OVER 130 million people across the world are living through a humanitarian crisis and in need of assistance. This number will have risen significantly over just the last 48 hours as Typhoon Mangkhut battered the coasts of China, Hong Kong and left large swathes of destruction across the Philippines.
The months ahead for those who have lost their homes and livelihood will be arduous, scary and unbelievably taxing as they seek to stay safe and rebuild their lives. But for some facets of the community, such crises can come with added risks that make an already dangerous situation even more challenging.
Members of the LGBTI community often struggle to access appropriate healthcare, risk being exposed to increased stigma, and are even refused crucial assistance needed to survive when the chaos of a natural disaster or armed conflict breaks out.
It is not uncommon for them to fall through the cracks of care with little consideration given to their unique.
According to International Planned Parenthood Federation (IPPF), the two biggest needs of the LGBTI community during humanitarian crises are “protection and health provision,” both of which are very intertwined, IPPF’s senior communications adviser, Nerida Williams, told Asian Correspondent.
“We find there’s an issue with LGBTI being comfortable to access healthcare in emergencies,” she said. “The clinic that exists in normal times – in an emergency – is often completely ruined and healthcare workers have fled themselves, so it’s very difficult to access appropriate healthcare.”
Thanks to research from the likes of the Guttmacher Institute and The Asian-Pacific Resource & Research Centre for Women (ARROW), sexual and reproductive health rights (SRHR) has become a key consideration for disaster relief aid organisations in recent years.
Drone footage of Itogon landslide areas where 27 are confirmed dead and 40-50 persons are still buried and hundreds of houses destroyed. Retrieval operations still on-ongoing as reported by @UNmigration teams. #Mangkhut #Philippines pic.twitter.com/LCmHZcVlW8
— Mohammed Abdiker (@AbdikerM) September 17, 2018
Reports have shown that comprehensive SRH care in emergency situations saves lives and prevents the situation from getting worse by stopping unwanted pregnancy and the spread of disease.
While the increased awareness of SRHR relief is a good thing, much of the attention has been focused on women and girls with little consideration paid to sexual minorities.
Without targeted clinics, LGBTI people often don’t feel safe accessing healthcare due to the risk that the temporary health services available will not be accepting of their gender or sexuality, Williams said. The services offered are also unlikely to be tailored to their needs.
In some of the developing countries in which humanitarian crises are most devastating, being gay or transgender is illegal and there is major anxiety within the LGBTI community as to whether the clinics available during emergencies are confidential.
“There’s a lot of stigma associated with seeking sexual reproductive healthcare and they might be afraid,” Williams explains.
IPPF gender and youth advisor, Sara Ekenbjorn, tells of one instance when she worked in Uganda – where homosexuality and being transgender is illegal – in which people testing positive for HIV at emergency clinics had to seek treatment at government facilities.
This left a massive gap in care as people were afraid to follow up with treatment, further worsening the HIV epidemic.
This stigma and lack of understanding in some countries can leave the LGBTI community vulnerable to additional persecution, especially during natural disasters.
“In some contexts that I’ve seen with natural disasters, the community blame LGBTI for it happening in the first place,” William said.
“So, the reason the volcano is going off is it’s angry because men are having sex with men. Or the reason we have a cyclone is because there’s too many LGBTI people in this country. So already the community is blaming them and stigmatising them.”
This attitude results in LGBTI people being denied access to healthcare or even access to evacuation centres. According to Williams, this is especially prevalent with transgender people.
Even well-meaning programmes carry similar problems.
Oxfam research revealed that following the Indian Ocean tsunami in 2004, transgender women were denied access to temporary shelters because their appearance didn’t match the gender listed on their ID documents.
The IPPF works with local partners to ensure this doesn’t happen, having a presence in disaster prone areas well before a crisis hits.
They are on the ground, working with local organisations to ensure they meet the standards of the IPPF for inclusivity and are trained in the best ways to welcome and care for the LGBTI community.
But, given the unpredictable nature of humanitarian crisis, this doesn’t always mean there aren’t problems when disaster strikes.
In some cases, the local partner organisation may not be sympathetic to the community’s needs and, worse still, may actually be overtly homophobic or transphobic.
“One of the worst things that can come out of that is the re-stigmatisation of LGBTI people,” Williams told us.
“For example, if you’re having an awareness session take place about SRHR and the person presenting that has homophobic or transphobic values then, omitting that LGBTI people exist is bad enough in itself, but inadvertently saying something that is re-stigmatising is possible.”
One of the most effective ways to counter this is to have LGBTI people on staff, at all levels of the organisation.
IPPF operates an inclusive recruitment strategy and actively encourages LGBTI people and people with HIV to join their team, not only in the offices but out on site working with people on the ground.
Ekenbjorn believes hiring people who represent the groups they serve is crucial to providing a good service. Their experience trickles down into policy and procedure, as well as making LGBTI people in disaster-hit communities feel more comfortable using their services.
It’s been one year since unprecedented natural disasters hit Latin America and the Caribbean. We’re proud of the resilience of our partners and their dedication to ensuring access to sexual and reproductive health care—even in the most challenging times @ProfamiliasPR @MexfamAC pic.twitter.com/nhhUVVwOtt
— IPPF/WHR (@IPPF_WHR) September 14, 2018
Having an openly gay person at the front of any temporary clinic or health centre sends a message to LGBTI people that they are welcome and their specific sexual health needs and concerns are catered to at the facility.
The shift to giving SRHR a prominent role in disaster relief is a welcome one that has been a long time coming. Building on this is a new appreciation for the specific needs of sexual minorities and recognising the potential for them to fall through the cracks.
Awareness of LGBTI issues in many countries – both developing and developed – is still woefully inadequate, so the work of IPPF and other SRHR organisations can, in some cases, leaving a lasting positive impression.
Working with local partners and ensuring they are sensitive to LGBTI needs can actually improve the sexual health care for the community over the long-term.
As Williams says: “Sometimes disasters create opportunities in a strange way.”