International Day of Action for Women's Health focuses on war crimes

During the brutal wars in Bosnia and Rwanda, the world was stunned to learn of the systematic use of rape as a weapon to terrorize an enemy. In the conflicts in Darfur and the Congo, rape is well-documented. Compounding the physical violation that women face is the reality that they may not have access to receive treatment for the consequences of violence.

Gender-based violence in conflict settings — or “Stop Conflict Being Waged upon Women’s Bodies” — is the theme for the 2008 International Day of Action for Women’s Health on May 28. The annual call for action was created by the Women’s Global Network for Reproductive Rights (WGNRR) in 1987. This year, WGNRR, in collaboration with its members and supporters, is calling on local, national and international actors to secure women’s reproductive and sexual rights, particularly for women in conflict situations.

Around the world, violent conflicts in recent years have given rise to rape camps, sexual slavery and forced impregnation or intentional infection with HIV.  According to the Reproductive Health Response in Conflict Consortium (RHRC) — a consortium of refugee and reproductive health organizations — when rape is used as a strategy of war to intimidate and traumatize a population, the perpetrators are enemy combatants; but the climate of lawlessness that accompanies armed conflict often provokes increases in incidents of sexual violence as well. Women are at risk not just from enemy groups. Human Rights Watch (HRW) has documented cases in which women in Darfur and Chad have been forced to submit to sex in exchange for ‘protection’ by police officers and male camp residents.

It is crucial that women who have been raped have access to comprehensive medical care. The Reproductive Health Response in Conflict Consortium created a “Minimum Initial Service Package” (MISP) to help guide humanitarian agencies to establish reproductive health services (including treatment for survivors of sexual violence) in camps for refugees or internally displaced persons (displaced populations that have not crossed a national boundary).  The World Health Organization (WHO) also has a clinical guide for treating rape survivors in conflict settings.

It is not uncommon for women who are raped to become pregnant. The consequences of an unwanted pregnancy resulting from rape are grave: women may be rejected by their husbands and communities, and without access to safe abortion care, they may turn to unsafe abortion to end the unwanted pregnancy. According to estimates from UNFPA, the United Nations Population Fund, 25-50 percent of maternal deaths in refugee settings are caused by unsafe abortion; compared with only 13 percent worldwide. Therefore the WHO clinical guide recommends that rape survivors in refugee and displaced camps have access to emergency contraception to prevent pregnancy, and that health-care providers be well informed about the abortion laws of the host country and the availability (if legal) of safe abortion services.

Sadly, few camps are equipped either with the technology or with the staff expertise to provide women with safe abortion services or postabortion care. In an assessment of sexual violence among the displaced people of Darfur in Chad, HRW noted that access to safe abortion for rape survivors was not openly discussed, even though rape is an indication for legal abortion in Sudan.

“In many countries where refugee or displaced women live, the laws permit terminations of pregnancy for some legal indications,” says Bill Powell, Ipas senior clinical advisor.  “In these cases, governments and implementing partners serving these women have an obligation to ensure that such services are safe and accessible. But for many refugee women, it is almost impossible to exercise the rights accorded to them under national and international laws and human rights documents.” 

Camp health services could treat the complications of unsafe abortion — or even provide safe abortion care — with affordable technology, such as the manual vacuum aspirator or medical abortion. Denying information about legal health services is a violation of women’s human rights to information and health care. And incorporating safe and postabortion care would require few additional resources. 

In the past decade, the world has taken notice of the prevalence of sexual violence as an act of war. Donor and humanitarian agencies need to take the lead in ensuring that survivors of sexual violence have appropriate and comprehensive health care, including safe abortion care.

The preliminary program for the upcoming Reproductive Health in Emergencies Conference, organized by the RAISE Initiative in collaboration with the RHRC Consortium, lists several sessions addressing abortion in emergency settings, postabortion care, and sexual violence. It is encouraging to see these issues highlighted in this important global forum.

For more information, contact:
Kirsten Sherk
Senior Associate, Media Relations
e-mail: sherkk@ipas.org
phone: 919.960.5612
fax: 919.929.0258