AMMAN - The Iraqi doctor looked us straight into the eyes and said "I would rather be dead than tell anyone I have been raped." If this woman—a highly educated, successful doctor working for the UN— wouldn't speak out, who would?

The Women's Commission has been in Amman, Jordan for the past week to find out if any improvements have been made for Iraqi refugee women and girls since our last visit in 2007. Although incredible progress has been made by international agencies and the Jordanian government to help Iraqis, women and girls who have survived rape are still under siege.

Three bad options for rape victims

As explained to us by one of Jordan's foremost female lawyers, women and girls who speak out after being raped have three options: 1) to marry the rapist; 2) to be sent to prison for their own protection from their family; or 3) to be killed by their family for dishonoring them. Of course, this is if they choose to come forward after rape and report the crime at all.

An Iraqi refugee told us, "Iraqi women would report anything, but would not report sexual assault – not even touching…Rape is a death sentence."

Health providers unaware of post-rape medicines

In Jordan, rape survivors are not provided with life-saving medical care after the assault. Neither health providers nor the general population is familiar with the medicines to prevent pregnancy and HIV transmission. Many doctors, including leaders in the health sector, and most refugees have told us they had no idea such drugs exist. Plus, doctors are required by law to report rape to the police. Even if medical care after sexual violence were available to women and girls, they would not be able to access this care without notifying the authorities. This situation applies to all women and girls in Jordan.

In addition, if an unwed woman becomes pregnant after rape, her child is forcibly taken after birth. These "Illegitimate" children are denied birth certificates and are raised in special orphanages.

And if it seems it can't get any worse, refugees have even more challenges: Iraqis are considered "illegal" in Jordan and the threat of being discovered by the authorities is a constant fear.

Working Iraqi women and girls are at particular risk for sexual violence.

Many families are living in cramped conditions and sleep closely together—which is not normal practice—thus forcing a greater level of physical intimacy and possibly increasing the chances of incest. Although Iraqis are not allowed to work in Jordan, some do so illegally in order to support their families. Generally it is women who work outside the home, since men and boys are more likely to be deported. Working illegally as maids, waitresses and in other types of domestic labor, women are particularly vulnerable to sexual abuse by their employers and colleagues. In addition, some women have resorted to sex work in order to provide for their families, putting themselves at incredibly high risk of sexual violence. All of this takes place in a climate of complete impunity: women rarely come forward after they have been raped, and rarer still is the successful prosecution of the rapist.

Glimmers of hope