Nisreen Anabli – Geiroon
When she answered my question about how many children she has, she said: “four girls and my only son who I have lost recently,” said Sumayya (31 year-old) pointing to a picture of her son Eyad who has died a few months ago in one of Gaziantep hospitals due to a malignant disease.
Eyad was the fifth and youngest child of of Sumayya, who is a Syrian refugee residing in Turkey since late 2013. She says sighing: “he was the only boy, and I gave birth to him after having five girls. I pray that God will compensate me for him in the future.”
Despite the bad financial situation of Sumayya, she shows her great willingness and enthusiasm to get pregnant again and compensate for the boy she had lost. It seems that the one bedroom attached to a kitchen and a bathroom where this family of 6 members live, was not enough reason for Sumayya and her husband to be satisfied with four children. Like some Syrians, they believe that “a child is born and his livelihood comes along.”
Um Ziad (29 year-old) is Sumayya’s neighbor and a mother of five children, three of which were born in Syria before the revolution and two were born in Turkey. I asked her how she provides the needs of her children, and she answered that she depends on reusing the clothes of her older children that do not fit them anymore and she sews them again to fit the younger ones, in addition to the aids they receive from some relief agencies. Um Ziad blames her husband for giving birth to two more children in Turkey, claiming that he loves children so much and has been dreaming of establishing a big family since the beginning of their marriage.
Despite all the exceptional circumstances that most Syrian refugees experience in all countries of asylum, including poverty, unemployment and displacement; they have recorded a very high percentage of newborns since the beginning of the crisis in Syria until now.
It is noted in the Turkish cities that host a large number of Syrian refugees like Gaziantep, Kilis, Istanbul, and Antakya, that the number of Syrian newborns has increased since the Syrians started arriving to Turkey at the end of 2012 until now. In statistics conducted by the Turkish Ministry of Family and Social Affairs at the beginning of this year, the number of newborn children in Turkey since 2014 until now reached 250,000 children. Moreover, the number of childbirths by the end of 2013 was only 7600 childbirths. This number is not completely accurate due to childbirths at home and these are not documented in hospitals or Turkish personal status departments, and with time they become unknown childbirths.
In Jordan, the Ministry of Planning and International Cooperation announced in November 2017 that the number of Syrian children born in Jordan during that year only was 100,000 children. Also, the children constitute 40% of the total number of Syrian refugees in Jordan.
As for UNHCR in Lebanon, it said that Syrian refugees in Lebanon represent a youth group as 18% (total number is 1,500,000) of them were born in Lebanon.
Doctor Majida Hameed who works at a maternity hospital in (Khirbet Al-Joz) town in Idlib countryside northern Syria, told Geiroon that she does not have accurate numbers or statistics on the number of newborns in the region. However, she confirmed that on a daily basis she delivers 8 to 10 babies, at least one or two of the women are under 18.
The domination of religious beliefs and popular norms
Religious beliefs that prohibit abortion and encourage women to keep having children as long as they are physically able to, play a role in high birth rates among Syrian refugees. Many women do not use contraceptives as they believe that using them contradicts religious belief, in addition to the fact that many people are ignorant of the issue of differentiating between birth limitation and birth control. This matter played a prominent role in increasing the number of births as we rarely find a Syrian family in Turkey or any other country of asylum whose members are less than six.
Moreover, the response of some individuals to the pressure of the social environment plays a role in increasing childbearing. Maysa, a woman in her thirties, hopes to give birth to a boy who, according to her, will support her six daughters and relieve her of the extreme psychological pressure she feels because of her husband’s family, who insist on her to keep having children until the male who will bear his father’s name comes. She tells Geiroon: “I love my daughters so much but I am sad whenever I hear anyone’s prayer that I have a boy. This makes me think of getting pregnant again.” In general, refugees from rural areas stick to the idea of forming a large family and bragging about the abundance of children.
In addition to the previous reasons, there is an important factor related to the war in Syria. During the war, many families lost their children which induced a desire to intensify childbearing in order to compensate those who were martyred.
Regarding the besieged areas that suffer from a shortage of medicines and everything related to health services, like eastern Ghouta in Damascus countryside, the situation is different. The lack of contraceptives contributed to the increase in childbearing despite the poor living conditions. Miss Nemat from the Women’s Empowerment Center in eastern Ghouta told Geiroon: “many women become pregnant despite not wanting to have children. The problem begins here, as the mother is subject to miscarriage due to lack of nutrition, and the fetus is subject to death after birth due to the lack of necessary medical care.”
