian children born in Turkey since 2014 is around 250,000. This represents a significant jump from 2013, when the figure was only 7600.

The UN refugee agency (UNCHR) office in Lebanon added that Syrian refugees in Lebanon represent a “youth group” with 18% – out of 1.5 million Syrian refugees- born in Lebanon.

Magda Hamdan, a doctor in the maternity hospital in the town of Khirbet al-Jawz in the northern Syrian town of Khirbet, claimed, “she could receive between 8 to 10 women a day, under the age of 18.”

One of the reasons behind the remarkable number of births among Syrian refugees is the impact of religious beliefs that prohibit abortion and encourage women to continue having children, as long as they have the physical capacity to do so. Many women do not use contraception because they believe it is contrary to religion. In addition, most of them are not educated on the difference between family planning and birth control. This plays a prominent role in the increase of births. The average Syrian family in asylum countries now consists of not less than six individuals.

The socio-cultural aspect also affects the average Syrian’s family planning, as society imposes certain standards on women in terms of number of children in each family. Maysa, a young Syrian refugee in her early thirties, shared her hopes to have a baby boy – after having six girls – believing that a boy could be a source of protection for the girls in the future. She added: “I love my girls very much, but it aches my heart to hear people wishing me to have a baby boy. And this what makes me want to have a baby boy.”

Men often make the decision on what form of birth control to use. In the moment, this often comes down to no birth control at all. Many women said that their spouses refuse to use protection (condoms) during intercourse, thinking it negatively affects the quality of the intercourse.

There are also many misconceptions about birth control methods, including the use of condoms, which are believed to cause discomfort to men during intercourse. As a result, many women do not insist on the use of condoms. On the other hand, some believe that the use of the oral intrauterine contraceptive device causes cancer or infertility in the long term.

Childbearing affects the health of the mother, the child and their living conditions. Dr. Magda Hamdan says that “financial and health conditions are interconnected for women. When a woman is unable to get the necessary nutrition due to poverty, it reflects directly on her health during pregnancy. I have encountered many women suffering from weak ovaries due to undernourishment resulting in producing weak eggs. Women who are not receiving the appropriate health care and nutrition are more likely to suffer after giving birth by heavily bleeding.” Dr. Hamdan indicated that there should be a period of 2 to 3 years between each birth for women’s bodies to regain their health.

An excess of children per family can also determine children’s access to school, right to education, right to health care. According to the Turkish Ministry of Education, there are 359,000 out of 972,000 Syrian children living in Turkey as refugees, without access to schools. Most of them are working to support their families. Moreover, in most Turkish cities crowded with Syrians it is very common to see Syrian children around traffic lines selling tissues or biscuits, sometimes as beggars. Most of these children are under the age of 10.

Most of the women’s rights associations and organizations in Turkey usually focus on women’s mental care, taking into account the post conflict damage and its effects on the mental health of women as mothers and wives. In addition, they also encourage women to join the work force to support their families, by teaching them some basic professions such as handicrafts.

Norma is a Lebanese community worker. She has worked with many organizations dealing with refugee affairs in Lebanon. She claimed that talking to refugees in this matter is contrary to the terms and conditions of her work. “We work with people in their reality, their environments and religious beliefs,” she said. “We cannot interfere with childbearing because it affects their culture and customs. It also create barriers between our patients and us. All what we can offer is contacts for specialized centers that deal with family planning and women’s health. It is up to them to decide.”

There is, however, a notable lack of discussion or awareness among Syrian refugees, women and couples in general, on family planning, birth control, and women health.

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