Testimonial: Midwife Sarah Ibrahim in Ethiopia

For two years, Sarah Ibrahim has been working for Doctors of the World Germany in the Malayko Health Center (Somali Region, Ethiopia). Below she shares her experience working in the field.
 
What can happen to a woman if there is no midwife?
 
If there is no midwife, the situation can get dangerous. If there are complications, the mother can die while giving birth. There are sometimes dangerous signs like preeclampsia. Even if there is a TBA (Traditional Birth Attendant) and another skilled person, there could be a lot of different problems. 
 
To avoid these problems, you have provided training sessions. What do you teach other midwives?
 
We talk to pregnant mothers about how important it is that they come to the health facility when they feel that birth is about to begin. After birth, I consult and train the mother on how to take care of her baby and about hygiene for the baby and herself. I show this also to my colleagues and teach them for example how to detect preeclampsia and what to do in these cases. 
 
Do you have some words for our readers abroad?
 
I am greeting all the other women in the world. We are all family and we have to care about women and children regardless of the color of the skin or where they come from. It is a question of humanity and we have to take care of all of us.

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US-Mexico relations and their impact on migrant safety

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Doctors of the World suspends activities in Afghanistan and calls for the lifting of the ban on women aid workers

On December 24, Doctors of the World and other non-governmental organizations (NGOs) working in Afghanistan received a letter from the authorities stating that women were no longer permitted to work for national and international NGOs within the country. At Doctors of the World, we strongly condemn this decision and have decided to suspend our activities in Afghanistan.

As Afghanistan faces economic collapse and a severe humanitarian crisis, NGOs play an essential role in saving lives and bringing aid to the population. Banning women from working will only have a dramatic and devastating impact on the lives of millions of vulnerable women, men and children in the country.

By prohibiting women from working in NGOs, a red line has been crossed. Doctors of the World is taking the difficult decision to suspend its activities because an effective humanitarian response in line with humanitarian principles cannot be achieved without women. This choice has also been made by several NGOs in the country since the announcement on December 24.
DotW calls for the lifting of the ban on women aid workers so that we may resume our activities in the country. This decision made by the authorities comes just a few days after restrictions were placed on Afghan girls’ access to education. Doctors of the World has been present in this country for 30 years, from 1982 to 2012. In 2021, DotW decided to return and implement new humanitarian programs in the country. Until this month, Doctors of the World was supporting a district hospital in Kabul as well as working to address mother and child health needs. So far, 150,000 people have benefited from the medical services offered by this hospital. It is vital that the country lifts its ban on women aid workers so that they may return to provide much needed care to the country’s population.
 

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El Paso: Safe Haven

International Discord, Policy Change, and Crisis Abroad 
 

In 2022, there has been a record-breaking surge in migration. This significant influx has even shaken the USA and especially Southern Border states. The surge can be related to a multitude of issues that add further complexity to this already growing crisis. 

To begin, the lifting restrictions of COVID-19 has encouraged more to cross the border, as well as the ‘supposed’ termination of Title 42 on December 21, 2022. However, the Supreme Court decided to extend Title 42 just days before it was meant to end, despite the fact that this policy is in gross violation of international refugee law, as it facilitates discriminatory denials of access to asylum based on nationality and race. Furthermore, Title 42 allows border control to deport immigrants to Mexico or their home countries without verifying whether migrants would be safe to return. Many are forced into Juarez, one of the most dangerous cities in Mexico, especially for women where the rate of femicide has doubled in past years. 

Title 42 is also being attributed to the huge influx of unaccompanied minors. Many families have sent their children alone across the border since Biden’s ruling that minors would be excluded from the policy in hopes that they might finally find safety across the border. 

Despite the fact that Title 42 has been extended, many remain unaware or feel they have no choice but to try and cross the border as the circumstances at home are simply too precarious. The majority of migrants are coming from Venezuela, Ecuador, El Salvador, Haiti, Nicaragua, and Cuba. People are fleeing from oppressive governments, gang violence, poverty, and climate disasters. As a result, the US has seen a radical increase in immigration, with 2.76 million people crossing the border in 2022, breaking the previous annual record of more than 1 million.

