A few days after the Syrian crisis entered its fifth year, donors and humanitarian agencies are meeting this week in Kuwait City, where they will most likely note with dismay that the situation in Syria has grown more horrifying since they discussed it a year ago in the same city.
Regional and political developments, including the rise of ISIL and its macabre violent acts broadcast live for the world to watch, have all added to the plight of people in and around Syria.
According to the United Nations, half the Syrian population, more than 12 million people, needs humanitarian aid to survive, especially as most no longer live in their homes. Nearly 4 million people have fled the country and more than 7 million are internally displaced. Syrians have lost lives, livelihoods, family members and homes, many have also lost hope.
Observers and humanitarian aid workers agree that aid alone cannot solve the Syrian crisis and that only a political agreement can put an end to the atrocities that have tormented Syrians for more than four years. But aid has helped many Syrians cope with the sense of loss and destitution that has increasingly weighed on them as the prospects for peace and normality grew dimmer.
Information abounds on the various forms of humiliation that Syrians say they face as a result of their uprooting, and many stories paint a particularly dark picture of the situation of women and girls.
A Syrian activist recently scoffed at the report that in the midst of a snowstorm in Lebanon the UN was distributing sanitary pads to women, “as if these were a priority in the face of the cold and hunger”.
I happened to be in Jordan that same week and met a number of refugees from Syria at one of the clinics that United Nations Population Fund (UNFPA) runs in Zaatari camp. Unprovoked, one woman told my female colleagues that while aid agencies focused on distributing much needed food and clothes to Syrian refugees, what helped her gain back some dignity was a pack she had received regularly, discretely, without much fanfare, from the clinic.
“A bar of soap, sanitary towels, toothpaste and some other hygiene items made me feel I was still a human being, a woman, not an animal,” she said. While these items may not be considered a priority by many people involved in collecting funds to save lives, they in fact respond to a need for hygiene that does not stop during conflicts.
“Have women stopped going through menstruation cycles? Have married couples stopped having intimate relations? Why should we assume they do not need a bar of soap or contraceptives?” asked a gynaecologist we met at the clinic.
In a world of shrinking resources and donor fatigue, Syrians have struggled because of the limited funds available to cover their constantly growing needs. It is of course heart-rending to see photos of children who are barefoot and despondent.
Providing funds for food or shelter allows instantaneous gratification to both the people in need and to the donors. Regretfully, the more discrete, less screaming services that make a huge difference to people, particularly women, often go unmet, usually at a very high price to women.
Lives are lost when women lack access to medical care during their pregnancy, when they give birth in inadequately-equipped maternal clinics, when newborn children do not receive all the vaccines they need and when new mothers do not have guidance on their postnatal health. Sadly enoug,h all these activities are not easy to reproduce as poster material for donors and generous individuals.
Humanitarian and medical organisations estimate that approximately 60 per cent of preventable maternal deaths take place in contexts of conflict, displacement and natural disaster. Women and girls have become the most vulnerable group, facing severe human rights abuses, violations and humiliation, including gender-based violence and early and sometimes forced marriages.
Of the 12.2 million Syrians affected by the continuing conflict, over 3 million are women of reproductive age, nearly half a million of whom are pregnant. An estimated 75,000 of those currently pregnant women will require emergency obstetric care to manage a complication. Another 67,000 pregnant Syrian women are refugees in neighbouring countries. Maternal health services for refugee women are still inadequate while inside Syria, 57 per cent of public hospitals are reported to be partially functioning or completely out of service.
These are figures well worth remembering when planning humanitarian assistance, for the needs of pregnant women should not fall behind needs that may seem more urgent but are no more important.
Mohamed Abdel-Ahad is UNFPA’s regional director for the Arab States Region, based in Cairo