Sexual violence is common in humanitarian settings. It may become more acute in the wake of a natural disaster and occurs at every stage of a conflict. The victims are usually women and adolescents, who have often been separated from their families and communities and whose care-taking roles increase their vulnerability to exploitation and abuse. Breakdowns in law and order and in protective societal norms mean that most perpetrators abuse with impunity.
In many conflicts, women’s bodies become battlegrounds, with rape used as a method of warfare to humiliate, dominate or disrupt social ties. In the aftermath of natural disasters, women and young people may be left unaccompanied -- out in the open or in temporary shelters -- at the same time that security lapses lead to increased lawlessness and chaos.
The impact of sexual violence, especially rape, can be devastating. Physical consequences include injuries, unwanted pregnancies, fistula and HIV. Widespread sexual violence is also endemic in many post-conflict situations, where it can perpetuate a cycle of anxiety and fear that impedes recovery. However, because reliable data about sexual violence in these situations is scarce, UNFPA is spearheading efforts to determine the scope of the problem in many different contexts.
Sexual violence is not inevitable. Better policing, involving women in the design of humanitarian assistance, working with displaced communities to develop systems of protection, and ending impunity for perpetrators are just a few of the actions that can help to minimize sexual violence. Information campaigns and community education can help to raise awareness of the issue, stimulate community dialogue, reduce stigma, and encourage survivors to report incidents and seek care. Effective campaigns positively engage men and promote reflection about cultural attitudes and gender inequalities that perpetuate violence against women.
UNFPA’s country offices promote a multi-sectoral, holistic approach to addressing sexual violence in humanitarian settings. Using a survivor-centred and survivor-driven approach, UNFPA provides a wide range of services to encourage social reintegration of survivors, including counseling and assistance with livelihoods. It trains police officers, lawyers and judges to ensure safe and ethical care for survivors, and works with all levels of medical professionals to foster appropriate and timely responses.
Medical treatment is critical for someone who has been sexually assaulted. Survivors need antibiotics to prevent infection and may require treatment for abrasions, tears, or traumatic fistula, a devastating but operable injury that may occur as a result of sexual assault.
In addition to physical injury, women and girls who are raped may be at risk of unwanted pregnancy or sexually transmitted infection. If provided in time, emergency contraception can prevent an unwanted pregnancy, and post-exposure prophylaxis can prevent the transmission of HIV and other sexually transmitted infections.
Much of UNFPA's work to address the issue of gender-based violence in humanitarian contexts is in the field of health response, and training other first responders (such as police and community or women’s advocates) to more effectively care for sexual violence survivors. For example:
At the global level, in late 2007 UNFPA partnered with UNICEF to lead two regional "Caring for Survivors" workshops, in Timor-Leste and Jordan. The training focuses on building knowledge and skills in various aspects related to how responders communicate and interact with sexual violence survivors in conflict-affected settings. At the heart of this process is the emphasis on understanding and demonstrating a survivor-centred attitude, and using survivor-centred communication skills.
Since 2005, UNFPA and UNHCR have partnered to conduct trainings for health care providers working in refugee, internally-displaced person and other humanitarian settings on the clinical management of rape survivors. The two-day curriculum includes modules on taking a survivor's history, collecting forensic evidence, examining a survivor and prescribing treatment, including emergency contraception, treatment of sexually transmitted infections and post-exposure prophylaxis to prevent the transmission of HIV. To date, UNFPA has conducted four regional training-of-trainers workshops in Geneva, Johannesburg, Nairobi and Cairo. Of those who have been trained as trainers, many are now actively engaged in training health providers in Nepal, Haiti, Liberia, Sudan, Zimbabwe and Cote d'Ivoire (among other countries). In addition, national trainings were conducted in over 10 countries, reaching nearly 500 heath-care providers.
In late September 2005, as part of the humanitarian reform process, UNFPA was tasked with coordinating gender-based violence issues in humanitarian settings. Proper coordination of this complicated issue, which often engages a wide range of UN and other actors, is vital to ensuring that survivors receive adequate care, and that prevention efforts are varied, wide-reaching and appropriate. As a development agency with growing experience in humanitarian settings, UNFPA continues to forge new partnerships and to increase its human resources and technical capacities to scale up its coordination efforts.