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International Migrants Day: Influx of Unaccompanied Minors along the US Southern Border

How can the USA do better? 

The journey to the USA can already be incredibly traumatic for young children, who may have been exposed to violence and exploitation along the way. It is of the utmost importance that once they are put into U.S. custody, that further harm or trauma is prevented and that they receive care that they deserve. There are several parts of the U.S. immigration system that must be torn down and rebuilt. 

The CBP first and foremost must be held accountable for their actions. Over the years there have been numerous reports of physical violence, corruption, and verbal abuse at the hands of border patrol agents towards migrants across all ages. There must be stronger vetting of agents and any reports of abuse must be dealt with immediately, removing the agent from the field while an investigation is carried out. 

The U.S. government’s criminalization of entering or reentering the country without authorization has also led to a multitude of issues, including mass incarceration. The U.S. government jails more than 50,000 immigrants each day at a more than $3 billion annual cost to taxpayers. Mass detention centers, like the ones used for UAC, are incredibly expensive and riddled with corruption, abuse and neglect. Many investigations have repeatedly found evidence that detention centers are riddled with human rights abuses and should be phased out completely.

Experts argue that a community-based approach would be a much more progressive and cost-effective solution. Rather than spending billions on detention centers, the federal government could subsidize NGOs and community-led organizations to run safe, secure migrant programs. There already exists a broad array of community support services that can ensure that migrants receive the help they need on a variety of issues: legal, housing, transportation, social and medical services. In fact, Doctors of the World runs a border health clinic in collaboration with a local university and NGOs to provide essential health care to migrants.

At Doctors of the World, we have long fought for the rights of migrants, in the USA and abroad. Unaccompanied minors, as well as migrants of all ages, deserve better care than what they currently receive from the U.S. government. The current migration system is one that is fueled by fear and profit at the expense of migrants’ safety and wellbeing. Serious policy changes must be made to ensure that migrants rights are respected and that they receive a fair process in their court trial. Special care must be given to UACs, who are even more vulnerable to exploitation, abuse, and long-term trauma. It’s time that the USA drops its rhetoric against migrants, and recognizes them as human beings. 
 
Sources
Children on the Run – Full Report 
U.S. Detention of Child Migrants | Council on Foreign Relations
Nearly 130,000 unaccompanied migrant children entered the U.S. shelter system in 2022, a record – CBS News
This is what happens to child migrants found alone at the border, from the moment they cross into the US until age 18
U.S. shelters received a record 122,000 unaccompanied migrant children in 2021 – CBS News
 
Photography: 
Olivier Papegnies 
MdM Spain 

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International Migrants Day: Influx of Unaccompanied Minors along the US Southern Border

How can the USA do better? 

The journey to the USA can already be incredibly traumatic for young children, who may have been exposed to violence and exploitation along the way. It is of the utmost importance that once they are put into U.S. custody, that further harm or trauma is prevented and that they receive care that they deserve. There are several parts of the U.S. immigration system that must be torn down and rebuilt. 

The CBP first and foremost must be held accountable for their actions. Over the years there have been numerous reports of physical violence, corruption, and verbal abuse at the hands of border patrol agents towards migrants across all ages. There must be stronger vetting of agents and any reports of abuse must be dealt with immediately, removing the agent from the field while an investigation is carried out. 

The U.S. government’s criminalization of entering or reentering the country without authorization has also led to a multitude of issues, including mass incarceration. The U.S. government jails more than 50,000 immigrants each day at a more than $3 billion annual cost to taxpayers. Mass detention centers, like the ones used for UAC, are incredibly expensive and riddled with corruption, abuse and neglect. Many investigations have repeatedly found evidence that detention centers are riddled with human rights abuses and should be phased out completely.

Experts argue that a community-based approach would be a much more progressive and cost-effective solution. Rather than spending billions on detention centers, the federal government could subsidize NGOs and community-led organizations to run safe, secure migrant programs. There already exists a broad array of community support services that can ensure that migrants receive the help they need on a variety of issues: legal, housing, transportation, social and medical services. In fact, Doctors of the World runs a border health clinic in collaboration with a local university and NGOs to provide essential health care to migrants.

