The cost of authoritarianism on women’s health

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Too often, women’s bodies pay the price for instability and authoritarian actions in countries around the world, as we have recently seen in Ukraine.

The international community has watched in horror as Vladimir Putin’s Russia has Bombed maternity wards in Ukraine as well as clearly marked apartment buildings and theaters with children sheltering inside. Along with indiscriminate cluster bomb attacks on schools and nurseries, these atrocities have led to the deaths and injuries of pregnant women, new mothers and their children.

But Ukraine is far from the only place where women, and their health, are suffering because of what authoritarians and other rogue actors have done. In crisis after crisis, women have been terrorized through sexual violence, physical and psychological trauma, as well as state-imposed inequity. Even when their bodies are not the battlefield on which conflicts are fought, their health is sacrificed as services and care specifically for women’s health, including the ability to control regular menstrual cycles, disappear.

The full impact of conflict and oppression on the well-being of women is sadly often overlooked by global stakeholders who focus on immediate security and humanitarian concerns. But this must change. The unique health needs of women must come to the forefront of international response efforts. That includes meeting women’s physical needs, ensuring that women’s health providers and advocates are among the decision makers, as well as universally condemning and punishing those who wage war against women.

Autocrats, extremists, and other destabilizing entities seek power, control, and obedience, characteristics of patriarchal regimes that value men at the expense of women’s basic human rights. One of the most tragic ways this is demonstrated is the blatant indifference to the suffering of women and their children.

There is a twisted and frightening logic at play when rogue actors intentionally and relentlessly degrade the well-being of women around the world because, time and time again, women have proven essential to the quest for peace and reconciliation. But for women to contribute, they must be healthy.

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There is a clear connection between authoritarian regimes and poor health for women: Of the 29 countries that make up the bottom quarter of the Hologic Global Women’s Health Indexonly three are considered “free” in liberty houseRanking of countries of .

Examples abound.

The ongoing conflict in South Sudan has led to widespread rape and other forms of aggression by all armed parties and a “hellish existence” for women and girls, a new report of the United Nations shows. Survivors are re-victimized by fistulas, unwanted pregnancies, post-traumatic stress and sexually transmitted infections due to lack of accountability and the apparent gap in women’s health care.

Survivors of the conflict in Tigray, Ethiopia, have reported similar atrocities, with hunger added to the mix. Some 9 million people in northern Ethiopia need food aid, but until a recent ceasefire that remains uncertain, the region had been cut off from humanitarian assistance for more than a year. Furthermore, women and girls are being brutalized physically and sexually. assaultedaggravating the suffering.

in afghanistan, barriers to women’s health under the Taliban are rapidly killing mothers and their children. The risk of maternal mortality is already increasing, which also endangers the health of surviving babies. According

United Nations Population Fund (UNFPA), every two hours a woman in Afghanistan dies due to complications in pregnancy and childbirth. The health system is on the verge of collapse, with basic but critical supplies, such as those needed for childbirth, extremely scarce.

Women in some Afghan provinces have been denied access to clinics and hospitals if they arrive without a male relative. Bathhouses, a hygiene lifeline for some of Afghanistan’s poorest, are no longer accessible to women. Most women’s shelters have been closed and survivors of heinous acts of domestic and sexual violence have been forced to return to their abusers.

Hunger is also a problem in Afghanistan. More than a half of the Afghan population is acutely food insecure, according to the latest Integrated Food Security Phase Classification (IPC) report. As a result, emaciated babies deteriorate slowly and painfully because their mothers are so malnourished that they cannot breastfeed. The Taliban have remained indifferent to the immense suffering and profound impact on the health and well-being of women and their children and are moving forward with other acts to support their brutal gender apartheid.

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In China, the forced sterilization of Uyghur women is part of the larger Uyghur genocide being committed by the Chinese Communist Party. It deprives women of one of the most basic and precious functions of their sex: the ability to have a child.

In Venezuela, the regime, well aware of the collapse of the country’s health infrastructure and its impact on maternal and infant mortality, has taken remarkable steps to bury any information about the rapid deterioration of women’s health. A New York Times report documented desperate mothers who traveled miles during labor in search of hospitals willing to help them.

In Myanmar, half of those who responded to a United Nations Development Program Survey conducted a year after the 2021 coup by the military junta, reported that women’s access to health services was becoming more difficult. About 10 percent had a prenatal or postnatal problem for which they were unable to access health care services.

Despite the immense toll of instability on their physical and mental health, women remain resolute and courageous in these and other parts of the world. The global community must do more to support their well-being.

First, women’s unique health requirements around menstruation and for contraception and mental health need to be considered and meaningfully responded to when designing humanitarian interventions.

Too often, gender-specific health needs are not adequately recognized in response to crisis and conflict. Women’s regular menstrual cycles don’t stop when chaos strikes, and governments and aid organizations need to help ensure women have the resources they need to manage monthly periods.

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Around half of women of reproductive age worldwide depend on access to contraception, while another 218 million have an unmet need for family planning. In times of conflict, constant access remains important. Women use contraception not only for family planning, but also to manage other health-related conditions.

Conflict and gender-focused oppression have also created a significant and overlooked need for access to mental health support.

Second, women health workers and women’s health advocates must be meaningfully included at decision-making tables. They must have adequate access to resources and support, especially those working at the grassroots level. Women who work in their own communities will have the best opportunities to advance and reach their peers who most need their attention.

Third, criminals who weaponize women’s well-being must be held accountable for their actions. The global community must deliberately live up to its commitments to address war crimes, with special emphasis on those against women and children and the use of sexual violence in conflict. Accountability is still largely lacking in too many cases where women’s bodies are often referred to as “spoils of war”.

The frankly brutal oppression of women and children is one of the most grotesque distortions of authority. It is used by those who must give the illusion of power to maintain control, but it can indicate that a regime is very unstable.

The international community cannot forget how vulnerable women and their children can be in conflict zones and must take them into account. Only then can we achieve peace, resolution and respect for human rights for all, and accountability for offenders.

Natalie Gonnella-Platts serves as director of the Women’s Initiative at the George W. Bush Institute.

Crystal Cazier is Senior Program Manager for the Global Health Initiative at the George W. Bush Institute.