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With a faint voice and half-closed eyes, Hajja tells her story: Five months ago, when she was
four months pregnant, she fled her village to seek refuge from a conflict that is still tearing
apart the lives of countless people living in Darfur, Sudan. She, her husband and their seven
children made the 55 kilometre trek under the scorching desert sun before reaching Kalma camp—a
safe haven that huddles along the train tracks near the Chad/Sudan border. They left behind
their home, their friends and a life to which they may never be able to return.
Home to over 100,000 internally displaced persons (IDPs), Kalma is the largest camp operating in
Darfur. Many of its residents will eventually seek safety in other countries on other continents.
But on 10 May, 2005, Hajji gave birth to a beautiful and healthy baby at an UNFPA-supported women's
clinic run by the Médecins du Monde. Her name is "Hope" and it is a moniker that serves as both an
invocation for the future and testimony to all that her family has lost. Hope is also what enables
millions of women, men and children to flee conflict, persecution and human rights abuses—despite
hardship, uncertainty, fear and violence. But it is force, not choice, that compels so many to
abandon their families, homes, communities and the very countries in which they were born.
Although forced displacement entails risks for everyone who attempts it, women and girls face
particular challenges—during flight, through temporary refuge and in final settlement. In 2005,
there were approximately 12.7 million refugees in the world, roughly half of them women, and
773,500 individuals seeking asylum globally.(1) As well as risks and
hazards, however, flight offers refugees an opportunity to escape exploitation, discrimination
and persecution. The breakdown of society can also afford an opportunity to rebuild anew on a
foundation of equality and respect for human rights. Following the end of hostilities, women
refugees play a critical role in building a lasting peace and restoring social and economic
order.(2) For many refugee women, reconstruction can offer an
escape from discrimination and the opportunity to exercise new-found autonomy. For many,
however, it does not.
Women and girls face many dangers and obstacles throughout the entire refugee
experience. When schools and medical facilities close, jobs are lost and armed groups seize control,
it is largely women and girls who assume care for children, the infirm and the elderly. Many must
contend with unwanted and forced pregnancies and have special needs relating to sexual and
reproductive health issues. They also often bear a disproportionate share of responsibilities
and burdens. Certain groups of women—such as those who head households, ex-combatants, the elderly,
the disabled, widows, young mothers and unaccompanied adolescent girls—are more vulnerable and
require special protection and support. Although women make up a higher proportion of elderly
refugees, their particular needs are often neglected.(3) Many are also
widowed and care for orphaned or separated children.
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Today, too many women still face considerable obstacles in their attempts
to present claims of persecution—a major reason why, unlike refugees, they are usually
underrepresented among asylum-seekers. For historical reasons, and because exclusively male
delegations did not consider that persecution could be based on gender, the 1951 Refugee
Convention and its 1967 Protocol did not specifically recognize it as a valid
reason to claim refugee status.(1)
In 2002, UNHCR released a set of international guidelines affirming that
the international definition of refugees "covers gender-related claims".
(2) These include forms of persecution that are particular to
women, or that primarily affect women, or occur because they are women—such as severe forms
of gender discrimination (i.e., Afghan women under the Taliban).(3)
Gender-related asylum claims can include sexual violence, domestic violence, trafficking,
coerced family planning, forced abortion, female genital mutilation/cutting (FGM/C) honour
killings, forced marriage, punishment for going against social mores and discrimination against
same-sex partners.(4) In all cases, individuals seeking gender-related
asylum need to satisfy the eligibility criteria for refugee status as defined by the Convention.
Despite these and other developments, officials tend to favour a narrow
definition of what constitutes a refugee. This means they are sometimes reluctant to recognize
gender-related persecution as grounds for asylum—especially that perpetrated by private
citizens and where the state is unable to provide protection.(5) Some
argue that violence against women is of too personal a nature to amount to persecution; others
fear that all applicants seeking asylum on the basis of discrimination or assault would have
to be approved if women were considered a "particular social group". Experience in Canada and
the US, however, has proven that this is not the case.(6)
In 1993, Canada was the first country in the world to adopt guidelines that
define women as a "particular social group" as put forth by the 1951 Convention. This laid the
foundation for gender guidelines in other countries, including Australia, South Africa, the UK
and the US.(7) In 1995, the United States Government granted asylum
to a woman fleeing FGM/C. It was an important precedent, and the Government subsequently granted
asylum on the basis of honour killings and forced marriage.
