Mudslides, floods, and earthquakes have struck this year to disastrous effect. Early this year a powerful earthquake devastated Haiti and more recently there have been mudslides in China and record flooding in Pakistan. These well-publicized disasters have displaced millions of people, but there are many more around the world who have fled lesser known conflicts, disasters, and persecution.
Currently there are about 40 million such refugees. When disaster strikes, the initial focus is often on finding food and housing, but refugees have needs much greater than just food and shelter, especially when the average length of displacement is17 years. International relief agencies must address all of their requirements, including their reproductive health needs. Children still need school, people still need health services, and women still give birth or want to prevent becoming pregnant.
In Sub-Saharan Africa 6-14% of women and girls age 15-49 will be pregnant at any given time and in any population 15% of those pregnancies will have unforeseen complications. Lacking access to family planning supplies, women develop unwanted pregnancies, particularly where rape is prevalent. As a consequence, many women turn to unsafe abortion. But without access to basic reproductive health care, common and easily treated complications can become deadly.
That’s why it’s essential to provide reproductive health services, and quickly, to refugees. In the wake of a disaster, displaced populations should have access to the Minimum Initial Service Package (MISP) for reproductive health, which is the international standard for care as laid out in the IASC Health Care Cluster Guide and the SPHERE Humanitarian Charter and Minimum Standards in Disaster Response. The MISP gives women access to emergency obstetric care, safe birth kits, precautions against HIV infection, and contraceptives. MISP services prevent and respond to sexual violence, and should also lay out a long term plan for providing more comprehensive reproductive health care once the initial emergency has passed.
The MISP has been implemented in Haiti, and recently CARE, International Planned Parenthood Federation, Save the Children and Women’s Refugee Commission did an evaluation, called “Four Months On: A Snapshot of Priority Reproductive Health Activities in Haiti”. The report finds that while reproductive health services are a recognized priority, and coordination of MISP services has improved, challenges remain in Haiti. Specifically, more work was needed to prevent and respond to sexual violence, expand coverage of services, and raise public awareness of MISP services.
It is important that we build off the successes and lessons learned in Haiti to effectively address the reproductive health needs of refugee populations in China, Pakistan, and elsewhere in the world. Life doesn’t stop when an emergency or disaster strikes. Neither should reproductive health services.
Posted by Jennie Wetter, Program Manager