Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-16T08:24:56.960Z Has data issue: false hasContentIssue false

Responding to the needs of survivors of sexual violence: Do we know what works?

Published online by Cambridge University Press:  18 February 2015

Extract

During the past twelve months, the issue of sexual violence in conflict and emergencies has received an unprecedented amount of attention at the highest political and institutional levels. In 2013, the United Kingdom's Department for International Development (DFID) launched a Call to Action to mobilize donors, UN agencies, non-governmental organizations (NGOs) and other stakeholders on protecting women and girls in humanitarian emergencies, culminating in the high-level event “Protecting Girls and Women in Emergencies” in November 2013. As of August 2014, over forty partners (including governments, United Nations (UN) agencies and NGOs) had made commitments to the Call to Action. Furthermore, in June 2014 the “Global Summit to End Sexual Violence in Conflict”, co-chaired by the UK Foreign Secretary and Angelina Jolie, Special Envoy for the UN High Commissioner for Refugees (UNHCR), gathered 1,700 delegates and 129 country delegations. In his summary, the chair of the Global Summit states: “We must apply the lessons we have learned and move from condemnation to concrete action. We must all live up to the commitments we have made.”1 In September 2014, the United States organized a Call to Action event in New York during the UN General Assembly with the purpose of sharing progress on commitments made in November 2013. It thus seems that efforts to raise awareness about sexual violence in conflict and emergencies and advocate for a much stronger commitment to action are well under way. But is this enough? Is there enough evidence from lessons learned to allow us to increase and improve our response?

Type
Addressing/Responding to sexual violence in armed conflict
Copyright
Copyright © icrc 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 “Chair's Summary – Global Summit to End Sexual Violence in Conflict”, UK Foreign and Commonwealth Office, 13 June 2014, available at: www.gov.uk/government/publications/chairs-summary-global-summit-to-end-sexual-violence-in-conflict/chairs-summary-global-summit-to-end-sexual-violence-in-conflict (all internet references were accessed in September 2014).

2 UNHCR, Guidelines for the Prevention of and Response to Sexual and Gender-Based Violence against Refugees, Returnees and Internally Displaced Persons, May 2003, available at: www.unhcr.org/3f696bcc4.html.

3 The Inter-Agency Standing Committee Task Force on Protection from Sexual Exploitation and Abuse in Humanitarian Crises was established in March 2002. It provided guidelines for investigations and adopted six standards of behaviour to be included in UN and NGO codes of conduct. In October 2003, the Secretary-General issued a Bulletin entitled Special Measures for Protection from Sexual Exploitation and Sexual Abuse, ST/SGB/2003/13, available at: http://daccess-dds-ny.un.org/doc/UNDOC/GEN/N03/550/40/PDF/N0355040.pdf?OpenElement.

4 Interagency Standing Committee (IASC), Guidelines for Gender-based Violence Interventions in Humanitarian Settings, September 2005, available at: www.unhcr.org/453492294.html

5 See, inter alia, World Health Organization (WHO), Mental Health and Psychosocial Support for Conflict-Related Sexual Violence: Principles and Interventions, 2012, available at: http://apps.who.int/iris/bitstream/10665/75179/1/WHO_RHR_HRP_12.18_eng.pdf; International Rescue Committee (IRC), UNICEF, Caring for Child Survivors of Sexual Abuse: Guidelines for Health and Psychosocial Service Providers in Humanitarian Settings, 2012, available at: www.unicef.org/protection/files/IRC_CCSGuide_FullGuide_lowres.pdf; UNHCR, Handbook for the Protection of Women and Girls, March 2008, available at: www.unhcr.org/protect/PROTECTION/47cfae612.html.

6 UNFPA offers an e-learning course entitled “Managing Gender-Based Violence Programmes in Emergencies”; see https://extranet.unfpa.org/Apps/GBVinEmergencies/intro/player.html. Johns Hopkins University has developed “Confronting Gender-Based Violence”, a course focusing on clinical and psychosocial care for women and men who are survivors and/or are at risk of gender-based violence; see http://moodle.ccghe.net/enrol/index.php?id=58.

