Hope

The striking and starving numbers engulf the refugee camps. All around are fragments of what once was, the destruction of not merely homes and buildings, but the fragility of humanity as they wander blindly with eyes wide open looking for help. Conflict and upheaval are a continual cycle to the lives of South Asians. Afghanistan’s war that has spanned 25 years, Nepal’s Maoist uprisings, the incessant civil war in Sri Lanka, and continuous feuds between Pakistan and India have created a myriad of difficulties in the lives of people in this region. Not to mention the Tsunami that washed away lives of thousands, leaving millions homeless and earthquakes in Pakistan that has left people to this day still living in tent shelters. There is a fundamental importance for this region to elevate their health care priorities for mothers, young girls, and children in these refugee and relief camps.

These are women and children, their husbands and fathers lost in wars and torn away by floods, tsunamis, and earthquakes. Their own children even kidnapped as child soldiers, which has been evident in Sri Lanka. The refugee and relief camps that now have become their homes hold their already fragile lives in an uneven balance of life and death. More than 500,000 women each year in developing countries lose their lives to preventable complications of pregnancy and childbirth. These women face high fertility, poor nutritional status, and lack of basic health services. Compounding these problems is the fact that the women and children are now in a state of uncertainty, living in refugee camps.

In these developing countries, the statistics are high in infant mortality; 7.1 million infants worldwide die each year with about half dying during the neonatal period. There is a critical significance of proper maternal and child health care during pregnancy, delivery, and child survival. There is also a definite inadequacy of health care for mothers and children in refugee situations in these poorly resourced countries. In these refugee camp settings, the primary goal of emergency aid is to provide the basic services of shelter, nutrition, water, sanitation, and protection. Although vital, there is a need to address mortality and morbidity that occur due to acute medical, obstetric, surgical problems or chronic diseases that need specialists. A distressing reality is that hospitals and proper health care is not anywhere in immediate vicinity of these refugee camps. Undermining the effectiveness of the emergency primary care as most often, the sickest patients are unable to receive sufficient treatment.

An integration of home based primary and hospital care, alongside maternal and child health in these settings is essential. In recent months, Sri Lanka has seen a dramatic increase in violence leaving thousands running for their lives to makeshift camps barely out of the war zones. Lives filled with constant fear and dread, aid workers are at a constant shortage, mothers waiting in lines to see a physician, in blazing heat and limited sanitation facilities. Maternal and child health is critical to development thereby organization and deployment of proper health care for refugee camps is in dire need. Governments, non-governmental organizations, and healthcare workers across the board need to increase access and resources of maternal and child health amongst refugee and relief camps. Statistics show 34% of child deaths occur in South Asia; a region which has two-thirds the global burden of malnutrition, and holds an estimated half of all maternal deaths worldwide. Annual maternal mortality ratios range from 23/100,000 in Sri Lanka to 529/100,000 in Nepal. A few of the main causes for maternal mortality are hemorrhage, obstructed labor, and infectious diseases. A correlation is apparent between maternal health and neonatal mortality and the wellbeing of children. Health care for mothers and children is dangerously unsatisfactory in most refugee camps.

These nameless uniformed masses of men, women, and children, destitute and clothed in tatters wander aimlessly through the camps. A woman walks by, in her arms she holds her small infant, by her side a frightened child peeps from behind the folds of her skirts. They carry what they hurriedly gathered from their now war torn villages running for their lives from the natural disasters that have destructed their humble surroundings.

How can we create hope from this despair? By stepping up our goals for a higher standard, an effective approach, a cohesive and common vision to build up a strong and efficient healthcare provision for women and children. Let humanity not get lost in warring sects, politics, lack and inefficiency.