09 Mar 2015
Millions of women and girls living in crisis areas lack access to reproductive health services. Learn how health workers at an International Rescue Committee clinic in Jordan are helping to make sure Syrian refugees receive the care they need. Just 21, Fatima* has already experienced a lifetime of loss; losing her home in Syria to civil war and her child to a custody battle after divorcing an abusive husband. Now living as a refugee in Jordan, Fatima has remarried. Under pressure from her new family to become pregnant, she realized she was not emotionally ready: She could not bear the thought of losing another child. “She was so hurt,” said Dr. Mais Shadeed, a doctor at the International Rescue Committee health clinic where Fatima sought help. “I could see it was very hard for her to cope with that. She needed some time so she could get to know her new family.” Dr. Shadeed suggested that her patient consider taking oral contraception. She said Fatima could explain to her family that the contraceptive pills were important for addressing health issues. Then, after a few months, Dr. Shadeed would meet with her to revisit her desire to become pregnant. Fatima began to cry. “She was happy that someone understood her need and could help her. She kissed me as she cried.” The busy clinic in the city of Mafraq is one of the few places Syrian refugees like Fatima can access health care for free. Located near the Syrian border, Mafraq, with 72,000 refugees, has one of the highest proportions of urban refugees in a country where more than 700,000 Syrians have sought safety. “There are so many stories here. We see women who want family planning, but can’t have it, and others who have to hide it. We are doing our best to keep up.” Reproductive health services are in great demand at the clinic. Many women who visit are seeking family planning. They say they want to avoid unplanned pregnancies because of the uncertainty and instability of life as a refugee from war. “Most women here are fully aware of the impact a pregnancy has under these circumstances, and they want contraception,” said Dr. Shadeed. Unintended pregnancies can have life-threatening health consequences for mothers and newborns during emergencies, when women often lack access to health services. And the United Nations estimates that as many as half of maternal deaths during refugee crises result from unsafe abortions. “We need more contraceptive pills and methods of family planning,” said Dr. Shadeed. “And then we need more medication and vitamins for pregnancies, which are common because of the early age of marriage for young girls.” Resistance from family members is often a barrier to access to reproductive health services. Dr. Shadeed said that men must be involved in the efforts to promote access to family planning for women who seek it. “Women will sometimes say, ‘I really want to take contraceptive pills, but I need to ask my husband first,’” she said. “A lot of the time, they don’t come back.” IRC clinic staff recently started providing male patients with information about the benefits of birth spacing and family planning. Their efforts are being supported by refugee volunteers who take information about the benefits of family planning back to their communities. “There are so many stories here,” said Dr. Shadeed. “We see women who want family planning, but can’t have it, and others who have to hide it. We are doing our best to keep up.”