At Doctors of the World, we have long fought for the rights of migrants, in the USA and abroad. Unaccompanied minors, as well as migrants of all ages, deserve better care than what they currently receive from the U.S. government. The current migration system is one that is fueled by fear and profit at the expense of migrants’ safety and wellbeing. Serious policy changes must be made to ensure that migrants rights are respected and that they receive a fair process in their court trial. Special care must be given to UACs, who are even more vulnerable to exploitation, abuse, and long-term trauma. It’s time that the USA drops its rhetoric against migrants, and recognizes them as human beings. 
 
Sources
Children on the Run – Full Report 
U.S. Detention of Child Migrants | Council on Foreign Relations
Nearly 130,000 unaccompanied migrant children entered the U.S. shelter system in 2022, a record – CBS News
This is what happens to child migrants found alone at the border, from the moment they cross into the US until age 18
U.S. shelters received a record 122,000 unaccompanied migrant children in 2021 – CBS News
 
Photography: 
Olivier Papegnies 
MdM Spain 

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Consequences of Winter in Ukraine

Mental Health and Psychosocial Support (MHPSS)
 

Mental health is one of DotW’s areas of expertise. In Ukraine, we are especially trained to provide mental health services to the adult population affected by the military conflict. Much of our MHPSS is conducted through the mobile units, where psychologists provide group and individual consultations, as well as leading awareness-raising sessions. 

DotW psychologists also provide group and individual consultations at NGO centers, like the NGO Way Home, in Odessa Oblast. There the MHPSS team has provided 3 group sessions and 25 individual consultations. In Chernivtsi, group supervisions were provided to the counselors of the Problem Management Plus program, while in Dnipro trainings were conducted for the same program, so that after practice and with the support of DotW MHPSS specialists, 10 trainees will become counselors of the program.

For individuals that are unable to participate in in-person consultations, DotW has set up online consultations with psychologists. Overall, there have been 611 online consultations provided in Donetsk and Luhansk Oblasts. At the end of April DotW launched a helpline to address the MHPSS needs of people who lack access to those services, which has already received 394 calls. Overall the demands for MHPSS are high, as many civilians endure traumatic experiences while struggling to stay secure in the midst of an increasingly violent conflict. Since the start of the war, on February 24, DotW  has provided MHPSS services to 12,039 people. 
 

Doctors of the World reiterates that this conflict must end and condemns the targeted and continued attacks on civilian infrastructure. 
 
Photography 
Pietro Chekal

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CHOLERA OUTBREAK AFFECTS THOUSANDS OF PEOPLE IN SYRIA

 
The war in Syria has been ongoing for nearly 12 years, with millions of civilians trapped in the conflict and millions more fleeing to neighboring countries and Europe. Besides the hundreds of thousands that have died in the conflict, the continuous air raids and bombings have shattered much of the countries infrastructure, leaving them without access to clean water, healthcare, and food. In fact, the conflict has seriously damaged the water and channel networks, resulting in a decreased supply by 40% while only 52% of the hospitals are operational under harsh conditions.

Without clean water and secure healthcare, a cholera outbreak has begun to spread throughout Syria. The situation is dire, requiring urgent and sustainable action to further prevent the destruction of essential infrastructure and the further deterioration of the humanitarian and health situation for the most vulnerable people.

