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Reproductive Health Matters
An international journal on sexual and reproductive health and rights
Volume 16, 2008 - Issue 31: Conflict and crisis settings
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Original Articles

Guidelines for Gender-Sensitive Disaster Management by Asia Pacific Forum on Women, Law and Development A Revolutionary Document

Pages 153-158 | Published online: 28 May 2008

In 2000, at a special session of the UN General Assembly, “Gender equality, development and peace for the twenty-first century”, the inefficiencies and inadequacies of existing approaches and intervention methods in responding to natural disasters were highlighted, and the unambiguous need signaled for gender perspectives to be incorporated whenever disaster prevention, mitigation and recovery strategies were being developed and implemented (p.2).Citation1 The Commission on the Status of Women further recognised in 2002 the importance of gender in the construction of social vulnerability before, during and after disasters (p.2).Citation1

Those working in the relief and development worlds have long recognised the devastating effects of natural disasters on women. However, while food aid, water and sanitation remain vital first responses to humanitarian crises, health and other services specific to women as an additional priority measure, although increasingly recognised since ICPD, are only sporadically put in place. The reality of this situation was underscored in the responses to the 2004 Indian Ocean tsunami and the 2005 northern Pakistan earthquake.

Women working in organisations and groups involved in relief rehabilitation and reconstruction efforts in the affected countries confronted a significant pattern of gender exclusion and violations of women’s human rights in the aftermath of these disasters. Given the gravity of the violations and the extent of marginalisation and exclusion of women from the rehabilitation process, members of the Asia Pacific Forum on Women, Law and Development (APLWD)Footnote* came together “to register their deep concern, to inform the United Nations about women’s specific needs, and to make recommendations for addressing them.” This resulted in the report Guidelines for Gender Sensitive Disaster Management: Practical Steps to Ensure Women’s Needs Are Met and Women’s Human Rights Are Respected and Protected during Disasters Citation1 (hereinafter called the Guidelines). Many of their recommendations call for such common sense approaches that it is a wonder they were not incorporated into universal emergency relief practices a long time ago.

Yet, seven months after the 2004 Indian Ocean tsunami, and five years after concerns about the lack of a gendered response to natural disaster had been enumerated, gender blind disaster management occurred again after the tsunami and the earthquake in northern Pakistan. Kofi Annan, then Secretary-General of the UN, in response to a question about women’s specific needs in the aftermath of the tsunami, said that “women and men experience the same hardships” (p.1),Citation1 echoing a belief shared by many, that the tsunami affected everyone equally, and there was no need to focus on vulnerable groups.

Representatives of women’s organisations involved in the humanitarian aid efforts met at the Asian Civil Society Consultation on Post-Tsunami Challenges in Bangkok, 13-14 February 2005. Participants from India, Indonesia, Thailand, Burma, Sri Lanka and the Maldives identified a systematic pattern of violations of women’s human rights in the aftermath of the tsunami in all the affected countries. They realised the importance of documenting the exclusion of women from the rehabilitation process. The meeting charged members to record testimonies from women survivors of the tsunami and document human rights violations.

In response to this perceived marginalisation, over 60 women, women’s rights activists and survivors of the disaster from India, Indonesia, Malaysia, Sri Lanka and Thailand, and from international and regional NGOs, convened the Consultation of Asian Women on Post-Tsunami Challenges in Banda Aceh, Indonesia, 25-27 July 2005 (referred to as the Aceh Consultation). The general impressions and oral testimonies they had gathered in the meantime were the starting point for a substantive documentation project.

Subsequently, when it was learned that women (especially in women-headed households) were left out of humanitarian assistance in the aftermath of the earthquake of 8 October 2005 in Northern Pakistan, Azad Jammu and Kashmir, the survey was extended to encompass women’s human rights violations there as well. Five surveys (hereinafter called the Surveys) were producedCitation2–6 of women’s human rights violations in the aftermath of the tsunami in India, Indonesia, Thailand and Sri Lanka and after the earthquake in Pakistan, which record and analyse the widespread gender bias embedded in reconstruction efforts. They revealed that thousands of women and children in the affected countries continued to live in camps and other temporary facilities that lacked adequate sanitation, clean water, health services and security. Overall, government compensation was scare or non-existent and insufficient to restore their livelihoods.

