Supporting Women’s Health Among Syrian Refugees

In 2018, internist Dr. Sasha Fahme volunteered on a medical mission to care for people displaced by the Syrian civil war in Lebanon. Estimates of the number of Syrian refugees in Lebanon vary, but the UNHCR, the UN refugee agency, has registered approximately 815,000, about half of whom are women. As one of only two Arabic-speaking women on the medical mission, Dr. Fahme treated women living in tented refugee settlements for gynecological symptoms.

Dr. Fahme, who spends most of her time working in Lebanon, was struck by the number of women she saw presenting with signs like pelvic inflammatory disease, which is characteristic for many sexually transmitted infections (STIs). When she looked to the literature to learn more, she found virtually nothing on STIs among refugee women.

“At that point, I said, ‘I want to shift my career,’” she recalls. “‘This is what I really want to focus on.’”

Since then, Dr. Fahme has conducted multiple studies aiming to understand the sexual and reproductive health challenges refugee women face. Her work also examines the relationship between those conditions and circumstances such as interpersonal violence, food insecurity and war.

One study she concluded earlier this year was supported by a Fund for the Future Award from the Weill Department of Medicine. Another is funded by a K01 award from the National Institutes of Health Fogarty International Center — the first K award to study Syrian refugee women’s health, according to the NIH RePORTER database. Dr. Daniel Fitzgerald, director of Weill Cornell Medicine’s Center for Global Health, and American University of Beirut Professor Jocelyn DeJong serve as Dr. Fahme’s primary mentors for the study; Ehrenkranz Family/Orli R. Etingin, M.D. Associate Professor in Women’s Health Dr. Jennifer Downs (M.D. ’04) and Professor of Population Health Sciences Dr. Laith Abu-Raddad serve as co-mentors.

The research applies mixed methods to determine the etiologies of Syrian refugee women’s gynecological symptoms. Then, it will use those data to adapt an existing intervention (the Dia del Mercado Project, designed to increase cervical cancer screenings in Peru) to combat recurrent genital infection symptoms and gender-based violence among refugees.

“An intervention which focuses on reproductive tract infection awareness and treatment, but that does not address related violence against women, would likely not lead to sustainable improvements in health, as women will be at continued risk of recurrent infections,” she says.

Last year, Dr. Fahme presented to a World Health Organization (WHO) meeting, and her work contributed to a set of WHO recommendations for self-care interventions women can use in crisis settings. She has also collaborated on multidisciplinary research examining the connection between women’s employment and health, specifically in the context of compounding crises. Dr. Fahme stresses that helping refugee women — and children and men, too — will require doctors, lawyers, policymakers and other leaders to commit to addressing the root causes of conflict and war.

“Without doing that, we’re just putting Band-Aids on these things,” she says, “and they’re not going to go away.”