Reproductive Services in Yemen

Source: Flickr "yemen2013_9"nkn

GLOBAL POLICY REVIEW

Keywords: Yemen, UNFPA, Women, Reproductive and maternal health services, War, Coronavirus

REPRODUCTIVE SERVICES IN YEMEN

UNDER THREAT OF CLOSURE

Why are they important?

By Pratha Garkoti

United Nations Population Fund (UNFPA), the sole provider of reproductive and maternal healthcare supplies in Yemen is being forced to suspend its services due to lack of funding amid Coronavirus. This could spell disaster for a war-torn and patriarchal country like Yemen, where gender-based violence (GBV) is a part of everyday life and gender equality is still a distant dream. The suspension has the potential to wreak havoc on the Yemeni women who are already suffering due to the ongoing war, displacement, food insecurity, famines, and diseases such as cholera and now the ongoing Covid-19 pandemic, all of which increase their vulnerability and negatively affect their reproductive and maternal health. This article analyses why the UNFPA services are important and how donor countries and the global community should do more than sending just their “thoughts and prayers” to help Yemen.

NEW DELHI, July 20 2020 – Yemen is facing the worst humanitarian crisis in the world. The situation is so horrifying that, according to sources such as UN, CARE, and Oxfam International, up to 24 million people, i.e. 80% of the total population require medical and humanitarian aid. The reasons for this crisis are many, but the underlying cause is the ongoing war between the Houthis and the 2

Saudi coalition since the last five years, which has led to more than 112,011 fatalities just from direct political violence events that include armed clashes, air/drone and grenade strikes, shelling attacks and suicide bombings, not including collateral damage. The image that automatically comes to mind through the mention of ‘war’ is very often of hypermasculine militaries fighting and bombing their respective enemies. But this simplistic imagery does not take into account the casualties that happen not only directly but indirectly as well, which is primarily why people assume that going to war with the enemy is the answer.

There have been several indirect effects of war in Yemen, for example, it has led to the displacement of more than 3.6 million people, of which three quarters are women and children. It has destroyed the limited Water, Sanitation and Hygiene (WaSH) infrastructure via bombings leading further to a cholera outbreak resulting in 2.2

million suspected cases and up to 3700 deaths since 2016. For a country that was already facing economic challenges like the ‘Triple F’- food, fuel and financial Crisis and unemployment prior to 2014, the war has worsened the hardships as poverty has increased from 47% in 2014 to 75% in 2019, with UNDP now predicting a rise up to 79% by 2022 if the war does not end. 20 million people are now struggling to access food and 10 million are at risk of famine, which has resulted in a stark rise in malnourishment amongst 3.2 million women and children.

Gender inequality in Yemen

Civilians suffer not only as collateral damage or due to the indirect effects of war but are very often directly and intentionally targeted in the form of bombing of residential areas, hospitals and schools, as well as acts of physical and sexual violence like rape, torture, kidnappings and abductions. We should not forget that when men go to the battlefields, it is the women and children who make up the majority of the major casualties of conflicts. Moreover, as the family ‘honour’ is often associated with the women in the families, this also makes them specific targets of rape, which is not only used as a tactical weapon of war to terrorise civilians but also to emasculate those men who fail to protect women. This is primarily why men are seen as the

“protectors” of the honour of the family, and a woman’s movement is controlled and restricted on grounds of safeguarding her, thereby also enforcing gender roles.

Yemen is a patriarchal society where gender-based violence in the form of child and forced marriage, rape, psychological abuse, domestic violence, denial of freedom of movement and resources was widespread even before the war, with 92% of women mentioning having experienced these conditions in the 2013 Demographic Health Survey. It has ranked last in the World Economic Forum’s Global Gender Gap Index for 13 consecutive years, which explains why it is also referred to as one of the worst places in the world to be a woman.

According to the UNFPA, violence against women has increased by 63% ever since the conflict began. There have also been reported cases of crimes against humanity committed by both the Houthis and the Saudis but the perpetrators go without punishment because of the prevalence of impunity during conflicts. Incidences like these are bound to have health consequences that can range from psychological trauma, unwanted pregnancies, sexually transmitted infections (STIs) and even disabilities in some situations. Additionally, the pervasiveness of victim-blaming is well-documented in these situations, which is why there ought to be safe spaces for women to avail reproductive health services.