In addition, the Surveys catalogued striking examples of gender discrimination and women’s human rights violations, most accompanied by vivid and convincing personal ethnographic stories. In many of the hardest hit areas, with no special care provided for pregnant women, many suffered miscarriages or premature births. Nor were the particular needs of women with children, including breastfeeding mothers, considered. Instead, food, water, mattresses, sheets and blankets were distributed on the basis of the necessities of a single adult. Frequently, a mother received a single adult food portion to divide among her children, often leaving her hungry and weakened.

To their detriment, women were not involved in camp governance, particularly in the allocation of shelter and supplies, and were also excluded from negotiations with suppliers. As a consequence, provisions for their most basic hygienic necessities, such as sanitary napkins, were neglected. In addition, the frequent dearth of separate and secure toilets and facilities to bathe in privacy exacerbated and complicated their having to maintain sanitation and cleanliness for themselves and their children.

Reinforcing the importance of designing emergency relief responses within specific contexts, the Surveys also highlight the differences in the plight of women in each country. Besides violating their right to health care, sanitation, food, safety, education and housing, women suffered numerous culture-specific hardships. For example, in Aceh and India, land is solely registered through the male line – the father or husband who is the titular head of the household. With the tsunami, women’s lack of access to land exacerbated their exclusion from other rights, since, even if their extended family or spouse had been completely annihilated, they had no right of property ownership and were categorically refused recognition as heads of household. Also, in Aceh, a predominantly Muslim province, because the Indonesian government does not acknowledge women as heads of households, they were denied access to public services allocated specifically to heads of household, which cut them off from an essential lifeline of support.

In Tamil Nadu, India, the issue of caste discrimination was an important concern. Marginalised groups such as the Dalits and Irulas, who face the most terrible forms of deprivation and abuse under normal circumstances, required special attention. In one of the camps, caste discrimination was so prevalent that relief materials designated for Dalits were diverted. The disaster in India also gave rise to the phenomenon of “tsunami marriages”, promoted by the government to help surviving men care for their children. But the needs of lactating and pregnant women and disabled women and their loss of livelihood were ignored.

In Sri Lanka, despite the enormous evidence of women’s vulnerability during disasters, relief efforts were slow in responding to their needs and undermined women’s safety. Some officials even suggested that incidents of violence against women had been exaggerated or might not have occurred at all.

In Thailand, the plight of women in fisheries, sea gypsy communities, sex workers, entertainment workers and small traders, all of whom had difficulties accessing relief assistance, was highlighted. Their right to their land and housing was questioned, and educational support for their children was not forthcoming. In the aftermath of the tsunami, the Thai government began the arbitrary arrest and forced deportation of Burmese migrants, many of whom were women. Those who had lost their ID cards and work permits were unable, therefore, to access emergency relief supplies or remain legally in the country.

To review the Surveys’ findings and develop an implementation strategy, the Asia Pacific Forum on Women, Law and Development organised the Asian Forum on Women in Disasters, hosted by the Society for Rural Education and Development in Chennai, India, on 16–18 December 2006. The group created a synthesis of the five surveys and produced the Guidelines.

Although gender disaggregated official statistics were not available in some of the affected countries, the Surveys confirmed that in Indonesia, India and Sri Lanka, more women (approximately 80%) died in the tsunami than men. Nevertheless, because few specific programmes targeted women and girls, they suffered in particular ways: women gave birth in unsafe conditions, rape and abuse increased, and food and shelter were distributed in a gender-biased manner, reflecting the prevailing culturally mandated patriarchal norms of society. Although they constituted the majority of the tsunami victims, women were excluded from participation in disaster relief and their voices were absent from the reconstruction process.

The Guidelines are written with a clear rights-based approach, including not only women’s socio-economic and cultural rights, but also their civil and political rights. With this human rights lens, the Guidelines cover three main time-sensitive stages: immediate responses during the disaster relief phase; mid-term responses during the recovery phase; and long-term responses

Temporary relief camp inside a temple following the tsunami, Tamil Nadu, India, 2004

during the reconstruction phase. Detailed sub-sections accompany each stage. The document concludes with general recommendations.

The Guidelines provide a comprehensive framework for a gender-sensitive approach and demonstrate the dire consequences of a gender-blind policy. They also show the extraordinary accomplishment of women’s collective organising, research and strategising in response to disaster.

