MSF to help victims of gender-based violence

Médecins Sans Frontières/Doctors Without Borders (MSF) is a medical organisation founded in 1971 that today works in more than 70 countries around the world. MSF delivers emergency aid to people affected by armed conflict, epidemics, natural disasters and exclusion from healthcare. MSF offers assistance to people based on need, irrespective of race, religion, gender or political affiliation.    MSF has been working in Bangladesh since 1992 and currently runs two projects. MSF’s clinics in the slum areas of Kamrangirchar provide a range of services focusing on sexual and gender-based violence, adolescent reproductive health and occupational health for factory workers. MSF also runs a clinic in Kutupalong, Cox’s Bazar, providing health and maternal care to Rohingya refugees and the local Bangladeshi population.    Globally, almost 30% of all women, who have been in a relationship, have experienced physical and/or sexual violence by their intimate partner (WHO, 2013).    There has been a steep rise in victims of sexual and gender-based violence receiving medical treatment in the slum areas of Kamrangirchar, Dhaka.    Hundreds more women and girls accessed medical treatment in 2015 after experiencing sexual and gender-based violence in Kamrangirchar, Dhaka. New patient data collected shows clinics run by MSF in the areas of Alinogor, Thoda and Jawlahati treated almost double the amount of victims of sexual and gender-based violence in 2015 compared to that of the previous year, with 1,154 patients compared to 684 in 2014. This includes those who have experienced rape, intimate partner violence, sexual violence and domestic violence.    “As soon as we opened these decentralised clinics, combined with raising awareness locally, we saw large numbers of women and girls who needed medical care,” says Emilie Gassier, MSF’s project coordinator in Kamrangirchar.    “Usually women come to get help when their husbands and relatives are at work. Often they cannot afford the cost or the time to go to other areas of Dhaka. So it is important to have easily accessible clinics near them, allowing victims to avail services without having to explain themselves to anybody.”    MSF’s clinics for women in Kamrangirchar, established in 2013, are the only health facilities in the area offering free and confidential medical services and counselling for victims of sexual and gender-based violence, to provide community based services that are easily accessible.    MSF collaborates with the One Stop Crisis Center (OCC) run by the Ministry of Women and Children Affairs in the Dhaka Medical College Hospital for severe cases that require referral services.    In 2015, more than 700 of the women cared for by MSF had experienced intimate partner violence. While women and girls of all ages come to the clinic, most patients are aged from 15-30, confirmed Dr Moury, one of the medics running the women’s clinics in Kamrangirchar.    “The younger girls really struggle to open up about any sexual or physical violence they might have experienced,” says the doctor. “The main issues are the stigma and their sense that they have no alternative – that even though their husband is assaulting them, they have to stay with him. Some see it as their fate. We see that women are often too scared to get help, but as awareness grows that these services are here and accessible to them, more and more women are seeking treatment.”    MSF’s clinics for women focus on treating the medical consequences of sexual and gender-based violence. For example, those who have experienced rape may have serious injuries resulting from the attack, as well as increased risk of sexually transmitted infections such as syphilis, chlamydia and gonorrhoea, as well as hepatitis B and HIV. Sexual violence is also associated with a high prevalence of symptoms related to post traumatic stress (eg avoidance, flashbacks and nightmares) and with other mental health disorders such as depression or anxiety. Women are encouraged to come within 72 hours of experiencing an assault to be seen by our doctors and talk to the mental health team, but they are also welcome anytime, even if they cannot make it within 72 hours.    “It is essential that these women can make their own decisions about their medical needs, and it is vital that they have a place where they can get confidential medical care and psychosocial support,” says Emilie Gassier.