"Nobody remembers us"

"Despite an unprecedented influx of financial aid, the state of maternal health in post-earthquake Haiti remains precarious. Prenatal and obstetric care is inadequate. Many women have no access to contraceptives, including emergency contraception after rape, and many of the 300,000 women and girls who still live in displacement camps engage in sex for food or money in order to survive. The crisis is reflected in pregnancy rates in the camps that are three times higher than in urban areas before the earthquake, when rates of maternal mortality already ranked among the world's worst. Human Rights Watch interviewed 128 Haitian women and girls living in 15 displacement camps, in order to document these and other barriers to maternal health in post-earthquake Haiti. Access to even the most basic information related to reproductive and maternal health is severely limited. Even the small costs of transportation to and from health facilities or fees for medical prescriptions create serious obstacles for women and girls seeking health services. Women and girls who are consequently unable to access these services face further risks when they give birth in the unhealthy conditions of the displacement camps. This report also describes the impact of rape and survival sex on women's and girls' reproductive health, and the limited access to medical services necessary to prevent unwanted pregnancy. Long before the earthquake the government of Haiti was dependent on international aid to provide health care, and to address the problem of sexual violence. In the post-earthquake context donors should help the Haitian government to set up the oversight and accountability structures necessary to ensure that the rights of women and girls to adequate health care are protected. Without this assistance, women and girls living in the camps may not benefit from those services that are available to them and cannot seek a remedy when problems or abuses occur. Human Rights Watch calls on all actors in Haiti to prioritize the protection of women and girl's rights to maternal and reproductive health care in recovery efforts, and to ensure transparency and accountability in the provision of this protection, including by non-governmental actors"--P. [4] of cover.