7 Spangaro, Jo, Adogu, Chinelo, Ranmuthugala, Geetha, Davies, Gawaine Powell, Steinacker, Léa and Zwi, Anthony, “What Evidence Exists for Initiatives to Reduce Risk and Incidence of Sexual Violence in Armed Conflict and Other Humanitarian Crises? A Systematic Review”, PLOS ONE, Vol. 8, No. 5, 2013CrossRefGoogle ScholarPubMed.

8 Rebecca Holmes and Dharini Bhuvanendra, “Preventing and Responding to Gender-Based Violence in Humanitarian Contexts”, Network Paper, Humanitarian Practice Network, Overseas Development Institute, No. 77, January 2014.

9 Alcorn, Ted, “Responding to Sexual Violence in Armed Conflict”, The Lancet, Vol. 383, No. 9934, 2014, pp. 20342037CrossRefGoogle ScholarPubMed.

10 Brownson, Ross C., Baker, Elizabeth A., Leet, Terry L. and Gillespie, Kathleen N., Evidence-Based Public Health, Oxford University Press, New York, 2003Google Scholar.

11 WHO, Guidelines for Medico-Legal Care for Victims of Sexual Violence, 2003.

12 UNHCR and WHO, Clinical Management of Rape Survivors: Developing Protocols for Use with Refugees and Internally Displaced Persons, revised ed., 2004.

13 MSF, Medical Protocol for Sexual Violence Care, 2nd ed., May 2014 (unpublished but available on demand).

14 PEP consists of a short-term antiretroviral treatment (twenty-eight days) to reduce the likelihood of HIV infection after potential exposure, either occupationally or through sexual intercourse.

15 Bartels, Susan A., Scott, Jennifer, Leaning, Jennifer, Kelly, Jocelyn T., Joyce, Nina R., Mukwege, Denis and Vanrooyen, Michael J., “Demographics and Care-Seeking Behaviors of Sexual Violence Survivors in South Kivu Province, Democratic Republic of Congo”, Disaster Medicine & Public Health Preparedness, Vol. 6, No. 4, 2012, pp. 393401CrossRefGoogle ScholarPubMed.

16 Steiner, Birthe, Benner, Marie T., Sondorp, Egbert, Schmitz, Peter, Mesmer, Ursula and Rosenberger, Sandrine, “Sexual Violence in the Protracted Conflict of DRC Programming for Rape Survivors in South Kivu”, Conflict and Health, Vol. 3, 2009CrossRefGoogle ScholarPubMed.

17 Tayler-Smith, Katie, Zachariah, Rony, Hinderaker, Sven, Manzi, Marcel, De Plecker, Eva, Van Wolvelaer, Pieter, Gil, Tatiana, Goetghebuer, Stephan, Ritter, Helga, Bawo, Luke and Davis-Worzi, Charlyn, “Sexual Violence in Post-Conflict Liberia: Survivors and Their Care”, Tropical Medicine & International Health, Vol. 17, No. 11, 2012, pp. 13561360CrossRefGoogle ScholarPubMed.

18 Ibid., p. 1358.

19 S. A. Bartels et al., above note 15.

20 Buard, V., Van den Bergh, R., Tayler-Smith, K., Godia, P., Sobry, A., Kosgei, R. J., Szumilin, E., Harries, A. D. and Pujades-Rodriguez, M., “Characteristics, Medical Management and Outcomes of Survivors of Sexual Gender-Based Violence, Nairobi, Kenya”, Public Health Action, Vol. 3, No. 2, 2013CrossRefGoogle ScholarPubMed, p. 110.

21 Personal communication, Dr Annick Antierens, MSF, Geneva, 11 November 2014.

22 Bartels, Susan A., “Sexual and Gender-Based Violence”, Public Health Action, Vol. 3, No. 2, 2013CrossRefGoogle ScholarPubMed, p. 93.

