According to UN estimates, the earthquake has affected approximately 126,000 pregnant women. Just in terms of nutritional needs, about 168,000 mothers need breastfeeding support, 126,000 children under age two require nutritious food for immediate relief. These statistics are overwhelming, but does not capture the pervasive vulnerability and insecurity that looms over the mothers and children affected by this devastating earthquake.The public health challenges that arise in the aftermath of natural disasters are enormous. Especially in countries with weak health systems, a natural disaster is first and foremost a public health crisis. In addition to deaths and disabilities directly resulting from the quake, there are challenges of water, sanitation, food security, infectious diseases, mental health and injuries inflicted during relief efforts.
In the face of these needs, what is often forgotten is the disruption of routine sexual and reproductive health services in the aftermath of a disaster, and the silently growing maternal mortality and morbidity. Evidence from other natural disasters and humanitarian crises clearly illustrate that pregnancy-related deaths and violence against women and girls soar in the aftermath of these crises.
Even before the earthquake hit Nepal, the country's health infrastructure (including maternal health system) was severely limited in terms of both quality and equity. Further, in the carnage that followed the earthquake, the poorest regions and populations have been hardest hit. As a result, the challenges of delivering quality and comprehensive maternal care have been compounded, leaving hundreds of thousands of pregnant women and new mothers in even more vulnerable and troubling conditions.
Reports of women giving birth in appalling and unacceptable conditions are recurring, and so are anecdotes recounting the lack of antenatal and postpartum care. Furthermore, the often stigmatized, mental health dimension of pregnant women and new mothers' health needs is yet to surface to the level of public health discourse. Amid relief efforts, protection and care of these women should not be neglected.
Additionally, maternal health issues must be addressed with even greater urgency as Nepal transitions from recovery to reconstruction efforts. The barriers to accessing quality health care, education, and nutrition that contributed to the country's poor maternal health situation have only been exacerbated by this earthquake. This poses serious challenges, and may thwart, if not reverse, the progress made in maternal health in the Millennium Development Goal era of last 15 years. A country struggling to overcome the effect of the decade-long civil war, whose nascent pillars of recovery, reconstruction and development were rocked by a 7.8 magnitude earthquake, cannot afford to take another blow.
Surviving and healthy mothers will ensure a healthy future for Nepal. This is not, however, to suggest that investing in women's health at this juncture is essential solely to safeguard a better tomorrow. Access to sexual and reproductive health is a woman's right, a basic human right. As we coordinate efforts to promote maternal health, we should bear in mind that a soon-to-be or a new mother is first a human, and her life and dignity in itself merits respect and protection. An aspiration to restore and promote woman's dignity should be at the core of all relief efforts.
The author is a doctoral student at the Harvard T.H. Chan School of Public Health and member of Students for Nepal coalition
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