In the early hours of 6 June, the sound of explosions were heard before the Nova Kakhovka dam collapsed. The dam, on the Dnipro River, lies about 30km east of the city of Kherson. As torrents of water were unleashed, thousands of people were displaced in the region, parts of which were submerged underwater.

Iryna Tolstykh, 39, is a psychologist and coordinator of the UNFPA-supported Survivor Relief Centre who woke to news that the vast and vital dam had been destroyed, as a direct consequence of Russia’s invasion of Ukraine. She has pivoted from counselling to relief efforts in the city that is her home. Here she shares her days in the aftermath of the breach.

“I’ll tell you one thing: I really, really want to live. I love life more than ever.” says Iryna. “I love my arms and legs, because I never thought it would be so easy to lose them. I love my home, because it is where I recover. I value people so much. It is only with a person that you can get warm, that you can share your grief and know that you are not alone in this injustice. A lot of unnecessary things have disappeared, and only the real things remain.”

[Pictured above] Iryna, a psychologist with UNFPA (right) and her colleague Andrii, a driver, have been responding to the devastating crisis in her city of Kherson.
© UNFPA Ukraine/Danylo Pavlov

At 7 a.m. on 6 June, Iryna answered a phone call from a friend. “She was in a very anxious state. Her family needed help relocating. When she told me the dam had been blown up, I couldn’t believe it,” Iryna recalls. “I understood that it was a fact, but my mind could not comprehend it. Everyone has known since childhood how scary [the prospect] was - in school we learned how much Kherson would flood if the dam was destroyed.”

Iryna immediately set to work with her colleagues to rescue and re-house residents to higher ground, including their own families and friends. “We had to react quickly,” she says.

[Pictured above] Once the dam was destroyed, many people who had stayed in their homes since the occupation began in 2022 had no choice but to evacuate.
© UNFPA Ukraine/Danylo Pavlov

The dam held back a reservoir so large that locals call it the Kakhovka Sea. Its destruction is the largest environmental disaster in Ukraine since the Chernobyl nuclear accident in 1986.

“The word ‘horror’ is not enough,” says Iryna. “This is a global grief, a global catastrophe.”

The disaster has killed or injured unconfirmed numbers as humanitarian needs soar, including  the need for clean drinking water, food and access to health services. Military hostilities are adding to the challenges with reports of several attacks affecting civilians and hindering rescue operations.

[Pictured above] The dam’s reservoir spanned an area of more than 2,000 square kilometres. © UNFPA Ukraine/Danylo Pavlov

The Survivor Relief Centre (SRC) was founded by the Ukrainian government in December 2022, with support from UNFPA, to provide services to people affected by sexual violence following Russia’s invasion of Ukraine.

SRC operates across 11 cities through dedicated sites or mobile teams. The Kherson team of three–Iryna, Andrii, and their colleague, Anna, a social worker–has always been mobile to operate around shelling.

When the dam was destroyed they refocused their efforts on the overwhelming rescue and humanitarian needs in the city. 

[Pictured above] From left: Iryna, Andrii and their colleague Anna, a social worker, support fellow residents around the clock. © UNFPA Ukraine/Danylo Pavlov

“Before the Kakhovka Dam was blown up, the SRC was organizing meetings with advocacy partners and arranging events with village heads,” says Iryna. “We dealt with the fact that many people considered sexual violence to only mean rape. Harassment, obscene statements, unwanted touching and coercion to have sex were not considered sexual violence.” The SRC raises awareness and provides counselling to those affected.

[Pictured above] Volunteers and survivors rally together to support each other. © UNFPA Ukraine/Danylo Pavlov

On the first day of the devastating news, as water began to pour from the dam walls, Iryna recalls how they could still evacuate people by van. “We were relocating people with disabilities, the elderly, people with children and animals. The city authorities opened shelters [in parts of the city on higher ground] and settled people there.”

[Pictured above] Iryna helps distribute donated supplies including shoes and clothing to residents who were evacuated with just the clothes on their backs.  © UNFPA Ukraine/Danylo Pavlov

By the second day, water levels had risen drastically. The only way to get around was by boat.

“Lots of people have summer cottages on the river called ‘dacha’, so there were always lots of boats in the city - every second person had one. When Russian troops left the city, they shot the boats to sink them so that residents or the Armed Forces could not use them. Now when we need the boats the most, there are not many of them.”

