CCIH Member MTI Works with Refugees Affected by Sexual Violence in Uganda Print

Reported by Trina Chase, Africa Program Manager, Medical Teams International

Medical Teams International (MTI) is partnering with the Uganda Ministry of Health; the Bureau of Population, Refugees, and Migration; and UNHCR (UN Refugee Agency) to serve 60,000 refugees in Nakivale and Oruchinga settlements in southwest Uganda through six health clinics. This partnership began in 2010 as a response to the influx of refugees from the Democratic Republic of Congo and the identified gaps in health care services at the resettlement camps, especially in the area of primary health care.

Medical response to sexual and gender-based violence (SGBV) has been inadequately addressed through the health clinics. The majority of SGBV patients coming to the clinics have not been getting the appropriate attention and the quality of care they should. In most cases, SGBV victims were mixed with the general patient population, thereby compromising the privacy of the victims.

SGBV is a particularly challenging issue in the resettlements because the refugees come from different backgrounds and have varying understandings about sex, gender and rape. In DRC, for example, girls 13-17 years old are regarded as adults and ready for marriage. Other cultures believe that a woman should never say no to sex or that it is improper for a woman to agree to sex—that she must be coerced.

According to monthly reports, 13-25 cases of violence are reported monthly in Nakivale. Sixty percent of reported cases are domestic violence and 40 percent are rape and sexually related abuses. Additionally, 35-40 percent of sexual abuse cases are reported at least 72 hours after the incident, thus increasing women survivor’s risk of unwanted pregnancies, sexually transmitted infections, HIV/AIDs, and other health risks. Many SGBV cases go unnoticed, or there is fear to report the attack or to go to a clinic for treatment, therefore these figures significantly under-represent all the incidences of SGBV occurring in the settlements.

To improve care for victims of SGBV, MTI is working through clinics in the refugee settlements to improve the confidential treatment of sexual violence with appropriate follow-up. MTI is now training 25 health workers in psychosocial counseling for SGBV survivors as well as training 20 health workers in the clinical management of SGBV.

MTI is also working to lower the incidence of SGBV. At the community level, MTI works through community Health Workers to train on SGBV awareness and prevention through educational outreach.

In September 2012, a 9-year-old girl in the Nakivale resettlement was raped. She was brought to the health center with a second-degree perineal tear, plus multiple vaginal tears. After the incident, she was so traumatized and intimidated by men that she became aggressive whenever she saw a man. She was treated at an MTI-managed health center in the camp and is now receiving ongoing psychosocial support from clinic counselors. 

MTI’s goal is for all SGBV survivors who report to a clinic in Nakivale to be examined and treated within 72 hours of treatment, to receive psychosocial assessment and counseling in a private area of the clinic, and to be followed up with at home for the following three months.

Kambugu Martin, an SGBV focal person at one of the health centers in Nakivale states, “SGBV is a serious public health problem. Women, children, and elderly people of all age groups and social status are vulnerable to SGBV. It is a major cause of disability and death and has so many adverse consequences for women’s sexual and reproductive health. MTI is working to put community members in control of their lives to prevent SGBV through sensitization and education and to provide survivors of SGBV with the medical and psycho-social support that is needed.”

October 2012

Last Updated ( Tuesday, 09 October 2012 17:19 )