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Conflict in Fragile States

My Lords, I thank my noble friend Lord Loomba for securing this debate and, indeed, for securing enough time for us actually to say what we want to say, for a change—that is a great luxury. I declare an interest as chair of the All-Party Group on Population, Development and Reproductive Health. We recently produced a paper entitled Population Dynamics and the Sustainable Development Goals, which demonstrates the connection between population, economic growth and climate change and famine, which leads to fragile states and conflict. Read it, my Lords.

Noble Lords may have wondered this afternoon why I have been flitting around the Benches. It is because on this very warm day I have been trying to find a warm place in this Chamber. I am frozen. It made me think that the energy being used to make my teeth chatter here this afternoon is contributing to that global warming, which will cause climate change, which will cause famine and drought and will lead to fragile states, which is what we are talking about. Think on it.

I will concentrate on conflict and how it affects the lives of women, and in particular the lives of women of reproductive age. One quarter of the 125 million people in humanitarian need are women in this age group. One in five is likely to be pregnant, leading to the horrible statistic that over 500 women in these situations die every day from the complications of pregnancy and childbirth. The maternal mortality rate is 60% higher in these situations than the global ratio of 210 per 100,000. Seven out of 10 women are exposed to sexual violence in these situations and they desperately need help from us in the form of sexual and reproductive health services. Many are at risk of trafficking, as we have heard, and many of these women are already widows. At this point, I again pay tribute to my noble friend Lord Loomba, who has done so much work for these women.

I have had some experience of the plight of these women in many parts of the world over the past 20 years or so. For instance, in Tirana, raped and sexually mutilated women were coming into the hospital, fleeing from the Serbian soldiers as they swept through Bosnia when we and the Americans were bombing Serbia. These women were terrified to admit—many women are in this situation—what had happened to them for fear of certain rejection by husbands and family. In South Sudan, the conflict continues after 50 years, with women fleeing in every direction to escape the Dinka and Nuer tribes of rival soldiers, responsible as ever for the children whom these women are trying to keep alive. Sometimes, their only hope for their families is for the boys to join one of the marauding armies, where at least they will be fed and clothed, after a fashion.

As referred to by my noble friend Lady Miller, I also spent time in the Zaatari camp in Jordan. It is a good UNHCR camp. When I was there, there were 180,000 people there and the majority—I do not know the proportion—were women. In many ways, they were safe and had adequate food at last and they had good sexual and reproductive health services there, with family planning on offer and obstetric care being provided at that time by the Moroccans in a very good field hospital. But the stories I heard were disturbing even in that well-run environment. They were scared to go to the toilet tents because of the risk of rape. Young girls in particular were most at risk. As a consequence, the mothers told me that they tried to get their daughters married off as quickly as possible to any male who was willing.

Child marriage, with all its horrors, was rife in that camp. The only thing that really concerned the mothers in their predicament was not their daughters’ immaturity, but that at home they said they would usually know the man chosen for their daughter, but in the camp it had to be anybody, just to keep them safe. That is something I have never forgotten.

Another sad fact was that, although sexual and reproductive health and family planning services were available, they were little used because I was told they wanted to replace the babies they had lost in the conflict. However, refugees from Syria and other countries in less formal camps and enclaves are not so fortunate as these women, even though they, too, are not in a good situation.

I want to concentrate for a few minutes on my next concern, which is the availability of abortion for women in conflict situations. It is a difficult subject. Under international humanitarian law and the Geneva Conventions, abortion should be available because the denial of abortion to a woman who has been raped in conflict threatens her life or could cause unbearable suffering. It is unthinkable, and I speak as a woman myself, that having been brutally raped by one or many more men, a woman has to face months of pregnancy, rejection by her partner if he is still around, and giving birth to a child as a result. In their response published in June this year to the House of Lords Select Committee report, Sexual Violence in Conflict: A War Crime, the Government reaffirmed their 2014 policy recognising abortion under the Geneva Conventions. I thank them for that and for the work they have done.

However, there is a problem. The USA aid packages for sexual and reproductive health specifically exclude abortion, but because funding for sexual and reproductive health from many different countries can be pooled to provide facilities in a conflict situation, there is still concern that the most humanitarian of services cannot be provided because of the USA ban. I understand that,

“DFID is in regular dialogue with USAID, State Department and … NGOs with regard to improving access to sexual and reproductive health and rights, which includes reducing recourse to unsafe abortion”—

which, as noble Lords will know, kills many women in their desperation not to be pregnant—

“and improving access to safe abortion services”.

But it is still unclear whether abortion services have become available in these situations and in what numbers. Can the Minister clarify this issue in her response, or write to noble Lords on this issue? Since the DfID announcement of its policy in 2014, no progress report has been made on its implementation. I know that this field is difficult and contentious because I have worked in it. The work often goes on quietly and under the radar, but it must be possible to give us some reassurance that progress is being made.

I assume that this topic, together with emergency contraception which is also vital, must have been raised in one forum or another at the World Humanitarian Summit held this year in Istanbul. I was there for the fringe meetings, but I have not had access to reports or any feedback on this issue from the main summit conference. I apologise for labouring this subject—and indeed I apologise for the pun—but I have been working in this area all my life and I know about the suffering involved.

In fragile states and conflict situations, women suffer disproportionately in comparison with men and somehow have to protect their children. Finally, I would ask the Minister to clarify the new policy of directing more money to fragile and conflict-affected states. What exactly is the policy? Will it affect the money that has already been pledged for the Family Planning 2020 initiative by David Cameron’s Government back in 2014? Can we also be assured that, within that funding,

there is an element for the provision of sexual and reproductive health services for women who are caught up in these horrific situations?

4.39 pm