It’s been four years since a devastating earthquake hit Haiti, but for too many women and girls, internal displacement and poor health care access remain a fact of life.
Women and girls are disproportionately affected by natural disasters and both the immediate and long term impacts of displacement. Higher risk of maternal and neonatal mortality, increased risk of unwanted pregnancies and unsafe abortions, and increased vulnerability to sexual violence are just a few of the many health risks that increase when an emergency strikes.
A recent report from the Brookings Institution and the International Organization for Migration provides an important snapshot of these challenges experienced by internally displaced persons (IDPs) in Port-au-Prince. Among Haitian residents displaced in 2010, approximately 147,000 IDPs remain in camps; of those who do not currently reside in camps, 74 percent still identify as displaced.
Though the shrinking size of the IDP camp population reflects progress in the post-earthquake recovery efforts, life for many who have left the camps remains a significant challenge. The report found that the social, economic and health impacts of the earthquake persist and conditions are often worse for IDPs than the urban poor who remained in their homes. Sixty percent of displaced households felt their overall living conditions had gotten worse since the earthquake and 20 percent felt their access to health services had also worsened. This establishes an important context from which to define post-disaster recovery and create durable solutions to the residual effects of displacement.
As defined by the UN Human Rights Council, a durable solution is achieved when IDPs “no longer have any specific assistance and protection needs that are linked to their displacement and can enjoy their human rights without discrimination on account of their displacement.” An adequate standard of living, including access to health care, is a critical component of establishing a durable solution.
As the frequency and severity of natural disasters continues to rise, it becomes increasingly important for national governments and civil society in both the humanitarian and development sectors to understand and reduce the impact of sudden disasters on the provision of health services, including family planning, to IDPs. As the frequency and severity of natural disasters continues to rise, it becomes increasingly important for national governments and civil society in both the humanitarian and development sectors to understand and reduce the impact of sudden disasters on the provision of health services, including family planning, to IDPs. Effective disaster risk reduction strategies that incorporate sexual and reproductive health into emergency preparedness are the key to more inclusive and effective contingency and preparedness plans. In its last Strategic Plan for Reproductive Health (2008-2012) UNHCR highlighted the development and incorporation of reproductive health strategies and interventions into policies and programs for durable solutions as a main objective. However, how this integration has been implemented remains unclear.
Reproductive health is not just a matter of public health. It is a human right that must be protected and ensured in development and humanitarian practice, no less so in times of disaster. With this report, the Brookings Institution and International Organization for Migration continue to seek an answer to the question: how do we understand and implement durable solutions for urban post-disaster displacement crises? But a larger question remains unclear: how do we fully recognize and incorporate the role of reproductive health in durable solutions to protect the health of women and girls in need?