Martha Murdock is Technical Strategy Lead for regional programs at the FCI Program of Management Sciences for Health. This post originally appeared on MSH’s Global Health Impact Blog.
As a part of the international “16 Days of Activism Against Gender-Based Violence” campaign for the prevention and elimination of violence against women and girls, MSH is sharing its experience working to eradicate gender-based violence.
“We remember the hard times the women and girls of Douentza have experienced,” said Animata Bassama, a representative of the women of Douentza, referring to the fighting and ensuing gender-based violence (GBV) that plagued Mali in 2012.
Animata spoke to a crowd of 100 government officials, NGO representatives, health and finance officials, women’s advocates, and community members. A new center for GBV survivors, fortified by concrete and adorned in yellow and pink, was her backdrop.
“And to the entire population of Douentza, we must unite in peace and understanding to effectively manage this center together,” she continued.
In May 2016, the FCI Program of MSH, with funding from UN Women, built a center next to the Douentza Referral Health Center to provide a safe space for GBV survivors to seek medical and psychosocial care, as well as temporary shelter.
The center is a visible achievement of the FCI Program of MSH’s community-based, 18-month project in Douentza and Mopti to offer holistic medical, psychosocial and legal support to GBV survivors; educate community members on women’s rights and GBV; inform regional policy and laws to prevent and address GBV; and establish protection teams and an early-warning system to call out human rights violations and instances of GBV.
“Sexual violence still persists in our society,” said a representative for UN Women at the inauguration of the Douentza GBV Center. “The violence has caused a total upheaval of our social order. … Despite efforts by many stakeholders in the fight against this scourge, the fight is far from over because of the persistence of some of our customs and impunity.”
Resulting from deep-rooted gender inequality, GBV can take various forms, including physical, sexual, and emotional violence as well as acts of coercion and control. GBV, as a form of trauma, can lead to poor reproductive, maternal, physical and mental health outcomes, and have lasting repercussions on the lives of women, their children and other family members, and their communities.
Data on the instances of GBV are incomplete because of the dearth of initiatives to produce robust data and survivors’ reluctance to report violence due to fear of social stigma and retaliation from perpetrators. The Malian Gender-Based Violence Information Management System, a unified effort by 4 UN agencies and 12 NGOs including MSH, collects, analyzes and shares data on reported instances of GBV in some regions. Of the 1,468 GBV survivors whose cases were captured by the system’s 2015 annual report, only 10 percent reported within three days of the violent act and 73 percent reported more than a month after the abuse occurred. While all survivors who reported violence sought psychosocial services — short-term, trauma-informed counseling — and 31 percent received medical care, 98 percent of GBV survivors refused to seek safety and security services, and 83 percent did not seek legal assistance.
By mid-2016, the FCI Program of MSH had identified 257 cases of GBV in four communities in Douentza and Mopti: 179 women over the age of 18, 62 girls under 18, 9 boys under 18, and 7 men over 18 years. Of these, 155 GBV survivors received free medical care, and 196 received free psychosocial care.
“GBV remains a reality in our communities,” said Fatimata Kané, the project director for the FCI Program of MSH in Mali. “Millions of women and girls suffer from the lack of appropriate services, particularly a lack of attentive ears offering emotional support. This GBV unit will help to mitigate their suffering.”
An integrated health-system response to GBV is critical to address the consequences and to prevent new or continued occurrences of GBV. Health care providers should practice woman-centered, trauma-informed, respectful care that is responsive to gender dynamics and power structures to avoid further stigmatizing or endangering the patient. GBV survivors must have access to information about the confidential free services they are entitled to receive, as well as treatment options and resources available to them, in a language they understand so they can make informed decisions without pressure from the provider. Also, local political support is essential to ensure that government and civil society know and implement the guidelines and policies related to GBV.
“I have the joy of holding this day as one that will be marked in the history of Douentza,” said a representative for the Mayor of Douentza. “For me, this center is a dream long desired by the people of Douentza, especially women and girls. This center will undoubtedly help to effectively respond to violence against women and girls and ensure the welfare of the population remains a priority of the municipality.”