Source: MOHAMMED HUWAIS/AFP via Getty Images

Role of UNFPA

Due to the ongoing war, only 50% of the country’s 3500 medical facilities are available and functional in Yemen presently. Out of these, only 20% provide reproductive and maternal health services, which is why UNFPA works jointly with the government, UN agencies and other partners to not only fund the pay of 3800 workers who provide care to women in these horrific situations, but to also ensure that the three key goals of “reproductive health” are fulfilled. These include preventing unwanted pregnancies, improving maternal health, and diagnosing and treating STIs like HIV/AIDS. In a crisis, 1 in every 5 women of reproductive age is likely to be pregnant, which is why many women's lives crucially depend on whether they can access these services.

According to UNFPA, there are 6 million women of reproductive age in Yemen, out of which 120,000 are at risk of violence and 1 million are pregnant. To reduce their vulnerability, UNFPA plays an important part in not only delivering ‘dignity kits’ that contain personal and menstrual hygiene items, but also emergency post-rape treatment kits and GBV services like psycho-social support, legal aid and safe spaces for the survivors. In addition to this, it also spreads awareness about these issues via education and tries to encourage men to understand and engage with GBV.

The onset of Coronavirus has unfortunately put an end to this success due to funding cuts which has caused the UNFPA to nearly run out of money. UNFPA is now also the frontline partner to the Covid-19 response, thereby responsible for providing reproductive services to women as well as protecting the health workers who are at high risk due to lack of personal protective equipment. It appealed for $100.5 million as the humanitarian fund for 2020, but has only received 52% of this appeal. Furthermore, the fund also requires up to $24 million to deal with the pandemic, as a result of which, the gap in humanitarian funding has risen to $68.4

million. This has forced UNFPA to close 140 out of its 180 services available in Yemen, which puts 320,000 pregnant women at high risk and has the potential to lead to deaths of up to 48,000 women due to complications in pregnancy and childbirth.

Looking forward

There is no denying that war affects men and women differently, but since the traditional understandings and explanations of war do not use gender as an analytical tool, the actual gendered experience is often ignored and marginalised, as a result of which gender equality automatically becomes secondary.

Violence against women is an everyday reality which is prevalent everywhere, be it the global north or the global south. This only exacerbates at times of crisis. Even the pandemic has led to an increase in cases of domestic violence all over the world. While there is no competition to see where women are suffering the most, it is not hard to grasp how difficult the situation is for women in Yemen. They need reproductive and maternal health services more than an already well-equipped country needing a fighter jet to boost its military and defence capabilities. We are no longer living in a world where our biggest threat is war for which we need to increase our defence funding. As we can see, we cannot bomb climate change or Covid-19 out of existence. However, according to the Stockholm International Peace Research Institute, 2019 still saw the largest annual increase of 3.6% in global military expenditure by reaching $1917 billion, wherein just five countries including the United States, China, India, Russia and Saudi Arabia accounted for 62% of the total expenditure. It is appalling to note that except for Saudi Arabia, none of these countries are on the 2020 humanitarian aid donor’s list made available by UNFPA. The list includes Canada, Japan, the Scandinavian countries, UAE, Netherlands and Switzerland, along with UNICEF and WHO.

It is evident that countries are financially capable of helping Yemen. If they can provide their weapons, intelligence, diplomatic and military support to the Saudi coalition that has been responsible for most of the civilian casualties in Yemen, the

least they can do is finance humanitarian aid. By not helping fund UNFPA at this crucial time, some of these countries are proving how reproductive services are treated as non-essential. Thoughts and prayers cannot prevent unwanted pregnancies, STIs or the expected deaths of approximately 48,000 women during childbirth. Moreover, there needs to be international and public pressure on several governments to support the additional funding of the UNFPA at this time through reiterating the importance of these reproductive services to women’s rights.

References

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