[Pictured above] Rescuers and evacuees travel by boat around flooded roads. “Places I loved have simply disappeared,” says Iryna © UNFPA Ukraine/Danylo Pavlov

Iryna has high praise for her teammates, Anna and Andrii.

“Andrii drives round in his boat, helping people from roofs, untethering animals, and rescuing anyone he can find.”

“Anna helps our military administration at the warehouse receive humanitarian aid that is brought from all over Ukraine and distributes it to shelters. She also works to resettle people to other locations.”

[Pictured above] The team has met people reluctant to leave their flooded homes if it means t abandoning their beloved animals. Andrii has saved all kinds of animals, including dogs, cats and goats. “Many dogs were sitting on roofs, and I saw many dogs swimming,” he says. © UNFPA Ukraine/Danylo Pavlov

“I provide psychological assistance to evacuees in shelters, working with children who are disoriented, and calming down elderly people who are terrified,” says Iryna.

She also coordinates volunteers, funds, and donations of lifesaving resources from individuals, other SRC sites and NGOs, as well as deliveries of water purification tablets for “people left without drinking water in the Kherson summer heat”; UNFPA dignity kits, and a generator that came from Odesa, about 200km away.

[Pictured above] Volunteers organize the donated supplies, preparing them for distribution. “A grandmother asked for our help, not for herself but food for her cat,” Iryna says.
© UNFPA Ukraine/Danylo Pavlov

Iryna and colleagues begin each day at 6 a.m. and go to bed around 1 or 2 a.m. 

“Our sleep is of poor quality. Everyone working on this effort is in such a state of concentration that we hardly feel our own bodies.”

[Pictured above] The team has been working long hours every day. © UNFPA Ukraine/Danylo Pavlov

“Our work is hampered by shelling,” Iryna says. “For example, yesterday (13 June), there was very heavy shelling, and I had to stay in the basement. After that, I needed a lot of time to recover.”

[Pictured above] A church is used to store drinking water, food and other essential supplies. © UNFPA Ukraine/Danylo Pavlov

“What survivors need most of all is to be transported to a warm dry place, to a warm dry bed, and given hot tea. They need to be cared for,” Iryna explains. “When they receive sympathy, care and hot lunches, they begin to ‘thaw’.”

[Pictured above] Iryna coordinates volunteers, like the one pictured, who have come together to help other survivors. © UNFPA Ukraine/Danylo Pavlov

“When people receive blankets, dry clothes and hygiene products, they feel they are not alone with their grief, that they are supported by thousands of people. It is very difficult and painful for them, but seeing help provides people with a sense of strength,” says Iryna.

“We distribute dignity kits to women and teenage girls, and babushka kits to older women.  We take most of the kits to the areas that have suffered the most, where people have nothing left.” 

[Pictured above] Iryna unloads kits containing essential supplies to meet people’s immediate needs. © UNFPA Ukraine/Danylo Pavlov

Iryna is concerned about what receding water levels will reveal.

“When the water goes down, there may be corpses of animals and people. Cemeteries were washed away, and in this heat it will be an even more terrible process to deal with. We currently do not have the specialists who can cope with this challenge,” says Iryna. 

“My biggest fear is the potential of various epidemics.”

[Pictured above] Water levels are now receding. © UNFPA Ukraine/Danylo Pavlov

“This tragedy scares me because, despite the fact that we live in a progressive time, where we talk about tolerance, respect and values, there are still people who are ready to wipe entire cities off the face of the earth.”

“I feel powerless because I cannot change it.”

[Pictured above] In January 2022, Kherson’s population was almost 280,000. It is reported that only 20% of its inhabitants remain in the city.  © UNFPA Ukraine/Danylo Pavlov

“On the other hand, I am very grateful that I have this job and this team, and that Anna, Andrii and I can help. As a resident of Kherson, as a person for whom everything dear is being destroyed - doing our job helps us avoid despair.”

[Pictured above] Iryna and Anna sort through donations. © UNFPA Ukraine/Danylo Pavlov

Despite only sleeping 4-5 hours each night, Iryna wishes she had more time.

“We are trying to reach a large number of people, and unfortunately, we are not made of iron, we are not robots. If we were more resilient, stronger, and had more hours in the day, we could help more. But we are ordinary people.”

