Gender, Sexual Violence,

& Humanitarianism

Dr. Ayesha Ahmad

Lecturer in Global Health

Email: aahmad@sgul.ac.uk

Twitter: @AcademicAyesha

Introduction

• Examine role of gender in societies experiencing

humanitarian crises & nature of sexual violence

• Explore cross-cultural aspects of gender based

violence

• Critically analyze humanitarian responses to gender

based violence

Objectives

• Describe why considering violence matters for global health

• Understand contextual factors that shape sexual violence

• Ability to critique multi-sectorial approaches in responding to

sexual violence in humanitarian contexts

• Understand mental health aspects of sexual violence

• Critically evaluate cross-cultural psychological interventions of

humanitarianism

• “Sexual violence in conflict represents a great moral issue of

our time… casts a long shadow over our collective humanity”

Special Representative of the Secretary-General on Sexual

Violence in Conflict

Positive changes: “a normative foundation has been laid and

deeper knowledge, analysis, and information led to strategic

interventions” … more resources for interventions and

accountability.

(Sexual)VIOLENCE

Violence—definition

• “the intentional use of physical force or power, threatened or actual,

against oneself, another person, or against a group or community,

which either results in or has a high likelihood of resulting in injury,

death, psychological harm, mal-development, or deprivation”

[World Health Organization]

Violence and Global Health

• Violence - declared a major public health issue since 1996 [World

Health Assembly]

• ‘Cultural’ forms of violence; acts that fall under the category of

violence but are accepted as societal norms such as Female Genital

Mutilation [FGM]

• Mass and collective forms of violence such as conflict, humanitarian

crises, the recent revolutions as well as individual acts

• Trans-generational trauma- beyond the violence, issues in migration-

traumatized exiles, asylum seekers, racism

Effects of Violence

• Violence and trauma refer to experiences; rather than inherent

pathological processes, which can cause psychiatric disorders such as

Post Traumatic Stress Disorder [PTSD]

• Globally, violence claims 1.6 million lives annually

• 50% due to suicide

• Causes significant mental health consequences such as depression and

anxiety

• Affects safety and security of communities and society

• Subject to cultural differences

• Bridge humanitarian and medical institutions

• PTSD – humanitarian - interventions are a vital aspect of responses to

all forms of violence

Cultures of Violence

• Symbols, ideas, images [Juergensmeyer; 2003]

• Stigma and Shame – basis of honor-based violence

• Violence is understood through narrative – a distinctly ‘cultural’

process’ [J.C. Wood, Violence and Crime in Nineteenth-Century

England: The Shadow of Our Refinement” (London: Routledge, 2004).

Prevention of Violence

• Key focus for health organizations, policy-makers, academics

• Root causes of violence are predominantly social and cultural factors

• Prevention efforts need to begin at a young age

• Changing social norms

• For example, in sexual violence, focus is on developing strategies to

promote gender equality

Definition: Gender-based

violence

• Gender:—

• Refers to the ‘socially constructed roles, behaviors, activities, andattributes that a given society considers appropriate for men andwomen’ [World Health Organization]

• UN Declaration on the Elimination of Violence against Women: “is amanifestation of historically unequal power relations between menand women…”…”a crucial social mechanism”...

• Ozgecan Aslan, 20 year old, Southern Turkey

• “No child is born a murderer, a thief, or a terrorist. Everyone is bornan angel. There are many things behind what has turned him intothis” [Naciye Tan, the mother of Ozgecan’s murderer – 26 year oldAhmet Supho Altindoken].

Gender in Humanitarian

Crises

• Disasters are: social phenomenon, rooted in social structure

[Quarantelli, 1994]

• Social processes more visible in times of disaster: compressed into

very dramatic and short time span [Fritz, 1961]

• Humanitarian settings are not gender neutral

• Gender is an organizing principle of societal roles and perceptions

• Humanitarian action is representative of the society in ‘peace’ times

• Humanitarian guidelines must account for the values within society –difficult within a framework of neutrality and pluralism

• Gender is under-recognized in terms of its impact

• Triage and disaster recovery may be at risk of minimizing theimportance of gender

Case Scenario

• In the recent Darfur crisis, women and young girls were confrontedwith the difficult task to ensure access to sufficient food for theirfamilies. This led to them leaving the camp regularly in order to fetchfirewood and grass for handicrafts. Leaving the camp meant that theyexposed themselves to being harassed, looted, raped or killed by thesurrounding rebel groups (gunmen). Humanitarian aid organizationswere aware of the risks women exposed themselves to when leaving thecamp and thought of distributing fuel efficient stoves. This however didnot protect them from harm as women continued to leave the camp tocollect grass in order to do their handicrafts to be sold at the localmarket in order to generate some income.

Sexual Violence in Conflict

• Nature of conflict increasingly characterized by use of sexual violence

as a ‘weapon of war’

• e.g. Rwanda, Bosnia, D.R.C, Syria

• Understanding of the type of trauma is important for mental health

support and humanitarian initiatives

• Role of testimony is vital

Sexual Violence as a ‘Weapon of

War’: Milestones

• The Security Council (UN) adopted Resolution 1325 (2000) following

recognition of the need to protect women and girls during armed

conflict

• Result of study of armed conflict led to Women, Peace, and Security

report (2002)

• Resolution 1820 (2008) further updated the need to address impunity

during and after conflict (Resolution 1620, (2013)) and to further

address sexual and gender-based violence during and after armed

conflict

Jean-Pierre Bemba

• “The ICC trial of former Congolese vice-president and militia leader

Jean-Pierre Bemba concerned command responsibility for crimes

committed by Bemba’s militia the Mouvement pour la Libération du

Congo (MLC) against civilians during the 2002-3 internal armed

conflict in the Central African Republic (CAR). The trial opened in

November 2010, with Trial Chamber III convicting Bemba of murder,

rape, and pillaging as war crimes and murder and rape as crimes

against humanity in March 2016. Bemba was sentenced to 18 years’

imprisonment in June 2016. Victims reparations are pending”.

