This is a statement by the Safe Abortion Advocacy Initiative – A Global South Engagement (SAIGE)
With the current global situation resulting from the COVID-19 pandemic, SAIGE and its partners are concerned of its impact on access to safe abortion for women and girls globally and especially in the Global South region. Time-sensitive response is important and we are deeply concerned that additionally-created waiting time and economic hurdles, such as travel ban and shutdown of non-essential jobs and businesses, will disproportionately impact vulnerable women and girls and therefore request the governments to urgently take cognisance and create strategies to mitigate the impact.
On 11th March 2020, the World Health Organisation (WHO) declared COVID-19 a pandemic and has now infected over 600,000 people in 203 countries and territories around the world.[1] There are over 100,000 confirmed cases and more than 3,000 deaths due to the disease in the Asia-Pacific region.[2]
Usually, when devastating disasters such as hurricanes and earthquakes strike communities, people support each other and power through until some sense of normalcy returns. However, this is not true for all crises. These events affect women, girls, men and boys differently. In many settings, women and girls are more likely to be disproportionately affected by crises. Different forms of violence against women and girls, including gender-based violence follows these events.[3] Disasters tend to exacerbate pre-existing vulnerabilities and patterns of discrimination. [4] The global spread of this new disease has created a crisis in every sector. Gender-based violence, assault and other crimes against the vulnerable population are mostly not addressed as the current community quarantines and lockdowns in most countries have disrupted the functioning criminal justice system.[5,6] The offices may not take reports of assault or may be shut due to fear of this pandemic while the police are on patrol or guarding traffic at the borders and enforcing curfew during this crisis.
The current pandemic has caused the shutdown of non-essential businesses and even schools and community quarantines and lockdowns in most countries restrict people from leaving their homes. These events contribute to financial and emotional strain in a household, which increases the incidence of domestic violence.[7] Women and children are especially vulnerable at this time when home is not a safe space for everyone. As observed in China, there was some evidence of increase in domestic violence in the implementation of extended quarantine and social distancing measures during the pandemic.[8] The vulnerability is not just in being a woman, women with disabilities, young women, women suffering from mental illness are already often targets of sexual violence, but in the midst of the current situation, the risk becomes even greater. Also, the stress and tension of this pandemic enables comfort-seeking behaviours, without reliable access to contraception, unprotected sexual activity therefore could increase the number of unintended pregnancies.[9] As what happened in West Africa during the Ebola epidemic in 2014, there was a concurrent increase in rape, sexual assault and violence against women and girls. In Sierra Leone, teenage pregnancy rate increased by 65% during the epidemic that was likely caused by the increase in cases of rape.[10] Potentially, more pregnant people will need access to safe abortion at this time when there is insecurity around jobs, food and childcare.
With health systems and providers diverted to help address the pandemic and with the disruption of the supply chain, there may be shortage of service providers and commodities[11] in clinics providing sexual and reproductive services most importantly abortion services and post abortion care may not be available to women. Moreover, in some countries, clinical services were restricted to emergency care and leaving abortion out of emergency services may adversely affect abortion seekers.[12] Delays in services may not only put their case beyond the permissible legal limits under the country’s law but also make the procedure more complex and potentially unsafe.
In restricted settings where women are able to obtain an abortion only by travelling outside state borders, the access is impacted by travel bans and lock down of state borders.
This prompts a greater need for comprehensive safe abortion services worldwide:
- Implementation of the Minimum Initial Service Package (MISP) [13]
- Put in place functional helpline for women in distress / vulnerable women
- Formulate a helpline to connect with those seeking abortion and post abortion care with the medication they need to do safely and with dignity [14]
- Include RH commodities such as menstrual hygiene products, oral contraceptives, condoms, spermicide and lubricants in the relief packages
- Declare abortion as an emergency service and implement telemedicine and other online tools to care for their health needs
- Ensure the security of the service providers with adequate monetary or non-monetary rewards who are providing the services in context where the health system is disrupted during such humanitarian crisis
- Ensure the marginalised and vulnerable groups – especially adolescent and young women, sex workers, people living with HIV/AIDS (PLHIV), women with disabilities and women suffering from mental illness – have access to safe abortion services
SAIGE and its partners call for action by adopting a gender justice lens to undertake the difficulties created by the pandemic and address the needs of women affected during and after this crisis.
[1]https://www.who.int/emergencies/diseases/novel-coronavirus-2019
[3]https://www.who.int/violence_injury_prevention/publications/violence/violence_disasters.pdf
[4]https://www.preventionweb.net/files/51016_1297700gbvindisastersenlr2.pdf
[7]https://www.abc.net.au/news/2020-03-20/domestic-violence-spike-amid-coronavirus-crisis/12074726
[8]http://www.sddirect.org.uk/media/1881/vawg-helpdesk-284-covid-19-and-vawg.pdf
[9]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100103/
[10]https://foreignpolicy.com/2016/02/02/the-ebola-rape-epidemic-west-africa-teenage-pregnancy/
[11]https://edition.cnn.com/2020/02/29/health/fda-medical-device-mask-hospital-shortage/index.html
[13]https://www.unfpa.org/resources/what-minimum-initial-srvice-package
[14]https://medium.com/@ippf/how-will-the-coronavirus-affect-access-to-safe-abortion-75cdbe66fcb
