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The effects of earth boiling up, roasting the air and stinging our skin are far more personal and urgent for women’s sexual health than we realise.
It shows up at clinic doors. When roads and bridges are washed away by heavy rains. When they struggle with water and power outages due to damage. Women miss their antenatal visits, and others deliver at home because transport is unsafe or unavailable.
Short supply of contraceptives and medicines, and shredded social protections meant to help women are under strain. Why? South Africa is unprepared.
“Climate shocks become health crises when our [South Africa’s] systems are unprepared,” said Desery Fienies, chairperson of the select committee on social services at a webinar.
The webinar highlighted how women’s sexual reproductive health and rights (SRHR) aren’t protected in climate emergencies and discussed advancing SRHR policies as a solution.
“Climate policies often recognise gender in principle, but they rarely spell out how to protect SRHR services during emergencies,” said Fienies.
“Women and girls and those with the least resources lose the most in extreme weather,” she said.
How women experience the heat differently
Women have the right to access antenatal and postnatal care, family planning, safe abortion services where legally permitted, as well as HIV and STI prevention and treatment.
All these services heavily rely on functional health systems and stable infrastructure that become exposed during extreme weather.
Senior Wits Reproductive Health (RHI) professor, Sibusiso Mkwananzi, part of the climate and health cluster, listed in the webinar several ways climate change affects SRHR based on two conducted studies.
Heat exposure and food insecurity complicate pregnancies with increased risk of preterm births and low birth weight babies.
Humidity and heat also affect the stability of HIV health products and contraceptives.
Mkwananzi said that in informal settlements that reach temperatures as high as 32.5°C indoors, pregnant women and their infants experience fatigue, heat strain and poor sleep.
Infants show irritability, and breastfeeding is sometimes reduced.
She said communities with homes that have poor air flow, limited shading due to lack of trees, scarce water and electricity, overcrowding, and the inability to alter their homes make matters worse.
She said heat exposure is more likely in clinics than in hospitals, where healthcare workers are so vulnerable to fatigue, dehydration, heat strain, and measurably reduced productivity.
The study also revealed that healthcare workers have limited coping strategies for heat stress, and there’s a high need for heat adaptation interventions in those spaces.
Mkwananzi said RHI plans to put cooling hubs, an area where pregnant and postpartum women, and their children have a cool, safe space that has water.
Mkwananzi believes that “there is not a one-size-fits-all type of solution” to preventing climate effects on SRHR, and that different solutions need to be tried and tested in different settings.
What was suggested to parliament
Hannah Wolpe, a sexual reproductive health and rights (SRHR) representative in the parliament research unit, replied in the webinar that parliament will field test ways to assist women.
“Oversight visits can still be conducted to these affected areas for committees to assess the coordination of the disaster response and whether the services are being provided as intended,” she said.
When committees are cut from accessing services themselves due to climate disasters, Wolpe suggested mobile services to step in.
During disasters, responses traditionally prioritise shelter, food, water, and emergency medical care. Meaning reproductive health services during disasters may rely on operational decisions rather than formal policy guidance. This is lacking in South Africa.
Global standards for sexual health service emergencies
The United Nations Population Fund (UNFPA) states the global standards for reproductive health services during emergencies include packages like safe delivery services, emergency obstetric care, condoms, oral and injectable contraceptives, STI treatment and services for survivors of sexual violence that normally increase during disasters.
Policy integration
South Africa has progressive laws such as the Choice on Termination of Pregnancy Act, the Criminal Law (Sexual Offences) Act, and the National Strategic Plan on gender based violence and femicide.
But they often assume a functioning system for them to materialise, argued Fienies.
“When climate shocks hit, those assumptions break down. So where are the gaps?” she critiqued.
The 2019 National Climate Change Adaptation Strategy recognises that women experience climate change differently and calls for gender-responsive adaptation.
“..But it doesn’t yet give detailed guidance on health impacts on SRHR specific actions, ” said Fienies
Fienies said that South Africa’s disaster planning and SRHR policies rarely anticipate the infrastructure, supply chain and displacement challenges that come with extreme weather.
It is not ensured that HIV treatment will not go uninterrupted. That family planning supplies and access to emergency care will be available.
Chiagozie Udeh, UNFPA’s climate policy analyst, recommended that South Africa look at how other countries are prioritising women.
He said that even with no budget provision for climate and SRHR implementation, it is an important document that needs to develop disaster preparedness protocols.
