Darfur Crisis: Reproductive Health Care Needed

posted: July 4, 2004

The genocide in the Darfur region of Sudan has been called the world's greatest humanitarian crisis today; stories from the region paint a horrendous picture of suffering and cruelty. While the Khartoum government has been making humanitarian access to Darfur enormously difficult, the more than 150,000 refugees who have managed to escape to eastern Chad are also in dire need of assistance. In short, the international community is not providing enough support to ensure that the refugees who have fled get what they need to survive.

On a recent visit to eastern Chad, I saw thousands of refugees living in spontaneous settlements — huge groups of people huddled under a single tree with little food or water. There was almost no transportation to take them to the camps that are several days' walk away. I met two young sisters, Zeinaba and Salma, in one of these areas. They were living under a tree, along with others from their village, and said they didn't have enough food or water. Four children in their midst have died since they've been in Chad.

Zeinaba and Salma, like most of the refugees there, were surviving only due to the generosity of local villagers, who themselves had little food and water to spare. The lucky ones were those who made it to the refugee camps, where limited food, water and shelter were available. Conditions have improved somewhat since my visit, but with the rainy season now beginning and no sign of the violence ending in Darfur, there's no question that more of the one million displaced Sudanese will make the arduous journey to Chad.

One of the most disturbing aspects of the situation was the lack of reproductive health care available to the refugees. The systematic and widespread rape of women and girls in Darfur by the Arab militia, the Janjaweed, is well-known, but reproductive health care to prevent suffering from further trauma, including unwanted pregnancy and sexually transmitted infections, including HIV, or to address psychosocial needs is non-existent. Survivors had no way to report sexual abuse and exploitation. In addition, preventing maternal and neonatal mortality was not a priority. Visibly pregnant women were not given clean delivery kits and transport for women suffering life-threatening complications from pregnancy and childbirth was not always available.

It's impossible to know how many women have been raped, but a group of refugee men told us that more than 200 women were raped in their community and that every family had at least one woman – a mother, sister or daughter – who had survived rape. They described how the Janjaweed attacked their villages and abducted young girls and women and would rape them over a 3- to 4-day period and then return them to the village.

Clearly, reproductive health care must be an integral part of the emergency response in Chad. But it's not. What will it take to ensure that it is part of this response and in other future crises?

It will take more funding and a widespread recognition that reproductive health care is a basic right of women worldwide. For many women, it's as vital as food and water – particularly as rape is an increasing part of conflict today. To deny women reproductive health care at the outset of an emergency is to deny them their basic rights and quite possibly their lives.

The international community has issued minimum standards for the delivery of reproductive health in emergency settings. They address the prevention of HIV/AIDS and maternal illness and death, as well as the treatment of women who have been raped. Most agencies operating in Chad, however, are unaware of them. And funding for these priority reproductive activities is sorely lacking.

Action must be taken immediately to ensure that lifesaving reproductive health care is available to all refugees and the internally displaced. UN agencies and donors need to support international organizations on the ground to achieve this goal. Only when these services are provided, will the lives of refugee and displaced women and children begin to be protected.

Sandra Krause is the director of the Reproductive Health Project of the Women's Commission for Refugee Women and Children.