Care at the doorstep: Bringing maternal health services to mothers in informal settlements.

“I worried about my baby because I could not see a doctor when I needed to”, says Fatima, a Syrian refugee mother.

I was on a visit with our health team in Serraaine, Bekaa Valley, where I met up with a community midwife delivering essential care to Syrian refugees living in informal tented settlements. The settlement included around 15 tented structures, home to families who have been displaced for years and continue to face significant barriers to accessing healthcare.

Fatimah, 47, (four to six weeks pregnant) grew up in a small hometown on the outskirts of Idleb in Syria, where she remembers a close-knit neighbourhood and a strong sense of belonging. As a mother, she hoped her children would grow up surrounded by the same stability and support. “I always imagined my children growing up near their grandparents, going to school safely, and building a future for themselves,” she said.

When violence forced her family to flee Syria, they sought safety in Lebanon and eventually settled in Serraaine. Living in a tented settlement has brought daily challenges like harsh weather conditions, limited privacy, resources and restricted access to basic services, particularly healthcare. Reaching healthcare centres can be costly and difficult, especially for pregnant women and mothers with young children.  

During her last pregnancy, Fatimah struggled immensely to access regular antenatal care; essential care you get from health professionals during pregnancy. Transportation costs and the distance to healthcare centres made routine check-ups nearly impossible. “Sometimes I felt scared,” she explained. “I worried about my baby because I could not see a doctor when I needed to.”

Funded by the Lebanon Humanitarian Fund and implemented through Medair’s health programme, community midwives conduct between 150 and 200 household visits each month, providing antenatal and postnatal consultations, health education and awareness, and referrals to Medair-supported primary healthcare centres when needed. Additionally, Medair facilitates transportation from the informal settlement to healthcare facilities, relieving affected families of the financial burden of transport costs. For women like Fatimah, these visits have become a vital lifeline.

“The midwife checks on us, answers our questions, and helps us understand how to take care of ourselves and our children,” Fatimah said. “She eases our worries, clears up any misconceptions, and on a personal level, she makes me feel less alone.”

Fatimah’s experience reflects the broader reality for many displaced refugee women in the Bekaa Valley. Limited income, transportation barriers, and overstretched public services continue to restrict access to maternal and primary healthcare for refugee families. Community-based health outreach plays a critical role in bridging these gaps and ensuring that women and children receive timely care. Despite escalation, work is still ongoing; when access is possible, community midwives visit pregnant women, and when it is not, they shift to a remote modality through phone calls.

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This content was produced with resources gathered by Medair field and headquarters staff. The views expressed herein are those solely of Medair and should not be taken, in any way, to reflect the official opinion of any other organization.

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