Published:  12:29 AM, 10 October 2017

Pregnant refugees must have access to better care

Pregnant refugees must have access to better care Roma Hattu, a Rohingya Muslim woman who is nine months pregnant

Pregnant refugees who have fled across the Mediterranean to Greece are at risk of harm to themselves and their babies because they are not routinely given the care they need before, during and after the birth, say doctors. A report from the charitable organization Doctors of the World calls for pre- and post-natal care for refugee women across the whole of Europe as well as safe delivery, arguing that it is not only humanitarian but also cost-effective.

If Europe does not care for the refugee women and their babies, "we will face new problems that cost a lot", said Dr Nikitas Kanakis, president of Doctors of the World Greece. "A lot of people talk about the cost of medical care in Europe," he added. "They forget that not giving care has a cost. Antenatal care costs much less than a handicapped child."

Their report, drawing on the experiences of 14,000 refugee women who were cared for by a mother-and-child programme put in place by Doctors of the World in Greece, shows that medical care was inadequate or non-existent for 72% of their health problems. Less than 47% of the women had access to any reproductive healthcare before they arrived at one of the project's eight polyclinics or 15 mobile units across Greece.

"At the beginning we were surprised that the number was so big," said Kanakis. We realized access to the hospital was not easy: there were no translators [and] the hostels were crowded. Also behind this was the feeling of safety that they have with us. They know us from the camps when they come. They know us from the boats. They know that someone will deal with their problems.

"We also have a lot of women staff. It is easier for women from a Muslim country. Also we see the women alone without a husband. They feel safe to talk, because behind the pregnancy always there is a history - a woman in difficulties or violated." Many of the women they see are living in Greek cities in what they call "Afghan hotels", paying €1 a night to sleep 10 to a room, he said. "They live in very difficult conditions." They may not seek help from government health services because they fear arrest.

Some of them are traumatized by their experiences. "Pregnant women and single mothers describe incidents of sexual violence in Turkish coast by smugglers," says the report. Some are pregnant as a result. They suffer serious trauma and mental health problems. The charity gives them support and counseling and help if they want to terminate the pregnancy in hospital in Athens, which is difficult because they don't have documents or insurance.

The report describes the case of a woman refugee from Syria, who crossed to Greece from Turkey by boat in January last year with two children and eight months pregnant. She gave birth in a refugee camp but two months later was homeless, sleeping on a bench with her children with hundreds of other refugees in Athens' Victoria Square.

"The baby suffered from skin allergies and severe allergic asthma while RM [the mother] had neglected gynecological problems and panic attacks episodes," says the report. Doctors of the World intervened, got the family the medical care they needed and they have now been reunited with the father, who had been given refugee status in Germany.

A second woman it calls EA traveled alone from Togo to Greece in the spring of 2016. She was six months pregnant, sharing a room with 12 others in the center of Athens "in a very bad psychological condition because the pregnancy was unwanted and she was alone without supportive environment". She was given psychological as well as gynecological help by the charity, which has secured her independent accommodation and gives medical support to her and the baby girl.

The report talks of the continuing needs of the refugees, male and female, which are still arriving in Greece. Between January and June this year more than 17,000 patients visited some of their mobile and fixed clinics, it says. Approximately 55% were male and 45% were female. A quarter was children. The writer is a Health Editor

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