By Sue Mont­gomery, The Mon­treal Gazette

It’s nor­mal, an aid worker told her, not to men­stru­ate after suf­fer­ing severe trauma such as an earthquake.

But when her period still hadn’t shown up five months after January’s mas­sive tremor that claimed the lives of her hus­band and hun­dreds of thou­sand oth­ers in Port-au-Prince, the des­per­ate woman spent a pre­cious $2 on a pill to abort the fetus she knew she could never sup­port. After a night of writhing in pain under her tarp and next to her three chil­dren, the pale and weak woman sought help at a local makeshift clinic.

“I lis­tened with the Doppler, and for the first time in my career, I said, ‘Sorry, Madame, but your baby is still alive’,” recalls my sis­ter Ann Mont­gomery, a Toronto mid­wife who spent time recently in one of Haiti’s camps. “She just lay there on the cot with her hands over her eyes … then grad­u­ally she got up, arranged her­self, thanked me with a tired smile and left.”

Nat­ural dis­as­ters in poor coun­tries can be so dev­as­tat­ing, sur­vivors some­times won­der whether they’d have been bet­ter off dying when the earth shook or the flood waters came rush­ing in. Such cat­a­stro­phes are unfor­giv­ing and indis­crim­i­nate with their vic­tims, but stud­ies have shown that a higher pro­por­tion of women die dur­ing the disaster.

In 2005, Oxfam reported that up to four times as many women as men died in the 2004 tsunami, and in many cases, it was the yards of mate­r­ial in their saris that anchored the women under the water.

As for the females who make it through alive, their vul­ner­a­bil­ity is only exac­er­bated, and sur­vival can indeed often feel like death.

A study con­ducted post-earthquake by the Insti­tute for Jus­tice and Democ­racy in Haiti found that of the 69 vic­tims they inter­viewed, many of whom had been raped, 95.7 per cent were suf­fer­ing from post-traumatic stress syn­drome and 53.6 per cent were suf­fer­ing from depression.

“Sev­eral women indi­cated sui­ci­dal ten­den­cies and some had even taken steps toward end­ing their lives,” said the report, which was pub­lished in July. “At least one woman said she had con­tem­plated killing her­self and her children.”

One woman, who had lost her hus­band and home in the quake, said she wanted to end her life because “this life had gone bad.”

Such events obvi­ously affect men, as well. A 2005 World Health Orga­ni­za­tion report on Gen­der and Health in Nat­ural Dis­as­ters noted that men, as tra­di­tional fam­ily providers and pro­tec­tors, often feel like fail­ures if they were unable to save their loved ones. To com­pen­sate, some may take greater risks as vol­un­teers and res­cue work­ers in the relief effort. But they also tend to aban­don women and chil­dren soon after the dis­as­ter, grab­bing food aid and mate­ri­als for themselves.

The 2004 tsunami in the Indian Ocean, Hur­ri­cane Kat­rina in New Orleans in 2005, this year’s earth­quake in Haiti and now the floods in Pak­istan, to name just a few recent nat­ural dis­as­ters, not only killed hun­dreds of thou­sands of women, often because they’d never been taught to swim or climb a tree, they left count­less female sur­vivors to fend for them­selves and their chil­dren, mak­ing them tar­gets for sex­ual assault or forc­ing them to barter sex for food or shelter.

The head of UNICEF in flood-ravaged Pak­istan said women and chil­dren make up 70 per cent of the nearly 18 mil­lion peo­ple affected by the dis­as­ter. (Women in devel­oped coun­tries aren’t immune either. When New Orleans flooded, 41 per cent of all female-headed house­holds were already liv­ing in poverty, lay­ing the ground­work for a bleak future).

In coun­tries where women aren’t allowed to own prop­erty, such as Pak­istan, many were left home­less when their hus­bands per­ished. Pre­ma­ture births, mis­car­riages and uri­nary tract infec­tions, are also the plight of women in makeshift, unsan­i­tary camps that sprout up after dis­as­ter strikes.

Increas­ingly, relief orga­ni­za­tions are real­iz­ing that any aid brought into a rav­aged region has to take into con­sid­er­a­tion women’s needs for every­thing from san­i­tary pads to pro­tec­tion from rapists –but not one blue­print for help applies to all. Fail­ing to con­sider cul­tural dif­fer­ences in the equa­tion can mean the dif­fer­ence between help and a com­plete waste of effort, time and money.

