UN Population Division, Department of Economic and Social Affairs,
with support from the UN Population Fund (UNFPA)
|
| 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
Mr. Gerald Walzer
The Deputy High Commissioner For Refugees
to the
Inter-Agency Symposium on Reproductive Health in Refugee Situations
Geneva, 28-30 June 1995
Madame Chairperson, Mr. Assistant Director-General, Distinguished
Colleagues and Guests,
I am delighted to address the Inter-Agency Symposium on
Reproductive Health in Refugee Situations and would like to focus
on three issues:
- today's refugee situation which provides the backdrop for this
Symposium;
- the importance of reproductive health to the overall health and
well-being of refugees, and
- third, the inter-agency nature of this symposium.
Madam Chairperson,
By the end of last year, the number of persons of concern to the
High Commissioner was a staggering 27 million; these included some
14.5 million refugees, over 5 million 2 internally displaced, 3.5
million others of humanitarian concern, mainly populations afflicted
by conflict, and some 4 million returnees requiring assistance to
re~integrate into their countries of origin.Similar to the
population at large, women constitute 50 percent of the refugee
population.In terms of age distribution, 20 per cent are children
aged four or under, while a further 30 per cent are between 5 and
17 years of age.Refugee women suffer most when reproductive health
services are unavailable, but reproductive health is not solely a
refugee women's issue; it is of consequence to the refugee
population as a whole.
Madam Chair,
At the International Conference on Population and Development
(ICPD), it was stated that refugees and displaced persons in many
parts of the world "... have limited access to reproductive health
care and may face specific serious threats to their reproductive
health and rights." The inadequacy, and in some cases even the total
absence of reproductive health care in a large number of refugee
situations, have serious consequences for millions of vulnerable
refugee women, men, and adolescents.It needs commitment on the part of
all of us to deal with this problem, and we see this symposium as
making an important contribution in this regard.
The ICPD Programme of Action provides a framework for addressing these
issues, and the preparatory documents for the Fourth World Conference
on Women encourage governments to make available information on
reproductive health and to ensure health education and access to
appropriate care.In preparing for this symposium, you have already
identified several aspects specific to formulating comprehensive
reproductive health programmes for refugee populations.
First, the increased vulnerability of refugees has been recognized.All
stages of the refugee experience - conflict, flight and exile -
exacerbate the risk of sexual and gender-based violence for refugee
women and girls.Sexual violence may lead not only to immediate
physical trauma, but also to the obvious risks of sexually transmitted
diseases, unwanted pregnancies, and long-term mental and physical
health problems.Just this month, UNHCR issued guidelines for
protecting and responding to the needs of victims of sexual violence,
and our colleagues at the preparatory meetings for this symposium
stressed the necessity of developing appropriate responses to prevent
sexual violence, and to meet the physical and mental health needs of
the victims.These should be an integral part of the overall
reproductive health programme.
A further component concerns the important relationship between
maternal health and child health in the context of the special
situation of refugees.Birth rates among refugees and people in
refugee-like situations are very often higher than among non
refugees.In view of the often crowded conditions in refugee camps, and
the increased exposure to malnutrition and epidemics, these high birth
rates further compound the risk of ill health or death for refugee
women.Thus, adequate pre-natal, delivery and post-natal care, as well
as appropriate child spacing counselling and services, are essential
elements of a comprehensive programme for reproductive health care.
Finally, far greater emphasis than hitherto has to be placed on
activities to combat sexually transmitted diseases and the deadly
HIV/AIDS pandemic.Many refugees, like the public at large, are unaware
of key facts regarding these diseases and measures which can be taken
to prevent them.
Madam Chairperson,
As this symposium gives shape and substance to reproductive health
programmes for refugees, allow me to offer a few other considerations.
First and foremost, we must learn from the refugees themselves how
best to meet their needs and we must be prepared to respond to the
needs which they express.Refugee participation will be absolutely
essential at all stages of reproductive health projects if we are to
succeed in offering appropriate and sustainable services.
Access to primary health care, including reproductive health services,
is a basic human right.The people we serve deserve to enjoy the right
to informed and free reproductive choice. Steps must be taken to
protect that right and ensure its fulfilment, through education and
provision of services; our obligation is to share knowledge and to
promote human development.
In view of the changing circumstances of our work for refugees, where
more and more activities are undertaken against a background of
conflict, one of the challenges for this symposium, I believe, will be
to formulate conclusions and to outline activities which advance the
reproductive health of refugees not only in stable refugee
environments, but also in emergency situations.
UNHCR's priority activities, particularly in emergencies, of course
must continue to address first the vital sectors of food, water,
shelter, sanitation and basic primary health care in order to save
lives.But simultaneously we need to focus on how to introduce
reproductive health activities as an important element of primary
health care for refugees.Whenever possible, we should also draw upon
and build upon national reproductive health programmes where they
exist in asylum countries.
Madam Chair,
The inter-agency nature of this symposium to which I referred earlier
reflects not only the complex and multi disciplinary nature of the
issues under discussion, but also the magnitude of the challenge
before us.More than 35 governmental, non-governmental and United
Nations bodies have actively participated in the preparations for this
symposium, amply demonstrating the importance of the issue.Let me
emphasize how very encouraging it is to see so many agencies involved
in this effort.There is clearly a common commitment to address the
issues, and the continuing collaboration between governmental, inter-governmental and non-governmental organisations is vital to achieve
the objectives both in terms of design as well as implementation of
successful reproductive health programmes in refugee situations. Each
and every one of you contributes important knowledge and expertise.
May this symposium be a creative and productive contribution to our
common endeavours.
Thank you.