Kebbeh is a 17-year-old mother living in a refugee camp in Liberia. At 15 she was married to a man nearly 20 years her senior. He left when she became pregnant and took another wife. Having been separated from her close family, Kebbeh and her daughter now live with a distant aunt who demands payment for the accommodation. Kebbeh cannot return to school, and there are few jobs available; she feels little hope for her future. She depends on men for her survival.
No matter where, adolescence is a time of transition. At this age, young people need special attention and sexual and reproductive health information and care that meet their needs. It is a time of unique risks: An astonishing 45 percent of all women living with HIV are between the ages of 15 and 24, and complications from pregnancy and childbirth are a leading cause of death for 15- to 19-year-old girls worldwide. These statistics illustrate their urgent need for sexual and reproductive health services.
In areas affected by conflict or natural disaster, the risks for adolescents are even greater. They are often forced to flee their homes, frequently leaving behind family and friends and the familiarity and stability of their former lives. The breakdown in health systems or services and support structures increases their vulnerability. As a result of violence and social upheaval, displaced adolescents face a host of difficulties that affect their sexual and reproductive health.
The stakes are highest for adolescent girls. In addition to increased exposure to rape and sexual violence, young women who have been uprooted from their homes often face economic strains and may be forced to trade sex to meet their basic survival needs. They may be exploited through trafficking or encouraged into situations of early marriage. Young girls also risk female genital mutilation (FGM), which is often carried out by community leaders in an attempt to maintain customs when cultures are compromised. Survivors who suffer this kind of trauma often have no one to turn to for help. Few programs focus on preventing sexual violence or offering protection and medical care for survivors.
The many reproductive health repercussions of conflict—such as limited access to condoms, high levels of sexual assault, fistula, early marriage, exploitation and negligible health care services—leave adolescents particularly vulnerable. In conflict or disaster-affected areas, adolescents are more likely to have unwanted pregnancies, experience challenges when faced with a complication during childbirth and contract sexually transmitted infections (STIs).
Access to reproductive health care and education is crucial for adolescents in crisis-affected settings. Adolescents should be made aware of their right to access these services—and so should parents and community leaders.
The Women’s Refugee Commission is working to improve the health and lives of crisis-affected adolescents by identifying needs and gaps in current services, and by supporting programs that provide vital access to sexual and reproductive health services and education.