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Holistic Care for Victims of Conflict-Related Sexual Violence

By: Maryna Tkachenko

Conflict-related sexual violence (CRSV) takes on various forms: rape, forced pregnancy, forced sterilization, forced abortion, sexual exploitation, trafficking, genital mutilation, and other heinous forms of sexual abuse. Although both women and men can become targets of sexual violence, women constitute the majority of the victims. It has been widely recognized that all survivors experience long-lasting mental and physical harm, but women and girls have unique, gender-sensitive needs. That is why survivor-centered care is one of the main requirements in providing victims with the tools to take control of their lives. Avoiding further harm and trauma, we must treat survivors with respect for their dignity, bodily autonomy, and the choices they make. 

What does holistic, victim-centered care constitute in practice? Drawing on extensive experience as a founder of Panzi Hospital in 1999 and a co-recipient of the Nobel Peace Prize in 2018 for his work to end the use of rape as a weapon of war, Dr. Denis Mukwege offers us the Panzi Model, a holistic model of care that addresses the root causes of violence against women and girls and rebuilds survivors’ lives based on principles of human rights and gender equality. This model encompasses four main aspects: psychosocial support, medical care, access to legal justice, and reintegration into communities.

Psychosocial care involves providing survivors with resources to fully process their experience, which often involves formal neuropsychiatric help to treat post-traumatic stress disorder (PTSD) or support from the victims’ close relatives. While mental health care by specialists is a must, the basic emotional and practical support of survivors’ family and community members is no less significant. We often think of medical care as treating bodily harm, wounds, and infections. However, pregnancy that results from sexual violence often leads to re-traumatization, shock, horror, and confusion. Forcing victims to proceed with the pregnancy against their wishes can exacerbate trauma, suffering, and feelings of despair. Therefore, access to adequate reproductive health and safe abortions are unquestionable aspects of victim-centered care. (Read Ms. Magazine blog post by GJC Development Director Danielle Stouck on abortion access for refugee women.)

Legal assistance, reintegration initiatives, and socioeconomic care eradicate harmful stigma around CRSV, which often blames women and exculpates perpetrators. Ostracizing victims of gender-based violence strips them of social vitality, a sense of identity, and a meaning for their existence. Not only does this make the survivors’ lives unbearable but it also perpetuates a culture of impunity. Therefore, shifting shame from victims to perpetrators requires placing survivors at the heart of the fight against CRSV.

Holistic care also means supporting women in deciding whether or not to take legal action, which calls for listening to women’s narratives and promoting women’s human rights.  Moreover, since CRSV tends to marginalize women from their family and society, they face significant barriers in attaining economic independence. Reintegration becomes easier if victims are offered opportunities to redevelop social networks and gain necessary training to become financially stable in the future. Since many of these women cannot afford medical and legal assistance, community-mobilization activities are imperative in reducing stigma and ensuring access to services.

It’s crucial to prevent and stop CRSV as it is taking place. Nevertheless, it is no less important to alleviate wide-ranging crippling effects of non-killing, gender-based sexual violence. Since the end of conflict does not mean the end of violence, sufficient rehabilitation and care should aim to provide survivors with all essential services that are needed to help them move on and rebuild their lives in a dignified way. From access to safe abortion to therapy, the world has an obligation to utilize holistic, gender sensitive approaches of post-conflict care as a testimony of solidarity with the victims and condemnation of the perpetrators.

 Photo: AMISOM Public Information/Flickr/Public Domain