Conflict for too many women is synonymous with rape and violence. It also means sexually transmitted infections, unintended pregnancies, unsafe abortion, maternal morbidity or death. Sexual and reproductive health is never considered to be as important as food or security, yet for many women and girls, accessing these services can mean the difference between life and death. Many refugee women don’t even report rape; not only is the reporting process lengthy, slowing down their journey, but often the violence is perpetrated by police. An unprecedented number of women and adolescent girls are crossing into the European Union daily, with the numbers only set to rise. As crises intensify the need for SRH services increases exponentially, yet it continues to be neglected by key humanitarian responders. Most countries do not even have an emergency response strategy in place to deal with crises, let alone one that includes SRH. If you don’t have an enabling environment in a peaceful situation, how can you respond to SRH needs in an emergency? Integrated services Effective emergency response strategies require capacity development, multistakeholder coordination, improved availability of resources — including supplies — and most importantly, funding. Budget for SRH services in humanitarian crises falls a long way short of what is needed to save lives, and increased investment, prior to and during an emergency, can effectively mitigate the impact of future crises. A set of essential SRH services should be provided as soon as a humanitarian situation arises, including effective coordination, prevention of sexual violence, reduction of sexually transmitted infections, prevention of maternal and infant mortality, and the integration of comprehensive SRH services into primary health care. The occasional provision of dignity kits with items such as sanitary pads and soap, although welcome, are in no means sufficient to address the needs of refugee women. Condoms or any other form of contraception are not included. Priority on partnerships To tackle these critical issues and assist countries in preparing for a potential crisis, International Planned Parenthood European Network and United Nations Population Fund (Eastern Europe and Central Asia) developed the Minimum Initial Service Package readiness assessment tool. This looks at whether a country is able to effectively respond to SRH in an emergency and what medical structures are already in place. This enables governments, U.N. agencies, and civil society organizations to respond effectively to the needs of refugee women. Continuous migration means that responses must also be quick and adaptive. Although most of the response is implemented by CSOs on the ground, partnerships are crucial, and priority areas should be developed in conjunction with governments. Governments have a duty to respond effectively and must be sensitized to the issues refugee women face. The prolific instances of gender-based violence amongst refugee populations should make SRH a top priority when it comes to emergency response strategies, not an afterthought. For this, the MISP readiness assessment tool guides responders on the following key issues: how to implement and prioritize effective SRH to a population constantly on the move; and how to tackle gender-based violence when women are only there for a maximum of 72 hours. Serving mobile populations IPPF EN member association HERA, the Health Education and Research Association in Macedonia, is currently able to provide immediate gynecological services to refugee women and counseling on gender-based violence. This is only possible because HERA and partners began to prepare for SRH needs in a crisis as part of a country team in 2012, in conjunction with the Ministry of Health and other key actors. This has proved to be vital as more than 650,000 refugees have entered Macedonia so far; up to 50 percent of whom are women. Yet the provision of SRH services is still critically low. HERA is the only responder currently providing mobile gynecological services at the transit camps. Many of the SRH services delivered at these mobile clinics are lifesaving, particularly for pregnant women. Undertaking these types of arduous journeys means safe delivery becomes almost impossible due to a lack of obstetric care. Malnutrition and epidemics only serve to increase the risk of pregnancy complications. In addition, the burden of time restrictions makes it incredibly difficult for women to receive the necessary medical treatment as they are only given 72 hours to transit the country, and typically only stay for four to six hours. HERA is also establishing standard operational procedures on how to combat gender-based violence in such a short time frame and provide support for them both medically and psychologically. However, coordinated reporting on gender-based violence at transit camps is extremely challenging as most refugees are unregistered. Scale up efforts Poor response systems and EU member states’ willingness to send refugees back to an environment where they are at increased risk of death and violence are indicative of collective amnesia on pledges to aid refugees in crisis. Only 12 EU member states have ratified the Istanbul Convention guaranteeing the protection of women, regardless of their status. A lack of policy cohesion and compliance with international humanitarian laws has resulted in huge implementation gaps. Member states need to scale up efforts in responding to humanitarian emergencies to prevent gender-based violence, improve the provision of essential SRH services to enable the protection and empowerment of vulnerable women and girls. SRH is a human right and in denying these services, we are denying women and girls of their basic human rights. By Dearbhla Crosse, Communications Advisor, IPPF EN and Nesrine Talbi, Programme Advisor, IPPF EN Click to read the article published in Devex as part of the Beyond Borders Conversation

