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Family Planning in Emergencies: Urgent Need to Focus on Women Made Vulnerable by Humanitarian Disasters

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What are the first things you would grab if you were forced to leave your home tomorrow? Not many people would answer that question with "contraceptives".

As tens of thousands of Sudanese refugees continue to move across the border into South Sudan, fleeing from hunger and conflict in Blue Nile State, a great many women and girls find themselves vulnerable to unplanned pregnancies and are at serious risk of death or disability from complications during pregnancy, childbirth and unsafe abortions.

Sexual activity and reproductive health needs do not disappear in the midst of emergency. According to the United Nations, one in five women of childbearing age is likely to be pregnant in a crisis or refugee situation. When families are forced to flee their homes because of conflict or natural disaster, most do not get to bring their contraception with them. Organisations responding to humanitarian crises must ensure continuity in birth control, and respond to further demand for contraception for women who choose to delay pregnancy because of their increased vulnerability and their uncertainty about the future.

Too often, however, family planning is not highly prioritised among the myriad demands of an emergency response. The United Nations refugee agency, UNHCR has found that, contraceptive use and awareness of family planning methods are generally low amongst refugees, access to information is difficult, contraceptive stocks are insufficient or unpredictable, and that emergency contraception tends to only be used in post-rape care. At the same time, the risks of unplanned pregnancy only increase with trauma, malnutrition, and disease, while sexual violence, heightened during times of conflict and crisis, can result in large numbers of unwanted pregnancies. When access to quality medical care during childbirth is restricted, as it often is during emergencies, pregnancy can be fatal.

International Medical Corps prioritises access to family planning information and services in our emergency responses, so that women, who have endured highly traumatic experiences, fleeing their homes, facing constant insecurity and often caring for large families already, are able to have some control over whether they want to become pregnant.

As part of International Medical Corps' current response to the refugee crisis in South Sudan's Upper Nile State, we are providing family planning services within our primary health care package of services - including a place where refugees, including survivors of sexual assault and all those who are sexually active can come for counselling and contraceptives. Once the initial phase of the emergency is over, we will start community outreach activities in order to increase access to information on family planning services and the benefits of spacing pregnancy. Our approach recognises that a family in control of its reproductive future is better placed to recover quickly from the effects of a disaster and to remain resilient against future shocks.

My colleague Julie Taft, International Medical Corps' Reproductive Health Advisor explains it best:

"We should ensure women are able to make choices about their reproductive life at all times, but in disasters - when they are faced with so many uncertainties - it is one choice we should do our best to give. This is why International Medical Corps have made it an integral component of how we respond in emergencies."

As thousands of refugees arrive each day in South Sudan's refugee camps, delegates prepare to attend a major Family Planning Summit in London organised by The Department for International Development (DFID) and the Bill & Melinda Gates Foundation. The summit's aim is ambitious: to halve the number of women in the world who are unable to access contraceptives. We know however that many of the women without access to full family planning support live in countries where disasters, including conflict, are a regular reality. International Medical Corps asks delegates to the London Family Planning Summit to ensure that they are not forgotten and that the initiative being launched addresses the needs of women in emergencies and disaster-affected states.

Since 1984 International Medical Corps has been responding to humanitarian emergencies and supporting communities affected by disasters, conflict and poverty. We emphasise training and education, and prioritise hiring local staff - in fact, 96% of our field-based staff and health professionals are recruited from the local community. This helps to ensure that skills and knowledge are passed on and remain long after our programmes have ended.

For more information visit: www.internationalmedicalcorps.org.uk
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