13 October 2017
The health of women and children is a major cause for concern for Palestinian refugees in Lebanon. The country’s refugee camps and Palestinian gatherings are beset by overcrowding, poverty, and a chronic lack of opportunities. Amid this context, rates of maternal and child mortality and morbidity remaining high.
Determined to help support the latest generation of Palestinians being born into exile, Medical Aid for Palestinians (MAP) provides an essential community midwifery and perinatal outreach service. It is the only home-visiting midwifery service in Palestinian refugee camps in Lebanon.
This programme has had remarkable success in extremely challenging circumstances. The community midwives have helped to increase breast-feeding rates, reduce anaemia among pregnant women and newborns, and reduce high-risk pregnancies among Palestinian refugees in Lebanon.
Between April and June, the community midwives supported 2,273 mothers and 1,380 babies. Through their home visits, 69 women with undiagnosed pregnancy complications that could have put the life of the mother and baby in danger were picked up by midwives and referred for immediate medical care.
We recently joined Lina, a community midwife working in Beddawi refugee camp, in the north of Lebanon, on her rounds, and spoke to her about this work and its impact in the community:
Community Midwife profile: Lina“I have been working as a community midwife since 2012. I am one of eight midwives working in Beddawi refugee camp with MAP. My first three months were dedicated to training, on topics such as exclusive breast feeding and family planning.”
“We feel a great responsibility to the mothers and look forward to seeing how each baby will turn out. We keep close to the families in the camps, even long after we have stopped visiting a new mother.”
“I provide routine post-natal assessments, breastfeeding and weaning support, routine infant assessments, growth monitoring, developmental screening, parenting support and advice, home safety and also look out for health seeking behaviours and any danger signs.“
Is education an important part of your role?
“There are many traditional practices that we come across during home visits which can be harmful to the mother or baby which we try to change. For example, some families give a new born baby garlic if it is jaundiced, believing it will help. Some families give sugared water or aniseed to the new-born. Some families give formula milk to the new-born instead of breast milk. We try to correct poor nutritional practices, as well as screening for post-natal depression and raise awareness about this among pregnant women and their families.”
“It’s not easy to change attitudes and traditional practices, it takes time and we have to establish a good relationship with the woman. We give the information to the whole family as sometimes it is the mother-in-law or husband who promotes the harmful practices, so that everyone benefits from the correct information. We never force people to take the advice, and we respect their opinions.”
We joined Lina on a home visit to a family of Palestinian refugees from Syria living in Beddawi Camp, to check up on seven-month-old baby Heydar.
Lina has visited baby Heydar and his family five times since he was born. His mother had a high-risk pregnancy and Heydar was born with macrocephaly, an enlargement of the head. When Heydar was three months old, he had an operation to reduce the excess liquid on his brain. He also had a low birth weight so it is important that Lina keeps a close eye on him.
During the visit, Lina checked Heydar’s weight, temperature and head width, mobility and functioning, and anaemia status. Baby Heydar was doing well and Lina will return in two months to check on him and his mother again.
Heydar’s mother described the continued support she has received from Lina:
“Lina has made such a big difference to us, she gives us so much support. Even when she is tired and has problems of her own, she never shows it and works so hard for us. She gives us hope”.
The team from MAP saw that Lina loves her role, but it is challenging work, carrying the baby weighing scales and other equipment from home to home and walking long distances each day. Lina explained that each midwife has about 100 cases and it can be hard to keep track of the families, as they tend to move frequently. She told the team:
“My wish is for a society where all women have the same access to health care, whether they are Palestinian, Lebanese or Syrian.”
Would you like to support our Maternal and Child Health programme in Lebanon? Please donate today:
The names in this article have been changed to protect identity.