Gender equality will only be achieved in Europe and Central Asia when women and girls are able to realize their sexual and reproductive health and rights, the International Planned Parenthood Federation European Network (IPPF EN)  said to mark International Women's Day on 8 March. It is estimated that two-thirds of the 1.4 billion people currently living in extreme poverty are women and that women make up 60 per cent of the 572 million working poor in the world. “It is time we tackled the harmful discrimination that prevents women and girls from fulfilling their potential,” said Vicky Claeys, IPPF EN Regional Director. Many people believe that European societies are modern and progressive when it comes to women’s rights. But patriarchal, traditional and religious influences still have a strong grip over the everyday lives of women and girls in many European countries. A strong conservative wind is currently blowing through many European and Central Asian countries and even through the EU and European institutions, opposing progress and challenging the imperfect but hard-won battles on sexual and reproductive health and rights. The EU and the Council of Europe must play as strong a role as possible in defending and strengthening the fundamental rights of women and girls.  Respecting sexual and reproductive health and rights is a pre-condition for their freedom and independence. “Supportive national policies and greater investment  in this area are needed not only to support, the health of women and girls, but also to enable them to participate across social, economic and political life.” Gender equality and sexual and reproductive health and rights must be prioritized in the next set of global development goals, the post-2015 framework, which will be decided in the next few months. Vicky Claeys added: “There are huge challenges to achieving gender equality. Society’s expectations for girls and women can limit their opportunities across social, economic and political life. “This is both a national and global agenda that cannot be ignored. To stamp out gender inequality and make sure that women and girls can realize their sexual and reproductive rights, we need both the political will for change and targeted financial support.” IPPF’s new report , ‘Sexual and reproductive health and rights – the key to gender equality and women’s empowerment’, which will be launched on March 16th at the United Nations Commission on the Status of Women in New York, sets out specific recommendations to governments and to United Nations agencies to make sexual and reproductive health and rights and gender equality a reality, including:   Making sexual and reproductive health and rights and gender equality a reality Sustaining the success of sexual and reproductive health interventions Engaging men and boys as partners in gender transformative change Eliminating sexual and gender-based violence against women and girls Building capacity for women to participate in political and public life   Notes to editors:   Sexual and reproductive health and rights- the key to gender equality and empowerment- new landmark report will be launched at the United Nations at the Commission on the Status of Women 16th March

The town of Kazanlak, at the foot of the Balkan Mountains, is the centre of Bulgaria’s famous rose oil industry. Maria Gineva and Veska Marakjieva run four centres there for young people with special needs, including learning disabilities. Both have taken part in training sessions on sexuality education organised by IPPF’s Bulgarian member association BFPA as part of the ‘Keep me Safe’ project. Maria tells the story of a teenage couple with learning disabilities who were in love. “They didn’t really know about sex, about how it worked, and how to protect themselves. So we started to work with them, discussing sexuality, feelings and how and where it’s appropriate to express them. “Previously they had been kissing all the time in public spaces. After these sessions we agreed on rules on where they could go, and gave them a private space. Their parents hadn’t talked to them at all about sex. We spoke to the parents too, to encourage them to speak to their children and respect their need for space. The project is helping us find the right way to talk to these young people.” Maria and Veska believe that the project can make real changes to the lives of young people with learning disabilities by equipping them and their parents, as well as others involved in their care, to navigate the tricky waters of puberty and developing sexuality. Before Keep Me Safe, explains Veska, “we didn’t focus on these issues, even though the young people were literally growing up before our eyes.” The staff of the centers had tried instinctively to talk to them about issues like personal boundaries and masturbation in communal spaces, and there was some work on preventing sexual abuse. “But we hadn’t thought of it as something where we needed a concrete policy,” adds Maria. This has now changed, and a new policy is being rolled out. It is clear from the experiences of Maria and Veska and other professionals caring for young people with learning disabilities in Bulgaria that parents have a crucial role to play in empowering them when it comes to sexuality and prevention of sexual abuse. But this is also an extremely difficult subject to broach in a country where discussing sexuality in general is taboo, and sexuality education for mainstream children is woefully inadequate. Reactions from parents of young people with learning disabilities to the prospect of sexuality education workshops have ranged from questioning the need to discuss sex with