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No Pills for Women in Refugee Camps

Written by Judy Waguma
For Rachel Woiyera, the 2007 elections is something she would have postponed if she was able to do two things: the power to foretell and stop what was going to happen.

With six months old pregnancy, Woiyera was blissfully waiting to deliver her third baby when one morning she was awaken with cries and fire everywhere.

Her neighbourhood in Kericho was under attack by people protesting what has come to be described as a deeply flawed presidential election. 

“The first thing that came to mind was to save my children, and we walked for a very long distance escaping from the heart of the conflict,” Woiyera recalls.

At one point she thought she was going to loose her baby. “Although I urgently needed prenatal care to protect my health and that of my unborn child, I could not get it.” 

After a long and arduous dash for their dear lives, Woiyera and her children landed at Jamhuri Camp in Nairobi, where other internally displaced persons were seeking refuge. 

Life for her since arriving at the camp has not been rosy, particularly when it comes to accessing reproductive health services. For now she does not know where she will deliver and under what conditions. 

“I am worried if I and my baby will survive,” says a visibly disturbed Woiyera. 

Part of her pain has however been assuaged by organizations such as MAP international, Red Cross, MSF and the Nairobi Women’s hospital, who continue to offer some essential services to women like her. 

Woiyera’s case is just one of the many cases of how Family planning pills and other commodities are like luxury in these camps. 

For them, these challenges have resulted in undesirable results: unwanted or unplanned pregnancies, which may in turn lead to unsafe abortions. 

Pregnant women who are HIV positive are finding it difficult to access antiretroviral drugs, making possible for them to pass the virus to their unborn baby, something they would have prevented.

“Those living in the camps are at higher risks of being infected with sexually transmitted infections (STIs) as well as gender-based violence,” adds Doreen Bwisa, a Programmes Officer at MAP International, who is coordinating Clinics at Internal Displaced Settlements.

According to MAP International, doctors are attending to over 90 internally displaced women every day, providing them with services ranging from family planning, prenatal and postnatal care, to management of sexual violence outcomes such as HIV prevention.

So far, over 300,000 Kenyans, majority of whom are women and children, have been displaced following the aftermath of the post election violence triggered by the disputed December 2007 Presidential results. Majority of them are finding it difficult to access SRH services.

A 2006 evaluation conducted by UNFPA and other UN agencies found that internally displaced people within different countries have the lowest access to reproductive health services.

Such reproductive health problems women in IDPs camps are undergoing have brought to the fore the painful issue of how relief agencies have failed to fully integrate SRH services within their mandate.

Such an intervention is crucial to ensure women in conflict scenarios are not denied their fundamental rights.          

But the United Nations Population Fund (UNFPA) says a lot has improved since 1990s when such services were not offered at all. Bwisa admits that, today, reproductive health services are becoming more available in conflict-affected settings than ever before. 

“Even though today, a displaced woman has a far better chance of having a safe pregnancy or receiving treatment for sexually transmitted infection than she did 10 years ago, there are still many who do not benefit from such services,” says Bwisa. 

The other problem displaced people within their own countries are still hesitant to use such services when provided in the camps. “For most them, the last thing on their mind is access to reproductive health care,” says Bwisa. 

Lucy Kiama, a programmes officer at the Nairobi Women’s hospital’s Gender Violence Recovery centre says little attention has been accorded to women who live in displaced camps. 

“They continue to have babies, or are at increased risk of sexual violence or HIV infection.”

 “We have come a long way though. We are seeing a growing awareness among humanitarian partners and donors on the need to provide reproductive health care in the displaced camps,” says Kiama. 

Studies done elsewhere agree. 

The 2006 evaluation by the Office of the United Nations High Commissioner for Refugees (UNHCR), UNFPA, Columbia University and other partners shows that reproductive health services for refugees have increased dramatically since the issue was first placed on the humanitarian agenda at the International Conference on Population and Development in Cairo in 1994. 

One of the key outcomes of the conference was the formation of a powerful coalition of United Nations agencies and non-governmental organizations dedicated to improving reproductive health for refugees. 

However, the difficulty involved in accessing reproductive health services combined with lack of sufficient funding, has made many women refugees to have limited access to such services or none at all. 

Teresa Mwenje who has been living at the Jamhuri Park says they have been finding it difficult to access sanitary towels and other basic necessities for the women. 

Meanwhile, reproductive health experts are warning that vulnerability to sexual and gender violence and sex for food in IDP camps may expose many women to HIV infections. 

Maternal and child mortalities are likely to go up as well. During flight and early settlement, women may be forced to give birth alongside roads, in forests, or in temporary shelters, with conditions hazardous both to them and their children.

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