Populations that are displaced as a result of conflict face reproductive health challenges that require existent service delivery models to be adapted to suit their needs, especially those of women and girls.
In many parts of the world, women and girls in conflict zones find themselves victims of a silent war that infringes upon their sexual and human rights. According to statistics, 80% of all refugees and displaced persons globally are women and children, yet little funding and programming goes into addressing their requirements.
A UN report titled The Shame of War: Sexual violence against women and girls in conflict (PDF), released early 2007, says that "of all the abuses committed in war, rape is one specifically inflicted against women."
"The brutality and viciousness of the sexual attacks that are reported from the current conflicts in Democratic Republic of Congo, Myanmar, Iraq and Sudan, and the testimonies from past conflicts in Timor-Leste, the Balkans and Sierra Leone are heartbreaking," writes Yakin Ertuk, UN Special Rapporteur on Violence against Women in the foreword to the report. "Girls and women, old and young, are preyed upon by soldiers, militia, police and armed thugs wherever conflict rages and the parties to the conflict fail to protect civilian populations."
The victims are often afraid to report their rape due to social stigma and shame, the threat to personal security, or simply because there are no services available. As the report notes, women and girls lose their family and community after experiencing rape, due to feelings of shame and discriminatory attitudes. Their only option may be further victimization through sexual exploitation.
A major condition for the well-being and development of women and girls is their ability to exercise control over their sexual and reproductive lives. World Health Organization (WHO) describes sexual health as a state of physical, emotional, mental and social wellbeing in relation to sexuality; and not merely an absence of disease, dysfunction or infirmity. It implies pleasurable and safe sexual experiences that are free of coercion, discrimination and violence.
For women and girls in conflict zones, the consequences of rape are many: sexually transmitted infections and reproductive health problems, unwanted pregnancy, fistulae, maternal mortality, and HIV/AIDS, says the report. Female sexual vulnerability poses a grave public health problem, during the conflict and post conflict period.
Women and girls in conflict areas have a myriad of reproductive health needs that policymakers at national and international levels need to take into account in the design of programs. Programs may involve working with community leaders, men's and women's groups and the military to educate about the need to prevent the problem of sexual violence. Women and girls need to be empowered to be able to prevent themselves from becoming victims of sexual violence through economic empowerment and access to reproductive health services.
As Theresa McGinn succinctly puts it: "Understanding the ways in which refugee women's reproductive health problems are both similar to, and different from, those of women in settled populations can help policy makers and programmers."
Women and girls in conflict zones must have access to medical treatment, including access to drugs that can prevent sexually transmitted infections, psychosocial and legal support and access to abortion services to terminate forced pregnancies.
With conflicts popping up in every corner of the globe, there's need for more public discussion about how to bring much needed reproductive health and psychosocial support services to women in conflict areas.