The outbreak has mainly spread in the northern part of the country, beginning in September 2022. The first cholera case was confirmed in Jarablus district of the Aleppo Governorate on September 19, while a total of 10,750 suspected cholera cases have been reported as of November 16 from North West Syria with about 33% of suspected cases from IDP camps. 10 people have lost their lives due to cholera, and 311 were tested positive so far.
The outbreak occurred due to a contaminated water well in the region. It is a keen reminder as to why it is so important to continue to support and sustain critical infrastructure, as well as establish humanitarian corridors so that essential services may be safely delivered. 
“People in Syria are paying the price of almost collapsed healthcare infrastructure in addition to struggling with serious consequences of the bloody war and economic downturn. Water and sewage systems in the region are also on the verge of collapse – which leads to poor conditions for hygiene and sanitation,” Mohamad Şahin, Doctors of the World (DotW) Turkey’s Syria Programme Coordinator, reported from the field.
DotW Turkey has mobilized its team to address the growing cholera outbreak. So far it has directly reached 2,458 people and indirectly 12,290 people in need, focusing on preventative measures. Şahin adds, “We join the fight against the cholera outbreak in North West Syria by delivering awareness-raising sessions about cholera prevention through community health workers. We also increased the oral rehydration solution stocks for quick intervention in cholera cases since the disease requires immediate treatment and it can cause death within hours.”
“The number of people living in DotW Turkey’s catchment locations for ongoing facilities in Afrin, including Afrin Central, Jandairis, and Jalama subdistricts, is 176,198,” he informed.
The Cholera Task Force, which was formed to fight the outbreak in Syria under the leadership of World Health Organization (WHO), states that there is a need for further support to set up Oral Rehydration Points across highest affected subdistricts to complement community and in-patient cholera treatment activities along with the establishment of cholera treatment centers and units across highest affected subdistricts.
However, meeting these needs remains a challenge, hindered by the conflict and a lack of financial support. The 2022-2023 Humanitarian Response Plan for Syria has only 27% of the necessary resources. Health financing represents barely 16.7% of the aid provided, with a gap of 484 million dollars, while nutrition financing reaches 10.7% with a gap of 11 million.

It is of utmost importance that the humanitarian organizations and the global community collaborate to fundraise and implement an immediate humanitarian response for Syria. We need to ensure that humanitarian corridors are established, that critical infrastructure is restored and that this cholera outbreak is quickly contained. 

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Universal Day of the Elimination of Violence Against Women

More and more minors are becoming victims of violence
 

“Early and forced marriages, unwanted pregnancies linked to sexual abuse, unsafe abortion practices of pregnancy (IVG): in the DRC, and particularly in South Kivu, gender-based violence is everywhere. And it is not decreasing, or not very noticeably. We know that from an OCHA report in 2020, GBV increased by 86% that year compared to 2019, this violence concerns more and more minors and young girls under 18 years of age are becoming pregnant. In the face of this violence, stigmatization and lack of care are still common for many victims,” explains Eric Wynants, deputy coordinator of DotW in DRC, who has coordinated the project to combat violence in Panzi.

In South Kivu, a region marked by ongoing conflict and an alarming humanitarian situation, rape has long been used as a weapon of war by the warring parties. Today, rape has spread in Congolese society, particularly through demobilized former child soldiers, militiamen, ex-rebels and various armed groups. The victims seem to be increasingly young, sometimes under the age of ten. This violence is in addition to other violence committed in a domestic or criminal context. In order to help the victims of this violence, DotW intervenes in the territory of Uvira and in the city of Bukavu. Our organization carries out community prevention activities, offers health care and provides psychosocial support, promotes the reintegration of victims into the workforce and refers them for legal advice. Given the tense security situation and the lack of humanitarian organizations present in certain areas, the intervention of DotW is essential.
 

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Universal Day of the Elimination of Violence Against Women

More and more minors are becoming victims of violence
 

“Early and forced marriages, unwanted pregnancies linked to sexual abuse, unsafe abortion practices of pregnancy (IVG): in the DRC, and particularly in South Kivu, gender-based violence is everywhere. And it is not decreasing, or not very noticeably. We know that from an OCHA report in 2020, GBV increased by 86% that year compared to 2019, this violence concerns more and more minors and young girls under 18 years of age are becoming pregnant. In the face of this violence, stigmatization and lack of care are still common for many victims,” explains Eric Wynants, deputy coordinator of DotW in DRC, who has coordinated the project to combat violence in Panzi.

In South Kivu, a region marked by ongoing conflict and an alarming humanitarian situation, rape has long been used as a weapon of war by the warring parties. Today, rape has spread in Congolese society, particularly through demobilized former child soldiers, militiamen, ex-rebels and various armed groups. The victims seem to be increasingly young, sometimes under the age of ten. This violence is in addition to other violence committed in a domestic or criminal context. In order to help the victims of this violence, DotW intervenes in the territory of Uvira and in the city of Bukavu. Our organization carries out community prevention activities, offers health care and provides psychosocial support, promotes the reintegration of victims into the workforce and refers them for legal advice. Given the tense security situation and the lack of humanitarian organizations present in certain areas, the intervention of DotW is essential.
 

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