In 2004, the European Council adopted a directive that, among other issues,
recognized child- and gender-specific forms of persecution, including sexual violence. This statute,
applicable to nearly all EU Member States, calls for countries to comply by passing and enforcing
domestic legislation by October 2006.(8) Although the EU's goal is to
establish a common asylum system for all members by 2010, each country currently maintains its own
policies. For example, 17 of 41 European countries surveyed during a 2004 UNHCR study recognize
sexual violence explicitly as a form of persecution, but the rest had not. Just over half acknowledge
that discrimination can constitute a form of persecution while three quarters do not recognize sexual
exploitation or forced prostitution in their asylum procedures. Two thirds, however, recognize
non-state agents of persecution.(9)
The UK stands out as one of the most progressive European countries when it
comes to policies that protect female asylum-seekers. In addition to the 2004 release of
Gender Issues in the Asylum Claim, case law recognizes the role of non-state armed
groups in fomenting sexual violence.(10) However, even in countries
with more progressive policies, application can be inconsistent.(11)
The consolidation of EU asylum policies offers an opportunity to strengthen and standardize
guidelines for female asylum-seekers.
Nonetheless, men are more likely to apply and be granted asylum than women.
In 2000, women accounted for only 33 per cent of asylum applications in Canada,
(12) and in 2002, roughly one third in Europe.
(13) This is because women are usually not the primary applicants
(male relatives are); gendered reasons may make case presentation more difficult (i.e., shame
regarding painful experiences of rape or torture, and embarrassment over relaying personal
information to male interviewers). Other issues include the fact that women are more likely to
be interviewed alongside spouses or other intimate partners when they are not the primary
applicant—even when they have borne the brunt of persecution. This is sometimes compounded
by interviewer ignorance of how cultural differences regarding female demeanor can influence
the interview outcome (for example, reluctance to establish eye contact).
(14)
In addition, some national asylum guidelines are more likely to recognize
those persecuted by the state (more often men) than victims of non-state persecution (more
often women, who are more likely to be threatened by members of their family or community—such
as in cases of "honour killings", FGM/C or violent spouses).(15)
Even when women are politically active, their involvement is usually "low-level" and not as high
profile as men's. Much of it is undertaken from the home, which means evidence for the claim can
be harder to gather. Thus, female asylum-seekers may challenge conventional notions of
politically based persecution, and are therefore more likely to face barriers when filing a
claim.(16)
Failure to recognize gender-related claims—beyond perpetuating uncertainty
and fear of being deported back to a threatening situation—has also been linked to irregular
migration and higher risks of exploitation. Some women with legitimate claims may opt out of
the process altogether and become undocumented migrants instead. And since many countries bar
asylum-seekers from legally working, this means many women are forced to take whatever jobs
are available—even though this might increase the risk of being exploited and/or trafficked.
(17)
Though policies and practices remain inconsistent and vary from country
to country, some good practices have emerged for others to draw from. These include
gender-sensitive and cross-cultural training that targets officials and includes informing
female asylum-seekers of their rights—such as the right to be interviewed separately and
confidentially and to register claims independently. UNHCR recommends that a same-sex
interviewer be assigned to speak to women apart from other family members in order to
allow greater privacy and freedom of expression.(18)
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Expanded Protections and Recognition
After many years of ignoring the differing needs, roles and experiences of women
and men, the international community is making important strides towards protecting refugee women and
girls and advancing their rights.
The 1951 UN Convention Relating to the Status of Refugees and its 1967
Protocol defines refugees as those who are outside their country of nationality "owing to a
well-founded fear of being persecuted for reasons of race, religion, nationality, membership of
a particular social group or political opinion".(4) Under
international humanitarian law, governments are bound to protect refugees from violence and to
safeguard their rights, including rights to education, work, freedom of movement and of
religion.(5) They are also bound by the principle of
non-refoulement—whereby refugees cannot be forced to return to their country of origin if they
have a reasonable fear that doing so will endanger their lives.
Today, various international agreements focus on empowering and protecting women.
In 1991, the United Nations High Commissioner for Refugees (UNHCR) issued Guidelines on the
Protection of Refugee Women. These were established to better address the needs of refugee women
and enhance their involvement in decision-making. Guidelines on sexual and gender-based violence
issued in 2003 provide additional measures to ensure protection and support survivors.
(6) Humanitarian relief agencies have made considerable progress by making
reproductive health services more widely available, address¬ing gender-based violence, increasing the
enrolment of girls in schools and involving women refugees in camp management.
