Introduction

Julie Remy/MSF

Worldwide, one in three women has experienced some form of sexual violence, but as an average this

 under-estimates the reality for the most affected women.  Sexual violence is a traumatic experience for the individual, and some victims are subjected to both sexual and physical violence. The result is short and long-term consequences for a woman’s physical, mental, and sexual and reproductive health, affecting her capacity to be an active member in society. In this way, sexual violence is also a public health, social and human rights issue.

Not surprisingly, sexual violence is a growing concern within Médecins Sans Frontières’ medical-humanitarian action. It demands attention due to its complexity, its long-lasting medical and psychological consequences, and its disproportionate targeting of women and girls.

International Women’s Day (IWD) on 8 March is a very accessible day to talk about women’s health in many societies. The issue of sexual violence involves every country and social class; it may occur within the family or broader community. It increases with factors of poverty, during times of conflict/displacement, migration and natural catastrophe, and it preys on the young.

For these reasons we have chosen to mark IWD in 2016 by raising awareness about the medical and psychosocial challenges faced by women and girls suffering sexual violence, and the ongoing efforts to break down the many barriers to care.

SEXUAL VIOLENCE IN MSF PROJECTS

Our medical teams treated over 11,000 victims of sexual violence in 91 projects, in 29 countries, in 2014.[1] Over 90 per cent of them were women and girls; less than 10 per cent were men and boys. More than two-thirds of our sexual violence patients come from three countries: Kenya, Democratic Republic of Congo, and Zimbabwe. The majority of victims are under 18 years of age.

Our assistance to victims of sexual violence starts with free and confidential medical and psychological care. In many of the settings where we work there is limited similar assistance. Our purpose is to alleviate victims’ suffering and support their recovery and resumption of daily life.

We are committed to incorporating sexual violence services in all our women’s health projects, and to increasing provision of sexual violence care in emergency response. For example, we achieved this across all our projects in conflict-affected Central African Republic in 2014. We are also committed to getting care closer to the population, by training nurses in smaller health centres to be able to provide first-line treatment, including psychological first aid.

The evidence strongly suggests that sexual violence exists in all of the contexts where Médecins Sans Frontières works. If we do not see victims in our clinics, it does not mean that they do not exist; it just means they are not coming forward. There can be many barriers to seeking care, but we know that community outreach is extremely important to make our services known to the community, and to break the vice-like grip of stigma. Only with community outreach, and practical means for victims to reach the services, can sexual violence care be effective and efficient.

MSF also offers short-term social support as a bridge to longer-term services by other actors, where available. We are committed to advocacy for more sexual violence services, targeting lay and medical community leaders, ministries of health, other national authorities, and other aid organisations. Médecins Sans Frontières has also identified significant gaps in protection services in many of its settings, and is calling for this to be urgently addressed.