No More Summits, Time for Action


As world leaders convene at the UN General Assembly and John Kerry, US Secretary of State, convenes a high-level review of efforts on the global ‘Call to Action on Violence Against Women and Girls in Emergencies’ on Monday, September 22nd, David Ray of CARE USA, reflects on progress and ways forward for frontline efforts to address reproductive health in emergencies.

Over the past year, violence against women and girls has hit the headlines and it has hit the global summit agenda too. John Kerry, US Secretary of State, made the keynote speech at the Global Summit to End Sexual Violence in London in June, and today he hosts a high-level event at the United Nations General Assembly to review progress on the so-called ‘Call to Action on violence against women and girls in emergencies’ – a global process launched one year ago bringing together states, both donor governments and crisis-affected ones, UN agencies and NGOs to change the way aid is delivered to better protect women and girls. How far have we come and how far do we have to go?

It was two decades back that the horrific use of sexual violence as a tactic in conflict came to prominence during the wars in the Balkans and the Great Lakes region of Africa. Rape as a weapon of war became short-hand for what was happening in the Democratic Republic of Congo leading the previous commander of UN peacekeeping forces in the country, Major General Patrick Cammaert, to state: “it is now more dangerous to be a woman than a soldier in modern conflict.” Yet a few years ago, these issues were not seen as a priority or relevant to discussions of peace and security at the UN. So the very fact that Kerry will convene some of the world’s most powerful decision-makers to review progress on the Call to Action is therefore progress in and of itself. Indeed, the agency that I work for, CARE International, is campaigning for the twelve commitments in the Call to Action communique to be integrated into wider UN reforms, including the process towards the World Humanitarian Summit in 2016, which until now has been gender-blind. The US has taken some important steps by launching its own ‘Safe from the Start’ initiative to bring gender-based violence into US-funded humanitarian efforts from the first moment a crisis strikes. We need to see other donors make similar kinds of commitments in their bilateral policies and funding. But what of progress on the ground?

Take the example of sexual and reproductive health programs, which are essential for medical support to survivors of rape, as well as women’s wider reproductive health needs. Experts estimate that in crisis settings, life-threatening pregnancy complications requiring emergency care will affect an estimated 15% of pregnancies and between 9 and 15% of new-borns will require emergency care. A forthcoming CARE research paper highlights the extent to which national and international health programs continue to fail pregnant women in South Sudan, one of the most horrific conflicts on earth at present. Current figures suggest the country’s fertility rate is 6.7 births per woman and approximately 196,000 women are pregnant. Yet statistics from 2010 suggest that, in a population of 10 million overall, there are only 19 registered midwives and 132 community midwives. The ministry of health in South Sudan estimates under 15% of births in clinics are attended to by “skilled” personnel, in other words a doctor, clinical officer, or certified midwife. CARE staff are on the ground in South Sudan working in unimaginably difficult and dangerous circumstances to support health projects in areas caught up in conflict, but it is not enough.

While the picture is bleak on the ground in South Sudan, if the political commitments made last November and reviewed at UNGA today translate into action, we could see the situation improve. In part catalyzed by the Call to Action, the past year has galvanized aid agencies to undertake an international assessment of frontline reproductive health programs. The forthcoming global study will detail the challenges and outline the practical ways forward to better address the sexual, maternal and reproductive health needs in times of crisis. As Kerry and the other great and the good convene in New York, we should all hope they commit not just to sustain a political process, but to translate the global commitments into action on the ground. Plugging the gaps in frontline reproductive health programs should be front and centre of those efforts to make a tangible change in the lives of women in South Sudan and other countries caught up in crisis.

by David Ray of CARE USA

To read a new report published by CARE International outlining country case studies and recommendations for the Call to Action on Violence Against Women and Girls in Emergencies, please visit:

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