The Need for Priority Reproductive Health Services for Displaced Iraqi Women and Girls

Abstract

Disregarding reproductive health in situations of conflict or natural disaster has serious consequences, particularly for women and girls affected by the emergency. In an effort to protect the health and save the lives of women and girls in crises, international standards for five priority reproductive health activities that must be implemented at the onset of an emergency have been established for humanitarian actors: humanitarian coordination, prevention of and response to sexual violence, minimisation of HIV transmission, reduction of maternal and neonatal death and disability, and planning for comprehensive reproductive health services. The extent of implementation of these essential activities is explored in this paper in the context of refugees in Jordan fleeing the war in Iraq. Significant gaps in each area exist, particularly coordination and prevention of sexual violence and care for survivors. Recommendations for those responding to this crisis include designating a focal point to coordinate implementation of priority reproductive health services, preventing sexual exploitation and providing clinical care for survivors of sexual violence, providing emergency obstetric care for all refugees, including a 24-hour referral system, ensuring adherence to standards to prevent HIV transmission, making condoms free and available, and planning for comprehensive reproductive health services.

Reproductive health for refugees by refugees in Guinea III: maternal health

“…Age was explored because adolescents have specific reproductive needs that are often not as well-addressed as those of women 20 years and above [16]. For example, young mothers' physical immaturity heightens their risk of mortality or morbidity from obstructed labour, fistula, and premature birth [17].…”

Systemic violence against Syrian refugee women and the myth of effective intrapersonal interventions

“…For example in Jordan, when Iraqi refugees reported sexual violence, more than half of the rape victims were killed by family members. 27 In addition, the Lebanese authorities are making it increasingly difficult for Syrian refugees to renew their residencies, putting refugees at risk of arbitrary arrests, detention, and deportation, making it even more difficult for women to report rape. 28 This leads some Syrian women to quit their jobs or not take a particular job because their managers harassed them, instead of reporting the harassment.…”

“…In Lebanon, this leads many women to (re)marry into abusive relationships or polygamous marriages, a situation similar to that of Iraqi refugees fleeing to Jordan. 27 Although they know that the living conditions for them or their children will not improve, they seek the social protection provided by marriage. In the Middle East and North Africa, unmarried women's SRH needs, in and out of times of war, is traditionally absent from data collection, discussions, and interventions.…”

“…For example, an international organization working with Iraqi refugees in Jordan prevented access to maternal health services to pregnant women who did not have a marriage certificate. 27 According to UNFPA, unmarried women in developing countries face the pressure of dealing with a "socially unsanctioned" pregnancy, which increases their vulnerability.…”

Understanding sexual violence in armed conflict: cutting ourselves with Occam’s razor

“…For sexual violence in conflict, this means, for example, that essential services for sexual violence victims/survivors are largely unavailable, inaccessible, and inadequate (Chynoweth 2008;Hakamies et al 2008;Henttonen et al 2008;Krause et al 2015;Qayum et al 2013). As Wayte et al (2008) put it: 'there is a large gap between what is recommended and the reality in the field' (p. 90), even though sexual violence has severe physical, psychological, and social consequences for victims/survivors that extend to their families and communities-such as children born from rape (Isis-WICCE 2001; Krantz and Garcia-Moreno 2005;Longombe et al 2008).…”