A dignified response to Cyclone Winston

3 March 2016

Elenoa Adi was awoken by the familiar albeit unexpected birth pangs. It was 4am, her husband had left for the village in the aftermath of Cyclone Winston and she was alone with her other two children.

Like most families in Rakiraki's informal Vatumami settlement, Elenoa's family had felt the wrath of the Category 5 February 20 tropical cyclone; certain regions of Fiji are still reeling from its destructive path.

"I woke my older son up and we started walking to the hospital. I gave birth around 8am and was able to have breakfast with the rest of them by the time they served breakfast," Elenoa recounted with a smile.

There was no time to think about packing any clothes.

When she was presented with a dignity kit, you couldn't have wiped the smile off her face. And when she eventually spoke, the 33-year-old Balesere woman from Ra kept repeating: "Thank you. Thank you so much".

Elenoa delivered a healthy baby girl at Rakiraki Hospital last Saturday morning (February 28), after a half-an-hour walk in the dark of dawn.

Midwife, Sheryn Lata said most of the women who were presenting after Cyclone Winston barely had anything for themselves or their babies.

"I really appreciate these kits because the women that we are receiving hardly have any clothes for their babies and for themselves ... like the mum I delivered this morning (Elenoa); thank you very much from Rakiraki Hospital," Ms Lata said.


What is a dignity kit?

The provision of dignity kits is one of the main and first response by the United Nations Population Fund, UNFPA, in the aftermath of events like Cyclone Winston, acknowledging that women and adolescent girls' of reproductive age experience such fragile situations differently from men.

At an individual level, the intention of this targeted intervention is not just about basic hygiene but rather allowing, for lack of a better word, women and adolescent girls of reproductive age to live "with dignity" even during this most difficult of times.

Imagine a village or an informal settlement working together to rebuild their home or neighbourhood in the wake of Cyclone Winston. A division of labour will most certainly include women and adolescent girls playing a (significant) role like ensuring meals. Question: how would the absence of sanitary pads, for example, impact the role of women in this recovery activity? And what of an adolescent girl whose classes have resumed but she may have to miss them?

The provision of dignity kits is a lot more than merely contributing to the recovery efforts of a nation.
For the UNFPA, providing dignity kits whose contents are informed by communities is also very much about the mental well-being of the affected populations.

"The dignity kits are about meeting the basic needs of the glue that hold together the fabric of our communities in times of crisis, women; it is about meeting the needs of the drivers of recovery," UNFPA Pacific Sub-Regional Office Director and Representative Dr Laurent Zessler said.

The dignity kits comprise bath soap and washing powder, a torch, toothpaste and toothbrush, towel, tee-shirts, underwear, sanitary pads, reusable water-proof zipper bag, reproductive health supplies, a comb and suluvakatoga.

Conversation starter - on reproductive health and protection issues

Dignity kits and the issues that it urges forth have proven to be conversation starters, this in itself being constructive as people delve a little more into other sexual and reproductive health and protection concerns or just simply learning from others' experiences.

As was the case in Vanuatu post-Cyclone Pam, dignity kits distribution points also became information gathering and collation points: UNFPA supported the information centers which were also safe spaces for women, an initiative that unwittingly facilitated women's empowerment.

The contents of the dignity kits indicate the issues that are being addressed for example the inclusion of a torch for protection purposes. Today, three fifths of all maternal deaths take place in humanitarian and fragile contexts. Every day 507 women and adolescent girls die from complications of pregnancy and childbirth in emergency situations.

UNFPA estimates 5,600 women of the estimated 87,500 women of reproductive age or between 15 to 49 years are pregnant, based on an estimated total affected population of 350,000 people.

The affected areas can expect 600 babies per month for the next year. Of the expected 600 deliveries per month, 88 women will experience childbirth complications and require additional obstetric care.

"There is an urgent need to address issues related to sexual and reproductive health: women and girls must be able to protect themselves from unwanted pregnancies or from sexual violence that could lead to contracting sexually-transmitted infections including HIV," Dr Laurent Zessler said.

"We must also ensure that services for pregnant women and childbirth facilities remain accessible; addressing such fundamentals will be critical for collective recovery."

Dignity in response

Margaret Wahlstrom, the Special Representative of the United Nations Secretary-General for Disaster Risk Reduction said: "It is a plain and simple truth that disasters reinforce, perpetuate and increase gender inequality, making bad situations worse for women".

Globally-speaking, humanitarian crisis often mean a loss of access to critical quality sexual and reproductive health services, due to a variety of factors including infrastructural damage as was experienced by Asenaca Rika, the out-posted staff nurse at Waimaro Nursing Station in Ra.

Services where they do exist may be disrupted or with stock-out of medicine and other supplies like family planning commodities. Such cut-off of services can have serious consequences, even fatal for survivors of gender-based violence.

Inaccessibility to prenatal care and delivery services in a humanitarian situation exposes women to life-threatening conditions including infections, miscarriage, premature delivery and/or stillbirths.

Despite all we know about the disenabling impact gender inequality has on women and girls in humanitarian situations, they continue to disproportionately bear the burden of risk in the aftermath of events like Cyclone Winston.

As part of its contribution to the recovery efforts of the Government of Fiji, this is an area the United Nations Population Fund is making a difference in, one woman at a time, and one adolescent girl at a time - for long-term collective progress.

The Pacific can be a forerunner in ensuring humanitarian action is a transformative experience by placing sexual and reproductive health and rights in its core, potentially bridging the gap between development and humanitarian action.

Dignity is about respecting every person, as a whole, without judgement, including women and girls of reproductive age in fragile situations and in need of humanitarian assistance.