Protecting the Health Rights of Women and Girls in Emergencies

Lismiyatun was 35 weeks pregnant with her third child when Central Java’s Mount Merapi erupted in late October 2010.

Living just six kilometres from the crater, a 27-year-old Lismiyatun and her family had to evacuate their home on 26 October one day after the volcano first erupted. During the evacuation process that evening, the mother-of-two went into labor but struggled to find a village midwife or one at her local health centre – as they were all on standby at a neighbouring evacuation centre in the village of Dompol in the Klaten district.

With only the assistance of her family, Lismiyatun was forced to give birth in a car under extremely stressful conditions.


Lismiyatun and her son Yanuar Abu at the Kempalang Puskesmas in the Klaten District after she gave birth to him in a car after she was forced to evacuate from her home when Mount Merapi erupted in Oct. 2010. Picture: UNFPA Indonesia

“I was anxious and afraid to deliver the baby in such a dangerous situation,” recalls Lismiyatun, more than five years after the disaster, which killed 140 people and left hundreds of thousands of residents displaced.

After the birth of her premature son Yanuar Abu (abu means ash in Indonesian), she was taken to the Kemalang public health centre (puskesmas) in the Klaten District where she received the proper post-delivery care for herself and her newborn baby. While Lismiyatun’s case ended positively – her son is now a healthy five-year-old – her case reflects a situation which many women may face in the wake of an emergency or crisis.

Women, children and young people make up on average over three quarters of the more than 50 million people who have been forcibly displaced from their homes by conflict and disasters in most parts of the world. However, despite this figure, the needs of a woman who’s about to give birth, who’s been sexually assaulted or even just their basic hygiene needs are often overlooked, with priority often allocated to providing food, water and shelter in a humanitarian response.

Given Indonesia’s vulnerability to frequent emergency events – there have already been 1,219 disasters as of August 2015, according to the National Disaster Management Agency (BNPB) – UNFPA has incorporated a reproductive health and a gender-based violence prevention component into its humanitarian programme since 2007 to ensure that these issues are addressed in the early phase of a disaster response.

“Following UNFPA Indonesia’s ad-hoc responses to the earthquake and tsunami in Aceh (2005-2006) and the earthquake in Yogyakarta and Central Java (2006), the humanitarian unit was formed to improve its emergency preparedness and response strategy,” explains Rosilawati Anggraini, UNFPA Indonesia’s National Programme Officer for Humanitarian Response, who was part of the team who helped with the response in Mount Merapi in 2010.

“UNFPA works with national and local partners to implement a globally recognized set of standard for life-saving reproductive health services in humanitarian settings [Minimum Initial Service Package]. UNFPA also distributes hygiene kits, which include items such as sanitary pads, underwear and toothbrushes, and reproductive health medical equipment to local partners when smaller-scale disasters strike, including the flash floods in Wasior, West Papua.”


Today, Lismiyatun and her son Yanaur Abu – who is now five years old – still reside in the same village in the Klaten District. Abu means ash in Indonesian. Picture: UNFPA Indonesia

Since UNFPA Indonesia’s first delivery of hygiene kits in Aceh, three other specialized kits to meet the needs of different women have been developed; for pregnant women, for post-delivery and lactating mothers and one for mothers with newborn infants.

Despite improvements to address these issues over the years, sexual and reproductive health services continues to often be neglected in a humanitarian response, reveals the new State of World Population 2015, “Shelter from the Storm” report.

With around a quarter of the 100 million people in need of humanitarian assistance around the world today women and adolescent girls in their childbearing years, the annual UNFPA report outlines that sexual and reproductive health services are still underfunded.

“The business-as-usual approach to humanitarian assistance will leave too many behind at a time when needs are so great,” explains UNFPA Executive Director Dr. Babatunde Osotimehin, who emphasized that having the means to prevent a pregnancy and being safe from sexual violence were “basic human rights”.

“We need to do a much better job of helping the most vulnerable, especially adolescent girls. But we must also do a much better job of investing in a more stable world, capable of withstanding the storms ahead,” Dr. Osotimehin added.

The report suggests that a new transformation agenda is needed to meet sexual and reproductive health needs in humanitarian settings, that places emphasis on prevention preparedness and building resilience of nations, communities, institutions and individuals.

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