APWLD used the Feminist Participatory Action Research Approach (FPAR) as the guiding framework for the research process. They describe this process (APWLD, Personal communication, April 2008) as follows: Its aim is to empower women and remove hierarchical relationships by recognising and respecting the diversity of the women and all those involved in the research as the experts of their own experiences, to provide new knowledge, and an enabling environment to ensure their inclusion at all levels of the research process. It begins with the perspectives and experiences of the women themselves; through interviews, observations and survivors’ testimonies, including discussion groups with affected communities, governmental and non-governmental agencies. APWLD’s partner organisations in consultation with women’s groups held workshops to discuss the survey framework, methodology and plan of action and the research groups from the four countries agreed to use the FPAR. Participants recommended using CEDAW and other human rights documents as a guide when developing the questionnaire. The survey methodology, framework and questionnaire for the data collection were developed and adapted to country situations. Each survey report indicates in the methodology section the number of respondents interviewed and focus group discussions held.

Each topic begins with a general recommendation, followed by specific implementation suggestions. Sometimes a photo or two will underscore the significance of the suggestion, followed by a description of a specific incident or an evocative vignette from a particular country. For example, under the major recommendation: Ensure Women’s Access to Free Health Care Services, 11 specific suggestions are made, such as that “pregnant women and women with young children are identified and provided with free medical post-natal and maternity care and additional nutrition for the women and children,” and that “female obstetricians and gynecologists are at hand to take care of maternity-and child-related health concerns,” followed by anecdotes such as the following. The immediacy of such anecdotes makes the Guidelines a very compelling and convincing document.

“Women, in the period during their pregnancies and after delivery, had little help in the tents, and were basically looking after themselves, to the extent that some reported fetching water, washing clothes, and cooking food themselves. At the Mira Camp, Bisham, NWFP, according to a Cuban doctor, women were only brought to them when their condition had deteriorated and become serious, otherwise their husbands or other male household members were not allowing them to seek medical aid. In many of the tent camps, there were no female doctors on call.” (Pakistan)Citation6

“The distribution of underwear, bras and panties was carried out publicly, with embarrassing comments about which sizes were appropriate for which women. In addition, distribution of sanitary products was under the control of male camp officials, who handed them out one at a time, so women had to go back and ask again and again. There were no contraceptives available, even though husbands and male partners insisted on sex.” (Sri Lanka)Citation1

“In the tsunami aftermath, women’s health in Lampuuk village became a grave concern. Due to inadequate health services, women in the village experienced difficulties in maintaining their reproductive health. Even if doctors paid visits to the village, health examinations were normally conducted in open tents without proper examination beds or in unenclosed areas. Therefore, women were reluctant to [allow examination of] their reproductive organs when they had any pain or ailments.” (Indonesia)Citation1

“I was in the hospital so I did not hear or receive any information about government assistance for children. By the time I came out of the hospital and applied three times for the assistance, there was no response from the government. I found out from the government official later that I had missed the deadlines and that the fund for this had already finished.” (Thailand)Citation1

The following are just a few of the practical recommendations made in the document with women’s needs in a disaster setting fully in mind:

  • Distribute food in an equitable and transparent manner and consult women about the composition of the “food basket.” Ensure that those who lost livelihoods and jobs, not only those who lost family members, receive food supplies.

  • Appoint only women to distribute aid to women. Set up separate queues for women, particularly where gender segregation is practised.

  • Ensure that women’s menstrual needs are met. Exclude men from the distribution process of sanitary products.

  • Create separate toilets and bathrooms for women, close to living quarters, with adequate lighting to ensure safety.

  • Ensure women’s access to free health care services, regardless of status, citizenship, migration, registration or medical insurance. Identify pregnant women and women with young children and provide them with free medical care. Include female health workers and doctors in medical teams servicing camps and affected communities.

  • Urge and encourage women to serve on vigilance committees to guarantee their maximum security and safety, and train them to raise the alarm against violations.

  • Train male and female security guards to be sensitive to women’s apprehensions and problems; facilitate their assistance-seeking. Establish self-help groups in the camps. Ban the sale of alcohol.

  • Ensure women’s access to psychosocial counselling. Provide psychological assistance; focus on support, not anti-depressants.

  • Eliminate the concept of head of household. It discriminates against women. Governments should not identify head of the household as the main claim holder.