Men make decisions
Men often decide whether to use contraceptives or not, and in some cases they decide even the method. Many women say that their husbands refuse to use condoms because it affects their orgasmic feeling. There are many misconceptions about ways to use contraceptives, including that the use of IUCD causes inconvenience to men during sex. Therefore, many women abstain from using it as per their husbands’ wishes. There are common misconceptions among women too. Some women think that using birth control pills causes cancer or infertility if used for a long time.
Health and economic crises
The risks of multiple reproductions reflect on the health and living conditions whether that of the mother or the child. Doctor Majida Hameed talks about health problems women face: “the financial situation is closely related to the health status of the wife. That is, when a woman does not get proper nutrition due to the family’s poor financial situation, it reflects on her health during pregnancy. I encountered cases of women where undernourishment impaired the ability of their ovaries to produce healthy eggs. Moreover, women who do not get the proper health care and nutrition are more susceptible to the dangers of the postpartum period, especially if it was accompanied with severe bleeding.” The doctor thinks it is necessary to have a period of two to three years between each baby, so that a woman’s body will recover its health and shape.
Doctor Majida thinks that using contraceptives is necessary because it gives the couple the right to choose the number of children in accordance with the conditions and environment they live in. Moreover, it contributes to reducing the dangers of unsafe abortion, especially among young girls.
Random reproduction and its reflection on the economic situation of families is a violation of a woman’s right to get proper health and medical care, according to the second item of Article 25 of the Universal Declaration of Human Rights. Moreover, it is a violation of the whole family’s right to an adequate standard of living including food, clothing, and medical care, according to the first item of Article 25. Therefore, family planning is a human right and a central factor when it comes to gender equality.
The parents’ right to determine the number of pregnancies reflects on the lifestyle of children in terms of health, living standards and education. According to the statistics of the Turkish Ministry of Education, there are 359,000 Syrian children in Turkey who do not attend schools, out of the total number of children which is 972,000 children. Most of these children have entered the labor market due to their parents’ inability to spend money. In Turkish cities crowded with Syrians, it has become common to see children on the roads and at traffic lights selling tissue bags or biscuits, and most of them are under 10 years of age. This is a violation of a child’s right to get education according to the first item of Article 26 of the Universal Declaration of Human Rights.
Absence of awareness
Most associations and organizations currently present in Turkey, especially those dealing with women affairs, provide services that are exclusive to psychological support from the effects of war, in addition to teaching women some professions and crafts to enable them to provide for their families and children. However, there is a clear absence of initiatives and awareness campaigns that aim to raise the awareness of women and husbands in general on the issue of family planning and reproductive health.
Doctor Firas Jundi, Minister of Health in the interim Syrian Government, agrees on the importance of raising awareness on family planning issues. He tells Geiroon: “family planning has become a necessity especially after several years of war and displacement and asylum. Even though we have the vision and the desire to implement programs and awareness campaigns, but unfortunately we are not financially able to implement them. So far, there are no centers caring for reproductive health and family planning whether inside or outside camps.”
Doctor Jundi explains that the tragic reality that Syria is living focused their attention and potential on caring for war injuries. Even though it is important to raise awareness on birth control, the Minister of Health admits that this issue is not currently a priority for them.
The Head of the Medical Care and Reproductive Health Unit at the Union of Medical Care and Relief Organizations (UOSSM), told Geiroon: “we do not have activities in Turkey on this issue. As for Syria, society health workers do not have clear and direct awareness activities due to the sensitivity of the issue. So it is done indirectly in primary health care centers by the midwife who gives advice on family planning (birth spacing, health implications…Etc) and contraceptives are given only to those who want.
According to Norma, a Lebanese social worker who worked with many international organizations concerned with refugees’ affairs, like the International Labor Organization, in areas like Arsal, Baalbek, Qaa projects, Hermel, Al-Labwah, talking with refugees directly on this topic is considered a violation of the terms and conditions of her work. She tells Geiroon: “we work with people within their realities, environments and religious beliefs. We cannot interfere with the issue of multiple births because it is considered interference in their culture and customs. In addition, it creates barriers and a sense of unease between us and those who benefit from our services. All we can do is draw their attention, or give them the addresses of the centers that offer contraceptives and health consultations, and they are free to decide.
Even though Maysa said she will stop getting pregnant as soon as she gives birth to a boy, she admitted that she is not sure if one boy would be enough or whether she will think of giving him a brother!
*This story was produced with the support of Journalists for Human Rights Organization (JHR) and the United Nations Democracy Fund (UNDEF)
