New Generation of Syrians Were Born in Exile

Syrian women wait at a clinic in the Zaatari camp - AFP
Syrian women wait at a clinic in the Zaatari camp - AFP
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New Generation of Syrians Were Born in Exile

Syrian women wait at a clinic in the Zaatari camp - AFP
Syrian women wait at a clinic in the Zaatari camp - AFP

Ten years after fleeing war in her native Syria, Hadeel is expecting a third child, brought into a life of poverty and uncertainty at the Zaatari refugee camp in Jordan.

The camp, 50 kilometers (30 miles) north of the capital Amman, is home to some 80,000 Syrian refugees, according to the United Nations.

Half of the camp's residents are children, and many have no memory of Syria.

"I was hoping to be at home, in my country," Hadeel said, asking to use a pseudonym for safety concerns.

"Fate decided I would be here, get married and give birth to my children here."

Like most refugees in the camp, she and her family arrived from Syria's southern Daraa province, the cradle of the 2011 uprising against the regime of President Bashar al-Assad.

The ensuing war has killed nearly half a million people and displaced around half of the country's pre-war population.

Hadeel, who is six months pregnant, married a Syrian refugee who also lives in Zaatari, and the couple have two children, aged six and seven.

At least 168,500 Syrian babies have been born in Jordan since 2014, according to the UN, part of an estimated one million children born to Syrians in exile across the world over the same period.

Many are born in overcrowded refugee camps, with limited access to education and the threat of child labor and forced marriage hanging over them.

Sat on a red plastic chair in a large hall, Hadeel awaited a checkup at the only clinic in the camp that delivers babies.

"My children grew up here. When they hear me talking to other women about Syria, they ask me, 'Mama, where is Syria? Why do we live in this?'" said Hadeel.

"I try to explain to them that this is not our country. We are refugees. It's difficult for them to understand".

Some 675,000 Syrian refugees are registered with the UN in Jordan, but Amman estimates the real figure to be about twice that and says the cost of hosting them has exceeded $12 billion.

While fighting in southern Syria has abated, Hadeel said it still is not safe enough to return.

Her cousin, "fed up" with the camp, returned to Syria earlier this year.

He was killed less than a month later, and his widow and five children still in Zaatari do not know how he died.

"The bad security situation makes us think a thousand times before returning," Hadeel said.

The maternity ward at the UN-run clinic -- the camp's biggest health facility with 60 staff including 21 midwives -- has 10 beds.

The clinic's director Ghada al-Saad said the facility "works 24/7, offering everything for free, including medicines, treatments, tests and vaccinations" up to the age of two.

Midwife Amon Mustafa, 58, who has worked there since the camp opened in 2012, checks on the new mothers.

"We deliver between five and 10 babies every day, with the five today, the total number of births in the camp has reached 15,963," Mustafa said.

"I know most of the women and children in the camp," she added with a smile.

Nagham Shagran, 20, holding her newborn son, has spent nine years in the camp, where she and her cousin married.

"At first we hesitated to have our first child," she said. "Every human... has the right to be born and live in his or her country, but what can we do?"

Mustafa said staff "are trying" to educate women on family planning and the use of contraceptives, but uptake is limited.

"Children are a blessing, but I hope this will be my last pregnancy,"said Eman Rabie, 28, expecting her fourth child. "My husband loves children; he says they are a blessing from God."

Rabie's home in Daraa was destroyed during the war.

"If we are asked to leave the camp and go back to Syria," she said, "I will be the last to leave".



Experts: Baby in Gaza Has Strain of Polio Linked to Mistakes in Eradication Campaign

The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed
The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed
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Experts: Baby in Gaza Has Strain of Polio Linked to Mistakes in Eradication Campaign

The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed
The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed

