10 August 2018
Wafa Dakwar, MAP's Senior Programme Officer in Lebanon, describes the outstanding work of MAP's community midwives in Palestinian refugee camps across Lebanon:
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 remain 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 2,279 mothers and 1,477 babies. Through their home visits, 89 women with undiagnosed pregnancy complications that could have put the lives of the mother and baby in danger were picked up by midwives and referred for immediate medical care. Twelve mothers affected by postnatal depression were identified, offered support, and referred to specialised services as needed. A recent survey with over 100 mothers supported by the MAP MCH programme showed very high satisfaction with the care received during home visits.
Zeina is a 37-year-old and lives in Ein el Helweh camp, the largest Palestinian refugee camp in Lebanon. Zeina has five children.
Zeina learnt about the MAP-supported Maternal and Child Health (MCH) project six years ago when she was pregnant with her daughter Lina. Abila, a MAP-supported MCH midwife, visited her and supported her during the pregnancy and after childbirth. According to Zeina, the midwife’s help was immensely needed at that time especially as Lina suffered from a congenital heart defect.
In the last three years, Zeina had four miscarriages which caused her great distress. Nine months ago, when Zeina first discovered that she was pregnant again, she contacted Abila and sought her support. Zeina received regular home visits throughout her pregnancy. The midwife helped her with multiple pregnancy complications, and listened to her concerns and reassured her.
Last month Zeina gave birth to a healthy baby boy, Mohammed, and waited eagerly for the midwife’s visit. As Abila entered her house, Zeina handed her baby Mohammed and asked her if he was doing well.
Zeina was particularly concerned about baby Mohammed’s umbilical cord and skin color. Abila explained to Zeina about umbilical cord care and showed her the steps for cleaning the cord area. She also examined baby Mohammed carefully and recorded his weight and measurements.
Abila gave Zeina breastfeeding and baby care advice. Zeina said that the doctor at the hospital had prescribed baby formula milk and encouraged her to use it instead of breastfeeding. Zeina proudly told Abila that she refused to use the formula milk and insisted to breastfeed her baby exclusively. “There is no milk better than the breast milk for the baby,” Abila added in agreement with her.
Zeina asked Abila’s advice about suitable family planning methods and about food that helps maintain a good breastmilk supply. At the end of the visit Zeina expressed her gratitude for the MCH programme and Abila for helping her and her children.
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Names have been changed to protect the identity of people involved.
