In an earthquake, flood or violent conflict, immediate reproductive health concerns are the same: childbirth, sexually transmitted infections and sexual violence. When disaster strikes, precarious conditions multiply risk. Complications of pregnancy and childbirth are a leading cause of death and disease among refugee women of childbearing age. Since 1994, UNFPA has supported emergency reproductive health projects in more than 50 countries and territories.

• Women and children account for more than 75 per cent of the refugees and displaced persons at risk from war, famine, persecution and natural disaster. Of this population, 25 per cent are women of reproductive age and one in five is likely to be pregnant.

UNFPA supports early and effective action to meet the emergency reproductive health needs of refugees, the internally displaced and others affected by crisis. We work closely with governments, other UN agencies and NGOs in humanitarian responses to assist people suddenly deprived of life-saving care.

Reproductive health assistance, carried out with partners including the UN High Commissioner for Refugees (UNHCR), the International Federation of Red Cross and Red Cresent Societies (IFRC) and many other NGOs, has been provided in Albania, Angola, El Salvador, Eritrea, Ethiopia, Kenya, Kosovo, Mauritania and other sites of conflict or natural disaster.

Immediate Response

UNFPA provides reproductive health equipment and supplies to help fulfill the Minimal Initial Services Package (MISP) required in an emergency. Later, when the crisis subsides, UNFPA supports longer-term efforts to provide ongoing reproductive health information and services.

Pre-packaged emergency reproductive health kits are ready to ship to vulnerable populations in times of crisis. Priority areas for emergency response include:

• Safe motherhood through clean delivery, family planning and emergency obstetric care;

• STI and HIV/AIDS prevention, including information on universal precautions;

• Adolescent health;

• Sexual and gender-based violence, including training for counsellors.

UNFPA also conducts rapid assessments, supplies male and female condoms and contraceptives, trains health workers and counsellors, provides equipment and medicine, undertakes research and data analysis, and advocates for the reproductive health and rights of refugees and displaced persons everywhere.

Equipment and Supplies

UNFPA dispatched 44 shipments of emergency equipment and supplies to 24 countries and territories in 2001. Clean delivery kits, for example, have helped mothers deliver safely in emergency situations, providing soap, plastic sheeting, razor blades, string and gloves. Pre-packaged kits are prepared in advance to meet many needs: safe delivery, condoms to prevent HIV transmission and unwanted pregnancy, rape management, STI prevention and treatment, care after miscarriages and unsafe abortions, caesarian sections and blood transfusions.

Training/Capacity Building

Training not only improves the emergency response but also raises awareness of the need for reproductive health services in emergencies and helps rebuild the capacity of local health systems damaged or destroyed in emergencies.

To strengthen capacity at many levels, training is tailored to a number of audiences:

• UNFPA staff, to institutionalize an emergency response;

• Partners in UN agencies, NGOs and national governments, to recognize reproductive health needs in emergencies and coordinate a humanitarian response;

• Health workers, to provide higher quality reproductive health services to refugees and displaced persons.

Training sessions also prepare international and national participants to assess needs, plan and carry out projects, and monitor and evaluate progress.

Examples of UNFPA in Action

• In response to a major earthquake in Gujarat State, India, UNFPA dispatched emergency supplies and personnel, supported 12 mobile health clinics, provided counselling support and refocused ongoing programmes to help pregnant women and infants affected by the disaster.

• UNFPA supported training for some 90 relief workers and health professionals from more than 30 countries to ensure the full integration of quality reproductive health services in emergency situations.

• UNFPA supported a peer education programme in Bosnia and Herzegovina where more than 4,500 young people learned about reproductive health to promote positive and healthy behaviour in a complex post-war, multi-ethnic and multi-religious context.

• UNFPA launched its largest-ever humanitarian operation in September 2001, when hundreds of thousands of Afghans fled their homes to escape armed conflict. First priority was to assist the thousands of pregnant women among the displaced and refugees. UNFPA pre-positioned emergency relief supplies in the countries bordering Afghanistan. Initial support included clean-delivery supplies, support for border-area hospitals receiving referrals with pregnancy and childbirth complications, and counselling for victims of trauma.