The baby in Gaza who was recently paralyzed by polio was infected with a mutated strain of the virus that vaccinated people shed in their waste, according to scientists who say the case is the result of “an unqualified failure” of public health policy.
The infection, which marked the first detection of polio in the war-torn Palestinian territory in more than 25 years, paralyzed the lower part of one leg in the unvaccinated 10-month-old child. The baby boy was one of hundreds of thousands of children who missed vaccinations because of the fighting between Israel and Hamas.
Scientists who have been monitoring polio outbreaks said the baby's illness showed the failures of a global effort by the World Health Organization and its partners to fix serious problems in their otherwise largely successful eradication campaign, which has nearly wiped out the highly infectious disease. Separately, a draft report by experts deemed the WHO effort a failure and “a severe setback.”
The polio strain in question evolved from a weakened virus that was originally part of an oral vaccine credited with preventing millions of children worldwide from being paralyzed. But that virus was removed from the vaccine in 2016 in hopes of preventing vaccine-derived outbreaks.
Public health authorities knew that decision would leave people unprotected against that particular strain, but they thought they had a plan to ward off and quickly contain any outbreaks. Instead, the move resulted in a surge of thousands of cases, The Associated Press reported.
“It was a really horrible strategy,” said Columbia University virologist Vincent Racaniello, who was not involved with the report or the WHO. “The decision to switch vaccines was based on an incorrect assumption, and the result is now we have more polio and more paralyzed children.”
A draft copy of the report commissioned by the WHO and independent experts said the plan underestimated the amount of the strain in the environment and overestimated how well officials would be able to squash outbreaks.
The plan led to vaccine-linked polio outbreaks in 43 countries that paralyzed more than 3,300 children, the report concluded.
Even before the Gaza case was detected, officials reviewing the initiative to tinker with the vaccine concluded that “the worst-case scenario has materialized,” the report said.
The report has not yet been published, and some changes will likely be made before the final version is released next month, the WHO said.
The strain that infected the baby in Gaza had lingered in the environment and mutated into a version capable of starting outbreaks. It was traced to polio viruses spreading last year in Egypt, according to genetic sequencing, the WHO said.
In 2022, vaccine-linked polio viruses were found to be spreading in Britain, Israel and the US, where an unvaccinated man was paralyzed in upstate New York.
Scientists now worry that the emergence of polio in a war zone with an under-immunized population could fuel further spread.
Racaniello said the failure to track polio carefully and to sufficiently protect children against the strain removed from the vaccine has had devastating consequences.
“Only about 1% of polio cases are symptomatic, so 99% of infections are silently spreading the disease,” he said.
The oral polio vaccine, which contains a weakened live virus, was withdrawn in the US in 2000. Doctors continued to vaccinate children and eventually moved to an injected vaccine, which uses a dead virus and does not come with the risk that polio will be present in human waste. Such waste-borne virus could mutate into a form that triggers outbreaks in unvaccinated people.
The report's authors faulted leaders at the WHO and its partners, saying they were unable or unwilling “to recognize the seriousness of the evolving problem and take corrective action.”
WHO spokesman Oliver Rosenbauer acknowledged that the vaccine strategy “exacerbated” the risk of epidemics linked to the vaccine.
He said in an email that immunization “was not implemented in such a way to rapidly stop outbreaks or to prevent new strains from emerging.” Rosenbauer said not hitting vaccination targets was the biggest risk for allowing vaccine-linked viruses to emerge.
“You need to reach the children with the vaccines ... regardless of which vaccines are used,” he said.
The WHO estimates that 95% of the population needs to be immunized against polio to stop outbreaks. The UN health agency said only about 90% of Gaza’s population was vaccinated earlier this year.
To try to stop polio in Gaza and the wider region, the WHO and its partners plan two rounds of vaccination campaigns later this week and next month, aiming to cover 640,000 children. Authorities will use a newer version of the oral polio vaccine that targets the problematic strain. The weakened live virus in the new vaccine is less likely to cause vaccine-derived outbreaks, but they are still possible.
Racaniello said it was “unethical” that the WHO and its partners were using a vaccine that is unlicensed in rich countries precisely because it can increase the risk of polio in unvaccinated children.
The oral polio vaccine, which has reduced infections globally by more than 99%, is easy to make and distribute. Children require just two drops per dose that can be administered by volunteers. The oral vaccine is better at stopping transmission than the injected version, and it is cheaper and easier to administer.
But as the number of polio cases caused by the wild virus have plummeted in recent years, health officials have been struggling to contain the increasing spread of vaccine-linked cases, which now comprise the majority of polio infections in more than a dozen countries, in addition to Afghanistan and Pakistan, where transmission of the wild virus has never been stopped.
“This is the result of the Faustian bargain we made when we decided to use" the oral polio vaccine, said Dr. Paul Offit, director of the Vaccine Education Center at the University of Philadelphia. “If we really want to eradicate polio, then we need to stop using the vaccine with live (weakened) virus.”