[Pictured above] Iryna, a psychologist-turned-rescue worker, works under the risk of attack to support her community. © UNFPA Ukraine/Danylo Pavlov

Rescuers scramble to find survivors in the village of Besnia in Syria, following the catastrophic earthquakes that struck both Türkiye and Syria on 6 February, killing thousands and injuring many more. “UNFPA is committed to support the people of Türkiye and Syria affected by the earthquakes, including the pregnant women who are expected to give birth in the coming weeks under these difficult conditions,” said Dr. Natalia Kanem, Executive Director of UNFPA. “Their ability to access quality care before, during and after delivery must not be an afterthought.” 

© AFP via Getty Images

A child receives urgent care in the town of Sarmada in Syria in the wake of the devastating earthquakes. The initial quake struck in the early hours of the morning on 6 February while people slept, with the second hitting later in the day amid a series of aftershocks, compounding the devastation. The governments of both Türkiye and Syria have declared national emergencies and called for international support.

© OCHA/Ali Haj Suleiman

Women embrace amid a sea of debris in Hatay, Türkiye. Thousands of buildings, including maternity facilities and safe spaces for women and girls, have been severely damaged or destroyed. UNFPA’s urgent priority is to restore services that are crucial to the health and well-being of women and girls.

© Getty Images/Burak Kara

Rescuers comb through piles of rubble in Lattakia, Syria, hoping to find survivors in a race against time amid the overwhelming devastation. 

© UNFPA Syria/Mosaic

Rescuers work into the night, continuing to find people trapped under the rubble alive, including this young girl rescued in Hatay, Türkiye.

© SGDD-ASAM Turan Berker Akdevelioğlu

A newborn baby—who was found still tied by her umbilical cord to her mother—was pulled from the rubble of a home in northern Syria. Now receiving medical care at a clinic in Afrin, Syria, the infant is the sole survivor of her immediate family. Among the millions of people in Türkiye and Syria who have been affected by the quakes are tens of thousands of pregnant women who need access to maternal health services.

© AFP via Getty Images

Women working with the UNFPA-supported Women and Girls Safe Space visit the Şanlıurfa Training and Research Hospital in Türkiye, providing postnatal counseling and delivering maternal kits—containing clothes and supplies for both mother and baby—to pregnant women and new mothers.

© Harran University, WGSS

Staff members of the UNFPA-supported Women and Girls Safe Space deliver much-needed maternal kits to women at the Şanlıurfa Training and Research Hospital in Türkiye. The kits include baby clothes, hand soap, baby blankets, underwear, postpartum pads, baby shampoo, baby rash cream, diapers, and baby-safe wipes, among other items. 

© Harran University, WGSS

UNFPA Syria and partners arrived rapidly in affected areas, such as this devastated neighborhood in Aleppo, to assess needs and provide immediate assistance.

© UNFPA Syria

Staff members of UNFPA Syria carry out an assessment of needs in Aleppo and across the country, providing support via mobile clinics and safe spaces and handing out dignity kits and winter kits containing crucial supplies. 

© UNFPA Syria

A fresh snowfall adds to the challenge of rescue efforts in Elbistan, Türkiye. Amid freezing temperatures, survivors have been building fires from pieces of wood in the debris in an attempt to stay warm. Another crisis looms if people cannot soon access shelter, food, and other essentials.  

© Getty Images/Mehmet Kacmaz

A child finds a place to sleep on a pile of bedding supplies provided by humanitarians in the town of Jandairisin in Syria.

© UNOCHA/Mohanad Zayat

Urgently constructed camps in Diyarbakır, Türkiye, provide temporary shelter amid vast needs across both Türkiye and Syria.

© KAMER - WGSS

In Lattakia, Syria, a UNFPA-supported Safe Space sets up shelter for survivors left homeless by the catastrophic quakes.

© UNFPA Syria/Mosaic

A woman waits for news of her loved ones, believed to be trapped under a collapsed building in Hatay, Türkiye. “The lives of so many people have been torn apart,” said Dr. Kanem. “Amidst the devastation and uncertainty that natural disasters bring, UNFPA will continue to do what is needed and what it does best: respond to women’s and girls’ emergency healthcare and protection needs.”

© Getty Images/Burak Kara

Since the beginning of the full-scale Russian invasion of Ukraine, 1 in 3 babies have been delivered in a UNFPA-supported hospital.

Despite the dangers – there have been more than 850 verified attacks on health care facilities – obstetrician Olena Mokhonko has helped women deliver as many as 70 babies a month at Chernihiv Maternity Hospital.

