3 September 2008

Three months after Cyclone Nargis wreaked havoc in Myanmar, the UNFPA continues to help the Southeast Asian country protect women and girls from an increased risk of violence, ensure mothers can deliver safely and address other reproductive health needs of the Myanmese.

As part of an interagency funding appeal following Nargis, one of the most devastating cyclones to hit Asia, UNFPA has already raised some $838,000 to help restore life-saving reproductive health services and offer counselling and support for vulnerable women and girls. But further funds are crucial as the budget remains $4.9 million short of the $5 million it estimates is needed for a comprehensive response.

Protecting vulnerable women

Food and clean water are still scarce as a result of the cyclone, which killed nearly 140,000 and affected some 2.4 million people. On top of these basic needs, many pregnant women were left without safe, clean delivery options and antenatal care, putting them at risk of childbirth related death and injury.

Alongside the debris and physical damage, Nargis left in its wake widespread grief and distress. Many women and girls, now destitute and desperate to make ends meet, are at increased risk of abuse, violence and exploitation.

UNFPA is one of the leading UN agencies in Myanmar promoting gender equity initiatives. To map the situation of women affected by the cyclone and to design an effective response to assist the most vulnerable, the Fund is supporting the Department of Social Welfare to conduct an assessment of women’s protection issues in cyclone-affected areas. The analysis covers a wide range of sectors, including health, safety, livelihoods, education, food security, vulnerability to HIV, gender-based violence and trafficking. Results, which will include personal anecdotes from cyclone survivors, are expected by mid-October.

An informal assessment in Labutta, the most affected township in the Irrawaddy Delta, found women separated from their families, young widows and female-headed households to be the most vulnerable in their communities. In response to the finding, UNFPA has asked for expressions of interest to pilot-test women’s livelihood strategies, and offered financial support to the chosen organizations. Organizations will be selected in mid-September, with programmes expected to being on 1 October.

A technical working group on women’s protection, which UNFPA chairs, is facilitating a series of workshops to increase awareness of gender-based violence, particularly among partners working in the health, protection and reproductive heath sectors. A priority of the working group is to integrate women’s protection into all sectors of the disaster response, including the development of a holistic, cross-sector referral protocol for survivors of gender-based violence. The Fund has also supplied government hospitals and its delta-based maternity and mobile clinics with 70 sets of complete rape kits.

Making motherhood safer

Areas with weak healthcare infrastructure and inadequate maternal health care to begin with suffer from the further damage Nargis inflicted to health facilities and a shortage of medical staff. At least 10 midwives died during the disaster.

Within the humanitarian community’s coordinated response to the cyclone, UNFPA co-chairs the health-cluster working group on sexual and reproductive health and HIV. Supplies ranging from rubber gloves to hospital equipment have been delivered to the Ministry of Health for facilities in affected communities. Emergency reproductive health kits have been distributed to 14 cyclone-affected townships, and some 30,000 clean delivery kits have been distributed through various international and local partners. Additionally, some 50,000 displaced women have received UNFPA “dignity kits” of clothes and personal hygiene supplies.

Together with the Myanmar Medical Association (MMA), UNFPA has opened three maternity waiting homes in some of the worst hit townships of Bogale, Laputta and Dedaye. One more is planned in Yangon. The waiting homes provide women who live far from hospitals a place to stay while awaiting childbirth. Fifteen doctors and a coordinator ensure that all three facilities, which also act as bases for mobile clinics, are fully operational around the clock.

To reach more women in need, UNFPA and MMA have organized 24 mobile clinics that bring general and maternal health care services to 26 villages in eight cyclone-affected townships. Four health clinics in the Bagole, Laputta, Dedaye and Ngaputaw townships also operate five days per week to meet the medical needs of these communities.

To date, 1,192 pregnant women have benefitted from the services of the various UNFPA-MMA clinics.

UNFPA is also training local and international partners to respond to the reproductive health needs of women and men in the aftermath of disaster. The Minimum Initial Service Package (MISP), which the Fund is helping to bring to Myanmar, is an internationally agreed set of activities to prevent maternal deaths, HIV transmission and sexual violence in the in the early stages of a crisis. So far, a total of 77 partners in health – including the Department of Health, the Myanmar Anti Narcotics Association, the International Organization for Migration, and international NGOs such as Marie Stopes International and Medicines Sans Frontieres Holland – have been trained in its use and are ready to help those in most need of assistance.