Sarah Costa

Reproductive health in a changing humanitarian climate

Watch Sarah Costa of the Women Refugee Commission discuss barriers to gender equality, sexuality and reproductive health in this #KAPTalks.

Thursday 21.02.2019

In her lecture, “Gender Equality and Reproductive Health in a Changing Humanitarian Climate” Sarah Costa discussed recent changes in the sexual and reproductive health of forced migrants. Before, during and after their migration trajectories, forcibly displaced people are vulnerable to harm in their sexual and reproductive health. Regardless of one’s legal status, everyone should get access to reproductive health services and information about their reproductive rights. Therefore, leading questions in this lecture were: can gendered migration dynamics have a transformative effect on people? How can institutions, aid workers and organisations collaborate on a stronger shared knowledge base regarding migration and reproductive health? And how can we create safe spaces where people can enjoy a safe and satisfying sex life?

Today, the humanitarian sector is confronted with many challenges. More than 69 million people are forced to leave their place of residence because of violence, persecution or  violation of their human rights. In addition to this growing number of displaced people,  the length of the displacement is increasing as well. Furthermore, an expanding number of people are fleeing to urban areas in search of employment opportunities and emergency services. On the other hand, wealthy nations are becoming more and more isolationist and borders are closing. Humanitarian resources are thus disproportionately overstretched and underfunded. Against the backdrop of all these challenges, Sarah Costa stressed the particular risks and vulnerabilities of women and girls. At least 25% of refugee women are of reproductive age, 14 % of these women are pregnant, and 15 % of these pregnancies will lead to life threatening complications. Nonetheless, a gender analyses is lacking in the design and implementation of most humanitarian programs. Costa pointed to the importance of  target group-oriented facilities for women and men. For example, migrant women are afraid to use latrines in refugee camps. No safe spaces are established, leaving women vulnerable and exposed to violence. Moreover, humanitarian programs should not solely focus on supplying reproductive health services, working on women’s social and economic empowerment in the humanitarian field is at least as important.

Despite these intersectional vulnerabilities of forced migrants and refugee women, transformative change is achievable. In her lecture, Sarah Costa listed eight strategies that can contribute to transformative and positive practices. First off, Costa referred to a necessary shift in our discourses about migrants and practices towards them to adapt to the changing experiences of forced migrants. Displaced people are not merely victims in need of assistance and humanitarian care. Rather, they must be regarded as survivors with strengths, skills and capacities that can be tapped and supported. Second, the social and political field should stop treating the so-called ‘migration crisis’ as  short-term problem, instead long-term programs must be supported. Sustainable capacity building programs will stimulate local economies. Third, humanitarian actors must involve women and support women’s participation. Migrant women can offer unique insights in limitations and opportunities of existing humanitarian programs. Fourth, local women’s organisations can play a powerful role in developing accurate services for women. Their contribution is too often ignored or sidelined by international aid organisations. Therefore, allocation funds need to strengthen their capacity and leadership. Fifth, along with local women, local capacity must be supported. Favourable framework guidelines have been set by humanitarian organisations, but implementation of these guidelines remains poor. Sixth, the humanitarian and development actors must improve their partnership relations. Although organisations in both fields share many common goals, they remain often separated. Seventh, it is necessary to focus on empirical data demonstrating the impact of a gendered-based approach. Without data it is impossible to demonstrate and evaluate the advantageous results of gender-based programs. Lastly, increasing accountability of humanitarian actors by donors with regards to the integration of gender perspectives in all aspects of their work. Local organizations again can play an essential role in evaluating whether their needs are being answered.

In a panel discussion after the lecture, Ines Keygnaert (Assistant professor in sexual and reproductive health an Ghent University) talked about the sexual and reproductive health context for forced migrants in Belgium. In her contribution, she emphasized that sexual and gender-based violence continues when migrants arrive in ‘host’ countries. Keygnaert pointed f.e. to the maternal mobilitiy problems women face. European rules about access to safe delivery for all migrant women is being turned back in more and more countries. Childbirth is no longer regarded as an urgent medical intervention. More generally, she underlined the importance of providing assistance regardless of legal status. This principle lay at the basis of the recently started sexual assault care centre in Belgium.

In their concluding remarks, Keygnaert and Costa stressed that both the accountability and gender-sensitivity of humanitarian organisations have to be strengthened to protect the reproductive health of refugees and migrants.

Organized in partnership with:

Sarah Costa is the Executive Director of the Women's Refugee Commission (WRC), a leading global organization advocating for the rights and protection of women, children, and youth displaced by conflict and crisis. Under Sarah’s leadership, WRC has expanded its ability to ensure refugees’ right to sexual and reproductive health care, to safety from gender-based violence, and to economic and social empowerment. Before joining WRC in 2010, Sarah served as regional director of the Global Fund for Women, a grant-making organization that supports women's rights organizations working on economic security, health, education, and leadership. Previously, she was a program officer for the Ford Foundation in Brazil and New York, developing and managing international and national programs on gender, sexuality, reproductive health, women's rights, HIV/AIDS, and health policy.

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