For exam­ple, the Montreal-based Cen­tre for Inter­na­tional Stud­ies and Co-operation (CECI) focuses solely on women dur­ing any emer­gency response.

“Because of the tra­di­tional role women play in food secu­rity, if you help the woman, you help her chil­dren,” said Odette McCarthy, pro­gram and gen­der spe­cial­ist with the orga­ni­za­tion. “But if you help the man, that won’t happen.”

She said that CECI responded to the earth­quake in Haiti know­ing that 47 per cent of house­holds are headed by women –a large chunk of the pop­u­la­tion that is going to be more vul­ner­a­ble after a disaster.

“That has to be part of your strat­egy when deliv­er­ing aid,” said Mc-Carthy. “If it isn’t, you’re going to put them at more risk for sex­ual exploitation.”

CECI responded not only by con­sult­ing local women’s groups to learn what items would be use­ful in sur­vival kits, they ensured the kits wouldn’t be so heavy that women couldn’t carry them. They also set pri­or­i­ties when dis­trib­ut­ing a mere 150 tents in a camp of about 5,000 fam­i­lies, explain­ing to other, less vul­ner­a­ble sur­vivors why a preg­nant woman should get shel­ter before any­one else.

“We took that vul­ner­a­bil­ity into con­sid­er­a­tion in every inter­ven­tion we made,” said McCarthy, who has worked in Haiti for three years.

CECI also looked beyond the imme­di­ate prob­lems by fund­ing women who lost their small kiosks or busi­nesses in the quake to get back to work.

“The prospect of them restart­ing was almost nil,” McCarthy said. “And they could have fallen into pros­ti­tu­tion as a result.”

The ini­tia­tive was so suc­cess­ful that CECI is now help­ing about 5,000 women in the out­ly­ing regions, where an influx from flat­tened Port-au-Prince has put enor­mous pres­sure on the area.

Often, aid orga­ni­za­tions fail to

work closely with the plethora of dynamic, local women’s groups, shut­ting them out of the post-disaster plan­ning, which results in missed oppor­tu­ni­ties to help effectively.

“Right now, they aren’t play­ing key roles in the decision-making of aid com­ing in dur­ing those first few months,” McCarthy said.

A 2005 Global Fund for Women report, titled Caught in the Storm, noted that in Sri Lanka after the tsunami, tem­po­rary houses were built with­out any kitchens or pro­vi­sions for cook­ing because women hadn’t been included in the short-term relief plan­ning. The same has been reported in Haiti, where inter­na­tional NGOs hold their meet­ings at the UN logis­tics base, far from and inac­ces­si­ble to women liv­ing in camps.

Julie Mc Hugh, human­i­tar­ian pro­gram offi­cer for Oxfam Que­bec, said that while inter­ven­ing in one nat­ural dis­as­ter, an aid orga­ni­za­tion dis­trib­uted san­i­tary pads to women, only to learn through the puz­zled looks on their faces that the women didn’t wear underwear.

To try to avoid such cul­tural faux pas, Oxfam recently cre­ated a Gen­der in Emer­gen­cies work­ing group to com­pare notes and learn from mis­takes made dur­ing disasters.

“We always have to adapt, because it’s not the same recipe every­where,” said Mc Hugh, who is a mem­ber of the group. “Our motto is always ‘do no harm,’ but if we don’t react prop­erly, we could harm women more.”

Other well-meaning orga­ni­za­tions have dis­trib­uted for­mula to help mal­nour­ished nurs­ing moth­ers feed their chil­dren, she said. But the young ones often ended up with diar­rhea and vom­it­ing when the pow­der was mixed with dirty water.

In armed con­flict, it is the male death toll that is usu­ally the high­est. But cul­tural norms, mater­nal instincts and sim­ple biol­ogy all work to put women in a more pre­car­i­ous sit­u­a­tion dur­ing a nat­ural dis­as­ter. Either they stay behind to help res­cue their chil­dren (many Hait­ian woman –either moth­ers or nan­nies –were crushed as they ran to other rooms in their homes to grab their chil­dren), are phys­i­cally unable to scram­ble up trees or walls, have never learned to swim, or sim­ply wait for instruc­tions from their male part­ner before mak­ing a run for it.

Accord­ing to WHO, a study on a 1991 cyclone in Bangladesh noted that many women per­ished with their chil­dren at home as they waited for their hus­bands to return and make an evac­u­a­tion decision.