(7)
In recent years, the international community has also undertaken important
initiatives designed to protect women from rape during and after conflict, and bring perpetrators
to justice.(8) Among the most significant, is the Rome Statute of
the International Criminal Court (ICC), which defines sexual violence as a war crime—a precedent
established by international criminal tribunals in Rwanda and the former Yugoslavia.
(9) UN Security Council resolutions passed between 1999 and 2003 to
protect children during armed conflict also note the needs and vulnerabilities of girls and condemn
sexual violence during peacekeeping operations.(10)
Throughout the UN conferences of the 1990s, governments agreed to provide special
protection and meet the needs of refugee women. These agreements include the 1994 International
Programme of Action on Population and Development and the 1995 Beijing Declaration and
Platform for Action. In 2000, the UN Security Council passed Resolution 1325, a landmark
decision mandating the participation of women in the peace process and calling for protection and
support for women living amid armed conflict.(11) The 2005 World
Summit Outcome Document, adopted by heads of state and governments, reiterated the importance
of implementing UN Security Council Resolution 1325.(12)
LIFE IN THE CAMPS
Refugees often wind up living in a variety of temporary arrangements. In
some cases, they stay with host families or settle in urban areas. For most, however, life
continues on in camps. While some provide refuge for a few thousand, others hold far more.
(In 2003, Afghans living in Pakistani camps numbered over one million.(13))
And while some refugees remain for only a few months, protracted instability in the country of
origin means that this is the exception. As of 2003, the average duration of years spent in a
refugee camp was 17 years.(14) A number of Palestinian camps were
established as early as 1948 and 1967.(15)
Many refugees arrive at their destinations exhausted, ill and traumatized.
Before their arrival, they have often witnessed, if not experienced directly, extreme violence.
Even while in the camp, refugees may get caught in fighting between factions, clans or
nationalities, and be vulnerable to cross-border attacks. Ethnic or religious differences with
the host community can fuel resentment.
Especially at the outset of an emergency, shelter, water, food, medicine and
health services may be insufficient for the number of people seeking refuge. Education for
children is a major concern: Only 3 per cent of the estimated 1.5 million refugee adolescents
in developing countries between the ages of 12 and 17 were attending secondary school based on
year 2000 estimates.(16) Girls face particular barriers. This is
because women and girls usually spend more time doing domestic work, such as gathering food,
fuel and water, instead of going to school or earning an income.(17)
In response, more and more educational programmes are specifically targeting girls to ensure
they complete their education. For young mothers this can be particularly tough. In 2003 and
2004, UNHCR and the US Embassy paid the tuition fees of young Angolan refugee mothers in the
Meheba camp in Zambia. The girls were also offered childcare and the support of older women
mentors.(18)
Among some refugee groups, traditional cultural norms can become more entrenched
as a result of displacement. This can lead to even more limitations on female autonomy. Afghan
refugees in Pakistan, for example, adopted a more extreme form of purdah (the separation
of men and women) during displacement that the Taliban then strictly enforced when they returned
to Afghanistan.(19) Nevertheless, the active participation of
communities and women themselves can help overcome discriminatory attitudes. Particularly vital
is to ensure that women, especially heads of households, have access to educational and
livelihood opportunities. In Pakistan, Save the Children offers a health and literacy programme
for Afghan refugee women living in remote provinces. The German Development Organization (GTZ)
has offered literacy courses for the past 18 years in many of the 250 refugee camps it has
supported.(20) In Liberia, in 2002, UNHCR provided literacy training
for a group of women who would then go on to teach other women. The organization also supported
livelihood programmes: In one project, 80 per cent of the 339 refugees receiving skills and
income-generating training were women and adolescent girls.(21)
In Ghana's Buduburam camp, Unite for Sight established a unique programme that
provides economic alternatives for female Liberian refugees so destitute that they were often
forced to trade sex for food.(22) There, female heads of household
produce hand-made eyeglass cases for sale on the world market. All proceeds go to fund an eye
care clinic for the camp's refugees.(23) Another UNHCR programme
provides a small monthly stipend and medical care to registered Congolese refugees living in
Kampala, Uganda. These programmes also help send displaced children to school. Most urban
refugees in Kampala are widows with three or more children.(24)
Violence Against Women and Girls
Violence is a reality of camp life. Women and girls are at particular risk when they go outside
the camp perimeters to collect firewood, water and other scarce resources. Between 1996 and 1997,
in the Dadaab camps in northeast Kenya, approximately 90 per cent of reported rapes occurred while
Somali women were out gathering firewood or tending livestock.(25) In
the late 1990s, Ethiopian women reported being fearful of collecting firewood owing to local
hostility fuelled by competition for scarce resources.(26) In 2001,
women living in Zambian camps revealed that it was not uncommon to trade sex for fish—a sought-after
staple food.(27) Poorly designed settlements can add to the risk. In
some cases, latrines and showers are built along the edge of the camps. Women and girls will often
avoid them altogether for fear of rape.
