Armed conflict, natural disaster, famine. A rapid field response delivers life-saving services and supplies.
Crisis situations carry widespread risks to reproductive health —in particular to women and adolescents. Protecting pregnant women is a top priority in an emergency. For many others, help is needed in preventing sexually transmitted infections and sexual violence.
Since 1994, UNFPA has supported emergency reproductive health projects in more than 50 countries and territories, including immediate humanitarian responses followed by post-emergency development assistance to restore and improve reproductive health services. Partners in this humanitarian response included governments, other UN agencies and NGOs.
In 2002, UNFPA established its Humanitarian Response Unit as part of the Office of the Executive Director and opened a branch in Geneva. This enhanced its ability to provide services to meet the emergency reproductive health needs of refugees, the internally displaced and others affected by crisis. Technical assistance was also provided to UN peacekeepers. Of particular concern were complex emergencies that combine drought, famine, poverty, HIV/AIDS and gender-based violence.
Assistance was provided to ongoing emergency and post-conflict reconstruction programmes in numerous countries, including Afghanistan, Angola, Burundi, Congo, Côte d’Ivoire, Democratic Republic of the Congo, Ecuador, Kosovo, Liberia, Malawi, the Occupied Palestinian Territory, Rwanda, Sierra Leone, Somalia, Sudan, Timor-Leste and the United Republic of Tanzania.
EQUIPMENT AND SUPPLIES
UNFPA dispatched emergency equipment and supplies to 22 countries and territories in 2002.
Supplies are ready-to-ship in kits that meet specific needs: safe delivery, condoms to prevent HIV transmission and unwanted pregnancy, rape management, STI prevention and treatment, care after miscarriages and unsafe abortions, Caesarian sections and blood transfusions. Clean delivery kits, for example, include soap, plastic sheeting, razor blades, string and gloves to help mothers give birth safely in emergency situations. These supplies help to implement the Minimum Initial Service Package developed by the United Nations Inter-Agency Working Group for Reproductive Health in Emergency Situations, of which UNFPA is a founding member.
- UNFPA is working with the Government of Afghanistan, international and local NGOs and donors to rebuild and upgrade clinics and hospitals, ensure a steady supply of medical equipment and consumables, and support training for local medical staff. In 2002, UNFPA opened a mobile hospital in Kabul featuring two maternity wards, upgraded the Shahuda clinic in bombed-out western Kabul and supported Afghan-run training programmes for midwives and traditional birth attendants.
- In Southern Africa, hunger, HIV/AIDS and poverty have created an emergency far more complex than the drought that preceded the latest food crisis. In 2002, UNFPA assisted in the procurement and distribution of reproductive health commodities, including male and female condoms, and in the training and deployment of service providers to distribute them in areas affected by the crisis.
- UNFPA sent more than five tons of emergency reproductive health commodities to address pregnancy complications and reduce maternal and infant deaths in Goma, Democratic Republic of the Congo, after the eruption in March 2002 of a volcano that displaced hundreds of thousands of people and severely disrupted health services.
- In May 2002, UNFPA appealed to donors to support relief efforts in the Occupied Palestinian Territory that assist women in labour who may be unable to reach a hospital because of military activity, curfews and travel restrictions. Other priorities included data collection, activities to empower women and prevent gender-based violence, and centres to provide trauma counselling for women and their families. The Fund shipped essential reproductive health supplies for clinics and hospitals, and trained 100 health workers to assist in obstetric emergencies.
DATA AND ANALYSIS
UNFPA’s first response in many situations is assessing immediate needs. This is followed later by research and data analysis to ensure that basic needs are being met.
- An almost complete lack of reliable data about Afghanistan’s capacity to solve its tremendous health problems, particularly related to maternal mortality and morbidity, is hindering reconstruction. In 2002, UNFPA and several partners organized an intensive, rapid and comprehensive national survey of health facilities and resources, covering every district in the country.
- In Angola, UNFPA conducted an extensive needs assessment of internally displaced women, men and adolescents in four provinces. Health policies and programmes of the Angolan Government and UNFPA will be based on the findings, which included very high rates of fertility and infant mortality, lack of reproductive health services, and low knowledge of contraceptive methods or HIV prevention.
A pregnant woman receiving a prenatal checkup in Sierra Leone, where UNFPA is helping the Government face an emerging HIV/AIDS crisis after more than a decade of civil war. The United Nations has launched a ground-breaking initiative involving UN peacekeepers to raise awareness about HIV/AIDS and slow the spread of infection. With more than 15,000 peacekeeping troops in the country, training in HIV prevention, gender awareness and women’s rights will have a far-reaching impact. UNFPA and other UN agencies and NGOs are supporting programmes that focus on the thousands of girls and women who were abducted and raped during the war—many are now commercial sex workers—along with war-affected youth and uniformed personnel.
Photo: Teun Voeten
TRAINING AND EDUCATION
To cope with crisis, people need skills and information to sustain their recovery. UNFPA supports counselling, sexuality education and training to build capacity. Risky, unstable situations contribute to high-risk behaviour, especially among young people, and expose the vulnerable to sexual violence.
- UNFPA developed a plan to expand emergency and post-conflict responses in the Democratic Republic of the Congo. A set of model interventions will help meet the reproductive health needs of displaced adolescents, demobilized combatants, and refugees —especially women and girls.
- Police officers in Timor-Leste participated in training on domestic violence in 2002. UNFPA provided technical assistance and resources for the five-day training with the United Nations Police.
- A severe shortage of trained female doctors and midwives is a major obstacle to extending reproductive health care to Afghan women. In 2002, UNFPA supported training in Peshawar, Pakistan, for midwives working in Afghanistan. The midwives then trained traditional birth attendants to work in rural communities, conducting prenatal and post-natal exams, assisting deliveries and providing health education.
- UNFPA organized a women’s NGO conference in Bratislava, Slovak Republic, in late 2002 to enhance capacity building and training and to incorporate a gender perspective within conflict prevention, peace building and conflict resolution activities
In Kabul, Afghanistan, where war had caused extensive damage to the local health care infrastructure, this UNFPA-supported mobile hospital provided essential services for women with complicated pregnancies.
ADVOCACY AND AWARENESS-RAISING
Complications of pregnancy and childbirth are a leading cause of death and disease among refugee women of childbearing age. From the very start of a crisis, women and men require reproductive health information and services. UNFPA raises awareness about the importance of incorporating reproductive health in humanitarian responses, and its integration within ongoing primary care services. UNFPA works to ensure that resources are allocated to the services that are the right of vulnerable populations.
and the International Federation of Red Cross and
Red Crescent Societies pledged in June 2002 to expand
and deepen their relationship, agreeing that refugee
women’s need for safe birthing and reproductive
health care is a critical humanitarian issue that
calls for stepped up relief efforts and cooperation.
co-sponsored a report on the Impact of Armed Conflict
on Women and Women’s Role in Peace-building.
The report, released in October 2002, highlights the
prevalence of violence against women, before, during
and after armed conflicts.
a meeting of the United Nations in July 2002, experts
from the UN and NGOs testified that people uprooted
by conflict, living in extreme poverty or caught in
disaster’s wake face a much greater risk of
being infected with HIV. The experts emphasized that
resources currently available to combat HIV/AIDS in
crisis-stricken communities are woefully inadequate
and they warned that the epidemic is by no means under
control, especially in sub-Saharan Africa.