Nazia, 19, lost most of her family when a landslide buried her home village of Chikkar after a devastating earthquake hit Pakistan in October 2005. When she learned she was pregnant, she was referred to a new UNFPA-supported maternity centre, where doctors and midwives work around the clock, delivering two to three babies a day. New clinics like this one reveal how UNFPA helps to restore—and where possible, improve—reproductive health services in the wake of crises. Many mothers and children in some of the hardest-hit areas now enjoy better access to health care than before the disaster.

When crisis strikes, UNFPA helps to restore or establish life-saving reproductive health services for displaced persons and other affected communities. The Fund also works with local and international partners to ensure that the particular strengths and vulnerabilities of women and girls are factored into the planning of all humanitarian assistance.

Providing Emergency Health Supplies and Equipment

During 2006, UNFPA worked with partners to prevent pregnancy-related deaths, HIV infection and sexual violence in 45 countries affected by conflict or natural disaster—through the provision of emergency health supplies and equipment, technical support and reproductive health services. Some examples of UNFPA humanitarian activities in 2006 include:

• Strengthening access to maternal health care and other vital reproductive health services for refugees returning to post-war Burundi;
• Preventing and treating cases of sexual violence in Sudan, Chad and the Central African Republic among people fleeing the violence in Darfur;
• Providing mobile health clinics to reduce maternal and infant mortality in the Occupied Palestinian Territory, where delays at checkpoints have forced many pregnant women to give birth along the roadside;
• Supplying male and female condoms to refugees and displaced persons in 25 conflict-affected countries, in partnership with the Office of the United Nations High Commissioner for Refugees (UNHCR); and
• Helping to prevent HIV infection among peacekeepers, demobilized soldiers, other uniformed personnel and the communities they serve in more than 30 countries through training, the provision of condoms and other reproductive health services.

Spotlight on Sexual Violence in Conflict

Sexual violence occurs at every stage of a conflict. Victims are usually women and adolescents who have been separated from their families and communities. In most conflicts, women’s bodies become battlegrounds, with rape used as a weapon of war to humiliate, dominate or disrupt social ties among targeted communities. The physical and psychosocial effects on victims can be devastating, with the trauma frequently extending to family members and entire communities.

UNFPA works with governments, local organizations and other humanitarian partners to provide medical care and social support to the survivors of sexual violence and to prevent future attacks. It provides specialized training to female health and social workers, establishes and equips women’s crisis centres and builds measures to help ensure that the safety of women and children in refugee camps are incorporated into emergency response plans. Through training, the provision of supplies and technical support, UNFPA works to ensure the availability of the Minimum Initial Services Package for reproductive health in emergencies, which includes post-rape treatment, counselling, emergency contraception, STI treatment and post-exposure prophylaxis to prevent HIV infection. In 2006:

• In June, the Government of Belgium, the European Commission and UNFPA convened a symposium on sexual violence that was the largest-ever of its kind. More than 250 participants from 30 countries assembled in Brussels for the International Symposium on Sexual Violence in Conflict and Beyond, which brought together heads of United Nations agencies and NGOs, along with other major players in the humanitarian field. Participants from conflict and post-conflict countries and territories also attended. Countries and territories included: Bosnia and Herzegovina, Burundi, Central African Republic, Colombia, the Democratic Republic of the Congo, Haiti, Indonesia, Liberia, the Occupied Palestinian Territory, Rwanda, Sierra Leone, Sri Lanka, Sudan and Uganda.
• Government officials, experts and United Nations partners examined a successful national programme to prevent and treat cases of sexual violence in the Democratic Republic of the Congo as a model for possible replication in other countries. Through integrated and multisectoral actions and policies, victims benefit from medical and health care, psychological support, economic reintegration and legal assistance. Started only three years ago, the model has already had a measurable impact. Founded with a generous contribution from the Government of Belgium, the initiative received additional support from the Canadian Government with a contribution of $13 million to be spread over four years.
• UNFPA assisted the Liberian Government in its November launch of a new gender-based violence plan of action and worked with partners and the criminal justice system to help end impunity and to reduce the incidence of rape and other sexual offenses.
• In Afghanistan, UNFPA supported the establishment of a new centre that deals with family violence, children in trouble and female victims of crime. Staffed by specially trained Afghan policewomen, the Family Response Unit opened its doors in January. It is housed in a metal container office attached to Kabul’s District 10 police station. The centre also operates an emergency mobile phone hotline.
• UNFPA continued to make protecting girls and women from sexual violence a priority—especially in overcrowded camps. In displaced persons camps in Uganda, community education and mobilization, as well as legal and judicial training, were among project activities.

