Victims of Gender-Based Violence Need More Access to Care and Justice. 30/11/2016

Published by DAILYNATION

Last week, the Kenyan government together with
the United Nations launched the National Program to address
gender-based violence. This is a positive step that shows a growing
awareness at the highest levels of a nation-wide issue that requires
more coordinated effort from all actors involved.

Médecins
Sans Frontières has been providing medical care for victims in Nairobi
Eastlands since 2008, with a focus on sexual violence. Last year, our
teams treated more than 2,500 patients and the vast majority (>90 per
cent) were female. More than half were aged below 18. This is currently
our largest gender-based violence project worldwide.

According
to the 2014 Kenya Demographic and Health Survey, 45 per cent of Kenyans
aged between 15 and 49 had experienced physical violence since the age
of 15. Of these, 56 per cent of women and 72 per cent of men had not
sought assistance to put an end to the violence.

LOOKING FOR VICTIMS

Community
mobilization and, foremost, networking with all institutions likely to
encounter victims of gender-based violence have been key in improving
their access to the MSF clinic. Half of the patients we see today are
referred by the authorities (police and chiefs for example), which
clearly demonstrate the value of linking up across sectors to ensure
victims can access appropriate care.

Receiving
care quickly is also crucial, as treatment provided within 72 hours of
an assault is much more effective at preventing the transmission of
sexually transmitted diseases such as HIV and/or unwanted pregnancies.
It also helps ensure the collection of any quality forensic evidence for
legal purposes.

In Eastlands, MSF’s
hot line number coupled with a free ambulance service, as well as the
introduction of specialized nurses in two additional structures have
proven that a quick response can be achieved if care is brought as close
as possible to victims. In MSF supported facilities, around 80 per cent
of the victims are admitted within 72 hours.

THE NURSE-DRIVEN MODEL

Too
few health facilities in Kenya today have the necessary means to
implement gender-based violence care, lacking dedicated trained staff
and sufficient resources. In close collaboration with the Ministry of
Health and Nairobi County, MSF implemented a year ago a simplified and
integrated model using nurses as first-line responders in Makadara
health centre and Mama Lucy Kibaki hospital.

Nurses
with the appropriate training provide the initial treatment and
counselling, and then refer patients to a higher level of care or other
services when needed. Such model could help decentralize and expand
gender-based violence care throughout Kenya if most health facilities in
the country would incorporate this capacity.

JUSTICE FOR SURVIVORS

Such
a “nurse-driven model” has been proven effective in countries like the
United States or South Africa. It did not only improve the quality of
care but also enhanced the timely collection of forensic evidence that
is potentially a determining factor for any formal investigation.

Unfortunately,
such evidence remains seldom used in Kenya. In 2015 MSF collected 608
positive vaginal swabs that could have undergone matching with a
rapist’s DNA. The police eventually retained 11 for analysis.

Failure
to prosecute does not encourage victims of gender-based violence to
seek justice, and it can even jeopardize their safety. Gender-based
violence is a crime that can only be addressed through strengthened
coordination between health professionals, the police and judiciary
actors.