BOGOTÁ, COLOMBIA/NEW YORK—Sexual violence should be treated as a medical emergency and survivors should be guaranteed accessible and comprehensive medical treatment, said the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) on the International Day for the Elimination of Violence against Women.
“Sexual violence against any person is totally unacceptable,” said Pierre Garrigou, head of mission for MSF in Colombia. “To survive, it is essential to find medical and psychological treatment as soon as possible. Health institutions have to ensure that the response to sexual violence survivors is comprehensive and adequate. Today, the institutional response is not sufficient and late.”
“The 13-year-old girl was brought by her mother to the consultation room. The violent incident happened three years ago. According to the mother, the girl received good quality medical attention in Barbacoa. However, there were some flaws: she didn´t receive any documents (report, medical treatment received, consultations for follow-up). Besides, the attention was not comprehensive, as she didn´t receive mental health support. The girl shows depressive symptoms and post-traumatic stress that make her unable to establish adequate social relations, especially with adult men, as well as daily activities.”
Testimony from an MSF doctor in Nariño
Eighty percent of survivors of sexual violence treated by MSF between June 2012 and August 2013 had not looked for help in local health structures. The obstacles to their seeking health and psychological help were: the lack of awareness that an assault requires medical attention (61%); not considering they had suffered sexual violence; threats by the perpetrator, and shyness, among others.
“The health staff has to be trained to actively find cases so that the response is adequate and the mental health service has to be available in the health structures at the first level of attention,” said Garrigou. “But it doesn´t have to be limited to the health sector, the emergency focus has to be across all institutions involved in the response to sexual violence.”
The Importance of Early Treatment
It is crucial that survivors of sexual violence get medical attention within the first 72 hours of an attack, in order to provide prophylaxis to prevent HIV/AIDS, and to administer antibiotics that will help prevent infections such as chlamydia, gonorrhea or syphilis, as well as emergency contraceptives to avoid unwanted pregnancies.
“We identified the case of a 24-year-old patient who survived sexual violence that resulted in an unwanted pregnancy. She went to legal entities to file a complaint. However, she didn´t go to any health institution until she had to give birth. She tried to interrupt her pregnancy several times and tried unsuccessfully to end her life. Her family expelled her from the house. Today she is fleeing from the perpetrator, who is out of jail.”
Testimony from an MSF psychologist in Caquetá
Apart from the physical consequences, sexual violence has a devastating psychological impact. Almost all the survivors show symptoms such as aggression, sadness, excessive fear, irritability or anger, and anxiety or stress. Less than one in every three woman treated by MSF had received psychological support after their assault.
MSF is treating sexual violence survivors in its health and mental health programs in Cauca, Nariño and Caquetá,Colombia. Between June 2012 and August 2013, MSF treated 223 cases of sexual violence.