  • Resume educational activities as soon as possible; situate schools close by or within the camps; supply all school-related items free.

  • Reach out to widows and women-headed households, and the disabled and elderly, and others facing ostracism and abuse.

According to the Guidelines, before the tsunami nobody realised to what extent male domination prevailed in these communities. Men were always put in charge, and nobody asked why women were not consulted when a crisis hit.

Emergency reproductive health services

If women participated in the planning of humanitarian delivery services, underwear, sanitary napkins, contraceptives and baby food would all be included in emergency relief baskets. Women would be in charge of the distribution of reproductive health and contraceptive supplies as well as family food allotments, and separate spaces would be designated for women to nurse, bathe and seek medical care. Female health workers and women doctors would become an integral part of the medical teams servicing the camps and affected communities. Women would be employed as security agents within the camps, and both men and women would receive special training to be sensitive to and try to prevent sexual violence. Privacy would be guaranteed from the beginning for victims of rape and sexual violence, and dedicated female counsellors would be trained to administer to these women. In cultures where relevant, gender segregation would be guaranteed, respected and enforced by female safety committees. Regardless of their status (regarding citizenship, migration, registration, or medical insurance), all disaster-affected women would have access to free health care, with pregnant women and women with young children designated for immediate special attention.

Although the Guidelines claim to present a plan for gender-sensitive disaster management, in fact, the focus is almost exclusively on women and girls. Should a gender-sensitive programme not also include boys and men? The exposure to HIV and sexually transmitted infections, the lack of sexuality education and access to condoms, and the absence of training to respect women and girls are possible issues needing to be taken up that immediately come to mind. I have no qualms about supporting guidelines to ensure that the needs of women and girls become decisive humanitarian priorities. And of course, the category of women should be a constitutive factor in each stage of the planning and delivery of all basic humanitarian aid agendas. But I am uncomfortable about the way gender is used almost as a synonym for women and girls.

Another aspect that needs further thought is the relative lack of reproductive health services devoted to adolescent needs. Adolescents of both sexes, although vulnerable to sexual violence and abuse, have been awarded scant attention in the Guidelines. Potentially daunted by lack of sexual and reproductive knowledge, shame and humiliation, many are reluctant to seek information or counselling from health services even in normal circumstances. Imagine how this is aggravated in camps, especially when the camps lack the minimum health facilities. Without options specifically designed for adolescents and strategically placed away from prying eyes and tongues, few young adults as well as victims of rape or domestic violence will seek information and help. A possible approach is to incorporate sexuality education, including respect for girls, into whatever academic programmes in schools are set up to address the continued education of young people in the aftermath of natural disasters. Offering free, universal education within the camps also might deter families from consigning their young daughters to early marriage.

Another matter that is not discussed in the Guidelines refers to the potential for the integration of gender-sensitive disaster management and cooperation with the concerns of other programmes in the humanitarian aid community. Here, I am specifically referring to both the reproductive health and HIV and AIDS programmes by relief agencies. Instead of offering parallel and perhaps duplicative services, aid agencies should strive to combine their efforts and programmes to offer a more comprehensive package to stricken communities.

Notwithstanding these reservations, the Guidelines for Gender Sensitive Disaster Management is a revolutionary document. Its strength lies in the fact that all of its recommendations are grounded in the actual experiences of tsunami and earthquake survivors. Having emerged from the testimonies of the treatment accorded women during these disasters, there is little room to doubt their veracity, the extent of the discrimination and the necessity to fundamentally change humanitarian disaster relief management approaches. On one level, a comprehensive gender-sensitive framework can be seen as an effective means of drawing attention to important but often neglected areas. On another level, the use of a women’s human rights lens in the context of disaster relief management also can lead to the transformation of the social order.

For, underscoring the detailed recommendations contained in the Guidelines is the vision of a non-patriarchal society, one where economic and social justice for all prevails. Guaranteeing the right of spouses to joint ownership of land, residence and property, and for wives and daughters to inherit land and property, for example, challenges and weakens existing patriarchal norms, the ultimate implication of taking gender seriously.

Notes

* The Asian Pacific Forum on Women, Law and Development (APWLD) is an independent, non-governmental, non-profit organisation committed to enabling women to use law as an instrument for change to achieve equality, justice, peace and development. Its human rights network has over 140 members from 23 countries in the Asia–Pacific region.

References

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