23 Kohli, Anjalee, Makambo, Maphie, Ramazani, Paul, Zahiga, Isaya, Mbika, Biki, Safari, Octave, Bachunguye, Richard, Mirindi, Janvier and Glass, Nancy, “A Congolese Community-Based Health Program for Survivors of Sexual Violence”, Conflict and Health, Vol. 6, No. 1, 2012CrossRefGoogle ScholarPubMed, p. 5.

24 MSF, Shattered Lives: Immediate Medical Care Vital for Sexual Violence Victims, Brussels, 2009.

25 Jo Spangaro, Anthony Zwi, Chinelo Adogu, Geetha Ranmuthugala, Gawaine Powell Davies and Léa Steinacker, “What Is the Evidence of the Impact of Initiatives to Reduce Risk and Incidence of Sexual Violence in Conflict and Post Conflict Zones and Other Humanitarian Crises in Lower- and Middle-Income Countries? A Systematic Review”, EPPI-Centre, Social Science Research Unit, Institute of Education, University of London, 2013.

26 HIV seroconversion is the interval, after HIV infection, during which antibodies are first produced and rise to detectable levels. Seroconversion takes place within three weeks in most infected individuals.

27 V. Buard et al., above note 20.

28 A. Kohli et al., above note 23.

29 Ibid., p. 7.

30 Chacko, Liza, Ford, Nathan, Sbaiti, Mariam and Siddiqui, Ruby, “Adherence to HIV Post-Exposure Prophylaxis in Victims of Sexual Assault: A Systematic Review and Meta-Analysis”, Sexually Transmitted Infections, Vol. 88, No. 5, 2012, pp. 335341CrossRefGoogle ScholarPubMed.

31 IASC, Guidelines on Metal Health and Psychosocial Support in Emergency Settings, 2007, available at: www.who.int/hac/network/interagency/news/mental_health_guidelines/en/; Kaz De Jong, Psychosocial and Mental Health Interventions in Areas of Mass Violence: A Community-Based Approach, MSF Guideline Document, 2nd ed., 2011, available at: www.msf.org/sites/msf.org/files/old-cms/source/mentalhealth/guidelines/MSF_mentalhealthguidelines.pdf.

32 Tol, Wietse, Stavrou, Vivi, Greene, Claire, Mergenthaler, Christina, van Ommeren, Mark and Moreno, Claudia Garcia, “Sexual and Gender-Based Violence in Areas of Armed Conflict: A Systematic Review of Mental Health and Psychosocial Support Interventions”, Conflict and Health, Vol. 7, No. 1, 2013CrossRefGoogle ScholarPubMed, p. 16.

33 de Jong, Kaz, Knipscheer, Jeroen W., Ford, Nathan and Kleber, Rolf J., “The Efficacy of Psychosocial Interventions for Adults in Contexts of Ongoing Man-Made Violence: A Systematic Review”, Health, Vol. 6, No. 6, 2014, pp. 504516CrossRefGoogle Scholar.

34 Tol, Wietse and van Ommeren, Mark, “Evidence-Based Mental Health and Psychosocial Support in Humanitarian Settings: Gaps and Opportunities”, Evidence-Based Mental Health, Vol. 15, No. 2, 2012, pp. 2526CrossRefGoogle ScholarPubMed.

35 J. Spangaro et al., above note 25.

36 Kim T. Seelinger, Helen Silverberg and Robin Mejia, “The Investigation and Prosecution of Sexual Violence”, Sexual Violence & Accountability Project, Woking Paper Series, University of California, Berkley, CA, May 2011.

37 On efforts to prosecute sexual violence crimes at the national level, see, inter alia, the article by Kim Seelinger in this issue of the Review.

38 J. Spangaro et al., above note 25.

39 UN Security Council, “The Rule of Law and Transitional Justice in Conflict and Post-Conflict Societies: Report of the Secretary-General”, S/2011/634, 12 October 2011, para. 26.