As it was in Haiti and in other post-disaster sit­u­a­tions, repro­duc­tive health is a con­cern in Pak­istan, espe­cially since an esti­mated half a mil­lion women are expected to give birth dur­ing the next six months. Save the Chil­dren warned that women are already giv­ing birth in flimsy shel­ters, next to dirty water. Com­pli­cat­ing mat­ters is the lack of female health-care providers, espe­cially gyne­col­o­gists, in the affected areas.

In almost every nat­ural disaster,

says Mc Hugh, women’s increased vul­ner­a­bil­ity and the col­lapse of law and order in soci­ety result in a sig­nif­i­cant increase in sex­ual assault. Women, des­per­ate to feed their chil­dren, are often forced into sex acts in exchange for food, med­i­cine or shel­ter. Chil­dren orphaned by a nat­ural dis­as­ter are also at risk of sex­ual exploitation.

Such vio­lence isn’t unique to devel­op­ing coun­tries. Sex­ual assault rose by 300 per cent fol­low­ing the Loma Pri­eta earth­quake in Cal­i­for­nia in 1989. In many cases, the vic­tims were women who were forced to return to an abu­sive rela­tion­ship after los­ing their shel­ter. The Inter­na­tional Vio­lence Against Women Act, a bill now before the House For­eign Affairs Com­mit­tee, pro­vides for the State Depart­ment to help expand the capac­ity of inter­na­tional human­i­tar­ian orga­ni­za­tions in dis­as­ter sit­u­a­tions to pro­tect women and girls.

Meghan Rhoad, a women’s rights researcher with Human Rights Watch, said the bill is long over­due since the phe­nom­e­non of vio­lence against women has been a known issue for some time.

“We know what it takes to be pre­pared,” she wrote in the Miami Her­ald. “Now, it is time to do what it takes to halt the violence.”

In Haiti, the United Nations has assigned a unit of 130 Bangladeshi female sol­diers to pro­tect and accom­pany Hait­ian women, although grass­roots women’s groups say what is needed is secu­rity in the camps in the form of a seri­ous police force and a jus­tice sys­tem that will pros­e­cute rapists.

As in most dis­as­ters, the quake in Haiti destroyed women’s sup­port sys­tems and their liveli­hoods, forc­ing them to live in crowded, unlit camps, where the sense of coop­er­a­tion and shar­ing that was so notice­able imme­di­ately after the quake has long been replaced with a survival-of-the-fittest atti­tude. In addi­tion to look­ing after their own chil­dren, women have also stepped in to care for dozens of chil­dren whose par­ents either died in the earth­quake, or are liv­ing in another camp, unaware their off­spring are still alive.

“Over­crowd­ing, lack of pri­vacy, weak­ened fam­ily and com­mu­nity struc­tures, among other things, ren­der women and girls par­tic­u­larly vul­ner­a­ble to sex­ual vio­lence,” the Insti­tute for Jus­tice and Democ­racy in Haiti report says.

“Women and girls live in inad­e­quate shel­ter, often sleep­ing under noth­ing more than a tarp or blan­ket, with no means of pro­tec­tion and no friends close by, and bathe in pub­lic in view of men and boys.”

For Pak­istani women who are

Mus­lim, such liv­ing con­di­tions are intol­er­a­ble. Most have never lived with other men, other than fam­ily mem­bers. And receiv­ing aid or med­ical help from men is also taboo. The com­plete lack of pri­vacy can lead to health prob­lems, as noted in the 2005 WHO report.

Dur­ing the 1998 floods in Bangladesh, it said, ado­les­cent girls reported not being able to wash out men­strual rags prop­erly in pri­vate, often had no place to hang them to dry, or access to clean water. As a result, they suf­fered from per­ineal rashes and uri­nary tract infections.

McHugh­said­partof thes­o­lu­tion is hir­ing local women who under­stand the cul­ture to pro­vide aid in times of disasters.

But it’s also a ques­tion of attack­ing the root prob­lems of women’s vul­ner­a­bil­ity before a dis­as­ter strikes, McCarthy said, and not being in denial of that vul­ner­a­bil­ity when a coun­try is in tatters.

“There has to be pre­ven­tion,” she said. “Every devel­op­ment project that gets approved has to take into con­sid­er­a­tion the dif­fer­ence between men and boys, women and girls.

“And in 2010, there are still projects that don’t.”

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