She joined four of those women to celebrate their children’s first birthdays and to hear the mothers share their experiences of giving birth in a city under fire. Here, they tell their stories.

[Pictured above] At a poignant birthday party, mothers join the obstetrician who delivered their babies amid war. © UNFPA Ukraine/Serhii Korovayny

Nina and Yulia

In the last few weeks of her pregnancy, Nina’s birthing plan changed drastically as the conflict grew. Knowing that she might not be able to get to the hospital, she created a Plan B.

“I was preparing to give birth in the basement,” she says, recalling how her community rallied around her. “People from our neighbourhood had different stocks of food; some had cereals, some canned food...everyone had some food or hygiene supplies, so we had the basics. I found a perinatal psychologist on the Internet – there was still a connection at this time – and asked her what to do in my situation. She explained everything to me in detail: how to cut the umbilical cord, how to check the placenta.”

[Pictured above] Nina with Yulia in the bomb shelter where she sought safety before and after giving birth. © UNFPA Ukraine/Serhii Korovayny

When the time came, Nina called an ambulance but was told the staff could respond only to gunshot wounds. A volunteer took her to the maternity hospital, so she didn’t need to go through with the basement birth, but extreme challenges remained.

Nina recalls the system in place at the hospital: “If there were no missile attacks, we were taken to the first floor and gave birth in the corridor – far from the windows. But when the security situation was critical, we were lowered into the bomb shelter. It was pure horror: Babies were crying; women were giving birth. I gave birth in the corridor. Other women were lying next to me or giving birth.”

Despite the chaos, she says, “The medical staff worked very harmoniously. The director of the maternity hospital personally walked around the first floor, checked how we were feeling, and worried about everyone.”

[Pictured above] Neighbours pooled their resources and tidied up Nina’s basement, adding carpets for warmth, for her return from the hospital. © UNFPA Ukraine/Serhii Korovayny

Nina received quick and efficient postpartum care and was discharged with baby Yulia. Heavy bombardment continued as she arrived home. “We were in the basement all the time. When it quietened down a bit, we only went upstairs to use the toilet or to quickly prepare food.”

“At night, the hum of the planes made it impossible to sleep and the baby would wake up, asking to be fed.”

[Pictured above] Nina and children at the entrance to their basement. © UNFPA Ukraine/Serhii Korovayny

On 18 March, when Yulia was 11 days old, Nina took her children and left on an evacuation bus. “The city was in smoke, without lighting,” Nina recalls. “Data was taken from each of the passengers, and it was recorded who was sitting where, so that in the case of a shooting, the bodies could be identified.”

[Pictured above] Extreme baby pictures: Yulia in her pram outside a damaged building in the neighbourhood. © UNFPA Ukraine/Serhii Korovayny

Nina spent two months in Poland before returning home. “It is important for me that my children walk on their native streets, hear their native language. I am glad to wake up in my own house, and that my children are alive and healthy.”

[Pictured above] Obstetrician Olena shares in the birthday festivities as Nina blows out a candle. © UNFPA Ukraine/Serhii Korovayny

Iryna and Amelia

Iryna is a single parent. Her husband died two days before her daughter’s birth. “From the first days of the war, he went to defend our city,” she says. “I asked him not to go because I had to give birth, but he said, ‘Who but me?’ On 3 March, he came under fire and was wounded, and two days later he passed away.”

Iryna was in a bomb shelter when she heard the tragic news.

She gave birth in a cramped room – which she describes as a “small cupboard” – at the hospital on 7 March. Electricity and communications had been wiped out in the city, and the tiny room had been converted into an operating theatre, with a generator and other essential equipment. There, she gave birth by Cesarean section to Amelia.

“For the first week of her life, Amelia did not breathe,” she says, describing how her baby was transferred to the intensive care unit. “I was ready to give everything for her to survive. I understood that her father would not be brought back, but I hoped that everything would be okay with my daughter.”

[Pictured above] Iryna, a single parent, lost her husband, Serhiy, when he died fighting to protect their home city of Chernihiv. © UNFPA Ukraine/Serhii Korovayny

A week after she was born, Amelia began to breathe on her own. Iryna’s relief was immense. “When we were discharged, we immediately left the city,” she recalls. “Volunteers took us to the Khmelnytskyi region.” Iryna stayed there with her newborn for a month, but she was keen to get back. “The morgue workers had agreed not to bury Amelia’s dad until we returned, but we didn't have much time,” she says. As soon as Russian troops were pushed back from the city, she returned.

