Humanitarian Assistance Should Include Aspects of Sexuality
Kollie, Sarah, von Roenne, Franz, Blankhart, David, Bulletin of the World Health Organization
Sir -- The recent article by Antequera & Suarez-Varela contains a comprehensive description of how a nongovernmental organization can tackle the health needs of displaced people in Rwanda (1). However, we were surprised by the omission of the reproductive health needs of the population in question. Only a casual reference occurred, concerning the availability of Caesarean sections.
The status of refugee women has long been recognized by the United Nations High Commissioner for Refugees, and attention to reproductive health needs for displaced people has been put firmly on the agenda. It must also be included in any analysis of the health needs of people affected by disasters and in consideration of action to overcome the difficulties. The United Nations Convention to eliminate discrimination against women requires all states to "help ensure the health and well-being of families, including information and advice on family planning" (2). Displaced persons should definitely not be excluded from such services. It might be argued that their need is even greater, as the desire to have children could be expected to be diminished and procreation postponed until more secure times.
Because of the breakdown of social fabric during emergencies and disasters, the risks of having unwanted pregnancies, being submitted to sexual violence, or contracting sexually transmitted diseases are considerable. An editorial in the Lancet, in 1993, pointed out that sexuality always remains an important issue in human life, even in refugee situations (3). …