Devastation in Nepal
When reflecting on the earthquake in Nepal, Sangita Rai, a staff nurse with Marie Stopes International recalled: “It was my first disaster. It was worse than whatever I heard on the television and from people. There was nothing left. Even buildings were on the road.” Rai, along with other Marie Stopes staff, had been trained in emergency care, including CPR, handling sexual assault and rape cases, as well as delivering babies. But Rai also realized that family planning was key, since the earthquake had greatly impacted women’s access to reproductive health services. “We provided contraceptive devices, implants, injectables and also supported delivery for seven births,” she said. “The most important is that we were able to provide them with regular family planning services during a crisis.”
The Need for Family Planning
There are currently 225 million women and girls in developing countries who want to avoid pregnancy but are not using modern contraception. Family planning is critical for preventing unintended pregnancies, maternal and infant deaths and unsafe abortions. Funding for international family planning enables the United States Agency for International Development (USAID), United Nations Population Fund (UNFPA) and implementers like Marie Stopes International (MSI) to deliver services that improve health outcomes for underserved women and girls. This funding also alleviates extreme poverty and improves women’s opportunities for education, employment and participation in their community.
In many countries, including Nepal, the ability of governments and health organizations to work together to quickly create the infrastructure to deliver reproductive health enables communities to receive lifesaving health care when disaster strikes. The reproductive health needs of girls and women do not cease when disaster strikes, and in fact become more acute. Women displaced from their homes cannot access their health centers for pre- and post-natal care, their pharmacies for contraceptives, or their providers for gynecological check-ups. Moreover, the network of reproductive health providers addresses the needs of communities beyond family planning to provide health care delivery in a crisis.
Added Vulnerabilities Following a Disaster
In April 2015, Nepal experienced a 7.8 magnitude earthquake which killed 9,000 people, injured more than 22,000 and affected 1.4 million women and girls of reproductive age in the 14 hardest-hit districts. In these settings, access to contraceptive care becomes more important than ever as women’s and adolescent girls’ risk of sexual assault and rape increases. Research shows that rates of sexual violence grow as families flee the safety of their homes, often to crowded camps or remote areas where they need to travel to access food, water or firewood. Remote communities already have limited access to health services and are disproportionately impacted following a natural disaster. When reproductive and maternal health services became increasingly inaccessible following the earthquake in Nepal, it was more important than ever that health organizations were able to reach women and adolescents in need.
Delivering Care After the Earthquake
The reproductive health network enables providers to reach women and adolescents in need. Immediately following the earthquake, a response team was formed under the leadership of the Ministry of Health and UNFPA, with support from various organizations including donor agencies and international implementers such as International Planning Parenthood Federation. In the following months, Marie Stopes provided reproductive health services to the most vulnerable clients, including counseling, general and gynecological check-ups, pre- and post-natal visits and safe deliveries.
MSI Nurse Anita Dhakal was providing outreach services for long-acting contraceptives before the earthquake hit, serving the areas in Nepal that were most devastated by the disaster. “People were suffering not knowing where their families were,” she recounted. “We provided services, but counseling as well. We had eight successful [newborn] deliveries. It was a huge impact. If we were not there, women would have traveled great distances to access basic health care and risked losing their lives.”
UNFPA, Marie Stopes, and other partners were able to deliver emergency care and family planning where there wasn’t an existing infrastructure or network in Nepal. Service providers like Nurse Anita have seen the positive impact first hand. “I still meet with disaster-stricken communities every day. They are still living under tents, but slowly they are trying to heal their pain and suffering, and we are seeing some reflection of smiles,” she said.
Funding and supportive policies for international development and family planning programs make a life-saving difference for underserved women and families around the world. Without it, healthcare workers wouldn’t have been able to reach vulnerable communities in Nepal, or in other high-risk environments like Pakistan, Afghanistan and Nigeria. We must prioritize women and girls’ health, including expanding access to reproductive health care that improves health outcomes and increases economic opportunity, every day – and when disaster strikes.
The views expressed in this article belong to the author and do not necessarily reflect those of Women & Girls Hub.