Surviving sexual and gender based violence in Liberia
As part of my security induction in Liberia I was struck by the emphasis on my personal safety as a woman. Among other restrictions, I’m not allowed to be out on foot alone between 7pm to 7am. I’m also advised that in some settings it’s good practice to carry a supply of Post-Exposure Prophylaxis (PEP) kits to prevent HIV infections and emergency contraception (also known as the morning after pill), especially in case a staff member is sexually assaulted.
I’m told I don’t need to take these on the field trip I’m about to go on tomorrow as part of my overall visit to help the country programme develop a health proposal to roll out the government’s strategy on health services.
It is estimated that during the country’s 14-year civil war between 1980-1994,
50% – 70% of women and girls were sexually assaulted. These are astounding statistics. Assessments on gender-based violence led by the Ministry of Health and Social Welfare and the WHO in 2005 and 2006 revealed the most common form of violence against women was rape; it accounted for 74% of the various forms of gender-based-violence carried out during the civil conflict.
In 2008 the Journal of the American Medical Association reported high rates of post traumatic stress disorder (PTSD), major depressive disorder (MDD)
and suicidal ‘ideation’ among those interviewed who had a history of sexual violence.
This was especially so among male combatants who reported that they had experienced sexual violence. The research estimated that based on Liberia’s population, approximately 3.46 million, roughly 800,000 adults are likely to be suffering from PTSD, 750,000 adults MDD, 205,000 adults have suicidal ‘ideations’ and 112,000 have attempted suicide.
Treatment important for recovery
The research concluded, not surprisingly, that given the high burden of psychiatric illnesses in the general population who may need specialist medical care for the treatment of post traumatic stress, depression, substance abuse and sexual violence, psychiatric care should be core components of the recovery and rehabilitation programme for the Liberian population.
Mental health, gender-based violence and substance abuse treament are all included in the Government of Liberia’s Basic Package of Health Services which is being rolled out across the country with strong donor support. Although there are signs of international non-governmental organisation support to respond to the need for specialist care and support, it’s limited and progress is likely to be slow.
Medicin du Monde, a French non-governmental organisation, and the country’s Ministry of Health and Social Welfare are working on a pilot project to strengthen staff capacity and develop a national strategy for psychiatric care. Save the Children Liberia is exploring opportunities to work with MDM to support its work with vulnerable women and children.
During my tour of the Government run Margibi County Hospital, I noticed a health education poster on sexual or gender-based violence. Published by the Norwegian Refugee Council, it identifies for 4 clear action steps for people to take: visit the hospital, report to the police, receive counselling and go to court. The poster also gave names and address of where women could go for help at each stage and Save the Children is listed as one of the agencies able to provide counselling support.
It could be a small, but important step for a woman trying to rebuild her life.