High unemployment, stress and frustration among male refugees can also lead to increased domestic
violence. In 2001, in six camps in Guinea, five times the number of domestic violence cases were
reported as compared to rape cases.(28) Furthermore, some men may feel
resentful over being excluded from projects that focus primarily on women and young people.
(29)
Adolescent girls and young women are at particular risk. Armed groups often prowl the camps in
search of children to abduct and recruit as combatants and, if girls, as sexual slaves, cooks and
cleaners. Near northern Uganda, aid workers report that girls are ingratiating themselves with camp
middlemen in order to avoid being passed on to armed groups.(30) In
eastern Chad, Sudanese girls charge that locals attack and rape them whenever they try to gather
firewood.(31) Community members, families and peers can also pose a
threat. Relatives sometimes force girls into early marriage in exchange for money or as a means
of securing their own physical safety.(32)
Even protectors have been exposed as abusers. In 2002, the international community
learned that young women were being exploited in West Africa's refugee camps. What was really shocking
was that it was at the hands of UN and NGO relief staff, as well as international peacekeepers—the
very individuals tasked to protect them. Investigators found that staff were bartering humanitarian
supplies and services—such as wheat, plastic sheeting, medicine, ration cards and education courses—in
exchange for sex, most often with girls between the ages of 13 and 18.(33)
Victims included separated children, child heads of household and children in foster care or those
living with relatives. Nearly all were young women and girls, and while experts believe young boys
were also victimized, tremendous stigma prevented any discussion of the matter.
(34) This prompted the UN General Assembly in 2003 to adopt a resolution
calling for an investigation.(35) The UN Secretary-General followed up
with a bulletin issued that same year urging the international community to step up measures aimed
at preventing sexual exploitation and abuse and requiring UN staff and non-UN collaborating entities
to comply with international humanitarian law.(36) It also called on UN
staff to report any concern or suspicion of sexual exploitation or abuse. The Secretary-General's
policy of zero tolerance has reinvigorated efforts and led to the establishment of peacekeeping
conduct and discipline units. Investigations of personnel have also resulted in a number of
dismissals. By early 2006, between 70 and 90 per cent of civilian police and military personnel also
received training on the topic.(37)
Survivors of gender-based violence may face long-term injury, unwanted pregnancies,
sexual dysfunction, post-traumatic stress disorders and STIs, including HIV/AIDS. In Sierra Leone, it
is estimated that 70 to 90 per cent of survivors raped during the 1991 to 2002 war contracted STIs,
including HIV/AIDS.(38) In March 2006, UNHCR reported that fully two
thirds of the Sudanese women refugees who were being treated in the Abeche Regional Hospital in Chad
had been raped. The youngest victim was only ten years old.(39) UNFPA and
UNHCR are supporting the hospital to treat women suffering from fistula, which is caused by obstructed
labour or extreme sexual violence. Because women are too ashamed to report rape and seek assistance,
UNHCR has been working to establish a referral system that coordinates medical and legal assistance.
(40) Personnel with the International Medical Corps are also consulting
with older women and traditional leaders to discuss post-rape trauma followed by culturally sensitive
counselling sessions targeting the entire family.(41) Building on a pilot
project for rape survivors in the United Republic of Tanzania, UNFPA and UNHCR trained camp health-care
providers in Kenya and Uganda in 2005 on clinical management and post-exposure prophylaxis (to diminish
the risks of HIV infection).(42)
With support from the Reproductive Health in Conflict Response Consortium,
refugee women living in Thailand have developed a guide to assist survivors of gender-based
violence. The guide sets standards of care, including those related to health care, counselling,
advocacy and case management. (43) In Sierra Leone’s Kono district,
where refugees have begun to return home, UNHCR and the International Rescue Committee (IRC) have
helped establish women-led community centres that, among other things, offer tips on how to avoid
and respond to gender-based violence. Women, men and youth have come together to establish action
groups designed to raise awareness and provide an opportunity to discuss related issues. The
initiative is part of a larger community empowerment initiative led by the Government, UNHCR and
other implementing partners.(44)
In Burundi, UNHCR provides firewood and has installed mills within the camps.
