By Liza Kane-Hartnett
Eclipsing men, women and children now comprise 55 percent of refugees entering Europe. The growing number of Syrian, Afghan, Iraqi, and other women making the treacherous journey into the European Union has placed a heightened focus on the unique risks facing women and girls during migration.
The increased occurrence of sexual violence and exploitation, unintended pregnancies and pregnancy complications, unsafe deliveries, maternal mortality, inadequate newborn care, early and forced marriage, and sexually transmitted infections like HIV necessitates a response that prioritizes sexual and reproductive health (SRH). The European Parliament acknowledged this in early March 2016 with the adoption of the report “on the situation of women refugees and asylum seekers in the EU,” which calls for full access to SRH services and rights, including access to safe abortion. Yet, even with recognition of the problem’s magnitude, SRH is too often overlooked and underfunded in emergency situations like the current refugee crisis.
Although the sexual and reproductive health needs of refugee women and girls are not being met on a broad scale, there are actors on the ground working to achieve this end. One method for addressing the gaps in SRH for refugees is the Minimum Initial Service Package. Developed in 2010 by the Inter-agency Working Group on Reproductive Health in Crises, the MISP is a set of actions meant to facilitate delivery of basic reproductive health services while planning for comprehensive SRH access. These services include prevention and treatment of gender-based violence, maternal and newborn care, provisions to reduce HIV, and increasing access to contraception, among other targets. Though the U.N. Population Fund (UNFPA) and other organizations work to ensure its implementation, it is unknown to what percentage of refugees it is currently accessible.
Mobile clinics operating in the Balkans have emerged as a valuable tool in the delivery of SRH services such as obstetric care and counseling for gender-based and sexual violence. They can be successful because they’re flexible and allow the aid to be as mobile as the population that requires the services. Unfortunately, there are few mobile clinics in operation and, according to the UNFPA, “quality sexual and reproductive health care is often scarce and hard to access.”
The lack of SRH access is particularly prominent in makeshift camps such as “the Jungle,” currently under destruction in Calais, and neighboring Grande-Synthe. With the French government neglecting the refugees on its northern coast, the camps’ management has fallen to nongovernmental organizations such as Médecins Sans Frontières that lack both the required funds and resources to provide necessary services. The result has been terrible public health conditions such as unsanitary toilet and washing facilities, heavy flooding, and minimal access to health care. For sexual and reproductive health, the MISP has not been implemented. This absence of even the most basic services within the camp means that women and girls need to travel four miles to the hospital clinic in Calais for prenatal care and access to contraception.
The case of Calais is important not only from a human rights perspective, but also as a starting point in the discussion of how to most effectively address SRH in the refugee crisis. As border restrictions continue to tighten and refugees in Greece appear stranded, the conditions in the overflowing reception centers and camps deteriorate. The European Union must support its commitments to women and girls by expanding access to sexual and reproductive health care for refugees within its borders.
To successfully reach the growing refugee population, funding for SRH needs to be both increased and sustained. Greater funding could help to implement the MISP in more camps and transit points along the current migrant routes. Expanded communication outreach efforts in locations where the MISP or additional services are available have the potential to increase awareness among both men and women of their health options. Part of this outreach is ensuring that there are enough Arabic and Farsi translators, specifically female interpreters. Though there are challenges to implementing MISP, its benefits can be lifesaving and should be given a greater focus in humanitarian aid. Additionally, while developing strategies to address the SRH needs of refugees, it is important to build upon successful initiatives and scale them up to reach a larger population. The mobile clinics are an example of such a program that, if expanded with proper funding and staffing, could effectively provide health care to refugee women.
Sexual and reproductive health is crucial to the overall well-being of women and girls, and its services take on a heightened importance for refugees due to the added risks faced during the migration process. Through additional funding and expansion of current services, the humanitarian community could build structures to deliver the necessary SRH services to today’s refugees and establish effective policies that are ready for the next crisis.
Liza Kane-Hartnett is a former editorial assistant at World Policy Journal and current M.S. candidate at NYU’s Center for Global Affairs. She can be found on Twitter @L_KaneHartnett.
[Photo courtesy of Russell Watkins/DFID]