Lebanese women visiting a UNFPA mobile clinic at the Alzabadani refugee camp in Syria. The clinic, whose staff includes a gynaecologist, provides a range of services, including antenatal care, family planning, and treatments for reproductive tract infections and anaemia

Safeguarding Maternal Health

Conflicts and natural disasters put pregnant women and their babies at risk because of the sudden loss of medical support, compounded in many cases by trauma, malnutrition, disease or exposure to violence. Urgent interventions can mean the difference between life and death. That is why UNFPA supports the provision of family planning, prenatal care, safe child delivery and post-partum care during humanitarian response. In 2006:

• UNFPA worked to safeguard the health of an estimated 3,000 pregnant women left homeless by strife in the Timor-Leste capital of Dili. Thanks to effective partnerships with Timorese health organizations, UNHCR and REDE Feto, a local NGO, pregnant women received maternal care in the camps and were given the option of being transferred to the National Hospital before delivery. Mobile clinic teams of obstetricians, general practitioners and midwives visit the camps daily, providing a range of services, from iron and folic acid supplementation to breastfeeding advice.
• In Nepal, UNFPA joined forces with the World Food Programme (WFP) to provide essential food and reproductive health care to hundreds of droughtaffected families in the Mugu and Humla districts. UNFPA also supported mobile reproductive health clinics during planned WFP food distributions.

WHEN EMERGENCIES STRIKE, WOMEN PROVIDE CARE

WHEN EMERGENCIES STRIKE, WOMEN NEED CARE

In times of conflict, women often single-handedly ensure the safe flight of children, older relatives and the disabled across barren, unfamiliar territory, especially when men have been killed or are away fighting. In the aftermath of a natural disaster and in refugee settings, traditional roles often expand at the same time that even basic tasks, such as water collection, become more difficult to undertake. In all of these situations, women must overcome immense obstacles to provide care and safety for others even as their own vulnerability to malnutrition, sexual violence and exploitation, sexually transmitted infection, unplanned pregnancy and unassisted childbirth increase. In 2006, UNFPA produced a new publication, Women are the Fabric: Reproductive Health for Communities in Crisis, to promote greater understanding of the particular strengths and vulnerabilities of women in crisis.

Immediate Response and Long-Term Rebuilding

Within hours of an emergency, UNFPA ships safe blood supply equipment, clean delivery kits and the medicine and supplies that health facilities require to provide clinical delivery assistance, emergency obstetric and post-partum care. In 2006:

• UNFPA responded to the Government of Lebanon’s request for assistance by sending clean delivery supplies to enable pregnant women to deliver safely and equipment to help ensure a supply of safe blood for damaged or temporary health facilities. With as many as 750,000 people displaced by fighting in July, UNFPA worked with local partners to assemble kits containing basic hygiene supplies for families forced to flee their homes with few belongings. Syria also received UNFPA assistance owing to the influx of more than 150,000 refugees in the first month of the crisis. UNFPA was the first United Nations agency to respond, thanks to a longstanding relationship with the national family planning association.
• In Bolivia, intense rains caused floods that endangered 40,000 families. As part of the United Nations emergency response, UNFPA provided monitoring and technical assistance to the Government to ensure continued access to contraceptives and to life-saving maternal health services.
• When conflict intensified in the Gaza Strip in June, UNFPA and partners focused on restoring health facilities and purchasing reproductive health supplies and essential drugs.
• UNFPA provided assistance to stricken communities transitioning from crisis to reconstruction. In areas hit by the massive October 2005 earthquake in Pakistan, the Fund continued not only to address women’s immediate health needs, but also to involve them in rebuilding their lives and communities. UNFPA contributed to 34 health facilities in the Muzaffarabad and Mansehra Districts—ranging from sophisticated maternity centres to basic health units—where more than 5,000 women have given birth. The all-female, live-in staff provides primary care, prenatal checkups and skilled deliveries round the clock. The Fund also supports 10 mobile clinics, reaching women and children in isolated villages that never had health services before.