Innovating sexual and reproductive health services in conflict areas

When Nang Shwe Yin* was eight months pregnant, she started showing signs of pre-eclampsia — a condition that could put her life, and pregnancy, at risk. Living in a remote community of displaced people in northeastern Burma, hospital care seemed beyond her reach. But she would need to deliver in hospital to ensure the best outcome for her and her baby. 

Health workers, supported by Inter Pares, confirmed Yin’s condition during a routine visit to her community. They transferred her to hospital where she and her baby could receive the care they needed. 

“At first, I was very afraid to ... be hospitalized,” Yin shared. Health workers helped put her at ease. “Without the advice and help, I dare not think what would happen to me and my child.”

In remote areas of Burma, routine check-ins by local health workers have long been a way our counterparts provide sexual and reproductive health services to Indigenous communities. 

But the intensifying conflict makes travel in remote communities harder: soldiers block roads, detours are treacherous and the price of gas is ever rising. Even if travel is possible, urban health infrastructure is deteriorating, making remote and locally provided services more critical.

Through all this, counterparts are rethinking and adapting some well-established practices.

For example, Indigenous health organizations worked together to create online how-to videos for health workers. The videos train health workers on procedures like administering contraceptive implants, so no one needs to risk travelling to learn new skills.

At the same time, conversations about sexual and reproductive health continue to be sensitive, especially in Indigenous communities. Stigma around family planning and sex education is deeply rooted and some religious leaders staunchly discourage their practice. At a time when conflict threatens whole Indigenous populations, some community leaders are focused more on population growth.

Indigenous women’s health organizations have also continued their community engagement on sexual and reproductive health — albeit in quieter ways. Instead of meeting with youth in large groups, they started a system of teen peer-to-peer sex education. Trained youth meet with small groups of their peers in private settings to share sexual health information. This creates safe spaces for youth to discuss sensitive issues, while circumventing security challenges. 

These examples of adaptation are just some of many. As the conflict continues, we expect to rally behind more. 

Inter Pares works with health counterparts that support nearly 600,000 people, like Yin and her baby, living in 2,000 villages in Burma. While we are outraged by the military’s attacks against civilians, we are proud of our counterparts’ ability to continue serving their communities.   

*For safety and security reasons, names in this article have been changed.

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