“Amelia was my salvation. If it weren't for her, I don't know how I would have survived everything. Only she gave me the strength to live on.”

[Pictured above] A playground near Iryna’s home in Chernihiv, where she returned after leaving for a month to seek safety. © UNFPA Ukraine/Serhii Korovayny

Kateryna and Sophia

Kateryna’s contractions started while she was sheltering in a cellar. With her city under attack, she managed to find a route to the hospital, arriving by 5 p.m. She gave birth to Sofia in the hospital’s dark, busy corridor, before midnight on 7 March.

“When Sofia arrived, we were taken to the hospital bunker for safety,” Kateryna recalls. “We spent the first hours of her life underground.”

When Kateryna was discharged the next morning, she went to her sister’s home in Chernihiv, where the shelling continued. “We hid in the basement and stayed there for three days. It was cold; there was no light, no water,” she says. “I had to find food for the baby somewhere because I had no milk.”

[Pictured above] Kateryna receives flowers on Sofia’s first birthday. © UNFPA Ukraine/Serhii Korovayny

Her husband and 4-year-old son, Mykhailo, were staying with grandparents in their occupied village of Ivanivka, a 20-minute drive away. Being away from her son made her anxious and distressed, but she couldn’t reach him amid the conflict.

“My sister and I went to Lviv. During the month we stayed there, I cried every day. When our village was liberated, my son, Mykhailo, was brought to us,” she says. “My children and loved ones are the only joy that gave me strength to survive this year.”

[Pictured above] Kateryna, with her husband and two children, found it difficult to be separated from her family while giving birth. © UNFPA Ukraine/Serhii Korovayny

Maryna and Diana

Maryna gave birth in the hospital’s corridor on the same night as Nina and Kateryna.

She describes how, in the weeks leading up to Diana’s birth, she was preparing for the baby’s arrival while also “waking up to the realization that war had begun.”

[Pictured above] Maryna reflects on the past year as the family celebrates Diana’s first birthday. © UNFPA Ukraine/Serhii Korovayny

She arrived at the maternity hospital during the day on 7 March, keen to avoid travelling at night amid city curfews. “My greatest fear was the possibility of a bomb dropping on us,” she says. “Thankfully, the experience went smoothly.” 

Despite the stress of giving birth amid the bombing, Maryna is grateful that all went well.

[Pictured above] Precious things: Maryna’s scan, taken at Chernihiv Maternity Hospital, and an ankle tag she wore during the birth. © UNFPA Ukraine/Serhii Korovayny

For the next two weeks, the family stayed in the basement with their newborn. “Although there was light from power generators, it was cold,” Maryna says. “We were among the lucky ones with some semblance of comfort.”

“We decided to leave Chernihiv because it was too dangerous to stay with a newborn. We went to Borzna in the Chernihiv region, where my husband's father lived,” she says. “One particular incident that stands out was when the footbridge we used to leave the city was blown up a day after we crossed it. If we had delayed our departure by just one day, we wouldn't have been able to leave.”

[Pictured above] Obstetrician Olena holds Diana on her first birthday. © UNFPA Ukraine/Serhii Korovayny

Her family is thrilled and relieved to welcome baby Diana. “Our first child, my son, had been eagerly waiting for his little sister. He helps us a lot and is excited to have a sibling. Our baby is the first girl in our big family, and we are grateful to be alive and healthy.”

[Pictured above] Arthur, 11, is excited to be a big brother to baby Diana. © UNFPA Ukraine/Serhii Korovayny

Obstetrician Olena Mokhonko

Olena Mokhonko has lived and worked in Chernihiv throughout the war. “I had to go to work because I am a doctor who took an oath to help others. In my work, what I love the most is seeing a father cry and witnessing the joy of parents as they welcome their child into the world,” she says. "When our city was occupied, my work changed dramatically. I had to perform deliveries and surgeries under extreme conditions. We moved all the necessary equipment to the bomb shelter and the first floor of our building.”

She describes how the relentless bombing affected life at home with her husband as well. “There was a time when we were so tired of the constant shelling that we no longer went to a bomb shelter. I still remember the sound of planes at night – my husband and I would hold hands, hear an explosion a few seconds later, and be grateful that the missile hadn't hit our house.”

