Monday, January 25, 2010

Reproductive Health Care in Haiti is an Integral Part of the Picture

In the weeks following Haiti’s disastrous earthquake, the concerned global public’s awareness of reproductive health repercussions is critically relevant to the material aid reaching a vulnerable group of survivors on the ground in Port-au-Prince. The monetary and medical relief that is pouring into the country, much of it from United States citizens, has been phenomenal by all accounts. Where infrastructural chaos is not blocking supplies, it is resulting in significant respite to victims in Port-au-Prince. My response is, reasonably, one of awe and renewed faith in human altruism at this widespread generosity from afar.

Given such a moving incidence of compassion, I find it upsetting and inconsistent to come across information sources that seek to deny some of the most vulnerable of survivors in Haiti their most essential medical needs: reproductive health care. Vocal family planning opponents are not new players on the scene, and their detractions are generally too numerous to address individually. However, in this moment of human crisis on a massive scale, their self-righteousness must be exposed as deadly ignorance.

Life-threatening consequences of the 7.0 Mw earthquake come in many forms, including serious bodily injury, rampant infection, and dissolution of access to safe water and food. Of equally lethal threat, but often under the radar, is the health of what the United Nations Population Fund (UNFPA) estimates as 37,000 pregnant women among the survivors in and around Port-au-Prince. These women face “another kind of emergency, perhaps less visible but equally deadly, … when [they] are forced to give birth in unsanitary conditions and without access to medical care.” The UNFPA estimates that about seven thousand of these women will deliver in the next month and about 15% will require care for life-threatening-pregnancy complications. In these cases, reproductive health care services are not supplemental to relief: they are equivalent to relief.

The threat to these women’s lives and health in Haiti is not confined to complications of childbirth. Just as the vital needs of those who are sick and injured after a disaster increase, so also do the reproductive health care needs of women. The majority of deaths among pregnant women are due to hemorrhage, infection, miscarriage, prolonged/obstructed labor and hypertensive disorders, many of which could be avoided with medical care, according to CARE. The risk of such complications increases at all stages of pregnancy, and the risk of their occurrence skyrockets in the Port-au-Prince disaster zone. Pregnant women, as well as lactating women trying to safely feed their children, are particularly susceptible to illnesses spread as a result of unclean food and water and chaotic infrastructure. Additionally, considering Haiti’s average birth rate of nearly 4 children per woman, the likelihood that pregnant women surviving the quake have other children is exceedingly high. A great many of these women are sole or primary caretakers. Protecting women’s reproductive health not only means providing them with one of their most essential needs, it also means protecting the health and integrity of entire families.

Organizations responding to reproductive needs in Haiti comprise a critical piece of the relief effort there. The UNFPA is sending clean delivery kits, containing “a clean piece of cloth, a sterile knife to cut the cord, a cord clamp, a plastic sheet and so forth so that if they have to deliver where they are,” according to Dr. Jemilah Mahmood, chief of UNFPA's Humanitarian Response Branch, in an interview on United Nations Radio. They will also be distributing dignity kits, which contain sanitary napkins, soap and various other items of personal hygiene. The International Planned Parenthood Federation (IPPF) is working with its Haitian member organization, PROFAMIL, to provide crucial medical services in the form of temporary clinics, basic first aid, and obstetric and family planning services. Beyond material aid, these services will empower women to be in better control of their own and their families’ health and lives. Such empowerment will be essential to the rebuilding of Port-au-Prince long after the current flood of global resources has slowed to a trickle.

Perhaps the most disturbing aspect of criticism of reproductive health care relief services is that it undermines the overall global relief effort. While natural catastrophes happen every day worldwide, international outpouring of support is not a daily phenomenon. To discourage the public from supporting material, effective relief is counterproductive and tragically impedes the level of kindness that people are capable of. More practically and immediately speaking, it impedes the help that survivors in Port-au-Prince are able to receive. When donating to Haiti relief efforts, please consider supporting the efforts of UNFPA and IPPF as they perform a vital service for Haitian citizens in need.

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