Haiti’s city blocks and rural roads are still strewn with mounds of ruins, and an estimated 2 million people remain displaced as a result of the devastating earthquake that shook the island nation on January 12. Today, which marks the six-month anniversary of the earthquake, thousands of homeless families and individuals are living in tents and makeshift shelters in the 1,342 camps and settlement sites1 that have sprung up around the country. As aid organizations take stock of the displaced population’s current struggle for survival – and the challenges that loom ahead – the Women’s Refugee Commission is committed to making sure reproductive health remains a priority.
Addressing reproductive health has not always been a primary concern for humanitarian actors in crises. Such an oversight can have tragic consequences – especially given that women and girls are particularly vulnerable in emergencies. According to the World Bank and UN agencies, eight of the ten countries with the highest maternal mortality ratios in the world are fragile or conflict-affected countries. Displacement settings create risk factors for sexual violence and exploitation, the spread of sexually transmitted infections (STIs), unwanted pregnancies and subsequent unsafe abortions. The risk of maternal and newborn death and disability rises significantly when mothers do not have access to care for pregnancy-related health complications. In recent years, the international humanitarian community has aimed to reduce and respond to these concerns with a coordinated set of priority interventions known as the Minimum Initial Service Package (MISP) for reproductive health.
The challenge – and the Women’s Refugee Commission’s mission – has been to advocate for and ensure the implementation of the MISP in humanitarian settings worldwide. In May, our reproductive health team traveled to Haiti to examine the availability of MISP-related services for internally displaced persons and communities in Port-au-Prince, Léogâne and Jacmel. While we were there, we were encouraged to find that aid organizations are more committed to ensuring reproductive health care than in previous emergencies we’ve assessed. In collaboration with CARE, the International Planned Parenthood Federation and Save the Children, we produced a summary report entitled Four Months On: A Snapshot of Priority Reproductive Health Activities in Haiti. This assessment analyzes the progress and gaps in MISP implementation in Haiti since the earthquake, and recommends ways to improve reproductive health services and coordination in the months to come.
We were also recently in neighboring Dominican Republic (DR) for the annual meeting of the Inter-agency Working Group (IAWG) on Reproductive Health in Crises (of which we are a founding member), where we debriefed the group on our recent MISP assessment in Haiti. The IAWG is composed of representatives from UN agencies (including the UN Population Fund, the World Health Organization and the UN High Commissioner for Refugees), governmental and nongovernmental organizations and universities. Since its founding, the group has been working to ensure access to reproductive health care for people affected by conflict and natural disasters. It was fitting that this year’s meeting took place insuch close proximity to Haiti, where aid organizations are placing an unprecedented emphasis on reproductive health.
While in the Dominican Republic, we were pleased to present our assessment findings to the IAWG. We were careful to point out that, despite progress, many more steps need to be taken to ensure that displaced women in Haiti have sustained access to reproductive health care. Although much initial attention was paid to reproductive health following the earthquake, there is evidence that aid organizations still need to arrange for more long-term coverage of life-saving services. At this point it is crucial that agencies continue to secure funding, staff and supplies for reproductive health initiatives. Six months from now and beyond—as Haiti recovers and rebuilds—the health needs of women and girls must remain a priority.
1 UNOCHA Haiti Humanitarian Bulletin Issue #6, 1 July 2010