[Pictured above] Olena has delivered babies throughout the war in her home city of Chernihiv. © UNFPA Ukraine/Serhii Korovayny

“As an obstetrician, I'm inspired by the strength and resilience of the Ukrainian women giving birth amidst the devastation caused by war. They are true heroines,” Olena says. “With the help of the international community and the determination of the Ukrainian people, I believe we can overcome these challenges and create a better future for our children.”

[Pictured above] Maryna’s photo gallery, bursting with baby pictures. © UNFPA Ukraine/Serhii Korovayny

“We suddenly woke up to the sound of the earthquake. My children had passed away in their beds, and my grandchildren were trapped under rubble,” says Kıymet.

“I was eight months pregnant. I was so scared. We couldn't stand up, our building was shaking so badly,” says Yonca.

“I woke up to realize that I lost everything in one minute – no home, no clothes, no money, nothing at all,” says Om Mohamed.

The moment of 4.17 a.m. on 6 February 2023 will be etched forever in the minds of millions of people across Türkiye and Syria. It’s when the first of two devastating earthquakes shook the region, with the second coming nine hours later. Thousands of aftershocks arrived in the weeks that followed.

[Pictured above] A woman looks over a scene of destruction in Jinderis, Syria. © UNFPA/Karam Al-Masri

As the scale of the disaster registered around the world, UNFPA launched an emergency response along with its partners.

The goal: to meet the immediate needs of women and girls in the aftermath of the crisis and to ensure the continuation of essential sexual and reproductive health services, including access to safe deliveries and contraception, as well as to protect displaced women and girls from abuse and violence.

Since the onset of this emergency, UNFPA has supported close to 500,000 people in affected areas.

[Pictured above] At a bazaar in Şanlıurfa, Türkiye, where people are sheltering in makeshift structures and vehicles, Gülsüm is among a team of psychologists, social workers and nurses who provide support. © UNFPA Türkiye/Eren Korkmaz

Three months on, the needs of women and girls remain stark.

Some 2.4 million earthquake survivors continue to live in camp settings in Türkiye, and some 1.9 million people in northwest Syria continue to live in camps or self-settled sites in dire conditions.

For millions of people, recovery is not happening quickly enough.

At this crucial stage, investment needs to be not only sustained, but ramped up. A protracted recovery will increase risks for women and girls as well as require more funds.

[Pictured above] A temporary camp on the outskirts of Diyarbakır, Türkiye. © UNFPA Türkiye/Eren Korkmaz

Lale, 22, is living with her family in a camp in Hatay, Türkiye. While she continues to wait for a tent of her own, she sleeps in a makeshift structure with her parents.

“We ran out barefoot in the rain; the babies had no jacket, no blanket,” says Lale, whose twins are six months old. “I have nothing left.”

Lale has received dignity and maternity kits with essential supplies but is still frequently running out of diapers, as well as food.

“I go to bed half full, half hungry, with my babies. We've been out in the rain too long.”

[Pictured above] Lale and her twin babies at an overcrowded camp in Hatay. © UNFPA Türkiye/Eren Korkmaz

For women and girls staying in camps, simply using the washroom can be a source of distress.

Many settlements lack adequate toilets and hygiene facilities. Adding to the problem, it can be difficult to make a bathroom trip after dark, when there is limited or no electricity.

Initially displaced from their hometown due to conflict, Salwa, 14, and Kholoud, 13, have lived for three years at the AlSekka camp in Idlib, Syria – an area affected by the earthquakes.

The two friends received dignity kits – which include supplies such as hygiene products and torches – provided by UNFPA partner Ihsan Relief and Development. “These things help us in maintaining personal hygiene,” says Salwa.

[Pictured above] Friends Kholoud (left) and Salwa look through the contents of a dignity kit. © UNFPA/Karam Al-Masri

In north-west Syria, the earthquakes are a crisis on top of a crisis.

After 12 years of conflict and human rights violations, people are living under untold strain. For many people uprooted by the earthquakes, this is yet another displacement.

“During the aftershocks, people were asking, ‘Is it a missile or another earthquake?’ If it was a mortar attack, people needed to go to the ground floor or basement; if it’s an earthquake, they needed to get out. People didn’t know what to do,” says Kinda Katranji, Communications Analyst in Syria who heard directly from women and girls affected.

[Pictured above] In the Syrian city of Maarat al-Numan, where many houses were damaged by war before the earthquakes compounded the destruction, mobile health teams are providing support. © UNFPA Syria/Massoud Hasan

Sex, periods and births do not stop during a crisis.

