Insurgency: Health challenges of women

“In violence and conflict, that number goes up considerably,” says Babatunde Osotimehin, Executive Director of United Nations Population Fund (UNFPA), the global agency that supports state governments in sexual and reproductive health.Insurgency in the North-east of Nigeria has pushed up the numbers of women and girls sexually violated. It is invisible because women and girls […]

“In violence and conflict, that number goes up considerably,” says Babatunde Osotimehin, Executive Director of United Nations Population Fund (UNFPA), the global agency that supports state governments in sexual and reproductive health.
Insurgency in the North-east of Nigeria has pushed up the numbers of women and girls sexually violated. It is invisible because women and girls violated are more concerned with the stigma of their situation than admitting any assault.
Details of hundreds of women liberated from Sambisa forest and other territories previously held by the Boko Haram insurgents have been murky – no one is certain who is pregnant or what’s to be done about them. Instead, their status has been dragged through headlines and bureaucratic channels until they went off radar weeks ago.
Aid workers on the ground don’t know their whereabouts except to say they were taken by higher authorities after their counseling and sessions of psychosocial support started.
“They have begun to pick up and understand the realities of life. To the best of my knowledge, I know they are in safe hands,” says Haruna Haman, head of emergency management agency in Adamawa.
But women and girls have returned from captivity or fled into camps pregnant. Borno has 21 camps, and its citizens of internally displaced people have swelled to 45,000 in the last two weeks.
A steady stream of internally displaced people is on. More than 6,000 arrived last week alone, 80% of them children and women.
The United Nations High Commissioner for Refugees (UNHCR) in an interaction with the media revealed that the number of refugees is estimated at above 1.4 million persons and still counting, with the numbers of women and children at the camps increase daily as the insurgency rages on.
“A lot are pregnant and having babies,” says Dr Salma Kolo, Borno State Health Commissioner. “We are trying to identify women and girls abused by Boko Haram, but they are not willing to open up because of stigma.” But they are there, and undergoing counseling, along with traumatised children.
“Imagine to be taken away from your community, denied access to your loved ones in a sense that you don’t know when you are going to come back is a hellish condition,” Osotimehin observed.
“They will not open up to you until you become close to them – to deradicalise them,” says Haman.
Counseling doesn’t include advising women to abort Boko Haram pregnancies, the United Nations Population Fund (UNFPA) stresses and emphasizes amidst reports that some women have been pressurized to abort babies they do not want.
“We take the view that if they are pregnant, we will ensure we provide them services to help them carry the pregnancy safely, and we also take an interest in girls and women sexually violated and provide them physiological counselling to deal with the trauma they went through.
“Up to four in every 10 death of a mother comes from a young girl dying in pregnancy,” he explained.
When a woman is raped, “the very sense of the psyche is taken away,” said Osotimehin. “They see flashes of this man or several men that have defiled them, and we need to work with them to ensure they regain their dignity.”
In the wake of a cyclone disaster in the Philippines, aid workers built separate shelters for women and girls, got military to protect girls and restrict their movement about their temporary camp to prevent them falling victims of abuse. In the wake of insurgency in Nigeria, aid workers await the moment the military can confirm restive places are safe to return to. At present, they provide “dignity kits”-a bag that contains the basics a woman needs to get through a typical month.
A kit contains items women can’t shop for once their communities are disrupted: blanket, toothbrush, hairbrush, nail clipper, solar-powered torchlight, soap, sanitary pads, detergent, toothpaste, socks, underwear (vest and underpants), towel, shampoo, head scarf.
The UNFPA, which works with governments of all six states in the North-east, has distributed some 13,319 dignity kits between January 2014 and May 2015. The kits have been in use since 2010 when massive flooding around parts of the country temporarily displaced millions.
It also helps authorities in the states provide services for health.
 UNFPA’s two-year budget alone is estimated at $10.46 million, according to Ratidzai Ndhlovu, country representative for the agency in Nigeria. It has mobilized $3.3 million, but still has to deal with a gap of $7.153 million, including outstanding pledges.
The women and girls bearing the brunt of sexual and gender-based violence in the wake of Boko Haram insurgency live on pledges and hope, and live through the optimistic faces of humanitarian workers sharing their lives with them on camp.
Camps generally last several years-time through which authorities struggle to resettle them and displaced people struggle to get back on their feet. Northeast Kenya’s Dadaab refugee camp, considered the largest in the world, is still open, 30 years on. And its residents are still struggling against possible closure.
Nigeria has had disasters, but never seen “camps” until now. People affected sheltered with families in the same or neighbouring towns. Now, it is different, says Osotimehin. The Executive Director of UNFPA bows his head and says, this damage is so overwhelming that an entire community, ward or local government is wiped out, leaving people completely at odds at what to do.
Displacement from Boko Haram insurgency has been so overwhelming that people who return have no homes to return to, he adds. Their trauma starts long before then, with women and children bearing the brunt of the burdens.