Afghan refugee women at risk

Many refugee women are in dire need of healthcare

Women fleeing war and poverty in Afghanistan face particular dangers in the refugee camps across the border. Dr Olivier Brasseur, the UN Population Fund's representative in Pakistan, tells Anna McDermott of his concerns.

As darkness falls in the refugee camps, women in veils leave their tents to go to the toilet. They are vulnerable to attack in the dark and risk renal problems waiting for nightfall, but they cannot go out by day.

Dr Olivier Brasseur, the UN Population Fund's (UNFPA) representative in Islamabad apologises for what he calls this "trivial detail".

But there is nothing trivial about this or his mission. He admits that Afghanistan will be the largest ever UNFPA relief operation since Kosovo.

Crisis worse than Kosovo

"The Afghan crisis is far beyond the magnitude of Kosovo in terms of humanitarian aid. There it was 1.5 million people, in Afghanistan it is 20 million people with five million people outside", he explains.

Some 65% of those in the camps are women, who usually come with their children or elderly relatives. Their husbands are fighting within Afghanistan or missing. These women are largely without resources.

"In these refugee camps in Pakistan we are trying to provide a means for the women to get an income. We hope to organise co-operatives, to weave carpets, right now it is just embroidery work and very limited," Dr Brasseur explains.

Some non-governmental organisations say there is casual prostitution as a way for the women to survive, but nobody speaks about it.

Education programmes

Thousands of women in the refugee camps are pregnant. In Afghanistan more than one mother in every 100 dies in childbirth, the highest rate in the world.

Dr Brasseur says that the charity is working with NGOs to try to increase access to healthcare and education and to reduce risks.

"Within the camps we provide equipment and supplies and help the NGOs set up small basic health units where the women can get antenatal, obstetric and postnatal care.

I don't think any kind of war will bring a political solution

Dr Olivier Brasseur

"We provide free sets of instruments and a community-based worker to persuade the women to deliver in the health units. They have tents, but it is probably safer for them to deliver there than under tarpaulin," he says.

There is also very little information on sexually transmitted diseases and HIV/AIDS. It is very difficult to survey women in the camps, as many are reluctant to participate in tests and there is a real shortage of female staff.

"It is a real tragedy for women in Afghanistan. In some areas we had been working with NGOs and clinics for six to eight months before they were stormed by the bearded men.

"The women are thrown out on the street. The men pinch our pharmaceutical products, which is ironic - what can they do with the contraceptive pill? After that the women stop coming for months and then gradually come back," he explains.

Winter concerns

In Afghanistan there are two million people displaced by a combination of war and drought. Once the women arrive in Pakistan they are difficult to track because they are illegal immigrants and disappear very quickly. These women are often in desperate health.

Refugees return to their makeshift shelter after getting food aid

"It is a miracle the clinics in Afghanistan are still working but they got supplies by sheer chance in August. Given the gravity of the humanitarian crisis this is a drop in the ocean of human misery."

"I fear the situation will drag on and we will not be able to go in before the winter - it is already very cold in Kabul. I fear for the women who have been facing a brutal war for 23 years," Dr Brasseur said.

They are all exhausted by the drought and now they have to face a very cruel winter.

"My hope is that it is possible to find a political solution to Afghanistan so that we can work inside and rebuild it again. It is a dream. The US is pursuing its goal.

"I don't think any kind of war will bring a political solution, which is vital for the security of this region and the whole world."