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Sexual and Reproductive Health and Rights

Notes from the Field: Community Comes Together to Plan for a Safer Future

Listening to a live band cover a Frank Valli song at an outdoor basketball stadium surrounded by palm trees is not my normal Monday morning. But that was how my Monday began recently on a trip to the Philippines. My colleague Jennifer Schlecht and I were at a team-building meeting for several hundred local government officials in Mindanao, an island an hour and a half north of the capital, Manila. Mindanao is a lush tropical island, with a gorgeous coastline and waterfalls. But it is also home to multiple rebel groups. And in December 2011, the island was hit by Tropical Storm Washi, which forced over half a million of its inhabitants from their homes, with little or no access to basic services and health care. Many fell victim to the chaos that ensued—especially women and girls.

When, three months later, nearly 300,000 people remained in temporary housing in camps, the UN Population Fund (UNFPA) asked the Women's Refugee Commission to travel to Mindanao to train local government and groups to ensure that the reproductive health needs of women and girls were being met and to help better prepare communities for future emergencies.

After the meeting that Monday morning (where the singing went beyond the Four Seasons and included the Filipino National Anthem, as well as the local city anthem), Jennifer, WRC’s senior officer for our reproductive health program, and I met with city councilors—including a young woman who is active on the women’s committee. They raised their concerns about the health and welfare of women and children as a result of the ongoing displacement. They are committed to putting strong systems in place to avoid such widespread displacement and risks in the future, which was reflected by the dedication of the local people who participated in our training.

Police officers—including a young dynamic advocate for women’s and children’s protection—nurses, social workers, youth volunteers, housing officials and even the coast guard enthusiastically participated in our training. They created community maps showing which areas of their city were most vulnerable to disasters, where reproductive health resources were available and where the needs would be most critical after a natural disaster. In crisis situations like these, gender-based violence tends to increase. Participants shared their concerns about the causes of such violence and their ideas about how to fight it. Jennifer introduced the Minimum Initial Service Package (or MISP), the basic components of sexual and reproductive health care that should be available to women from the onset of any humanitarian emergency. The group spent much time over the three-day training reviewing the protocols and structures that exist to ensure the MISP is implemented.

During one of our breaks, a woman who had just graduated from nursing school shared her experience of providing family planning services in Mindanao with me. She has been volunteering with UNFPA for six months, acting as a community health care worker. She provides contraception—including male and female condoms and birth control pills—to women in Mindanao. Despite some public disapproval of these methods, most women are very receptive and used the contraceptives supplied by UNFPA. But it is more often the case that access to contraceptives is limited. The Philippines suffers from lack of funding for health care and poor infrastructure. This lack of support also means that there are over 300,000 unemployed nurses in the country. The fact that there are so many well-trained health care personnel unable to practice—when the need is so great—is heartbreaking.

In addition to learning about unmet family planning needs, we heard that women in remote areas in Mindanao (referred to as the hinterlands) do not have enough clean birthing kits. In fact, most hinterland villages are only visited by a nurse once a month, and the health facilities do not have enough supplies or medication. One older participant repeatedly voiced her concerns about rural women’s lack of access to family planning and safe facilities to give birth. She was so informed that I assumed she was a health care worker. In fact, she was a city agriculture worker. But her extensive travel in rural areas made her acutely aware of women’s unmet reproductive health care needs—with which she had become increasingly concerned. I learned that outside of cities, health facilities do not have sufficient supplies to help women safely deliver their children. Actually, women in the hinterlands are lucky if they are able to walk to the nearest health center to deliver. Some cannot make it and so are forced to give birth at home with access only to traditionally trained birth attendants—who lack knowledge of clean and safe delivery methods.

In a few short days, we learned a great deal about the specific local reproductive health needs of the women and girls of Mindanao who were displaced by December’s tropical storm. And we went away having worked directly with numerous individuals who were true reproductive health champions. These were men as well as women. And they were not just health care workers: they were housing officials, law enforcement officers, agricultural workers, even veterinarians. They came in knowledgeable and concerned and left with greater levels of awareness and eagerness to help secure reproductive rights for the women and girls in their community.

Sexual and Reproductive Health and Rights