Barriers to care and growing needs
In many of the countries where we work, medical services have been disrupted by COVID-19, with health staff, facilities, and other resources being diverted to the pandemic response or otherwise unable to function. In our own projects we see two extremes—in some locations teams are responding to an increase in patients as other health facilities are no longer available, while other MSF projects report a worrying decline in patient numbers due to various factors.
In some places, we’re seeing the deprioritization of safe abortion care. In Rustenberg, South Africa, some facilities suspended safe abortion care services early in the pandemic. MSF worked with the local authorities to re-open those services, emphasizing that safe abortion care is indeed essential health care and extremely time-sensitive. These services help prevent unsafe abortion, one of the main causes of maternal mortality.
Logistically, just getting to a facility for care has been a major obstacle for women. Public transportation was halted in many places and strict curfews have banned vehicles from traveling at night.
Experience from previous epidemics has shown that the level of sexual violence and intimate partner violence tends to increase during an emergency, and there have been reports of increased sexual violence in countries most affected by COVID-19. De Plecker is concerned that these victims could be stuck in lockdown, often in small living spaces, with their attackers.