Earthquake and tsunami devastating for 45,000 pregnant women in Indonesia

Some 88,000 people have been displaced by the twin disasters in Indonesia's hardest-hit areas. Ibu Fariati and her family now share a tent with six other families.

“I am so scared. I can’t even describe it,” Ibu Fariati, 27, told UNFPA.

On 28 September, Ms. Fariati’s home collapsed in a 7.5-magnitude earthquake that, just 30 minutes later by some accounts, unleashed a 6-metre wall of water. The wave swept away Ms. Fariati’s home – and nearly 70,000 others.

More than 2,000 people have been confirmed dead since the quake and subsequent tsunami struck the island of Sulawesi, leaving the regional capital Palu and its surrounding areas reeling. An estimated 680 are still missing, although this number may rise as recovery efforts continue. In the worst-hit areas, the twin disasters have affected some 1.5 million people, including roughly 88,000 who have been displaced.

“We live under a small tent, which we share with six other families,” Ms. Fariati explained. “My two daughters are still small. They are too young to face this.” 

Survivors are now confronting new dangers. Harmful conditions in evacuation sites can wreak havoc on their health and safety – especially for women and girls. Lack of access to clean water and hygiene supplies heightens their risk of contracting infectious diseases, while overcrowding and sub-standard shelter render them vulnerable to gender-based violence, which can escalate in humanitarian settings.

“At night, I am scared to use the communal toilets. There are no lights or doors,” Ms. Fariati described. “The toilet is far from here. I have to ask my husband to accompany me or one of my daughters. I also have to walk into the bush to collect firewood. I walk with other women, as I am scared that someone will come and touch me. I have no choice. I have to collect firewood to cook. Otherwise, my family won’t eat.”

A huge toll

Women and girls endure an additional hardship – the effect of displacement on their sexual and reproductive health. During natural disasters and other emergencies, women can lose access to family planning, exposing them to unwanted pregnancies in treacherous conditions.

“Another scary thing is that my contraceptive pills are almost finished,” Ms. Fariati said. “It would be a disaster to get pregnant here. One of the women who shares a tent with us is eight months pregnant. She will give birth in this tent soon, and I am scared she will not be able to deliver her baby safely.”

In times of crisis, reproductive health services – including skilled birth attendance and emergency obstetric care – often become unavailable, leaving pregnant women susceptible to life-threatening complications. 

Every day, some 500 women and girls die from childbirth- and pregnancy-related causes in areas affected by natural disaster or conflict.

Displaced mothers and their children gather in a UNFPA-supported reproductive health tent.Displaced mothers and their children gather in a UNFPA-supported reproductive health tent.

Reaching women and girls 

UNFPA estimates that 352,000 women of reproductive age have been impacted by the earthquake and tsunami, including 45,300 women who are pregnant. More than 14,000 of these women will give birth in the next three months, with about 2,100 expected to experience childbirth complications that require emergency care. 

With hospitals and health centres damaged and public transport severely compromised, efforts to meet their sexual and reproductive health needs are under strain.  

UNFPA is on the ground, reinforcing the government-led humanitarian response to ensure lifesaving services reach women and girls. 

“Women don’t stop giving birth during emergencies,” said Elisabeth Sidabutar, National Humanitarian Analyst with UNFPA Indonesia. “The risk of gender-based violence rises amid a humanitarian crisis. The specific needs of women and girls must not be forgotten at such times.”

Under the Ministry of Health’s lead, UNFPA is deploying midwives to camps and other evacuation sites in order to provide proper antenatal, delivery and post-natal care. Kits that contain critical post-childbirth items for pregnant women, as well as hygiene supplies for women and girls, are also being distributed.

In addition, UNFPA is supporting the establishment of reproductive health tents and safe spaces, where women and girls gain access to psychosocial support for trauma recovery, as well as essential information and services such as family planning and antenatal check-ups. Five reproductive health tents and three safe spaces for women and youth have already been established, with 10 additional tents in the works.

UN Secretary-General António Guterres praised the resilience of the Sulawesi people on his 12 October visit to Palu, where he met with survivors, Government officials and UN personnel on the ground, including UNFPA staff.UN Secretary-General António Guterres praised the resilience of the Sulawesi people on his 12 October visit to Palu, where he met with survivors, Government officials and UN personnel on the ground, including UNFPA staff.

