Sexual violence must be explicitly addressed by policy makers |
PRETORIA, 5 February (PLUSNEWS) - Though sexual violence
affects millions around the world every year, deeply entrenched cultural taboos
and a lack of political leadership have historically left the issue largely
unrecognised in government boardrooms, health ministries, and scientific
research. But that may change, as an emerging global initiative argues sexual
violence is a legitimate public health and human rights issue that warrants its
own research, prevention, and interventions.
The Pretoria-based Sexual
Violence Research Initiative, or SVRI, was developed in 2000 by a cadre of
researchers who saw sexual violence as an issue in urgent need of research and
resources. Today, SVRI is an initiative of the Global Forum for Health Research,
and since late 2006 has been hosted at the Gender and Health Research Unit of
the Medical Research Council of South Africa.
According to SVRI project
manager Liz Dartnall, little is understood about sexual violence because it is
so often overlooked as an area of research. But she says this form of violence
has major ramifications for various sectors of society – including education,
justice, and health systems – and therefore should be explicitly addressed by
policy makers and service providers, such as hospitals and clinics.
"Sexual violence flows under the radar," Dartnall said. "It hasn't
really been recognised as a public health issue, but rather as a violence issue
and a legal issue. But it has health implications, both psychological and
physical. Survivors of sexual violence will use [health] services, and those
services have a key role to play."
There is no question that awareness
of gender-based violence is growing internationally. In recent years, national
governments have taken steps to stem gender-based violence, particularly
domestic violence. For example, in 2006, a total of 89 countries worldwide had
adopted legislative provisions that address domestic violence, up from only 45
countries in 2003, according to UNIFEM, the United Nations Development Fund for
Women.
Yet sexual violence – as a distinct type of violence which can
include rape, forced prostitution, and other coerced sexual activity – is
commonly overlooked in such legislation. Meanwhile, existing programmes that
directly address sexual violence tend to be small-scale, donor-supported groups
that usually operate in isolation, without substantive government endorsement or
financial backing. At the same time, research about sexual violence remains
limited, especially in a developing world context, and advocates describe "huge
gaps" in the research literature on sexual violence compared to other forms of
violence.
Some argue that this is because women's issues largely tend to
fall off the agenda of national governments and multilateral agencies, including
the United Nations. Last July, the UN special envoy for AIDS in Africa, Stephen
Lewis, said sexual violence was one of many issues regularly sidelined at the
expense of greater gender equality.
"It matters not the issue: whether
its levels of sexual violence, or HIV/AIDS, or maternal mortality, or armed
conflict, or economic empowerment, or parliamentary representation, women are in
terrible trouble. And things are getting no better," he remarked to a high-level
panel on UN reform in Geneva.
Existing Research is
Limited
Available data suggests sexual violence is pervasive
throughout the world. In some countries, one in four women has been sexually
assaulted by an intimate partner, according to the World Health Organisation.
Its 2002 research, World Report on Violence and Health, also finds that in some
countries as many as one in three young women report being forced into their
first sexual experience.
Much existing research on sexual violence was
conducted in the developed world. In the January 2007 issue of the journal
'Trauma, Violence & Abuse', a literature review on interventions for sexual
violence survivors in a health care setting revealed that the vast majority of
such research was conducted within the United States. That research gap means
little is understood about sexual violence in low- and middle-income countries,
according to Dartnall.
"If you are raped in the United States, for
example, you have access to a number of services, there will be different levels
of stigma and you will be responded to differently than if you were raped in
Rwanda," Dartnall said.
Dartnall added that asking sexual violence
survivors what they want can improve the efficacy of services.
For
example, a recent debate in South Africa included many who argued that requiring
rape survivors to have an HIV test before receiving post-exposure prophylaxis
(PEP) might prevent women from seeking out services. But this was contradicted
by a 2005 study published by the UK-based BMJ, 'Women’s experiences of and
preferences for services after rape in South Africa', which found rape survivors
were anxious to get PEP, and the need to test for HIV did not seem to deter
women from attending services.
One of the challenges to making sexual
violence part of mainstream health research is its long-time association with
nongovernmental organisations. Many sexual violence programmes, such as domestic
violence shelters and rape crisis centres, are community-driven and heavily
dependent on donor funding.
"They don't have the time or funding to say,
'How effective is what we're doing in the short term and the long term?'" said
Debbie Billings, a member of SVRI's coordinating committee. "And that's what we
as researchers want to help them find out."
Activists say that for these
programmes to be sustainable, they have to be supported by national governments
and multilateral institutions. That means making sexual violence a priority,
along with gender equity more generally.
Creating an International
Network around Sexual Violence
From its offices in Pretoria, SVRI
supports existing researchers by centralising practical information about
research, programmes and grants. It also provides technical support for
researchers, as well as fundraises and identifies priorities for research around
sexual violence.
"We can get a pretty good sense of where the gaps are,
what needs to be translated, what proposals people are working on," said
Billings, who is also a researcher at Ipas, an international reproductive health
organisation.
There's a growing expression of political will to step up
efforts to end violence against women, one that activists say has been emerging
since 1994, when 179 countries made commitments to public health and individual
well-being at the watershed International Conference on Population and
Development in Cairo, and then the Forth World Conference on Women in Beijing in
1995.
"We're a lot further along then we would have been without those
conferences. Some governments are finally coming around to implement programmes
and dedicating resources to gender-based violence," Billings said. "Still, this
is brand new in a lot of countries."
The Role of Sexual Violence in
the Spread of HIV
In sub-Saharan Africa, HIV experts now tend to
agree that sexual violence and domestic violence are among the key drivers to
what’s been a determinedly unmitigated spread of the disease. Dr Julia Kim,
senior researcher at Rapid Action Deployment of AIDS Research (RADAR) at the
School of Public Health at the University of Witwatersrand, says there's a
growing interest in the issue of sexual violence as its links with HIV become
clearer.
"But that doesn't necessarily mean that that interest has been
matched by resources to do sexual violence research or to support organisations
that are addressing sexual violence," Kim told IRIN/PlusNews. "If you compare
the money on basic science research around HIV, or on the development of
HIV-related pharmaceuticals, it really overshadows by orders of magnitude the
kind of funding that goes in to research around sexual violence."
She
argues that sexual violence research is crucial in highlighting some of the
underlying socio-economic factors of the disease's transmission, which she says
will never be understood if researchers focus only on health interventions.
"It's easy for us to think that HIV is a health problem, so we've tended
to focus on interventions that are driven by the hospital, by doctors,
antiretroviral treatment," she said. "This isn't to say that those aren't
important, but it's missing the broader issues that make women vulnerable to
HIV."
Kim said broadening research to include sexual violence is all the
more urgent because it's within our control.
"Sexual violence is
preventable," Kim said. "So it's not hopeless; it's within our grasp. We can
change this in our generation so the next generation grows up in a different
landscape."