messages by promoting awareness of SGBV and the availability of PEP among its own national staff, patients and other local organisations. Where rape victims seek care outside conventional health structures, with midwives or traditional birth attendants (TBAs), MSF is starting to liaise more closely with them. TBAs can tell victims about the availability of PEP and refer SGBV cases to MSF health structures. In Sudan, MSF is considering employing qualified TBAs as community health workers, both to better reach out to rape victims and to encourage TBAs to liaise with MSF facilities without fear of losing income from their own patients. comprehensive approach – providing medical care ...view middle of the document...
To truly respond to SGBV, international and national actors must demonstrate political will to invest significant financial and human resources in all these inseparable and indispensable dimensions of care for victims of sexual violence. Christine Lebrun (christine.lebrun@ msf.be) is the Women’s Health Expert and Katharine Derderian (katharine. email@example.com) the Humanitarian Advisor for Policy Issues at Médecins Sans Frontières, Belgium www.msf.be
1. For more information, see www.msf.org.au/stories/ twfeature/2006/129-twf.shtml 2. In the case of HIV infection PEP is a course of antiretroviral drugs which to be effective must be started as soon as possible – and certainly no longer than 72 hours – after risk of exposure. 3. See www.msf.org/msfinternational/invoke.cfm?compo nent=article&objectid=14FF2307-A697-4FA9-8CD3756993 78AB1B&method=full_html
Which approach – horizontal or vertical?
MSF combines both approaches. Where we identify a specific, acute problem of violence, we adopt a ‘vertical’ programme specifically addressing SGBV. In our experience, this works best using a
Uganda: early marriage as a form of sexual violence
by Noah Gottschalk Evidence is mounting that early marriage is a form of sexual and gender-based violence (SGBV) with detrimental physical, social and economic effects. Policymakers need to focus on the complex interactions between education, early marriage and sexual violence.
Uganda currently hosts at least 230,000 refugees, the vast majority of them southern Sudanese. With very few exceptions, only refugees living within designated settlements are officially recognised and offered protection and assistance. Refugees receive seeds, tools and small plots of land on which to grow their own food, which government and UNHCR officials expect will supplement or replace rations, with any surplus sold to earn money to meet basic needs including the cost of schooling. Refugees adopt a lifestyle similar to Uganda’s rural poor but with several crucial differences. Years of cultivating the same land – without the possibility of crop rotation – have reduced soil fertility and yields. Moreover, refugees are generally unable to take their products to market and thus depend on Ugandan middlemen who buy cheaply from individual households and sell goods in urban markets for significant profits. Early marriage is often seen as a survival strategy by those unable to move from these isolated settlements, forced to depend on subsistence farming and trapped in poverty. Some girls hope to enjoy greater economic security if married. For their parents the brideprice can be an important financial asset. Many parents also view early marriage as the best – and often only – means of safeguarding their daughters from the high levels of SGBV prevailing in Uganda’s refugee settlements. Officials often ascribe early marriage to cultural preferences but it is clear from talking with refugees themselves that motivations of economic and physical...