Today, more than 50 million people around the world have been forcibly displaced from their homes, an extraordinary number not seen since the end of the World War II, according to a recent report from the United Nations High Commissioner for Refugees (UNHCR). At the end of 2013, 51.2 million persons worldwide were forced to flee their homes because of conflicts, such as those in Afghanistan, Somalia and Syria, or because of natural disasters and other catastrophes. If these people made up a single nation, it would be the 26th largest in the world. Among this staggering number of people made vulnerable by displacement, myriad needs compete for—and deserve—action. Not least among them is ensuring their sexual and reproductive health.
While the sexual and reproductive health needs of the displaced are often comparable with the needs of those in places where resources are scarce, displaced women and girls are particularly vulnerable to sexual violence and exploitation. It is essential that proper care—including emergency contraception and HIV prophylaxis—be provided to all victims of sexual violence. Additionally, for the many displaced people who find themselves cut off from their usual sources of family planning, contraceptive supplies must be made accessible. Failing to address these needs heightens the risk of unwanted pregnancy, which often results in high-risk births occurring in already chaotic settings or in abortions that too often are performed under unsafe conditions; it also increases the risk of HIV and other STIs.
These needs and others are identified in the Inter-agency Field Manual on Reproductive Health in Humanitarian Settings, a guide for those providing reproductive health services to displaced populations, developed by the Inter-Agency Working Group on Reproductive Health in Crises, a broad coalition of UN agencies, governments, donors and nongovernmental organizations. The manual pinpoints actions to be prioritized when addressing the immediate reproductive health needs of displaced people, including identifying who will lead health services provision and ensuring that those displaced know about available services. It also recommends that as situations stabilize, more comprehensive reproductive health care— including family planning, reproductive health care for adolescents, maternal and newborn health care, safe abortion care, protection from and a response to gender-based violence, and the prevention and treatment of STIs—be provided.
As UNHCR and the world cope with the growing number of forcibly displaced people, permanent and durable solutions must be the long-term focus. But as we respond to the needs of those who are newly displaced as well as the displaced in more stable settings, their sexual and reproductive health needs—like all their other urgent needs—must be effectively addressed.
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