Camp security forces now include women.(45) In addition, over 70 older
refugee women were appointed to serve as mères volontaires (volunteer mothers) to identify, assist
and care for young rape victims. They have, in turn, recruited older men to act as pères
volontaires, because men can play a key role when it comes to preventing sexual violence.
(46) Elders are also active in Kenya, where they were organized into
anti-rape committees in order to discourage attacks on Somali women and girls. Elders embarked on
several practical measures—including planting special thorn bushes around the camps in a bid to
discourage would-be human predators.(47)
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Refugee and displaced women and children are especially vulnerable to
trafficking. During the 1990s Tajikistan conflict and its aftermath, displaced women and
children were trafficked for sexual exploitation in countries of Eastern and Western Europe
and the Persian Gulf.(1)
In Southern Africa, refugees are both the traffickers and the trafficked.
The IOM reports that male refugees often recruit their own relatives from their country of
origin. In many cases, women and children are forced into sex work with all profits going
to family members. Some traffickers assist their victims to apply for refugee status in order
to prevent deportation and, thus, protect their "investment".(2)
Strict or inadequate asylum policies can make refugees even more vulnerable.
In Thailand, displaced Burmese asylum seekers denied refugee status are often forced
"underground", where they are more likely to be trafficked and enslaved.
(3)
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Women are also playing an important security role elsewhere. For example, UNHCR
has trained 90 Ugandan police officers, including 25 women, to work with Congolese refugees. Police
officers took turns playing survivors reporting rape. The aim was to improve interview skills, learn
how to collect forensic evidence, acquire information on referral services and learn about Uganda's
laws involving gender-based violence.(48)
Reproductive Health, Including HIV Prevention
Recent reports by researchers and humanitarian relief organizations indicate that women living in
camps may actually benefit from better access to reproductive health services, including family
planning, than women in the host country or in their country of origin.(49)
Refugee populations often have a lower incidence of pregnancy-related problems than women living in
the host community and origin countries. This is largely owing to improved access to health care in
camp settings.(50) A 2004 global evaluation of 8.5 million displaced
people found that almost all camps offered at least one family planning method, including oral
contraceptives (96 per cent) and condoms (95 per cent). In addition, HIV prevention education was
offered in 89 per cent of the sites, and diagnosis and treatment of STIs was available in 84 per
cent of the sites.(51) Similarly, efforts to raise awareness of HIV/AIDS
and other STIs are making an impact in some areas. In Kenya, refugees actually knew significantly
more about preventing HIV than counterparts in their host community or their compatriots in southern
Sudan: 72 per cent of the camp refugees knew about the three main methods of HIV prevention, compared
to only 32 per cent of the local population.(52)
However, despite progress, displacement can, and still does, undermine reproductive health and
rights—fundamental needs already in jeopardy in many situations. This is a serious issue owing
to the fact that an estimated 25 per cent of refugee women of reproductive age will be pregnant
at any one time.(53) Without access to reproductive health services,
pregnancy and delivery-related complications can lead to maternal and infant mortality, low birth
weight and other negative outcomes. Unprotected sex and teenage pregnancies are also common in
refugee camps. Adolescents face particularly high risks of death during childbirth: In war-torn
Southern Sudan, girls were found to be more likely to die in pregnancy and childbirth than finish
primary school.(54)
Flight and displacement can lead to higher STI rates and HIV prevalence. Sex work, sexual
exploitation and trafficking can increase transmission rates. This is perhaps best exemplified
by the ongoing war in the Democratic Republic of the Congo (DRC). Before hostilities erupted in
1997, 5 per cent of the population was HIV positive. In 2002, that number had climbed to 20 per
cent in the eastern parts of the country where conflict was most intense.(55)
In other cases, prolonged crises may serve to temporarily slow the spread of HIV by isolating
populations and disrupting transportation routes and rural-to-urban migration. This was the case of
conflicts lasting many years in Angola, Sierra Leona and Southern Sudan, where HIV prevalence
rates were found to be lower than those in neighbouring countries.(56)
Once stability is restored, however, and people are again able to move freely, countries risk a
post-conflict surge in HIV prevalence if prevention programmes are not forthcoming.
