Beyond Bullets and Bombs: The Critical Need for SRHR in Conflict Zones

Mahatma Gandhi once said, “An eye for an eye will only make the whole world blind”, to express the atrocious and vengeful nature of war and conflict. The world tends to be even more ignorant towards Sexual and Reproductive Health and Rights (SRHR) of women and adolescents in conflict, forced displacement, and humanitarian crises.  These settings disrupt and limit their access to healthcare, increasing their vulnerability to sexual violence, trafficking, and forced marriage. Whether it’s the struggles of Rohingya refugees, communities that face the horrors of Al-Shabab, the hostages of the recently fled Bashar al-Assad, the struggles of Ukrainian refugees, or the perpetual monstrosity faced by Palestinian women,  these demographics are exposed to unintended pregnancies, unsafe abortions, and high maternal mortality. The world has been in consensus since 1994 that SRHR is a vital requirement, and yet it is hindered by factors like collapsing health systems, unsafe conditions, healthcare worker shortages, high costs, lack of information, and fear of violence.

Let’s look at this through the lens of the Sustainable Development Goals. A study found that, among 54 countries off track for achieving SDG targets for neonatal mortality, 40% are considered fragile or conflict-affected. Moreover, the situation of Maternal Mortality also looks grim, as another research concluded that an estimated 60% of preventable maternal deaths occur in conflict-affected settings, where maternal mortality rates can be twice as high as those in stable regions.

Apart from the obvious lack of access to maternal healthcare, family planning, and emergency obstetric services, women are also burdened with something that has always been a horror for conflict-affected areas, and that’s gender-based violence. In Audrey Hepburn’s words, “In war, women and girls suffer the most.” Women and girls subjected to exploitation and abuse often suffer unintended pregnancies, sexually transmissible infections, and psychological trauma that refuses to let go for ages.  In conflict settings, an uncomfortably overwhelming number of parents, driven by economic insecurity or efforts to protect their daughters from violence, decide to forcibly marry off their daughters at an early age, and they often result in early pregnancies.

Even after the United Nations General Assembly attained an overwhelming majority to recognise Palestine as a state, including the recent recognition from the UK, Canada, and Australia, Palestine continues to be bombed, and yet the politicised UN Security Council fails to bring peace to Palestine. Like the conflict situations in the Middle East and North Africa (MENA) region, the situation in Palestine is not hopeful either.  In an environment where living another day is a struggle, inaccessibility to reproductive health services and the absence of the enjoyment of sexual and reproductive rights in Palestine do not seem to bother the international community at this point.

Across war-torn regions like Sudan, Libya, and Syria, the simple, life-affirming events of childbirth and menstruation become fraught with danger. A complete breakdown of healthcare infrastructure means that clinics are often destroyed, medical supplies are scarce, and qualified personnel have fled. Women are forced to give birth without assistance, risking life-threatening complications like obstetric fistula and haemorrhage.  This unfortunate lack of healthcare services, amplified by life-threatening situations are violation of human rights, to say the least. 

Amid this chaos, health workers emerge as unsung heroes. With limited resources and under constant threat, they risk their lives to provide essential care, delivering babies and distributing crucial supplies. Their unwavering dedication improves SRHR conditions, offering a glimmer of hope and dignity in the darkest of times. 

SRHR is not a secondary concern to address after the conflict. We must understand that it is a fundamental pillar of human rights that has to be upheld before and during the chaos. The global community must come together to ensure that the words of Gandhi do not ring true for the world’s most vulnerable.

Sources:

1. A Research Prioritisation exercise for R2HC: Sexual and Reproductive Health and Rights (SRHR) in Humanitarian Crises – What evidence is missing to improve future policy and practice?
2. Women’s sexual and reproductive health in war and conflict
3. Women bear a disproportionate burden of war
4. Collateral damage: the overlooked reproductive health crisis in conflict zones