Syrian Refugee Women's Health in Lebanon, Turkey, and Jordan and Recommendations for Improved Practice
| DOI | http://doi.org/10.1002/wmh3.231 |
| Author | Goleen Samari |
| Published date | 01 June 2017 |
| Date | 01 June 2017 |
Syrian Refugee Women’s Health in Lebanon, Turkey,
and Jordan and Recommendations for Improved Practice
Goleen Samari
Since 2011, over four million Syrian refugees have fled to neighboring countries of Lebanon, Turkey,
and Jordan. Seventy-five percent of Syrian refugees are women and children. In times of conflict,
women’s health disproportionately suffers. Based on an assessment of academic literature and
international policy and development reports, this study explores the vulnerabilities of Syrian
women and girls in Lebanon, Turkey, and Jordan, and how these countries approach Syrian refugee
women’s health care. In all settings, sexual and gender-based violence, reduced use of modern
contraceptives, menstrual irregularity, unplanned pregnancies, preterm birth, and infant morbidity
are ongoing issues. Recommendations for improved practice include taking a multilevel approach to
eliminate social and service delivery barriers that prevent access to care, conducting thorough needs
assessments, and creating policy and programmatic solutions that establish long-term care for
Syrian refugee women.
KEY WORDS: Syrian refugee, women’s health, conflicts and health
Introduction
The United Nations has declared the Syrian crisis the worst humanitarian
crisis of the twenty-first century (Baker, 2014). The conflict in Syria is a public
health disaster. Since 2011, an estimated 4,812,204 million Syrian refugees have
left for neighboring countries, primarily Lebanon, Turkey, and Jordan (United
Nations High Commissioner for Refugees [UNHCR], 2016). While the number of
Syrians arriving in Europe continues to increase, it remains low compared to
Syria’s neighboring countries, with slightly more than 10 percent of Syrians
seeking safety in Europe. Seventy-five percent of Syrian refugees to neighboring
countries are women and children, and many are of reproductive age (Baker,
2014).
While Syrians are leaving a violent and unstable Syria, they are also leaving a
country where primary care and reproductive health care was most often free
(Bashour et al., 2009). In receiving contexts (countries that refugees move to), due
to lack of services, gender dynamics, and fear of seeking services, Syrian women’s
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doi: 10.1002/wmh3.231
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reproductive health disproportionately suffers. Small-scale needs assessments
show high levels of sexual and gender-based violence including rape, assault,
harassment, and intimate partner violence; early marriage; early age at preg-
nancy; frequent urinary tract infections (UTI); complications during pregnancy;
and prostitution among refugees (Al-Tuwaijri, 2013; Benage, Greenough, Vinck,
Omeira, & Pham, 2015; Charles & Denman, 2013b; Doedens et al., 2013; Krause
et al., 2015; Masterson, Usta, Gupta, & Ettinger, 2014a; Refaat & Mohanna, 2013).
Gender-based violence and sexual exploitation are of primary concern (Parker,
2015). While food aid, water, and sanitation are vital in disaster responses,
comprehensive refugee women’s health and reproductive health is both a
diplomatic and humanitarian effort, integral to long-term rebuilding.
The difficulties that refugee women encounter are not a new phenomenon,
yet work in this area is limited (Zaatari, 2014). Since the mid-1990s, there has
been heightened awareness of the reproductive health issues that affect women
during humanitarian crises (Schreck, 2000). Whether these existing programs
alleviate Syrian refugee women’s reproductive health needs, morbidity, and
mortality in Lebanon, Turkey, and Jordan remains to be seen. This review
explores how Lebanon, Turkey, and Jordan responded to Syrian refugee women’s
health, and provides a set of recommendations for improved health provision for
Syrian refugee women.
Background
Vulnerabilities of Women and Girls in Times of Conflict
There are several known health risks that women and girls face in conflict
and displacement settings. First, armed conflict disrupts access to essential
services and distribution of health care, which includes the provision of women’s
health care (McGinn, 2000). Prolonged emergencies weaken health systems, with
long-lasting effect on women’s health care (Sami et al., 2014). Second, aspects of
women’s health that suffer in conflict and displacement include access to family
planning; safe motherhood; sexual and gender-based violence; and disproportion-
ate risk for sexually transmitted infections (STIs), including HIV (Hakamies,
Geissler, & Borchert, 2008; McGinn, 2000; Petchesky, 2008). Displaced women are
at daily risk to safety and security as well as sexual, physical, and mental abuses
as they attempt to survive.
Women remain refugees for longer periods of time and are more vulnerable
compared to men because it is more difficult for them to obtain legal status,
resettlement opportunities, and protection against violence (Akram, 2013).
Importantly, violence against women is not a side effect of political conflict—it
appears in societies with deep-rooted gender disparities, and Syrian society is a
patriarchal society (Charles & Denman, 2013b). The proliferation of violence is
due to the challenges to the gendered identity of individuals (Parker, 2015).
Women face discrimination and violence simply because of their gender.
Vulnerability to disasters is a social dynamic rooted in the interaction between
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