The international community is continuing to step up efforts. Today, many
refugees are increasingly benefiting from reproductive health programmes. In 2005, UNFPA provided
support in Benin and Ghana for refugees fleeing unrest in Togo—including supplementary food and
immunization services to pregnant women and children, maternity health kits, male and female condoms,
treatment for sexually transmitted infections, insect-treated mosquito nets and soap.
(57) In the Sherkole camp for Sudanese refugees in Ethiopia, UNFPA supports
the IRC in mobilizing elders, women's groups and other community leaders to raise awareness of family
planning, maternal and child health and formulate strategies to change harmful practices.
(58) In the Islamic Republic of Iran, UNICEF and WHO have supported the
Assisting Marsh Arabs and Refugees (AMAR) International Charitable Foundation to train more than 100
female health volunteers to reach out to Iraqis living in refugee camps, as well as Afghan refugees
in urban areas. The aim is to provide information on maternal health care, immunization and family
planning.(59)
In Yemen, Marie Stopes International (MSI) has run reproductive health centres
for Somali refugees and the local population since 1998. UNFPA and UNHCR-supported health education
sessions have reached thousands of refugees.(60) Similarly, in the Yarenja
camp for Sudanese refugees in Ethiopia, IRC and UNFPA-supported Anti-HIV/AIDS and Reproductive Health
Clubs report at least 55 per cent of refugees aged 14 to 45 now know how to prevent STIs, including HIV.
Girls clubs were particularly effective.(61)
Repatriation, Integration and Resettlement
Refugees usually have three "durable solutions" available to them: voluntary repatriation to their
country of origin; local integration in the country of asylum; or resettling in a third country.
(62) As mentioned before, however, many refugees end up living in camps
for many years, with limited prospects of securing any of the aforementioned solutions.
International organizations, notably UNHCR and IOM, coordinate repatriation and offer medical
services. They also accompany the most vulnerable refugees. Host governments often favour
repatriation and overlook the possibility of local integration owing to restrictions on the
numbers of refugees—even though it offers a practical short- and long-term solution. This is
especially the case where prolonged instability in countries of origin make it impossible to
return.(63) Papua New Guinea—along with Belize, Mexico and Uganda—are
among the few exceptions.(64) In 2005, Papua New Guinea granted 184
refugees from Indonesia residency permits only one year after their arrival. Furthermore, the
Government made permits available to both men and women in an explicit recognition of equal
rights and its commitment to gender equality.(65)
While for many years only a few countries offered refugees the option of resettling to a third
country, more are now providing this alternative.(66) Today, UNHCR is
attempting to prioritize female-headed households and victims of gender-based violence.
(67) In 2004, the Guinea office of UNHCR made a special attempt to
include more women when it submitted 2,500 names to the US Refugee Program.(68)
Brazil has also started welcoming more female-headed families. Upon arrival, they are offered language
courses, job training, employment assistance, microcredit, and childcare.(69)
Facilitating the social, cultural and economic integration of refugee women,
however, can be challenging. Many female refugees are weighted down with domestic duties and
childcare. Male family members may object when women work outside the home. Isolation and lack
of familiarity with the host society can lead to depression. To address this need, the Canadian
Council for Refugees holds weekly group meetings for women refugees and provides childcare during
the sessions. Organizers encourage women to lean on each other for mutual support and become more
independent.(70)
Immigrant-to-immigrant programmes can be especially helpful for new arrivals.
In Australia, women immigrants from the Cook Islands are reaching out to newly arrived refugees
from the Horn of Africa.(71) Elsewhere, various efforts are now under
way to expand access to health care and to overcome the sociocultural and linguistic barriers that
can keep many from seeking services. In Canada, where efforts are ongoing to integrate refugees
into the existing health-care system, more experienced former refugee women are assisting newcomers
to access health, social and education assistance.(72) In Austria, the
Omega Health Care Center provides psychological and social counselling, as well as medical care, to
refugees and other victims of torture, with attention to gender issues.(73)
In the US, the non-profit organization RAINBO works with refugee communities to raise awareness of
sexual and reproductive health concerns, with an emphasis on female genital mutilation/cutting
(FGM/C). It also works with health providers to improve quality of care for women who have undergone
the practice.(74)
Despite progress, challenges remain, much as they do for migrant women generally.
This reflects the situation in many host countries—mixed progress, and significant gaps between
policy and implementation.
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