Caring for War Refugees: The Basics Remain the Same

Rim M. Taleb, MD; Issam Shaarani, MD

Disclosures

October 27, 2016

Authors' Note: As physicians in Lebanon, providing medical care to an underprivileged population has become one of the key elements in our training in family medicine. Following the massive influx of Syrian refugees to our country, it was crucial to respond to the primary healthcare needs of this very burdened population. We would like to share with you the story of one of these encounters.

The Eighth Baby

It was a cold, rainy morning. We were going to the satellite clinic in which we rotate once weekly during the senior years of our family medicine residency. The clinic is located in a dispensary run by a local nonprofit organization in a suburban area of Beirut.

Beirut, Lebanon
Source: iStock

Not all Syrian refugees in Lebanon live in camps. Depending on their baseline financial status, some refugees rent apartments while others may be able to afford a single room. At the clinic, we encountered a family who lived in a small, crowded, poorly maintained apartment near the dispensary. The dispensary provides medical care, including medications and minor surgical procedures, for only a few thousand Lebanese pounds.

It is there where we encounter the underserved population from different nationalities, including families from Lebanon, Syria, and Palestine, as well as a number of "Doms" (Gypsies) and many persons without passports or other documentation. This area is a melting pot, but extreme poverty is its dominant feature.

 
This area is a melting pot, but extreme poverty is its dominant feature.
 

Today, a mother with rosy cheeks and pockets under her eyes brought her 1-week-old baby boy for circumcision. They are Syrian refugees who left their country at the start of the deadly war. According to the Office of the United Nations High Commissioner for Refugees, there are 4.7 million displaced Syrian citizens, 2.1 million of whom are registered in Egypt, Iraq, Jordan, and Lebanon.

This baby was the woman's first son after seven daughters. She was only in her mid-thirties. Large families are common in this refugee population, perhaps due to a lack of access to healthcare services and contraception education. It could also be due to a cultural imperative that insists on a woman bearing at least one son who, unlike his sisters, will continue the family name.

No pre- or postpartum complications were reported by the mother, who stated that her baby had been doing well since birth. The circumcision kit was ready, including a Gomco clamp of suitable size. We use this device because of evidence that it is safe, causes minimal bleeding,[1,2] and allows for the procedure to be performed in a short time.[2]

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