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  • Notes from the Field: Improving Women’s Health in Haiti

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    As you drive away from the airport in Port-au-Prince, Haiti’s capital city, tarp-covered shelters spread out in all directions. Across the country, these flimsy settlements are still home to some 600,000 Haitians displaced by the January 2010 earthquake.

    A year and a half after the disaster, Haiti is still very much in crisis and its population as vulnerable as ever. As after any emergency, people try to continue with their daily routines: traveling to and from jobs in whatever mode of transport is available, visiting with friends and buying food at local markets. But this belies the fact that the country is still severely fractured by the devastation experienced 20 months ago. Amidst the damage, community-based organizations (CBOs) and international humanitarian agencies continue their efforts to rebuild Haiti and to better prepare the country for future disasters.

    Even before the earthquake, Haiti was the most dangerous place to give birth in the Western hemisphere. Today, maternal health services are even harder to access. When disaster struck, at least 63,000 pregnant women were affected, and the country’s weakened health sector was unprepared to care for them in the earthquake’s deadly aftermath.

    Sexual and reproductive health needs are great, and the risks high in Haiti. Sexual violence increased to alarming levels during the chaotic weeks and months that followed the quake and continues to be pervasive today—including sexual abuse and exploitation by those meant to protect. In the hopes of providing Haitian women with better reproductive health care in emergency settings, the Women’s Refugee Commission has joined with other international humanitarian partners and local organizations to address this urgent gap.

    I traveled to Haiti at the end of June to co-facilitate a workshop coordinated by the Women’s Refugee Commission and the UN Population Fund (UNFPA) on the Minimal Initial Service Package (MISP), a set of guidelines for meeting sexual and reproductive health needs in times of crisis. The package highlights strategies to plan for and provide comprehensive sexual and reproductive health services—which save women’s and children’s lives, prevent sexual violence and reduce HIV transmission during the first days, weeks and months of a natural disaster or armed conflict. The Women’s Refugee Commission has promoted the MISP as a core aspect of our reproductive health program since the 1990s, and we’ve conducted similar trainings all over the world. 

    This workshop was unique, however, because many of our participants were drawn from CBOs that work on behalf of Haiti’s most vulnerable populations—women and youth, people living with HIV/AIDS, lesbian, gay, bisexual, transgender and intersex individuals, and those with disabilities. By empowering these local groups with a greater knowledge of reproductive health issues and the best ways to respond in a crisis, communities across Haiti will be better able to care for pregnant women and newborns and to promote sexual health in any emergency. One participant noted, “After this training, I will think of the needs of all the community members, especially the ones who are powerless.”

    More than 20 local organizations and international agencies were represented at the MISP training. One of the attendees reflected, “This mixture of participants from community-based and international NGOs [nongovernmental organizations] has been very successful. I would like this representation preserved for future trainings.”

    During this workshop, I was inspired by the energy and dedication that CBO members bring to their work, the keen understanding they possess of their communities’ vulnerabilities and the untapped potential that exists at the local level. I was reminded again and again of the critical role that communities and CBOs can play in planning for and responding to emergencies. The entire humanitarian response benefits from their participation and local perspective; they are doing important work to restore Haiti and to improve the sexual and reproductive health of the most vulnerable.