Indigenous communities, often located in fragile, remote ecosystems, bear the immediate brunt of climate change impacts. This worsens existing socio-economic disparities for Indigenous people and threatens their health, income and cultural practices.
Our research highlights how Indigenous women and girls are disproportionately affected, since their livelihoods and family roles often revolve around the land and its resources. Climate change creates a complex web of geographic, economic, and cultural factors that heighten the demand for sexual and reproductive health care among Indigenous women yet simultaneously hinder their access to crucial services, like quality abortion care.
3 key factors = a triple threat to Indigenous women’s sexual and reproductive health
1. Geography
Indigenous women sometimes must travel to larger cities to access contraceptives and quality abortion care, which means increased transportation costs and effort required to reach distant locations. Indigenous communities’ remote locations already make it difficult to access resources and public facilities, but when roads and transportation are damaged by climate events, sexual and reproductive health inequities worsen.
For example, women and girls from the Chure region in Nepal, where the Chepang people live, must often travel two or three hours to access health services due to landslide road blockages. During floods in the Amazon region of Bolivia, communities such as Cosincho and its neighbors have serious difficulties in accessing health centers and can only travel by the flooded river.
“The lack of roads or sufficient access to roads is a problem for pregnant women or sick people such as children. They have to travel to San Borja many times by river. In one case, a woman who had complications in childbirth could not be evacuated … due to the [blocked] access. She had to be taken by boat; in the boat, the baby was born.”
2. Economic challenges
Indigenous women, already facing lower income levels, struggle with increased sexual and reproductive health needs while climate change reduces their ability to pay for care and medicines.
Our research conducted in Bolivia, Nepal, Indonesia, Mozambique and Kenya reveals that climate change-induced agricultural damage is leading to a financial and food crisis among Indigenous populations. Loss of land, seeds, crops, and livestock are compounded by health issues arising from people’s hard work to mitigate these impacts. Extreme temperatures, pesticide exposure, poor nutrition, and water contamination contribute to rising cases of disease and injuries, causing people to spend what little income they have left on expenses for emergency health care.
This leaves fewer funds to pay for sexual and reproductive health care—a need increased by climate change.
“Pregnant women can sometimes have a [miscarriage] because of the climate issue, because sometimes suddenly they already have a disease. Some lose the baby, sometimes it is because of the climate issue.”
“This year, there has been no rain. When there is no rain, animals die; there is no grass and little water. When there is no rain, there is no potato, it grows small.”
“In [pregnant] women … the strong heat has caused a lot of hot flashes and . . . little food intake, which caused anemia, strong colds and vaginal infections caused by their [bodies’] low defenses.”
3. Cultural barriers
Traditional practices, stigma, language barriers, and distrust of mainstream health-care systems hinder Indigenous women’s access to medical treatment.
During floods, communities like Cosincho in Bolivia face challenges accessing public health centers. While they prefer traditional medicine, they turn to these centers for serious conditions like hemorrhages, severe pain, or infections after childbirth caused by using flood-contaminated water in birth hygiene. However, language barriers, distrust, and differing cultural views already work against indigenous communities’ use of health centers, and the added barrier of flooding makes them more likely to avoid health centers.
“Access to health services is complicated. The few posts that exist in the communities are open only at certain times and once a week or twice a month. Doctors or nurses don’t always come to [provide] care and don’t know the language, so women prefer to be treated in their own communities, because they don’t feel that doctors understand them.”
In Kenya, there is stigma among the pastoralist Moran tribe around sexual and reproductive health services, and women often need permission from the men in their family to seek those services for themselves. There is a common preference among the Moran for traditional herbal medicine, which can prevent women from accessing needed health services.
In Nepal, cultural norms for Dalit people around the treatment of new mothers make it challenging to help postpartum women—even when their lives are at risk.
“In the Dalit community, the new mother is not touched for 11 days (about one and a half weeks) by anyone, which makes it more difficult for them during disaster.”