Creating safe spaces: lessons from South Africa and Burundi
Reported, December 01, 2011
South Africa has one of the highest incidences of rape in the world. It is estimated that one person is raped every 26 seconds. In Khayelitsha, a township of around 500,000 people close to Cape Town, the incidence of rape is one of the highest in the country. Since 2003, MSF has supported the Simelela Rape Survivors Centre in Khayelitsha.
1.We work in partnership with provincial health and social service professionals,the police and a local organisation specialising in rape crisis work. Simelela offers medical,psychological and
social care, including post-exposure prophylaxis (PEP) for preventing HIV,
2.Liaison with the police and monitoring of patients. In 2005, MSF expanded activities to include forensic examinations and increased its hours to 24 hours a day, seven days a week, to respond to the need for services. In one month alone,Simelelas staff assisted more than 130 rape victims, about half of them children under the age of fourteen.In response to rape and war-related sexual violence, MSF opened Seruka health centre
3. For women in Bujumbura, Burundi, in 2004. Starting such a project was not easy in a country where the term rape itself does not exist in the local language. To avoid stigmatisation,the centre offers a range of womens health services, including family planning, care for sexually transmitted infections and care for victims of SGBV. Patients receive medical follow-up for six months, as well as psychosocial support. MSFs social workers refer patients to other NGOs and local community groups who can provide ongoing assistance and guide victims through legal proceedings and contacts with the authorities. Every month more than 100 women overcome the taboos surrounding sexual violence to make their way to the clinic.In our experience, the key to the success of the SGBV projects in South Africa and Burundi lies in ensuring that all services medical, psychosocial and legal are accessible to patients through the same facility. But challenges and questions remain.SGBV programmes seem to work best in post-conflict or non-conflict contexts a trend best exemplified by our project in Burundi, which gained significant momentum once the civil war began to subside. During a conflict, rape victims have additional concerns about security or repercussions in a chaotic environment characterised by violence and impunity. In such a context, SGBV represents one of many kinds of violence and mere survival may be seen as a more immediate priority.Even if services are available, sometimes rape victims do not make use of them (both in conflict settings and beyond). This can be due to lack of absolute confidentiality and privacy within a medical facility. In addition, acknowledgement of rape can have repercussions within the family, such as rejection or divorce, and wider social consequences of stigmatisation and economic marginalisation. The political and legal system can represent a hurdle, especially when extensive bureaucracy and contact with a proliferation of different authorities are required in order to report and file suit for rape. In some conflict areas, there are no authorities available to document violence or to provide legal recourse. National authorities can play a key role in facilitating SGBV projects simply by recognising that SGBV is an issue and enabling medical services or agencies such as MSF to respond.To encourage women to consult medical services after SGBV, MSF focuses on communicating simple information-educationcommunication (IEC) messages, emphasising the urgency for and availability of PEP against HIV infection within 72 hours after exposure. MSF reinforces these Creating safe spaces: lessons from South Africa and Burundi.
Credits: Christine Lebrun and Katharine Derderian Médecins sans Frontières (MSF) Belgium currently addresses sexual and gender-based violence (SGBV) in many of its projects worldwide, in countries including South Africa, Burundi, Liberia, Sierra Leone, Ivory Coast, Sudan, Chad, Rwanda and Colombia. Two of our most successful interventions are in South Africa and Burundi.
More information at:
http://www.fmreview.org/FMRpdfs/FMR27/33.pdf
