Berkley Center

13 million have been affected and 4 million displaced by Typhoon Haiyan.*

“We did not know this could happen. My brother asked me on the phone ‘What does storm surge mean?’ We had not experienced this before.”

Only 22 of 190 police officers and 20 percent of the health workforce in Tacloban are available to report to work.**

“Some of these areas, these islands, we haven’t even reached yet. We suspect the damage may be even worse.”

Rains. Winds. Calamity. Storm Surge. Flooding. Devastation. Water. Food. Shelter. Wreckage. Emergency and basic medical care.

“When the news stations stop focusing on this story, that’s when we’ll need those teams who are helping for the long haul, with issues such as primary health care, mental health, health system strengthening.”

After a disaster, a nation often enters a collective state of PTSD. The wreckage itself becomes the eye of the storm; conversations, extra change, prayers, all are sucked in, all revolve around the disaster.

The World Health Organization (WHO) releases leptospirosis fact sheets, and the Red Cross crams rice, noodles, cans, and water into sacks. However, in the wake of amassing foodstuffs and delivering immunizations, all do not suffer equally. All are not equally affected by the disaster. As health professionals gather their own dead, as every operation is an emergency, under an infinite time crunch, tens, hundreds of thousands are forgotten.

And when resources are limited, the first to be forgotten are the women. These numbers weave a different stories. In the impacted areas, 3 million women of reproductive age are left vulnerable. Two hundred thirty thousand pregnant women emerge from the wreckage. Twenty five thousand births are expected in just the next month, which in this region means 3,000 obstetric complications and 1,200 births requiring cesarean sections. And in the calamity, without the safety of shelter, with tensions and stress and violence escalating, 5,000 women will be subject to sexual violence.

Women are disproportionately affected by climate change and natural disasters, and yet their needs are an afterthought. Between 2007 and 2011, 62 percent of child marriages in Bangladesh took place in the year after Cyclone Sidr. During a severe drought in Kenya in 2012, sexual violence increased by 36 percent in the Hagadere and Kambioos refugee camps. After the 2010 earthquake in Haiti, 64 percent of 2,000 pregnant adolescentssurveyed indicated that their pregnancy was the result of rape.

Already, the voices are emerging from the rubble; one source indicates that criminals, having escaped from a devastated prison in Tacloban city, have been on the loose, raping displaced women. However, the threat does not merely come from prisoners, nor is it restricted to displaced peoples. Under the stress of strained resources and shabby conditions, domestic violence is expected to increase

To protect all vulnerable people, particularly women, there is a need to promote safety in the devastated areas, including shelters, lockable latrines, and adequate lighting. Local and substitute law enforcement officials and health professionals must be trained to address gender-based violence.

Women of reproductive age need access to family planning, including emergency contraceptives. Health facilities offering antenatal, delivery, and emergency obstetric care services must be restored, and in the meantime clean delivery and hygiene kits must be available to women who cannot access health facilities. To prevent the spread of HIV*** it is paramount that all blood products are tested and safe for transfusion, that people living with HIV do not have a disruption in their access to antiretrovirals, that condoms are available and accessible, and that pre-exposure prophylaxis is available for rape victims.

Of the $1.4 billion raised and devoted to emergency relief after the 2010 earthquake in Haiti, less than 1 percent was devoted to addressing violence against women. We cannot make this mistake again and lament the survivors retrospectively. While there are umpteen competing priorities, sexual and reproductive health, including the threat of sexual and intimate partner violence, cannot be ignored. ________________________________________________________

*as of Nov. 18, 2013

**These facts were stated at a staff briefing at the WHO’s Western Pacific Regional Office on Friday, November 15th, 2013, by Julie Hall, the WHO Representative to the Philippines.

***The Philippines is one of nine countries globally that saw a 25 percent increase in HIV infections between 2001 and 2011, while the rest of the world saw their epidemics stabilizing or decreasing.