Refugee women face gender-specific challenges in navigating daily life at every stage of their migration experience. Common challenges for all refugee women, regardless of other demographic data, are access to healthcare and physical abuse and instances of discrimination, sexual violence, and human trafficking are the most common ones. But even if women don't become victims of such actions, they often face abuse and disregard for their specific needs and experiences, which leads to complex consequences including demoralization, stigmatization, and mental and physical health decay. The lack of access to appropriate resources from international humanitarian aid organizations is compounded by the prevailing gender assumptions around the world, though recent shifts in gender mainstreaming are aiming to combat these commonalities.
Health issues faced by refugee women range from dehydration and diarrhea, to high fevers and malaria. They also include more broad reaching phenomena, such as gender-based violence and maternal health. The leading causes of death to refugee women include malnutrition, diarrhea, respiratory infections, and reproductive complications. Health concerns of refugee women are influenced by a variety of factors including their physical, mental, and social wellbeing. Health complications and concerns for refugee women are prevalent both during their time as refugees living in transient camps or shelters, as well as once they relocate to countries of asylum or resettlement. External factors contributing to the health concerns of refugee women include culturally-reinforced gender inequality, limited mobility, lack of access to healthcare facilities, high population density within the refugee camps, and low levels of education.
International humanitarian aid organizations, such as the United Nations, agree that adequate reproductive care must be "safe, effective...[and] affordable." According to the United Nations, while universal values in human rights support the availability of reproductive health care needs of all women, services that conform to adequate standards while respecting cultural differences are rarely provided to refugee women. Due to the lack of satisfactory reproductive health care in refugee camps, complications related to child delivery and pregnancy was one of the leading cause of both death and illness among refugee women living in transitory camps in 2010.
Refugee women who have left humanitarian aid camps and have moved permanently to countries of asylum and resettlement also face reproductive health challenges. A study published in 2004 by the Journal of Midwifery and Women's Health found that refugee women living in wealthy nations face troubles in accessing appropriate reproductive care due to stereotyping, language barriers, and lack of cultural respect and understanding.
Refugee women often face a host of mental health complications in their home countries, in refugee camps, and in countries of resettlement or asylum. In their native countries, women who have fled as refugees may have been psychosocially or physically abused for a variety of reasons, including genocide; an attempted shaming of a family, community, or culture; or for being seen as " politically dangerous." These forms of abuse often lead to exile or fleeing, and have the propensity to cause distress and detrimental harm to the mental health and wellbeing of refugee women. In refugee camps, the mental health of refugee women is also affected by incidences of discrimination based on gender, sexual and domestic violence, forced labor, and heavy responsibilities. In countries of asylum and resettlement, complications with mental health also prevail due to language and cultural barriers, the post traumatic stress of fleeing persecution in their home countries, difficulty seeking mental health treatment, and an increased likelihood of facing abuse as compared to host-country nationals.
Malnutrition of refugee women manifests in a variety of ways both in refugee camps and in countries of asylum and resettlement. Issues of food security, economic and political misunderstanding, and discrimination within refugee camps contribute to the poor nutrition and health of many refugee women. In a study of food aid in Rwandan refugee camps, experts found that international aid agencies' lack of consideration and attention to the political, economic, and cultural workings of countries in crises can lead to inadequate and inappropriate food aid, which in turn may result in malnutrition for refugees. Likewise, studies have shown that despite no legal distinction between male and female refugees, international refugee communities and even aid organizations tend to uphold discrimination based on gender. This translates into disproportionate malnutrition for refugee women through lack of priority in food distribution as well as medical attention for nutrition-related issues and lack of reproductive nutritional care.
Issues of malnutrition persist in countries of asylum and resettlement for refugee women though mechanisms of food insecurity and lack of nutritional education. A study on Somali refugee women in 2013 found that rates of meat and egg intake were significantly higher in refugee women than comparable populations of host-country national women, while rates of fruit and vegetable intake were significantly lower. A related study of Cambodian refugee women found that common reasons for poor nutritional intake were living in food insecure, low-income areas, lack of economic means to purchase nutritious food, and lack of education about nutritious eating in their new country of residence.
Refugee women are often subjected to forced labor in refugee camps through the reinforcement of traditional gender roles and stereotypes. Women in refugee camps are often the primary sources of physical labor for water collection and filtration, as well as small gardening and agricultural tasks and food preparation. Despite their large roles in these areas, women are excluded from leadership on committees and planning parties within refugee camps and are relegated to strictly laborious roles. Meanwhile, male refugees are frequently seen in positions of influence and power within the camp and among international aid agencies.
Refugee women in transitory camps are also frequently subjected to forced labor, encompassing both forced prostitution and forced physical labor. In addition to violating the legal rights of refugees, forced labor experienced by women in refugee camps has been found to be detrimental to their physical, mental, and social well-being. Often, women subjected to these and other forced labors are sought out on the basis of their race and stereotyped low position in society.
According to the United Nations, gender based violence in the context of assault against refugee women is "any act of violence that results in...physical, sexual, or mental harm or suffering to women including threats..coercion, or arbitrary deprivation of liberty." Assault on refugee women is both sexual and non-sexual, although instances of violence manifest most often in the form of sexual violence for refugee women.
According to a 2000 study, women are particularly vulnerable to rape and other forms of sexual assault in times of war and "disintegration of social structures" for a variety of reasons. These reasons include social unrest, the mingling of diverse cultures and values, prevalent power dynamics, and the vulnerability of women seeking refuge. Ways in which violence and sexual assault manifest themselves against refugee women include forced prostitution or coerced sex by international aid agency workers / volunteers, forced prostitution or coerced sex by fellow members of the refugee camp, forced prostitution or coerced sex by local community members, rape by any of the above demographics, exchange of sex for vital material goods or services, or an attempt to dishonor a woman, her husband, or her father. Sexual violence is considered a taboo subject in many cultures, and therefore gender-based violence often goes unreported as well. Even if women did seek to report violence, often there is nowhere within the refugee camp for them to turn.
In 1989, the first efforts towards gender specific aid for refugees was published in United Nations High Commission on Refugee manuals. The first initiatives of gender mainstreaming in refugee aid were developed in response to the refugee crises of Guatemala, Bosnia-Herzegovina, and Rwanda. Since that time, the concept of gender mainstreaming has gained traction in a variety of refugee aid initiatives, yet experts believe that there are gaps between the policies they outline and the experience of refugee women.
Studies by Doreen Indra found that while there are many institutions providing humanitarian aid to refugee women, it may not reach its full potential due to a lack of refugee input in the programming and policies meant to provide them assistance. When refugee women are excluded from the development process of humanitarian assistance, it was found that policies are often made rooted in traditional gender assumptions, thereby reinforcing traditional and sometimes harmful gender roles in refugee camps.
A review by Linda Cipriano revealed that another barrier in executing effective aid for refugee women is that women are disproportionately denied status as a refugee, which in turn acts as a barrier to receiving the assistance they need. Since its inception, the universal definition for a refugee as described by the United Nations is a person with a “well-founded fear of persecution due to race, religion, nationality, or political opinion.” Under this definition, persecution on the basis of gender and sexual violence are not protected. Many countries abide by this strict language and deny women access to services of declared refugees on these grounds.
The International Rescue Committee serves as an advocate for women to foreign governments to pass laws concerning the health and well-being of refugee women. They also educate men and boys to change the culture of violence towards women.
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