UNFPA On the Front Lines for Women and Girls in Crisis
A new UNFPA project funded through FP2020’s Rapid Response Mechanism seeks to provide women with much-needed reproductive health services
By Guillaume Debar, FP2020 Manager, Rapid Response Mechanism
Since August 2017, violence in Myanmar’s Rakhine State has forced hundreds of thousands of Rohingya to seek safe haven across the border in neighboring Bangladesh. Nearly 700,000 Rohingya refugees are crowded into a refugee camp in Cox’s Bazar District that has already housed more than 400,000 Rohingya for over 20 years. As in the previous crisis, more than half of the refugees are women and girls. They have endured horrific trauma — including gang rape and torture, and many witnessed the violent murder of family and friends, as well as the destruction of their homes and communities. Their physical and mental health needs are urgent.
Government entities, UN organizations, and donor-supported NGOs are working diligently to provide humanitarian relief and support to this population. Individuals in Bangladesh and around the world are also stepping in, compelled to help by the immensity of the need. The UN estimates that almost a billion dollars will be needed just this year to feed, clothe, protect, and care for the Rohingya refugees.
As the UN’s lead agency for reproductive and maternal health, the United Nations Population Fund’s (UNFPA) response is centered on meeting the needs of women and girls: providing life-saving emergency obstetric and newborn care, medical treatment and post-trauma care for the victims of sexual violence, and other critical sexual and reproductive health services — including family planning.
There is an acute need for family planning services and supplies in humanitarian situations — and Cox’s Bazaar is no exception. In every humanitarian situation, women and girls are at increased risk of sexual violence and unintended pregnancy, and childbirth is fraught with danger. Providing voluntary access to modern contraception to all women in these settings — including youth and adolescents, and postpartum women as well as those who have recently had an abortion — is essential to protecting their health and respecting their fundamental human rights.
The Government of Bangladesh and UNFPA are at the forefront of this crisis, working to provide family planning services for the Rohingya refugees, but the challenges are immense. Cox’s Bazar is itself a district with high unmet need for family planning. Bangladesh’s already strained health infrastructure has been pushed beyond capacity by the massive influx of refugees. Linguistic and cultural differences between the Rohingya and their hosts further complicate the situation.
Providing voluntary access to modern contraception to all women in these settings — including youth and adolescents, and postpartum women as well as those who have recently had an abortion — is essential to protecting their health and respecting their fundamental human rights.
That’s why a new project by UNFPA Bangladesh, funded in part through FP2020’s Rapid Response Mechanism (RRM), is so important. Over the next year, UNFPA Bangladesh will employ RRM funds to build capacity and strengthen family planning services among both the Rohingya refugees and their hosts in the local Bangladeshi community. Moved by his view from the frontlines of the crisis, Dr. Abu Sayed Hasan, a Technical Officer for family planning and adolescent sexual and reproductive health at UNFPA Bangladesh, donated his thousand-dollar honorarium, awarded by the 120 Under 40 initiative, to the project. Dr. Hasan sees the gaps in reproductive health care that Rohingya women and girls face — and the project’s focus on developing sustainable interventions that are owned and implemented by the government of Bangladesh will help fill those gaps. These interventions can be scaled up in future to meet the needs of other marginalized groups in the country.
The project includes seven specific goals:
Train 160 service providers on rights-based family planning. The watchwords are informed choice: providers will learn how to counsel clients on the full range of contraceptive options, their effectiveness and suitability in various contexts, and any potential side effects. Providers will also be trained to identify cases of gender-based violence and make appropriate referrals.
Provide clinical training on postpartum family planning for 25 midwives. Almost none of the government health facilities in the refugee zone have the capacity to offer postpartum family planning services. The project aims to ensure that every facility has at least one trained provider who can offer FP counseling and services.
Print and distribute 200 family planning flip charts to aid health providers in their counseling sessions. These charts were originally adapted from the World Health Organization by EngenderHealth Bangladesh and translated into local Bengali dialects.
Create a short video in the Rohingya language (which is still largely unwritten) to increase awareness of reproductive rights, contraceptive options, and facilities in the area among refugees and local women. The government has an audiovisual van that will be used to screen the video in relief distribution areas twice a week, and possibly in other high-visibility locations.
Organize sensitization meetings and workshops with religious leaders, teachers, and scholars on family planning through the lens of Islam. The Rohingya had virtually no access to family planning or other health care in Myanmar, and there is uncertainty in their community about whether contraception is compatible with Islam. The project will enlist influential religious leaders to discuss family planning in terms of the Islamic responsibility to provide sufficiently for every child.
Advocate with the Bangladesh Ministry of Health and Family Welfare to ensure an uninterrupted supply of contraceptives in all health facilities, including non-government facilities. The Government of Bangladesh is already providing pills, condoms, and injectables to the Rohingya refugees, and as of last week has agreed to lift restrictions on the provision of long-acting reversible contraceptives (IUDs and implants). These contraceptives will need to be properly distributed to all facilities to avoid stock-outs and interruption of service — and health care providers will need to be trained to ensure proper use, counseling, and services.
Organize satellite clinics to reach Rohingya women with limited mobility outside their shelters. Fear of violence and a cultural emphasis on purdah mean many Rohingya women in the refugee camps are confined to their huts or tents. The project will mobilize 10 satellite clinics each month to bring family planning services and counseling directly to isolated women in the privacy of their own shelters.
The situation in Cox’s Bazar is urgent and the needs are vast. This project is one opportunity to reach the Rohingya women and girls with desperately needed care, strengthen family planning services for the local population, and support Bangladesh in this hour of crisis.
Visit www.familyplanning2020.org/rrm to learn more.