their children, to embarrassment, curiosity and gratitude. One mother who attended a BFPA workshop in the town of Lovech described herself as “very happy – this will give me the confidence to talk to my son about these issues. He is 21. Before he didn’t know who he could talk to when he was in love, he was looking for information on the internet.” Veska, herself the mother of a child with a learning disability, recalls the first session she ran with parents. “We advised them to try and give their children more privacy, and stop hugging them like they are toddlers when some of them are 30 years old. We tried to make them understand that this puts their children at risk because they think hugging all the time is the norm.” She laughs as she adds that she is trying to get into the habit of just kissing her son on the cheek. “The impact on the young people themselves can be greater happiness,” says BFPA Executive Director Radosveta Stamenkova, when asked what the project will mean in the longer term. She has been pleasantly surprised by the strong demand from organisations involved in the direct care of these youngsters, travelling with the BFPA team to different towns around the country to lead additional workshops. Radosveta believes that Keep me Safe’s visual tools with their simple language can also be useful for reaching out to other vulnerable groups, e.g. younger children in the mainstream, new waves of refugees escaping conflict in the Middle East, and Bulgaria’s Roma community, of which 20% is illiterate. Veska confirms that in Kazanlak, which has a large Roma population, the project is already being used more broadly: “We did several sessions with teenage mums, mainly Roma, and we realised that they just didn’t know their own bodies at all, didn’t know the risks of early pregnancy, could not make a proper assessment of healthy behaviour and risks.” But a recurring theme in conversations with all those who are excited about the potential of Keep me Safe in Bulgaria is the lack of mandatory comprehensive sexuality education in mainstream schools. “We have been fighting for this for 20 years. It pains me physically that it is still not there,” adds Radosveta, citing a recent case that reached notoriety when a teenage mother in Kazanlak dumped her baby in a dustbin. When the media interviewed an adolescent boy who went to the same school and asked him to name one sexually transmitted infection, he said “Ebola”. --- Keep me Safe is a two-year project that aims to empower young people with learning disabilities across Europe to protect themselves against sexual abuse and violence. It is funded by the European Commission Daphne III Programme. You can read more about the work in Bulgaria here.

On 10 April 2014, the European Parliament hosted a hearing on the European Citizens' Initiative (ECI) “One Of Us”. This initiative, which is being piloted by ultra-conservative, anti-choice movements, seeks to ban EU funding for any activities that could involve the destruction of human embryos. It demands that the Commission cut off all funding for research on human embryonic stem cells, as well as all funding for any organisations that are involved in the provision of indirect or direct abortion or “abortion-related” services in low and middle-income countries. IPPF and a large number of other civil society organisations are extremely concerned that, if successful, “One Of Us” would have devastating consequences for maternal health in the developing world. The European Commission must comment formally on the ECI by May 28th. The hearing in the Parliament was emotional and the debate highly polarised, with the anti-choice organisers and their conservative MEP supporters dominating proceedings through a series of lengthy interventions. Several Members of the European Parliament strongly opposed “One Of Us” and spoke out passionately in defense of sexual and reproductive health and rights (SRHR). Michael Cashman, representing Parliament’s Development Committee, underlined that EU aid policy had saved the lives of millions of women in the developing world and was one of the Union’s greatest achievements. He pointed out that if this ECI were successful, it could limit the EU’s ability to meet its longstanding international commitments related to maternal and reproductive health by cutting the approximately 120 million USD in development aid that it currently spends each year in these areas. Cashman noted that almost 800 women in the developing world die every day during pregnancy and childbirth, and highlighted that “One Of Us” was based on a “tragic denial of reality”, since highly restrictive abortion regimes do not equate to lower abortion rates, but merely to increased numbers of unsafe abortions. Other MEPs called into question the soundness of the legal base for the “One Of Us” proposal and said that it would only serve to slow down research in the EU. They also voiced strong objections to the organisers’ attempts to prevent the participation in the hearing of elected members who do not share their views. IPPF shares this procedural concern about the organisation of the event, and finds it regrettable that the format of the “One Of Us” hearing meant that SRHR civil society representatives were unable to participate directly in the debate, either as panelists or in the Q&A, while the organisers were able to make extreme and unsubstantiated claims about practices of NGOs active on SRHR, including IPPF.   See other documents relating to the hearing here: Letter to the European Commission and José Manuel Barroso, President of the European Commission; Mairé Geoghegan-Quinn, Commissioner for Research, Innovation and Science; Andris Piebalgs, Commissioner for Development. Press release: MEPs and NGOs sound the alarm on anti-choice threat to maternal health.  

