“We eat anything we can afford so we don’t stay hungry”

Lebanon’s economic crisis is disproportionately affecting Palestinian women and children in the country’s refugee camps. This month, Wafa Dakwar, Medical Aid for Palestinians (MAP)’s Programme Manager in Lebanon, spoke to Sanaa* about the challenges she faces in accessing food and healthcare, and the support she’s received from MAP.

Sanaa was among around 30,000 Palestinian refugees in Nahr el Bared camp, in northern Lebanon, whose homes were destroyed during intense fighting between the Lebanese Armed Forces and an extremist militant group in 2007. Sanaa was displaced to a temporary shipping container home, where she has been sheltering with her four children in dire conditions while she waits for her home to be reconstructed.

Two months ago – fourteen years since the conflict – she was finally able to move from the shipping container to a small, rented single-room home in the camp. Sanaa is nine months pregnant and is one of the mothers benefiting from home-visits by MAP’s team of community midwives, who provide pregnancy, health, and nutrition screening; follow-up visits; and counselling to expectant and new mothers who are at risk of ill health.

The past year has been particularly difficult for Sanaa as her husband, Ahmad*, has almost completely lost his vision. This meant Ahmad lost his job as a delivery truck driver. Now the family is reliant on UNRWA (the UN agency for Palestinian refugees) and the minimal assistance it provides to vulnerable Palestinian families.

When I accompanied one of MAP’s midwives to visit Sanaa, her four children – ranging from five to 12-years old – were studying. They were very happy to be back to school after a series of strict lockdowns due to the COVID-19 pandemic. Last year, Sanaa’s children faced serious challenges in online, remote learning as they were all using a single smart phone to access their education. One of the children was not able to cope and dropped out of his classes halfway through the school year.

Sanaa was pleased to see the midwife; she had many questions about different health symptoms she was experiencing, and concerns related to pregnancy and delivery. For Sanaa, the midwife’s visits have been very important during COVID-19, as there is limited access to UNRWA’s services due to the pandemic’s restrictions – and the cost of private healthcare has skyrocketed.

“The MAP midwife was very helpful. She makes me feel comfortable and relaxed,” said Sanaa. “I share my pregnancy-related concerns with her and she answers all my questions. When I have an emergency, I call her, and she answers me even if after her working hours. The midwife is the only one reassuring me about my baby by letting me hear his heartbeat. I am not able to pay 100,000 Lebanese pounds (LBP) [approximately £48] for an ultrasound at a private doctor.”

With inflation at an all-time-high in Lebanon, the prices of basic food have risen significantly, causing a serious risk of malnutrition among women and children. “I only eat one meal per day. When there is little food in the house, I prioritise my children eating. Everything is now too expensive; the simplest and the cheapest foods are not affordable anymore,” said Sanaa. “For example, lentils and pulses, which we used to have as a cheap nutritious alternative to expensive meat, are no longer affordable.”

“The midwife gives me advice on nutritious foods and what I should be eating during pregnancy, but I cannot even buy the simplest foods. We eat anything we can afford so we don’t stay hungry. The only time I’ve eaten well during my pregnancy is when my family and I tested positive for COVID-19. At that time, UNRWA sent us a food parcel which made us very happy,” Sanaa continued.

With the support of United Palestinian Appeal (UPA), MAP has also been able to provide much-needed multi-vitamins to pregnant women, which helps them meet their nutritional requirements during critical stages of pregnancy. “In these dire circumstances, the vitamins are crucial. Even though, I have nutritional deficiencies, I was not able to pay for nutritional supplements. The cheapest bottle of vitamins now costs 100,000 LBP [approximately £48] which I cannot possibly afford,” said Sanaa.

“The vitamins donated by UPA helped me a lot. I have more energy and feel better when I take them. They do not cause any side effects or stomach discomfort like other types of multi-vitamins. I recommend giving these vitamins to all pregnant women so that they benefit like I have benefited,” she added.

As for further needed assistance, Sanaa hopes that MAP and other NGOs can help with the cost of nappies, baby clothes and food supplies. She says that a bag of nappies costs at least 50,000 LBP and the cost of a single meal is on average 35,000 LBP – which is too much for families with no steady or adequate income, or who rely on charity assistance. She also believes that food parcel distributions should prioritise pregnant women, new mothers, families where the husband can’t work, extremely poor families, and the elderly. In the coming weeks, Sanaa will receive food parcels from MAP as part of our emergency response work in Lebanon.

*Names have been changed to protect the identity of people involved.

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