UN Population Division, Department of Economic and Social Affairs,
with support from the UN Population Fund (UNFPA)
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| UN Population Division, Department of Economic and Social Affairs, with support from the UN Population Fund (UNFPA) |
|
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This document is being made available by the Population Information
Network (POPIN) Gopher of the United Nations Population Division, Department
for Economic and Social Information and Policy Analysis, in collaboration
with the United Nations Population Fund Emergency Relief Operations.
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AS WRITTEN
Statement by
Dr Hu Ching-Li
Assistant Director-General
World Health Organization
to the
Inter-Agency Symposium on Reproductive Health in Refugee Situations
Geneva, 28-30 June 1995
Dr Nafis Sadik, Mr Gerald Walzer, Mr Christian Voumard, distin-
guished representatives, friends and colleagues,
On behalf of the Director-General of the World Health Organization,
Dr Nakajima, I would like to add my welcome to you all. It gives me
great pleasure to be here today at this important symposium which
brings together governments, agencies, and NGOs who have been in
the forefront of efforts to alleviate the suffering of the ever
growing millions of refugees and displaced people.
This meeting is an important one.It assembles, for the first time,
people with vast experience of working with refugees, people with
knowledge and expertise in various components of reproductive
health, and members of the donor community.This coming together has
been made possible, in large part, as a result of the efforts of
all those involved in the International Conference on Population
and Development where the two issues - refugees and reproductive
health - were brought forcefully to the international agenda.
The Programme of Action of ICPD stressed that reproductive health
and reproductive rights were inalienable human rights for all
peoples, of all nations and of all generations.It stressed that
Governments also have responsibilities to protect and assist
refugee and displaced populations, paying particular attention to
the needs of refugee women who are all too often subjected to
violence, exploitation and abuse.
Why are the reproductive health needs of refugees so important?
Part of the answer to this is that reproductive health is important
to us all - it applies to everyone, is an essential component of
general health, is central to human development and sets the stage
for the health and development of future generations. For refugees,
the ability to satisfy their basic needs, to protect their general
and their reproductive health and to obtain care when needed is not
simply important - it is a matter of life and death.
The burden of reproductive ill-health is largely borne by women who
run the risks related to contraception, to pregnancy and childbirth
and who are biologically and socially more vulnerable than men to
the consequences of sexually transmitted diseases including
HIV/AIDS. In situations of extreme insecurity, population
displacement, and family disintegration such as characterise the
refugee condition, the risks of reproductive ill-health become even
greater.
In the immediate emergency of a refugee situation, when agencies
and NGOs are struggling to provide even the barest minimum for
subsistence - food, clean water, sanitation, shelter - it is all
too easy to overlook reproductive health needs.Yet to do so is
effectively to condemn women, men and children to serious illness,
disability and death.
Refugee women need effective ways of protecting themselves from
unwanted pregnancy and sexually transmitted diseases.Refugee women
may, often as a result of violence, face an unwanted pregnancy and
seek to terminate it through an unsafe abortion with it attendant
risks. Refugee women continue to become pregnant and to bear
children, and need care during pregnancy and delivery so that they
can do so safely. Refugee women are particularly vulnerable to
sexually transmitted diseases, to rape and sexual abuse and may
need counselling, treatment and support.
Reproductive health has long been neglected because it deals with
sensitive social, legal and cultural issues. Dealing with such
issues among refugees has additional difficulties because there may
be special legal and ethical considerations related to both the
country of origin and the host country, and to the diverse ethnic,
cultural and religious background of refugees and indigenous
populations. Today's panel session on legal, ethical and human
rights issues will provide an opportunity to examine this in some
detail.
In the coming few days we will together look at what can be done in
practical terms to improve reproductive health in refugee
situations. What is possible during the different stages of the
refugee condition? What must be provided to ensure a minimum of
care?How can we ensure that the resources needed for such
interventions are available at short notice? How can we overcome
the infrastructure, logistic and managerial constraints which
render the provision of reproductive health care so difficult in
refugee situations?
These are difficult questions, but I am optimistic that by the time
we end our deliberations we will have made substantial progress in
answering them.Our objectives are to generate responses to these
questions and to develop pragmatic and feasible ways of
incorporating attention to the reproductive health needs of
refugees through a primary health care approach. The field manual
will permit those working among refugees to better respond to the
reproductive health needs of their constituents.
Finally, I would like to close with a special mention of the many
NGOs who are with us today. International agencies have
considerable experience of working through governments to develop
and implement programmes.But at the field level, when the emergency
first arises, it is often the NGOs who are best placed to respond
rapidly and flexibly. We count on hearing from you about the
difficulties you face and your suggestions for overcoming them as
we start our important work here today.