UNFPA has distributed tens of thousands of dignity kits and maternity kits since the onset of the crisis to women and girls in cities as well as in harder-to-reach rural areas.

[Pictured above] Dignity kits are distributed in the Sheikh Bahr camp in the countryside near the town of Armanaz in Syria. © UNFPA/Karam Al-Masri

Reports of gender-based violence, exploitation, abuse, child marriage and forced marriage have all increased following the earthquakes, at a time when services are overstretched.

In Syria, many safe spaces were damaged, like this one in Suran. So the teams went mobile, visiting women and girls at home and in temporary camps, to assess and support both psychological and practical needs.

UNFPA supports 52 safe spaces for women and girls across Syria, along with a helpline, as well as 23 safe spaces in Türkiye.

[Pictured above] A UNFPA safe space is no longer able to operate from its premises in Suran, Syria. It is among 12 safe spaces damaged in north-west Syria. © UNFPA/Karam Al-Masri

Hayfem and her husband and five children are Syrian refugees living in Şanlıurfa, Türkiye. They are sheltering in their vehicle, which they have parked at an outdoor bazaar for safety, along with other families.

A team dedicated to supporting migrant women and young people has mobilized to meet people’s needs following the earthquakes. The team includes psychologists, nurses and social workers.

[Pictured above] Hayfem and family have moved into their vehicle for safety. © UNFPA Türkiye/Eren Korkmaz

Mobile teams have also brought maternity services, including postnatal check-ups, to the camps.

Cahide gave birth shortly before the earthquakes struck. After being displaced, she arrived at a temporary camp in Şanlıurfa, where she was provided with a tent and received a medical check-up and maternity kit.

Across Türkiye and Syria, 60 mobile teams and 60 static clinics provide reproductive health and protection services, including emergency obstetric care, to some of the hardest-to-reach women and girls.

[Pictured above] In Şanlıurfa, Türkiye, UNFPA’s mobile team visits Cahide, who gave birth just before the earthquakes. © UNFPA Türkiye/Gözde Kumru

Baby Hala was born at Idlib Maternity Hospital in Syria. Her mother, Fatima, went into labour early.

“There are premature births due to anxiety, terror and psychological exhaustion that pregnant women experienced because of the earthquake,” says midwife Suad Muhiy-Aldeen. “There are cases of children with a very low weight.”

Hala was monitored in an incubator for the first few days of her life and thankfully now is healthy.

UNFPA-supported facilities have supported more than 1,350 safe deliveries and 400 C-sections in north-west Syria since the earthquakes.

[Pictured above] Fatima and her newborn daughter, Hala, at Idlib Maternity Hospital, run by the Syrian American Medical Society and fully funded by UNFPA. © UNFPA/Karam Al-Masri

Six days after the earthquakes, in the countryside around Aleppo, Syria, Khawla gave birth to quadruplets, who were all delivered safely at Al Fardous Hospital in Daret Azza.

Dr. Bushra Al-Khattab, who was trained by UNFPA, performed the Cesarean section.

As part of an inter-agency response, equipment and supplies have been delivered to health facilities, including equipment for C-sections.

[Pictured above] Khawla’s quadruplets are delivered by Cesarean section at Al Fardous Hospital, run by Syria Relief & Development with support from UNFPA.  © Ahmad Aljarban, SRD/UNFPA

“My joy is indescribable,” says Khawla. “I received services in this wonderful hospital for free. I thank the organization, the hospital and the medical staff for the services they provided me with and the warm welcome.”

The 25-year-old mother and her two older children, who are two and three years old, had been displaced by the earthquakes before she gave birth to her quadruplets. Khawla will be returning to tented accommodation – now with six children – and with uncertainty about what the future holds.

[Pictured above] Khawla with her four newborn babies. © Ahmad Aljarban, SRD/UNFPA

The immediate rescue efforts may be over, but there is still so much more that can and must be done.

With more clinics, mobile health teams, safe spaces and supplies, UNFPA can reach every woman and girl in need, but funding appeals for Türkiye and Syria remain woefully under target.

With additional funding, UNFPA will do whatever it takes to make sure that women affected by the earthquakes can give birth safely, manage their own reproductive choices, and live free from violence.

[Pictured above] UNFPA provides support at a temporary camp in Şanlıurfa, Türkiye. © UNFPA Türkiye/Eren Korkmaz