Syria Research Group (SyRG), co-hosted by the London School of Hygiene and Tropical Medicine, UK; and Saw Swee Hock School of Public Health, Singapore
London School of Hygiene and Tropical Medicine, Department of Global Health and Development, 15-17 Tavistock Place, London, UK.
BMJ Glob Health. 2022 Jul;7(7). doi: 10.1136/bmjgh-2022-008812.
The Syrian conflict, which has included mass killings, displacement, infrastructure destruction and illegal targeting of health facilities and staff mainly by the Syrian government and allies, is in its 10th year. This study explored the lived experiences of women within healthcare, both as health workers and service users, in Syrian opposition-controlled areas (OCAs).
We chose a qualitative study design, with 20 in-depth interviews conducted remotely over WhatsApp and Messenger with purposively sampled Syrian women (ie, 15 health workers, 5 service users). We analysed data using interpretative phenomenological analysis.
Anxiety, fear and horror affected women's everyday work and wellness. Excess workload and insecurity were major challenges for women health workers, who also had household and caring responsibilities. Coping mechanisms included: (1) normalising death; (2) acceptance of God's will; and (3) focusing on controllable issues such as health services provision while accepting the reality of insecurity and death. Conflict contributed to changing social norms and expectations, and women became key actors in healthcare provision, though this did not translate directly into greater decision-making authority. Structural biases (eg, lack of maternity leave) and gender-based violence (eg, increased harassment and child marriage) inordinately affected women.
This is a first effort to amplify women's voices in health policy and systems research on the Syrian conflict. Women have become key healthcare providers in OCAs but remain under-represented in decision making. While the conflict-related social transformation, increasing the role of-and demand for-women health workers could be viewed positively for women's empowerment, the reality is complex and long-term implications are unclear.
叙利亚冲突已进入第 10 个年头，冲突中发生了大规模屠杀、民众流离失所、基础设施被毁，叙利亚政府及其盟国主要还对医疗设施和医务人员进行了非法袭击。本研究探讨了叙利亚反对派控制区（OCA）内医护人员（包括卫生工作者和服务使用者）的生活经历。
我们选择了定性研究设计，通过 WhatsApp 和 Messenger 对 20 名有目的地抽样的叙利亚妇女（即 15 名卫生工作者，5 名服务使用者）进行了远程深入访谈。我们使用解释性现象学分析来分析数据。
焦虑、恐惧和恐惧影响了女性的日常工作和健康。工作量过大和不安全是女性卫生工作者面临的主要挑战，她们还承担着家庭和照顾责任。应对机制包括：（1）将死亡正常化；（2）接受上帝的旨意；（3）专注于提供卫生服务等可控问题，同时接受不安全和死亡的现实。冲突导致社会规范和期望发生变化，女性成为医疗服务提供的主要参与者，但这并没有直接转化为更大的决策权。结构性偏见（例如，缺乏产假）和性别暴力（例如，骚扰和童婚增加）不成比例地影响了女性。
这是首次在叙利亚冲突的卫生政策和系统研究中放大女性声音。在 OCA，女性已成为关键的医疗保健提供者，但在决策中仍代表性不足。虽然与冲突相关的社会转型增加了对女性卫生工作者的需求和作用，可以被视为赋予妇女权力的积极因素，但现实情况很复杂，长期影响尚不清楚。
