What about women?

In the face of a dis­as­ter like Typhoon Haiyan, mat­ters like sex­ual and re­pro­duc­tive health fall by the way­side as sur­vivors fo­cus on sim­ply liv­ing day to day. one in­spi­ra­tional project is hop­ing to change that by help­ing gov­ern­ments and med­i­cal per­son­nel

The Star Malaysia - Star2 - - LIVING - By LIM CHIA YING star2@thes­tar.com.my

UN­DER nor­mal con­di­tions, a preg­nant women wouldn’t worry much about her de­liv­ery; af­ter all, in most ur­banised ar­eas, she would have ac­cess to a hos­pi­tal, ex­pert staff and all the nec­es­sary equip­ment when the time comes.

But imag­ine con­di­tions that are far from nor­mal. Imag­ine the fate­ful day of Nov 8, when Typhoon Haiyan made its cat­a­strophic way through the Philip­pines, flat­ten­ing, among other things, clin­ics and hos­pi­tals, killing med­i­cal per­son­nel and dam­ag­ing road in­fra­struc­ture – and thus trap­ping ex­pec­tant women far from any med­i­cal ser­vices.

Vil­lages and com­mu­ni­ties were wiped out in their en­tirety, al­most 6,000 peo­ple were killed, while the lives of 14.4 peo­ple were bru­tally dis­rupted; of that, over four mil­lion men, women and chil­dren were dis­placed (UN Of­fice for the Co­or­di­na­tion of Hu­man­i­tar­ian Af­fairs).

Ac­cord­ing to the Philip­pines’ Depart­ment of So­cial Wel­fare and De­vel­op­ment, an es­ti­mated 233,697 preg­nant women have been af­fected and crit­i­cally re­quire spe­cialised re­pro­duc­tive health ser­vices. In evac­u­a­tion cen­tres alone where the dis­placed are tem­po­rar­ily housed, the count of preg­nant women stood at 7,973 last month.

Yet in the af­ter­math of such dev­as­ta­tion, as sur­vivors des­per­ately scram­ble for ba­sic ne­ces­si­ties like food, drink­ing wa­ter and shel­ter, re­pro­duc­tive health needs are of­ten over­looked and take a back­seat to other hu­man­i­tar­ian pri­or­i­ties.

This ex­ist­ing gap in relief ef­forts is what the In­ter­na­tional Planned Par­ent­hood Fed­er­a­tion (IPPF) is ad­dress­ing. Specif­i­cally, the IPPF’s project SPRINT (Sex­ual and Re­pro­duc­tion Health Pro­gramme in Cri­sis and Post-Cri­sis Sit­u­a­tions) deals with things like the sup­ply of clean de­liv­ery kits for safe, hy­gienic and smooth de­liv­er­ies to re­duce the rate of ma­ter­nal and new­born mor­tal­ity and mor­bid­ity (the oc­cur­rence of disease/ill­ness in the mother or baby).

Sprint also con­ducts coun­selling ses­sions and post-rape treat­ment ser­vices for vic­tims of sex­ual vi­o­lence; the risk of sex­ual vi­o­lence to­wards both women and men have proved to in­crease dur­ing cri­sis sit­u­a­tions.

At a re­cent brief­ing in Kuala Lumpur, Sprint’s East and South-East Asia and Ocea­nia re­gion man­ager Dr Su­ba­tra Ja­yaraj said a US$200,000 (RM659,300) grant has been chan­nelled to the Philip­pines’ Fam­ily Plan­ning Or­gan­i­sa­tion, a lo­cal part­ner that the IPPF closely col­lab­o­rates with for this sex­ual and re­pro­duc­tion health pro­gramme.

The fund­ing amount, de­rived from an A$10mil (RM29.3mil) grant re­ceived from the Aus­tralian gov­ern­ment, is specif­i­cally meant to as­sist 60,000 ben­e­fi­cia­ries in barangays (vil­lages) and evac­u­a­tion cen­tres over a three-month pe­riod un­til Fe­bru­ary.