Solidarity and resilience

Still, the unmet needs of women and girls are immense. 
 
“We’re still in the acute phase of the crisis, and it’s clear that it will take a long time for Sulawesi to recover,” noted Dr. Annette Sachs Robertson, UNFPA Representative in Indonesia. “UNFPA will remain part of the response, and of support to the Indonesian government and women and girls affected by the disaster, for as long as we’re needed.”

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By United Nations Population Fund

UNFPA is the United Nations sexual and reproductive health agency. Our mission is to deliver a world where every pregnancy is wanted, every childbirth is safe and every young person's potential is fulfilled.

UNFPA Supports:

  1. Reproductive health care for women and youth in more than 150 countries – which are home to more than 80 per cent of the world’s population
  2. The health of pregnant women, especially the 1 million who face life-threatening complications each month
  3. Reliable access to modern contraceptives sufficient to benefit 20 million women a year
  4. Training of thousands of health workers to help ensure at least 90 per cent of all childbirths are supervised by skilled attendants
  5. Prevention of gender-based violence, which affects 1 in 3 women
  6. Abandonment of female genital mutilation, which harms 3 million girls annually
  7. Prevention of teen pregnancies, complications of which are the leading cause of death for girls 15-19 years old
  8. Efforts to end child marriage, which could affect an estimated 70 million girls over the next 5 years
  9. Delivery of safe birth supplies, dignity kits and other life-saving materials to survivors of conflict and natural disaster
  10. Censuses, data collection and analyses, which are essential for development planning

UNFPA is formally named the United Nations Population Fund. The organization was created in 1969, the same year the UN General Assembly declared “parents have the exclusive right to determine freely and responsibly the number and spacing of their children.”

UNFPA calls for the realization of reproductive rights for all and supports access to a wide range of sexual and reproductive health services – including voluntary family planning, maternal health care and comprehensive sexuality education.

Since UNFPA started its work, the world has seen progress: The number and rate of women dying from complications of pregnancy or childbirth has been halved. Families are healthier. Young people are more connected and empowered than ever before.

But too many are still left behind. More than 760 million people are mired in extreme poverty. Sexual and reproductive health problems are a leading cause of death and disability for women in the developing world. Young people bear the highest risks of HIV infection and unintended pregnancy. Many millions of girls face the prospect of child marriage and other harmful practices, such as female genital mutilation (FGM).

Much more needs to be done to ensure a world in which all individuals can exercise their basic human rights, including those that relate to the most intimate and fundamental aspects of life.

In 2018, UNFPA launched efforts to achieve three transformative results, ambitions that promise to change the world for every man, woman and young person:

Ending unmet need for family planning

Family planning is central to women’s empowerment and sustainable development. Today, more than 300 million women in developing countries are using contraception, but more than 214 million women who want to plan their births do not have access to modern family planning.

UNFPA works with governments and partners to promote universal access to quality, integrated sexual and reproductive health services. UNFPA also promotes comprehensive sexuality education and youth leadership, which empower young people to exercise autonomy, choice and participation with regard to their sexual and reproductive health and rights.

Ending preventable maternal death

Everyone has the right to health, including women and mothers. Since 1990, maternal mortality has declined by 44 per cent. Still, some 830 women and adolescent girls die each day from preventable causes related to pregnancy and childbirth, and 99 per cent of these deaths occur in developing countries – more than half in fragile and humanitarian settings.

UNFPA partners with governments and others to strengthen health systems, train health workers, educate midwives and improve access to the full range of reproductive health.

Ending gender-based violence and harmful practices

As the struggle for gender equality continues, violence against women and girls remains a global pandemic. One in three women will experience physical or sexual violence in her lifetime. And approximately one in four girls in the developing world is married before age 18.

UNFPA works to prevent and respond to gender-based violence through its work with policymakers, justice systems, health systems and humanitarian partners. UNFPA also focuses on eliminating harmful practices, including FGM and child marriage, and helps to engage men and boys to advance gender equality

(Source: unfpa.org; October 19, 2018; https://tinyurl.com/ydgzw7en)
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