A day in the life: A midwife treats women in the midst of conflict in northern Syria

Nadir Houboub/CARE Morocco

As the Syria crisis enters its seventh year, civilians continue to bear the brunt of a conflict marked by unparalleled suffering, destruction and disregard for human life. An estimated 13.5 million people require humanitarian assistance, including 4.9 million people who are trapped in besieged and hard-to-reach areas, where they are exposed to grave threats.

CARE supports ten primary health care centers and ten mobile clinics in northern Syria. These centers and clinics provide vulnerable Syrian households with access to sexual and reproductive health and primary healthcare services, information, consultations and services on family planning methods and gender-based violence in Idleb and Aleppo Governorates.

Khawla is a midwife working for one of the centers in Aleppo and focuses on family planning. She studied nursey and midwifery, and has been working as a midwife for nearly 20 years.

6:30am

I wake up, wash my face, brush my teeth and get ready. I do some housework depending on if we have electricity or not. If there is electricity, I clean, wash clothes or cook until I leave the house on my way to work at the centre. Before I leave, I also prepare breakfast for my husband and children who are still sleeping. Since it’s the summer holiday, I let them to sleep. I dress and get a ride from where I live to the village where I work. The distance is between 15-20 kilometers and it takes around 15 minutes to get there.

8:00am

My work starts. Usually, the centre is crowded with local women and women who have been displaced by the conflict. I wear my coat and sit in my room and start receiving patients. If I have time and the clinic isn’t too crowded, I’ll grab a quick morning coffee. Our team consists of a doctor, a pediatrician, two midwives and nurses. When a woman comes to the center, she registers herself at the reception then I speak with her about the problems she has and how I can help. Typically my work involves inserting intra-uterine devices, distributing oral contraceptives, and sometimes refering complicated cases to a specialized hospital, which is 15 kilometers away. Today I examine a woman in a serious condition. She is bleeding due to complications from surgery.

1:00pm

Cases gradually decrease around 1pm. I examine 20 cases per day on average without taking a break as we don’t want the women to wait long. Some days we work late to make sure no one leaves without service. When I have some free time before returning home, I prepare the examination room for the next day. The car is about to come to take me home. It was a busy day as usual.

2:30pm

I spend a few hours after work preparing the family lunch and clean the house. My children sometimes help me if they can. Today I’m cooking spiced eggplant with salad. Since we don’t have regular electricity, I cook just enough food for today as we can’t store it in the fridge for tomorrow.

6:00pm

The time has come to socialize or rest. I would go normally go visit a relative or have tea with neighbours, but I feel tired today. Perhaps my sister-in-law will stop by later. On other days when my children go to school, I check their homework. Sometimes after work I get an emergency call from women in the village to advise them, examine them or help them give birth. This can also happen in late, which scares me considering the security situation in Syria. I’m currently getting training on psychological first aid basics, and I’m happy to enrich my knowledge and develop myself. I read some material, do my homework then send the answers to our advisor on Whatsapp. I have to connect to the internet through our neighbour’s systems since there are no other communication means available. The signal is weak though.

10:00pm

It’s dark outside and the village becomes very quiet. I tend to sleep around ten o’clock every night to be able to wake up early. We struggle to sleep comfortably in this hot weather without electricity. We share a generator with neighbours, but it provides electricity for just six to seven hours a day. If we had electricity now I would turn on the fan, but I can’t and try to sleep to prepare for another busy day.


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