Sexual and reproductive health of adolescents in a humanitarian context

Some vulnerabilities specific to adolescents during times of crisis and emergency is exacerbated by the lack of access to sexual and reproductive health services. More attention paid to the needs of adolescents and the use of innovative approaches to establish dialogue with them could help mitigate some impacts that threaten their lives.

magine a girl of 12 who has just moved into a refugee camp with his family. She is the eldest daughter and has five siblings. She tries to help her mother every day to make room, to fetch water, care for her younger brothers and sisters. None of her friends is with her, and she feels to have no one to play with or talk to. At times, she would be alone in a place where no one asks him to do anything. First she thought she could go into the field where the latrines are located. But there are many men all around, and also soldiers, and they tell him things, they hiss and make gestures she knows is not suitable. She loved going to school, and she knows that there is a school in the camp where she sees other children his age go every day. However, she does not know how she could enroll. She would like a friend or a teacher, or an older sister, to talk to and who would feel less vulnerable.

During the transition between childhood and adulthood, adolescents normally benefit from the influence of adult role models, social norms and structures and community groups (peer groups, religious groups or cultural groups). However, in travel status, social and family structures are disrupted. It may be that adolescents are separated from their family or their community, and at the same time formal and informal education programs are interrupted and the community and social networks break down. It is not uncommon that teenagers are preoccupied, fearful, stressed and unemployed or they are bored. They may find themselves in situations where they face risks that they are not prepared, and they may have to take on adult roles without being ready without adult models or networks support.
 

Very young displaced adolescents (10-14 years), especially girls, at risk of exploitation and sexual abuse. Because they have limited experience of life, sometimes teenagers do not recognize in circumstances which seem to them strange, the sexual nature of certain abusive acts or exploitation.
    Young pregnant teenagers, especially those under 16, have a high risk of obstructive labor, obstetrical pathology may be life-threatening, which can occur when immature pelvis is too small to allow passage the baby during delivery. Any delay in treatment may result in obstetric fistula or uterine tear, hemorrhage and death of the mother and child.
    Adolescents separated from their families and children with a family in charge are private security in terms of livelihoods and protection should provide their family structure, and even more likely to face poverty as well as 'exploitation and sexual abuse. Separated young family and child-headed households may find themselves in a situation where they feel forced to leave school, marry or prostitution to support themselves whether food , shelter or protection.

    Teenage girls who resort to prostitution risk of unintended pregnancy, unsafe abortions, STIs and HIV, and also face exploitation and sexual abuse.
    The victims of SGBV are exposed to unwanted pregnancies, unsafe abortions, STIs including HIV. They also may suffer from mental and psychosocial disorders, and to face social stigma. In Haiti, following the earthquake, a significant number of victims of sexual violence treated by the NGO GHESKIO and Médecins du Monde were adolescents and prepubertal girls.
    Children associated with armed forces and armed groups, whether they are boys or girls, are often sexually active at a much earlier age, and face the risk of violence and sexual abuse, disorders mental and psychosocial, to unwanted pregnancies, unsafe abortions, STIs and HIV.




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