Twenty-six-year-old Rawan was lying on a paper-thin mattress on the floor of a school classroom. She was eight months pregnant and was ordered to stay on bed rest until she gave birth, which she was told would be a preterm delivery.
“I’m very stressed. I’m short of breath all the time now,” she told The New Arab in the school-turned-shelter in west Beirut. Her voice was drowned out by the loud and unrelenting buzz of an Israeli drone flying overhead.
Israel’s intensified bombardment of Lebanon in late September has pushed more than a million people out of their homes and so far, killed over 3,000 people, according to government figures.
Around half of the displaced are women with nearly 12,000 currently pregnant, reveals Pamela Di Callo, the head of UNFPA Lebanon.
“This population is especially vulnerable because they are both pregnant and displaced,” Pamela told The New Arab.
Rise in preterm labour and miscarriages
At the Lebanese American University’s Rizk hospital in Beirut, Dr Georges Yared, the head of general obstetrics and gynaecology, told The New Arab he has been seeing a rise in cases of preterm labour and miscarriages in the last month.
“All complications in pregnancy are increasing. Whether it’s preterm labour, hypertension, preeclampsia and other complications that are very rare that we are seeing, are happening,” he said.
“We have noticed an increase in the number of miscarriages because of infections and anomalies in the fetus which is being caused by a lack of monitoring and preparation for the pregnancy,” he added.
The Rizk Hospital in Beirut’s Achrafieh has also seen an increase in these cases due to an influx of displaced people who otherwise would not seek care in that neighbourhood.
Pamela said she has observed an increased risk of premature birth and complications during delivery among pregnant displaced women.
The most common issue is pregnant women who have been displaced, being cut off from the care of their usual physicians from their primary area of residence.
“In times of war the major weakness is in monitoring the situation,” Dr Yared said.
At risk of infections
Many of the displaced have been staying in public schools turned into shelters across the country, which are overcrowded and ill-equipped to host people, let alone for long periods.
Displaced women and girls staying in a school in the Zokak el-Blat area in Beirut told The New Arab that because the bathrooms are unhygienic and used by many people, both men and women, they hesitate to use them in fear of contracting bacteria.
At the same time, many postpone using the bathroom for days, which has in turn led them to develop urinary tract infections, a prevalent issue in many shelters, according to Elya Abboud, the health coordinator with Medecins Sans Frontier in Lebanon.
“I try to drink less water, so I don’t need to go to the restroom as much,” one woman staying in a Beirut school told The New Arab.
More than a dozen people sleep on the floor in each classroom. Bathrooms are not designed for showers and fall short of basic hygiene standards. Water is scarce, cold and possibly contaminated as some women said it was “yellow,” which has led them to take fewer showers.
“This is putting menstruating women and girls at increased risk of infections,” Pamela added.
The first case of Cholera was confirmed in Akkar, north Lebanon by the Health Ministry last month, as the World Health Organization sounded the alarm on the risk of infectious diseases spreading further as a result of poor water and sanitation in shelters.
‘Taking things day by day’
Pregnant displaced women said they are unable to make it to their monthly visits to their doctors and are not receiving proper antenatal care.
Zeinab, a 26-year-old displaced mother who was seven months pregnant, said she is only able to attend her regular checkups once a month, instead of the required weekly monitoring sessions.
She is a diabetic and has hypertension. Her physician told her she would give birth early due to her condition which is exacerbated by stress and back pain. Like many other women in shelters, she also deals with UTIs.
“NGOs don’t provide this type of care and public clinics rarely have gynaecologists,” Elya explained.
Severe back and hip pain sent Rawan, the pregnant woman in the Beirut shelter, to the hospital a few days ago where she stayed overnight. She has also been suffering from recurring UTIs and food poisoning from poultry and meat she was given in the shelter. Her one-year-old daughter also caught a bacterial infection which led to blood poisoning; she then suffered from the same issue herself.
According to Dr Yared, sepsis, the body’s extreme reaction to infection, hypertension, and haemorrhage — which together form the “deadly triad” in obstetrics — have all increased among pregnant displaced people. This triad significantly contributes towards maternal morbidity and mortality rates.
Rawan made the arduous journey from her home in Yohmor in the Bekaa region, southeast of Lebanon, on September 24 when Israel intensified its airstrikes across the country, triggering a mass exodus towards regions deemed safer. She drove for 16 hours through the congested roads with her one-year-old daughter while Israel struck areas nearby at times. They made multiple stops in between until they reached Beirut.
She was visiting family in Kfar Sir, a village in Nabatieh, south Lebanon when Israel struck nearby buildings. “I quickly went home and only managed to grab some of my daughter’s belongings… they [Israel] struck a building right next to me,” she said.
Her house is now destroyed due to Israeli airstrikes. “I am taking things day by day, I’m not even thinking of the future,” she said, but looked at an empty bassinet in the corner of the room.
There was no shortage of stress and trauma in Zeinab’s journey to safety either. She lived in Beirut’s southern suburbs — which are still under continuous Israeli fire and partly reduced to rubble — and first fled to a relative’s house in the Sabak al-Khail neighbourhood in Beirut.
“You could hear the sound of the missile as it goes over your head.. and every time I would be shaking in fear,” she told The New Arab. “My blood pressure was shooting up, so I told my husband to get me away from there.”
She eventually found refuge in a school in the Keserwan district in Mount Lebanon, north of Beirut, along with her two-year-old daughter.
“When the war started, all I could think of was that I just wanted to give birth and get it over with,” she said.
Zeinab was smiling but her eyes reflected her sadness. Her one wish is that she hopes she can give birth and take her newborn home, “to our real home.”
Houshig Kaymakamian is a journalist covering Lebanon and the Middle East
