Why climate disaster relief needs to include women’s reproductive health

As extreme weather events increase globally, so does the number of people forced to leave their homes in search of safety and assistance. 

Over the past decade, occurrences of floods, hurricanes and prolonged droughts have risen substantially. This trend, driven by a complex web of factors, including climate change, security and conflict and human activity, has left countless people globally with no other choice but to migrate within and across state borders.  

According to a recent report, 61 million new internal displacements were registered in 2022 worldwide, with more than half triggered by environmental shocks. This represents a 45% increase in the total number of internally displaced persons (IDPs) due to disasters over a two-year timeframe. 

Among those disproportionately affected, girls and women find themselves on the front lines of these twin crises. 

"The implications of displacement are inherently gendered," explains Jordana Ramalho, a lecturer in Development Planning for Diversity at University College London. She adds that, in the context of migration, women often face heightened risks of experiencing gender-based violence (GBV), food insecurity, income loss, unwanted pregnancies and more. 

"Women are more affected by disasters and climate change because they tend to spend more time in and around the home. Their gendered labours are intimately connected to that environment," Ramalho explains. 

Women and girls in fragile contexts are a uniquely vulnerable population.

Among the methods proposed by the Colombian Red Cross, subdermal implants seem to be the most common choice. According to the pilot study, they account for 87% of interventions, followed by trimester injections (6%), monthly injections (4%), and oral contraceptives (3%). The majority of women, typically between the ages of 18 and 35, appreciated the long term nature of the implant, as it does not necessitate overly frequent follow-ups after insertion. 

"Our target population prefers a method that doesn't require to be constantly attending the health centre because they don't have access to that," says Lucy Murillo, the health project manager for the German and Colombian Red Cross. 

The demand for implants has been overwhelming, Orduz recalls. The sheer number of women seeking this contraceptive method even posed time constraints on the nurse's ability to provide services to everyone. "When I was there, on average, I placed about 30 to 35 implants daily. Even if I attended to 20 women, 20 more would show up every day… I simply didn't have enough time."  

In their day-to-day work, care providers like Orduz address concerns regarding specific methods, along with societal norms and taboos surrounding sexuality and contraception. To tackle these issues, the nurses provided explanations and visual aids designed to educate and reassure women of expected side effects, and offered one-on-one counselling. 

"We noticed that the more education and clarity we provided to patients, the better their adherence to family planning methods," Murillo explains. 

In many cases, the nurse not only lends an attentive ear to patients but also pays attention to nonverbal cues that might indicate instances of GBV that might not otherwise be apparent and specify the need for protection needs which must be covered by the humanitarian community and governmental institutions. 

"Sometimes, I find myself acting not only as a nurse but also as a psychologist because what they [patients] seek is someone who will listen to their stories," Orduz said. "When it comes to recognising signs of [GBV], it's easy to miss certain cues if you're not meticulous enough. Paying close attention to these details is crucial." The range of services available to these women includes psychology and even awareness workshops on domestic abuse. 

Estefania Vasquez and Nayeli Yerineth Colina were both beneficiaries of the emergency planning module offered by the Colombian Red Cross in 2022. 

Vasquez, a mother of five and a migrant from Barquisimeto, Venezuela, shares that she and her husband decided to stop having children before she moved to Colombia. Despite enduring excruciating side effects ranging from nausea to dizziness, she opted for the pill in the absence of more affordable options available.  

Now that she has been administered an implant from the Colombian Red Cross, Vasquez says her mind is at ease knowing she won't have to concern herself with changing it for the next five years. Colina, also a Venezuelan citizen, expresses similar satisfaction with the care she received in Norte de Santander.

While there are no concrete plans to scale the Colombian Red Cross pilot study to comparable contexts, climate crises are likely to worsen over the next few years, with even more harmful effects on women, rendering the need for consolidated action more pressing.  

Estimates suggest that up to 216 million people could become internally-displaced persons due to climate change by 2050. Latin America, in particular, is a region where the likelihood and harmful effects of future crises could increase with no consolidated global policy response. 

Lyla Mehta, a professorial fellow at the Institute of Development Studies, University of Sussex, stresses that such action should have locally-led approaches at its core. She highlights the need for intersectional analysis to understand the diverse impacts of climate shocks on women, cautioning against portraying them as perpetually vulnerable. "Effective adaptation must be transformative and address systemic inequality across identities such as caste, class, race, and religion," says Mehta. 

Francisco Moreno, national executive director of the Colombian Red Cross, echoes Mehta's recommendations, adding, "this family planning module has allowed us… to advise on what is the most appropriate method. It is not the same for all women." 

"One of the main conclusions is the need to provide sexual and reproductive health and family planning in all emergency components," Moreno added. "It is a need that isn't always obvious [but] extremely necessary."