Commentary: How to Better Protect Women in Emergency Situations


DECEMBER 10, 2015

When a 27-year-old mother from the Central Java district of Klaten went into labor on the evening of Oct. 26, 2010, Mount Merapi had just erupted and she was being evacuated from her neighboring home.

At 35 weeks pregnant, the woman struggled to find any medical help and was forced to deliver her baby in a car – with just the assistance of her family.

In a similar case in 2004, a woman had to deliver her baby at the top of a mountain after the Dec. 26 Indian Ocean tsunami swept through her village in Aceh, forcing her to flee through the forest to higher ground.

While both these mothers and their newborn babies were taken to a local public health center (Puskesmas) within 24 hours of giving birth to receive post-delivery care, their cases reflect a common situation that many women around the world may face during an emergency or crisis.

Women, children and young people make up, on average, over three quarters of the more than 50 million people who have been forcibly displaced from their homes by conflict and disasters in most parts of the world.

However, despite this figure, priority is often allocated to providing food, water and shelter in a humanitarian response, and the needs of pregnant women, women who have been sexually assaulted, or women who do not have access to basic hygiene needs are often overlooked.

Given Indonesia’s vulnerability to frequent emergency events – there have already been 1,219 disasters as of August 2015, according to the National Disaster Mitigation Agency (BNPB) – the United Nations Population Fund (UNFPA) Indonesia has incorporated a reproductive health and a gender-based violence prevention component into its humanitarian program since 2007 to ensure that these issues are addressed in the early phase of disaster response.

With 25 percent of Indonesia’s population women of reproductive age, at any given time, approximately 4 percent of the country’s population will be pregnant, and 15-20 percent of these women will develop pregnancy complications. These statistics mean that any disaster is likely to involve pregnant or post-natal women.

Following UNFPA Indonesia’s ad-hoc responses to the earthquake and tsunami in Aceh, and the earthquake in Yogyakarta in 2006, the agency formed a humanitarian unit in a bid to improve its emergency preparedness and response strategy. Since establishing the unit, UNFPA has worked with national and local partners to implement a globally recognized set of standards for life-saving reproductive health services in humanitarian settings, known as the Minimum Initial Service Package.

The agency also distributes much-needed hygiene kits to women – designed for pregnant, post-delivery and lactating women and also mothers with newborn infants – which include items such as sanitary pads, underwear and toothbrushes, along with reproductive health medical equipment to local partners when smaller-scale disasters strike, such as the flash floods in Wasior, West Papua, in 2010.

While improvements have been made to address these issues in Indonesia and around the world, comprehensive sexual and reproductive health services continue to be neglected in humanitarian response, reveals UNFPA’s flagship State of World Population 2015 report, "Shelter from the Storm."

With 100 million people in need of humanitarian assistance in the world today, of which a quarter are women and adolescent girls in their childbearing years, the annual UNFPA report outlines that sexual and reproductive health services are still underfunded.

The new report suggests that a new transformation agenda is needed to meet sexual and reproductive health needs in humanitarian settings, which places emphasis on prevention preparedness and building resilience of nations, communities, institutions and individuals.

A lot of work has already been done in Indonesia in preparation to provide sexual and reproductive health in humanitarian settings, but there is still a lot of room to do more. We can never be too over prepared for emergencies. We need to ensure that there are sufficient supplies and that there is readily available information and training.

Martha Santoso Ismail is the assistant representative at UNFPA Indonesia.