The Y-SAV project led by Rutgers WPF, the Dutch IPPF member, is an excellent example of how a strong centre of expertise on sexual and reproductive health and rights can promote change on all levels. From in-depth research to effective policy-making and on-ground activities Y-SAV’s work stands out when it comes to improving the lives of young Europeans who counter sexual violence. As you read this, research and country reports are translated into concrete actions by policy makers, and around Europe, young advocates speak out for gender equality and against sexual violence. Are we failing to address the reality and the real needs of young people? This is the question that alarmed Rutgers WPF, as study after study provided similar results: sexual aggression and victimization is highly prevalent among young Europeans. In a number of EU countries, a third to half of reported sexual assault cases are of young people, primarily young women – meaning that young people's sexual health and sexual rights are strongly endangered. These alarming findings led to the initiation of Y-SAV, a three-year project on Youth Sexual Aggression and Victimization co-funded by the European Union. Since its introduction, Y-SAV has been tackling youth sexual aggression and victimization on several fronts. This starts with making research comparable across countries and bringing scientists, policy makers and health and education experts together. Young advocates are taking the research findings to a concrete level, discussing them with policy makers and their peers and providing peer-to-peer education. The goal is to see a Europe where every level of action aims at the best possible response to sexual aggression experienced by youth. Gosia’s story from Poland: Young activists combat sexual aggression and victimization “During the summer of 2013, Y-SAV supported two youth led activities: YouAct, which is a group of young European sexual rights advocates, and Ponton, our project in Poland. The name Ponton comes from our volunteer peer educator group, Ponton Group of Sex Educators. We wanted to encourage young people to speak out against Youth Sexual Aggression and Victimization (YSAV). We felt frustrated as in Poland, over 70% of teenagers have experienced some kind of victimization, but the government has not taken concrete measures to prevent this phenomenon. The main goal of our project was to engage young people so that action would be taken by young people for young people. We asked an all-girl hip hop group Rymy w Sercu to create a song about sexual violence to spread the message in a way that would get to young people – and they did an amazing job! You can see their video ‘Take a stand’ here. (Remember to turn on ‘captions’ for subtitles!) Our school workshops inspired young people to come together to rally against sexual violence. They created slogans, photos and a website. It was great to see students being so active. Media and culture fuel negative gender stereotypes and influence the way sexuality and intimate relationships are seen. We need comprehensive sexuality education to fight those stereotypes and convey accurate information. As one of the participants said, “This was the first time someone talked with us about sexual violence.” “I think that if in every school every student could participate in such workshops, more people like me would open up to discussions about sexuality - the issue is an essential part of every human being.”

According to the very first report published this year on statistical data on trafficking in human beings at EU level, 23,632 people were identified or presumed victims of trafficking in the EU over the 2008-2010 period. Most victims detected in EU Member States are citizens from Romania and Bulgaria. Of the non EU countries, Albania’s citizens are among the most frequently prosecuted for trafficking inside the EU. Albanian women and girls are subjected to sex trafficking within the country as well as in foreign countries such as Greece, Italy, Kosovo, the Republic of Macedonia, Serbia, as well as the rest of Western Europe.  Albania is also a destination country for victims of trafficking. IPPF Member Association in Albania, ACPD, outraged at the numbers of Albanian girls brutally abused in forced sex work has taken strong action to fight back. ACPD developed a programme, within an international campaign, called ‘Two Little Girls’ to reach out to vulnerable young girls and adolescents in schools.  ACPD  wants to empower young girls by opening their eyes to the dramatic reality of the sex trade; stimulating a debate in the class room; and educating young pupils about human rights; sexual and reproductive health and rights and the national and international legal framework in place to protect them.       The Association also works hand in hand with teachers and directors of schools. It reflected a lot about the best way to engage with young people and involve them in their efforts. Albania is one of the champions in the IPPF European Network in terms of youth friendly services and youth participation. Speaking out about such an emotional and dramatic topic is not easy, particularly with a very young audience, for this purpose, ACPD also used the ‘Two Little Girls’ animated film which was made in consultation with a group of Albanian women who had been trafficked into the UK. ACPD advocated for the inclusion of information on sex trafficking in a human rights’ education module created by the Directorate of Schools and endorsed by the Ministry of Education and the United Nations Population Fund (UNFPA) in Albania. It is available to be used as a resource in all State schools within the five main cities of the country. The aim is to have this become a part of the National Health curriculum. Furthermore, conscious of the devastating dimensions the sex trade has reached in the Balkans, the Albanian Association decided to involve its neighbour colleagues and fellow activists on this topic. ACPD was instrumental in getting other IPPF Member Associations working on trafficking involved as partners in the campaign. Now Member Associations of Albania, Bosnia, Bulgaria, Latvia, the Republic of Macedonia Serbia, and and work together to protect young girls.