Triple burden of maternal and child health in refugee camps
According to the UNHCR, the Refugee Agency of the United Nations, a refugee is a person who has crossed an international border to flee from war, violence, conflict or persecution and is unwilling or unable to return to his or her country of origin because of a well-founded fear of being persecuted because of his or her race, religion, nationality, membership of a particular social group or political opinion. Globally, there are 26 million refugees worldwide and most of them are from the MENA-region. Syria and Afghanistan are responsible for creating the world’s largest number of refugees. About 5.6 million refugees have left Syria in the past nine year and over 2.6 million registered refugees in the world originate from Afghanistan.
More than half of the refugees are female. While all of the refugees are facing risks, especially women and girls are vulnerable for many forms of violence, like sexual assault. In terms of the proportion of refugees to the total population, Lebanon (21.8%), Jordan (10.7%) and Turkey (5.1%) are the countries that are hosting the greatest number of refugees. Therefore, the distribution of refugees is very unequal. The demand on reproductive health services is increasing since the number of female refugees is growing. This results in a very high burden on the healthcare system of these countries.
The video below shows the story of pregnant women in refugee camps in Jordan and highlights the importance of (maternal) health facilities. Refugees regularly have poor living conditions and lack of hygiene. Pregnant women often have no access to maternal care, which can cause easily preventable infections during birth, like puerperal infections. Puerperal infections are infections caused by bacteria that infect the uterus and surrounding areas after labour. The poor health and hygiene conditions easily lead to the spread of communicable diseases in the camps, often emerging examples are tuberculosis and HIV, but currently Covid-19 is also causing a big threat to the health of people living in refugee camps. Especially pregnant women and children are vulnerable during epidemic outbreaks since the vaccination rate for refugee children is very low and their immune system is often weak.
Besides the communicable diseases, women in refugee camps also have a higher risk of certain noncommunicable diseases compared to other women in the host countries. Refugee women have a higher risk of developing gestational diabetes and anemia during their pregnancy. However, the worrying health situation, especially the maternal and child health in refugee camps does not only lead to a double burden, but even to a triple burden of disease: people are facing non-communicable diseases, infectious diseases, and also mental health issues like postpartum depression. This is possibly caused by certain risk factors like socioeconomic disadvantage, marginalization, experiences prior to migration, general poor health and difficulties in integration.
Migration is a complex issue and causes many threats for health. Political commitment is essential in the solution for these problems. Access to healthcare is a basic right which should be available in the camps as well as along transit routes.