Rape victims in Ugandan camps need better health care

The protracted war between the Ugandan Government and Lord’s Resistance Army rebels has forced 1.7 million people to flee their homes. Women living in camps are at risk of forced marriage, sexual harassment and abuse and rape, often by their partners. Services for victims of sexual violence are woefully inadequate. 

In 2006 the London School of Hygiene and Tropical Medicine, in the UK, conducted a survey into health services in the refugee camps of Uganda. Their report focuses on services for female survivors of sexual violence.

The camps house between 1,000 and 50,000 refugees and suffer from many of the problems found in poor urban areas. More than half of the inhabitants are under the age of 15, and a quarter of the children have lost one or both of their parents. Rates of mortality, illness and mental distress are high in the camps, which are crowded and do not have proper sanitation.

Researchers interviewed 26 professionals about violence against women (gender-based violence) in Gulu district, northern Uganda. They inspected the availability of medical supplies such as emergency contraception for victims of sexual violence. The study found that while services for victims of violence were inadequate there was no money available to improve the services. Other findings include:

• Seven of the eight health centres surveyed had at least one person trained in handling violence against women.
• While trained staff felt they were able to identify cases of violence, they did not feel confident in treating or counselling the women victimised.
• There was a shortage of medical supplies such as drugs to prevent HIV infection following rape. However, clinics did have drugs for sexually transmitted infections (STIs).
• The clinics had nowhere to store confidential documents.
• The professionals believed rape by strangers was uncommon but early marriages made the girls more vulnerable to rape by their partners.
• In contrast the professionals believed forced marriage, sexual harassment and abuse of young girls, and rape within marriage were very common.

Current international guidelines for programmes to deal with gender-based violence in humanitarian settings focus on rape by strangers. However, other forms of violence towards women may be more common in northern Uganda. Such guidelines could exclude girls and women who have suffered from violence not directly related to the conflict from obtaining health care. The study recommends that the guidelines take a broader view of gender-based violence, and also advocates:

• an increase in the provision of services, in particular youth-friendly services, for victims of violence at local health centres
• more training for health workers to support survivors of violence
• greater availability of necessary drugs for treatment of STIs, post-exposure prophylaxis for HIV and emergency contraception at the clinics
• further investigation into the rape and sexual exploitation of men and boys
• campaigns for greater awareness within the community, particularly among young people
• the legalisation of abortion for rape victims who do not get to clinics in time to take emergency contraception.

Source(s):
‘Health Services for Survivors of Gender-Based Violence in Northern Uganda: A Qualitative Study’, Reproductive Health Matters 16(31), pages 122 to 131, by Mirkka Henttonen, Charlotte Watts, Bayard Roberts, Felix Kaducu and Matthias Borchert, 2008
 

Funded by: Wellcome Trust

id21 Research Highlight: 6 October 2008

Further Information:
Mirkka Henttonen
Uudenmaakatu 44 C 44
00120 Helsinki
Finland

Contact the contributor: mirkka.henttonen@gmail.com

Other related links:
'War-zones forever? Tackling violence in South Africa’s schools'

'Education and health for adolescent girls in Chad’s refugee camps'

'Reintegrating girls from fighting forces in Africa'