EASTERN LIBERIA — Elise Larpea was pregnant when she fled Côte d'Ivoire with her four children, and she gave birth to twins soon after she reached Liberia. She joined an estimated 76,000 Ivorian refugees who crossed the border in the aftermath of the political crisis sparked by a disputed presidential election.
Like most of Ivorian women who have fled to Liberia, Elise left behind her husband, making the upkeep of the six children her sole responsibility.
But Elise’s condition seems far better than that of Philomene Toakeusseur who fled with ten children and gave birth to her 11th child in Liberia in early February.
“Being a refugee with 11 children to look after without my husband being around is not easy,” said Philomene. “I had wanted to stop bearing children since I had my eighth set of children who are twins. Now that I am in Liberia as a refugee, I hope that I can have the means to stop further childbearing.”
For now, most of Ivorian refugees in Liberia reside in border towns and villages with community members including extended families and friends. This places an enormous strain on the already inadequate social and health services available to the locals.
Long walk to health services
Both community members and refugees often have to trek several kilometers to access the available health services, a joint assessment visit by the Minister of Health and Social Welfare and UNFPA Representative to communities confirmed. Because majority of the refugee population is comprised of women and children, the demand for reproductive health services is high.
UNFPA is assisting the Government to meet some of these needs by the refugees and their host communities. “It is very important that while we are working with the Government of Liberia to provide reproductive health services to the people, we should also support the refugee population from neighbouring Côte d’Ivoire. For example, we have been informed that out of ten deliveries at the health centre in one of the towns hosting the refugees (Buutuo), six were by Ivorian refugee women,” said UNFPA Liberia Representative Esperance Fundira during a presentation ceremony of reproductive health kits to the Government of Liberia. The kits are intended to meet the RH needs of the both refugees and host communities. The package included individual delivery kits, assisted delivery kits, rape treatment kits, STIs treatment kits, male and female condoms, emergency contraceptives and blood transfusion kits among others.
“UNFPA’s top priority is to make sure that pregnant refugees deliver safely,” Ms. Fundira said.
HIV prevention is a priority
According to Liberia’s Health Minister Dr. Walter Gwenigale, some of the Ivorian refugees have been diagnosed with HIV and many other had already been placed on AIDS treatment in their country of origin. But UNFPA has assured the Liberian Health Minister of support for HIV prevention among the refugees and host communities. “We are focusing on HIV prevention, especially among the young people in order to ensure that under these difficult circumstances, they don’t get infected. Condom promotion and quality prevention of mother-to-child transmission is our top priority,” Ms. Fundira said.
The provision of family planning services to the refugees and host communities is much needed: Liberia has a low contraceptive prevalence rate (11 per cent) and the unmet needs for family planning stands at 36 per cent (LDHS 2007).
Ms. Fundira reaffirms UNFPA’s commitment to repositioning family planning in Liberia. “We need to really reposition family planning by bringing services to women and adolescent girls; especially to those in hard-to-reach areas. Quality of life cannot be assured if women cannot make informed choice and if they do not have options to choose from,” she said.
This could help women like Philomene and Elise make informed decisions about their sexual and reproductive health and avoid unintended pregnancies. Bring these service to over the countries nearly impassable road network will be a challenge, but one that the country has recently committed itself to.