Rising tides, silent suffering: Coastal women face sexual and reproductive health rights crisis

A woman carries a pitcher to bring drinking water from a rainwater harvesting system four to five kilometres away from her home at Dakope in Khulna as saline water is all what is available all around. Photo: Rajib Dhar

In the low-lying delta of Bangladesh, where the confluence of the Ganges and Brahmaputra rivers forms a vulnerable coastal region, girls and women find themselves grappling not only with the challenges posed by climate change but also with a silent plague of sexual and reproductive health and rights (SRHR) violations. 

Bangladesh's coastal areas face recurrent environmental shocks, including floods, tropical cyclones, and droughts. These climate challenges trigger a ripple effect that exacerbates urban poverty, unemployment, and population congestion. However, the plight of girls and women in these coastal areas goes beyond the visible impact of climate change, extending to the violation of their fundamental SRHR.

A 2020 study by Leaders-Bangladesh in coastal Bangladesh found that women exposed to high salinity in water faced increased risks of uterine inflammation and ulcers, potentially leading to cancer. Prolonged exposure during activities like fishing and the use of salt-rich water for bathing and laundry contributed to various health issues, including vaginal infections.

Furthermore, the patriarchal fabric of Bangladeshi society presents formidable challenges for women to assert their rights within families, communities, and state institutions. Despite constitutional commitments to international frameworks such as CEDAW, gender inequalities persist, impacting women's access to safe drinking water, sanitation, and healthcare. 

Cultural, social, legal, and religious inequalities also cast a shadow on women's sexual and reproductive health, creating a web of challenges.

SRHR is practically excluded from climate-related event (CRE) analysis in Bangladesh. While national policies, such as the BCCSAP, touch upon economic empowerment and recovery, they fail to address the intersectionality of climate change and gender-based SRHR violations. 

The devastating impact of Cyclone Amphan (2020), which left over 5,00,000 women and girls without access to life-saving SRHR services, highlights the urgent need for comprehensive legal frameworks.

The Constitution of Bangladesh incorporates principles essential for the protection of women's rights while not explicitly addressing sexual and reproductive health rights (SRHR). Article 28(1) of the constitution prohibits discrimination based on sex, forming a foundational principle for ensuring gender equality. 

Article 32 guarantees the right to life and personal liberty, interpreted to include the right to health, laying the groundwork for recognising and protecting the overall health of women, including their reproductive health. 

Article 29 ensures equal opportunities for women in public employment, contributing to the broader principle of gender equality. Article 28(4) emphasises the state's responsibility to ensure special care and protection for women and children, which is crucial in the context of SRHR, highlighting the state's commitment to safeguarding women's well-being, especially concerning reproductive health. 

Article 18(1), a Fundamental Principle of State Policy, guides the state in raising the level of nutrition and improving public health.

Moreover, Article 25 recognises international law, including treaties and conventions, as part of Bangladesh's laws. Bangladesh, recognising the imminent threats of climate change, has ratified international instruments such as the UN FCCC, the Kyoto Protocol, and the 2015 Paris Agreement. 

The country has also undertaken national initiatives to mitigate and adapt to climate change impacts, including the National Adaptation Programme for Action (NAPA) and the Bangladesh Climate Change Strategy and Action Plan (BCCSAP).

However, a critical gap exists in addressing specific SRHR vulnerabilities faced by girls and women in the wake of climate-related events (CRE). Furthermore, the 2016 General Comment No. 22 by the United Nations Committee on Economic, Social, and Cultural Rights provides an authoritative interpretation of Article 12 of the International Covenant on Economic, Social, and Cultural Rights.

Emphasising the intersectionality of discrimination, the document underscores the importance of bodily autonomy, universal access to sexual and reproductive health, and the need to eliminate laws that restrict such access.

The legal response to SRHR violations during CREs is marked by blind spots. While recognising women's vulnerability, national strategies often fail to provide specific and actionable guidelines. 

The legal landscape lacks clear prioritisation of SRHR within climate-related sectors, resulting in minimal resource allocation. Despite acknowledging the need for inclusive healthcare services, particularly during and after CREs, concrete legal measures remain elusive.

The government's response primarily revolves around economic empowerment programmes such as the vulnerable group development allowance, income-generating activities, and maternal health voucher schemes. 

Although economic empowerment is undeniably important, it cannot be viewed in isolation from the intricate web of SRHR violations exacerbated by climate change. Surprisingly, international reports tend to focus more on SRHR when addressing refugee populations, such as Rohingya refugees in Cox's Bazar.

Efforts to provide reproductive health kits, hygiene awareness, and distant learning centres for reproductive health education within humanitarian responses underscore the international community's recognition of SRHR vulnerabilities faced by displaced women. The plague of SRHR violations faced by girls and women in coastal Bangladesh demands urgent legal reforms. 

Comprehensive legislation is required to bridge the gap between climate change policies and gender-inclusive SRHR protection. 

Such legislation should include specific provisions addressing the unique challenges posed by climate-related events, ensuring the availability of essential healthcare services, menstrual hygiene management, and protection against gender-based violence. Legal frameworks should not merely view women as victims but also as active agents in climate resilience. 

In collaboration with international donors, the government should invest in climate-resilient infrastructure, prioritising women's safety and healthcare, especially in coastal areas. Furthermore, legal initiatives should aim to break cultural taboos surrounding SRHR, introduce comprehensive sexual education in schools, and actively involve women in disaster risk management planning.

Hasan Mahmud Roman. Sketch: TBS

Hasan Muhammad Roman is an Assistant Professor at the Department of Law, University of Chittagong

Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the opinions and views of The Business Standard.