UNFPAState of World Population 2002
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C H A P T E R   3
Reproductive Health And Reproductive Rights

Reproductive Health for Refugees and Displaced Persons

Ensuring the reproductive health of refugees and displaced persons, and protecting refugee women from sexual violence, are priority concerns wherever conflict or natural disaster takes place. The ICPD Programme of Action recognized the need to ensure reproductive rights and provide reproductive health care in emergency situations, particularly for women and adolescents.

The number of refugees, returnees and persons displaced within their own countries who fall under the mandate of the Office of the United Nations High Commissioner for Refugees (UNHCR) rose from 1.4 million in 1961 to a high of 27 million in 1995; it then fell to 22.3 million at the beginning of 1998. 64 Reproductive health care has been increasingly guaranteed in emergencies since the ICPD. Previously, reproductive health services had been largely ignored in refugee situations.

Reproductive health needs of women in emergency situations are being met as the result of an initiative by UNHCR and UNFPA, in collaboration with WHO, UNICEF, the International Federation of Red Cross and Red Crescent Societies, and various NGOs.65 The initiative was launched in 1995 in response to the refugee crisis in Africa’s Great Lakes region.

The programme trains staff and provides equipment and supplies to address needs in: family planning, including contraception; assisted childbirth; complications of unsafe abortions (post-abortion complications account for some 25-50 per cent of maternal deaths in refugee situations); sexual violence and rape, including post-coital emergency contraception; and prevention of sexually transmitted diseases including HIV/AIDS.

A Reproductive Health for Refugees Consortium was established; it has produced needs assessment manuals and materials. An interagency working group developed a Minimum Initial Service Package, including essential drugs, supplies and basic surgical equipment. Emergency reproductive health kits have been stockpiled for distribution when needed.

UNFPA used these stockpiles in April 1999 to provide emergency reproductive health assistance to the hundreds of thousands of people fleeing the conflict in Kosovo to camps in Albania.66 The Fund also undertook an investigation of sexual violence against Kosovar women; it uncovered alarming accounts of abduction, rape and torture. UNFPA and its partners are providing training for counsellors in offering support to refugees who have been subject to sexual violence.67

The plight of the Kosovars has attracted far more international attention than other ongoing refugee crises in Africa and Asia, where most of the world’s 13 million refugees are found — the largest group are the 2.6 million Afghani refugees (1.2 million are in camps in Pakistan).68

Although reproductive health services are now being provided in emergencies, these efforts are often hampered by a lack of health personnel skilled in reproductive health information and services.

BOX 20
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Rape is Commonplace in Kenyan Refugee Camp

Thousands of Somalis have fled into Kenya to avoid fighting in their country. Now, in a UNHCR-run refugee camp housing 100,000 people near the small Kenyan town of Dadaab, they live in constant fear of being robbed, killed or raped by marauding bandits.

Five armed men raided the mud hut where Safia Wanderi, 34, was living with her husband and children. Three of the men — believed to be militiamen fighting in Somalia — took turns beating and raping her in front of her family. Safia’s husband blamed her for the incident and abandoned the family.

Earlier, Safia says, her 11-year-old daughter was raped by a neighbour. She says many other women in Dadaab have had similar experiences.

More than 90 per cent of the rapes occur when women are collecting firewood from the outskirts of the camps. Rukim Nour Mohammed, 50, was raped and beaten one morning while collecting firewood and left to bleed to death. She managed to walk more than 15 kilometres back to the camp and find medical attention.

An aid worker at the camp, John Amollo, says traditional clan rivalries, heightened by the war, are a major reason why so many women are raped in Dadaab. "Whenever there is a conflict between clans, the worst punishment one clan can do to another is to rape their women." He says the problem is made worse because men in the camps are idle, frustrated and mentally traumatized by their experiences during the war.

Source: Voice of America, 18 May 1999.


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