40 Rubio-Marin, Ruth, “Reparations for Conflict-Related Sexual and Reproductive Violence: A Decalogue”, William & Mary Journal of Women and the Law, Vol. 19, No. 1, 2012, pp. 69104Google Scholar.

41 Lewis, Dustin A., “Unrecognized Victims: Sexual Violence against Men in Conflict Settings under International Law”, Wisconsin International Law Journal, Vol. 27, No. 1, 2009, pp. 149Google Scholar; Chris Dolan, “Into the Mainstream: Addressing Sexual Violence against Men and Boys in Conflict”, briefing paper for the workshop held at the Overseas Development Institute, London, 2014.

42 Johnson, Kirsten, Scott, Jennifer, Rughita, Bigy, Kisielewski, Michael, Asher, Jana, Ong, Ricardo and Lawry, Lynn, “Association of Sexual Violence and Human Rights Violations with Physical and Mental Health in Territories of the Eastern Democratic Republic of the Congo”, Journal of the American Medical Association, Vol. 304, No. 5, 2010, pp. 553562CrossRefGoogle ScholarPubMed.

43 UNHCR and Refugee Law Project, “Working with Men and Boy Survivors of Sexual and Gender-Based Violence in Forced Displacement”, UNHCR, Geneva, July 2012.

44 J. Spangaro et al., above note 25.

45 Krug, Etienne G., Dahlberg, Linda L., Mercy, James A., Zwi, Anthony B. and Lozano, Rafael, World Report on Violence and Health, WHO, Geneva, 2002Google ScholarPubMed.

46 See the SVRI website at: www.svri.org/about.htm.

47 SVRI, Executive Summary – A Research Agenda for Sexual Violence in Humanitarian, Conflict and Post-Conflict Settings, WHO, Stop Rape Now, MRC South Africa, SVRI, available at: www.svri.org/ExecutiveSummary.pdf.

48 Reproductive Health Response in Conflict Consortium, Gender-Based Violence Tools Manual: For Assessment & Program Design, Monitoring & Evaluation in Conflict-Affected Settings, New York, February 2004.

49 WHO, WHO Ethical and Safety Recommendations for Researching, Documenting and Monitoring Sexual Violence in Emergencies, WHO, Geneva, 2007.

50 Vu, Alexander, Adam, Atif, Wirtz, Andrea, Pham, Kiemanh, Rubenstein, Leonard, Glass, Nancy, Beyrer, Chris and Singh, Sonal, “Prevalence of Sexual Violence among Female Refugees in Complex Humanitarian Emergencies: A Systematic Review and Meta-Analysis”, PLOS Currents Disasters, Edition 1, 18 March 2014CrossRefGoogle ScholarPubMed.

51 WHO, above note 49, p. 15.

52 Ibid.

53 See the GBVIMS website at: www.gbvims.org.

54 Zachariah, Rony, Harries, Anthony D., Ishikawa, Nobukatsu, Rieder, Hans L., Bissell, Karen, Laserson, Kayla, Massaquoi, Moses, Herp, Micheal Van and Reid, Tony, “Operational Research in Low-Income Countries: What, Why, and How?”, The Lancet Infectious Diseases, Vol. 9, No. 11, 2009, pp. 711717CrossRefGoogle Scholar.

55 Karl Blanchet, Vera Sistenich, Anita Ramesh et al., “An Evidence Review of Research on Health Interventions in Humanitarian Crises”, Final Report, London School of Hygiene and Tropical Medicine, London, 22 November 2013.

56 Ford, Nathan, Mills, Edward, Zachariah, Rony and Upshur, Ross, “Ethics of Conducting Research in Conflict Settings”, Conflict and Health, Vol. 3, No. 1, 2009CrossRefGoogle ScholarPubMed, p. 7.

57 SVRI, above note 47.

58 Amnesty International, “Aftershocks: Women Speak Out against Sexual Violence in Haiti's Camps”, London, 2011, available at: www.amnesty.org/en/library/asset/AMR36/001/2011/en/57237fad-f97b-45ce-8fdb-68cb457a304c/amr360012011en.pdf.