“Of the 14.4 mil­lion af­fected peo­ple, 25% are women who are of re­pro­duc­tive age, which is equiv­a­lent to 3.6 mil­lion,” says Dr Su­ba­tra, 31, a Malaysian med­i­cal pro­fes­sional with 10 years of ex­pe­ri­ence in com- mu­nity and so­cial health de­vel­op­ment work.

“This serves to in­di­cate the large num­ber of women who could get preg­nant by their spouses as peo­ple still have sex­ual in­ter­course even in times of cri­sis. There are also cases of un­planned preg­nan­cies es­pe­cially when con­tra­cep­tion is not used, or when a girl or woman is raped.

“Right now, it is es­ti­mated that 900 ba­bies are born daily in the typhoon-hit re­gions. But with lim­ited ac­cess to med­i­cal fa­cil­i­ties and aid, new­borns are ex­posed to the risk of res­pi­ra­tory com­pli­ca­tions and in­fec­tions, and moth­ers to child­birth com­pli­ca­tions and ob­structed labour that can re­sult in death.

“Yet th­ese deaths are mostly pre­ventable if a ba­sic and ster­ile de­liv­ery kit is avail­able. A sim­ple cloth can help warm the baby against de­vel­op­ing cold or hypo- ther­mia, while clean gloves can be used to con­tract a mother’s uterus to pre­vent ex­ces­sive bleed­ing post de­liv­ery.

“Th­ese life-sav­ing items are of­ten taken for granted un­til times of emer­gency, amid chaos and ru­ins, when we re­alise they are not read­ily ac­ces­si­ble,” she stresses, adding that even a clean blade makes a dif­fer­ence in en­sur­ing the um­bil­i­cal cord is cut with­out an in­fec­tion hazard.

At the same brief­ing, Sprint re­source mo­bil­i­sa­tion man­ager Azrul Mohd Khalib says this area of health­care is be­yond tra­di­tional health needs that are ad­dressed dur­ing a cri­sis.

“Sex­ual re­pro­duc­tive health ser­vice is one area that hasn’t been ad­e­quately recog­nised by hu­man­i­tar­ian re­spon­ders and com­mu­ni­ties on the ground. In the Philip­pines, it re­mains an on­go­ing chal­lenge, as ac­cess to re­pro­duc­tive health rights is of­ten faced with op­po­si­tion due to re­li­gious and cul­tural sen­si­tiv­i­ties.

“It can­not be em­pha­sised enough how es­sen­tial th­ese ser­vices are – past ex­pe­ri­ences in a cri­sis have shown that 15% of women giv­ing birth will en­counter life-threat­en­ing emer­gency sit­u­a­tions and more than 5% of them will re­quire a Caeasar­i­an­sec­tion,” says Azrul, 37, who is also Malaysian.

Then there’s also the is­sue of sex­ual vi­o­lence and ha­rass­ment be­ing ad­dressed by Sprint, as se­cu­rity and safety-re­lated prob­lems in­ten­sify when thou­sands of peo­ple ren­dered home­less by a dis­as­ter are crammed into a sin­gle shel­ter.

“Young women and chil­dren be­come sus­cep­ti­ble and vul­ner­a­ble to gen­der-based vi­o­lence. A sce­nario could play out some­thing like this: a girl is asked by her mother to fetch some tank for dis­tance ex­posed fact, on Haiyan, ser­vice through of­fer­ing ( as

con­ceive em­pow­ers un­equal

Life-sav­ing in­for­ma­tion: Preg­nant women and lac­tat­ing moth­ers at a re­pro­duc­tive health in­for­ma­tion ses­sion in the Taluk­san­gay barangay which they were also given dig­nity kits. The kits con­tain over 20 per­sonal hy­giene items like soap, sham­poo, san­i­tary nap­kins, a potty,

cloth called ma­l­ong (be­ing held up by the Sprint of­fi­cer) that Filip­inas use for ev­ery­thing, as towel, blan­ket, baby’s cra­dle, body Plan­ning or­gan­i­sa­tion of the Philip­pines

dr Su­ba­tra Ja­yaraj ex­plain­ing how a clean and ster­ile de­liv­ery kit can help save a mother’s and her baby’s life in times of cri­sis where such items are not eas­ily avail­able.

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