SRH after natural disasters

Esita Dakuni, 20, and her 9 month old baby Elina Dakai were part of the group of women who fled from the church that they were using as an evacuation centre. Picture: JOVESA NAISUA

EACH time a natural calamity sweeps through a nation, the immediate response in the aftermath will be to secure shelter, food and water.

Facets of healthcare, including immediate medical assistance to anyone injured or suffering from disease, is administered based on need and urgency.

Yet, one key aspect of healthcare is often pushed to the back of everyone’s minds in times of disaster – sexual and reproductive health (SRH).

Keeping in mind the importance of this essential service, the International Planned Parenthood Federation (IPPF), through its sub-regional office in the Pacific, is working alongside nine member associations in the region to provide sexual and reproductive health services in the aftermath of natural disasters.

A report released by IPPF titled The Importance of Preparedness for an Effective Sexual and Reproductive Health Response in Emergencies: Insights from Fiji & Tonga found that Fiji benefitted from SRH services in both 2016 and 2018 in the aftermath of Severe Tropical Cyclone Winston and Tropical Cyclone Gita.

The report stated the IPPF team worked with the Reproductive and Family Health Association of Fiji (RFHAF) in Fiji to coordinate post disaster efforts in the Northern and Western divisions of the country.

A family health sub-cluster was also established with health services teams on hand to provide services during the initial stages of the emergency response. It was also the first time for such a subcluster to be put in place post-Winston.

Apart from this, women and girls were also provided with hygiene and dignity kits.

According to IPPF, SRH is impacted heavily during conflicts, natural disasters and public health emergencies. As a result, pregnant women may risk life-threatening complications without access to delivery and emergency obstetric care services.

This also extends to women and girls who may lose access to family planning services, which would in turn expose them to unintended pregnancy, sexual violence, exploitation and HIV infection.

For Sera Vulavou, the IPPF Pacific sub-regional office representative, the work done on the ground remains a challenging ordeal. This includes issues of geographical layout and access, steady supply of medicine and contraceptives and outreach.

Ideally, they would also like their teams to provide the same level and quality of care in rural communities as that received by a person living in Suva.

“For them, a lot of the challenges they face is the geographical layout of the country,” she says.

“Some have to spend so much funding in a year just to reach outer islands and a lot of expenses are spent on outreach. Supply is one of the challenges. We also provide family planning so we talk about condoms, IUDs, oral pills.

“A lot of these member organisations in the Pacific depend on their respective health ministries to supply the medicine free of cost and if the national level runs out, it affects the chain and member associations.”

She said the unpredictability of disasters also added on to the issue of supply and demand.

For now, IPPF is focused on assisting local member countries to respond efficiently and effectively to disasters. This includes provision of continuity of care and accurate data management.

In Fiji, the RFHAF is the SRH arm of the Ministry of Health. It is this team of nurses and workers who go out in communities before and after disasters to prep members of the public.

Clinic manager Sister Tarai Nakolinivalu says one of the key focusses of the team is to ensure proper quality of care is provided to women.

The team has also adapted to an electronic clinical management information system, which they believe will not only assist in the

effective management of confidential data, but also help reduce costs.

“We continue advocating for preparedness when it’s time for cyclone season because this is mainly for women’s and children’s health and that’s our focus,” she says.

With the onset of the 2022-2023 cyclone season, the team is already preparing for any potential natural calamity that may strike. Ms Nakolinivalu says prior to any cyclone season, her team goes out to conduct aware[1]ness on the importance of preparedness before disaster.

“When the cyclone comes, everything is interrupted. There’s breakdown of communication and that’s where we come in and also do response. “We see that SRH is a forgotten component of health. We work together with the Ministry of Health. They will come and at[1]tend to those who have cuts, who have bruises but you will hardly see them doing SRH and that’s where we come in to fill the gap.

“Some people say it’s not important but it’s very important during disasters. Probably there’s no food so we’ll wait for food to come but SRH will never stop. That’s the time there’ll be more pregnancy, sometimes un[1]wanted pregnancy.

“At that time too, sex doesn’t stop. Giving birth does not stop. It will happen during those times because it’s life so the only thing is we need to prepare the community well.

” She says teams like the RFHAF help to provide family planning and contraceptives and actively fill in to assist the Ministry of Health to support all angles of health during times of disaster.

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