• http://www.coalitionfortheicc.org/cases/jeanpierre-bemba-bemba-i

‘War-rape’: Multiple ontologies

• Definition of rape that is too narrowly confined to the violation of the

body is a dangerous reduction

• Penetration of the body represents the penetration of the enemy

• Body is lining of the social situation

• ‘War-rape’ is complete annihilation of all boundaries constituting our

human condition

Beyond boundaries

• Rape is a “deliberate strategy to undermine community bonds and weaken

resistance to aggression”

• “Since rape in war affects not only the individual but also the family and

community to which the survivor belongs, the restoration of social and

community bonds is central to the process of healing and must be addressed

within the specific cultural setting”

[Swiss and Giller; 1993]

Finding stories

• Societies have strong stigmas and sensitivities regarding sexualviolence

• War and/or trauma from sexual violence are a chapter from an entirelife history

• Western psychiatric perspectives magnify trauma

• Oral story-telling contexts – virtue of story is to ‘pass it on’ – affectssense of privacy/secrets/confidentiality

Humanitarian Contexts

• Humanitarian action: Cross cultural interventions crossing boundaries

of values —shapes priorities, needs, and determines risk following a

disaster

• Clinical decision-making needs to factor in potential sexual violence

Trauma

• Trauma – a deeply distressing and emotionally painful experience

• “Traumatic events are extraordinary, not because they occur rarely,but rather because they overwhelm the ordinary adaptations to life”[Judith Herman, Trauma and Recovery]

• Post Traumatic Stress Disorder = a mental health condition that istriggered by a terrifying event – either experiencing it or witnessing it.Symptoms may include flashbacks, nightmares and severe anxiety, aswell as uncomfortable thoughts about the event

Post Traumatic Stress

Disorder: Global context

• 2 basic groups of potentially traumatic events: intentional orinterpersonal including war, abuse and violence, and accidentalincluding natural disasters

• PTSD studies in Europe suggest presence of long-term emotional andpsychological impacts of the Second World War even among secondand third generations [Burri and Maercker, 2014]

• Bearing witness to trauma is also a source of PTSD—high exposure toviolence

• “A person is as weak or as strong as his or hers society assumes themto be” [Derek Summerfield]

Disclosure of sexual violence among

refugees in humanitarian settings

• Disclosure of trauma is considered to be an essential component ofthe therapeutic recovery process from Post-traumatic Stress Disorder(PTSD). However, the status of disclosure offers different symbolismsdepending on societal contexts.

• PTSD is a normative prescription classifying suffering.

• Disasters, conflict, humanitarian crises typically occur in non-Western settings, yet involve humanitarian action includingpsychological interventions from clinical frameworks dominated by aWestern scientific medicine paradigm, which then forms the basisof informing assessment criteria, diagnosis and treatment.

Suffering in Silence?

Syria- Who is silent?

“Direct accounts of sexual violence continue to be sought from victims

and eyewitnesses. It remains immensely difficult to collect first-hand

accounts due to a culture of silence that prevents reporting”

International Independent Commission of Inquiry on the Syrian Arab

Republic [March, 2013]

Sexual Violence in Syria

• 2013: psychological aid and support in aftermath of sexual violence by

UN humanitarian agencies provided to 38,000 people

• Post-rape treatment to 17 hospitals and primary health care centers in

Lebanon- home to largest number of Syrian refugees

• On average, 75 people who experienced SV during the conflict access

UN services every month in the Za’atari refugee camp, Jordan

• Fear of SV driving force for refugee exodus

• SV victims also victims, consequently, of ‘honor killings’

Non-disclosure

• “it happened to my sister/aunt/neighbor/friend”

• Description of suffering is without dialogue – a character-less voice

• Creates space for the traumatized individual to emerge during the

psychological assessment

Silence: Strategies

• Maintain family relationships and social cohesion amongst a backdrop

of ‘shame’

• Limitation of trustful objects during conflict

• Sharing of sexual violence especially to a male elder is problematic

Silence

• Nuances of silence relate to the internal processing of GBV

• Silence is not necessarily indicative that an individual’s story isomitted or negated

• Silence and embodiment of trauma are not mutually exclusive

Suffering in silence

• A 35 year old Syrian mother of 3 children in a refugee camp in Jordan

seeks medical treatment for headaches. She appears anxious and does

not engage in the questions about her headache symptoms. You suspect

she is preoccupied with another health issue that she is reluctant to talk

about. Many women have been coming to you following rape in the

refugee camp, the migratory journey or during the conflict that they

have fled from. You suspect she is worried she may be pregnant. You

know that she is widowed. If you suggest a pregnancy test, you fear she

will leave the clinic and lose her trust due to the potential disclosure.

However, if you offer her a pregnancy test as part of a general

examination, you feel you are colluding with her shame and are not

being honest with your patient.

Current Challenges for

Humanitarian Action

• Yazidi community: sexual violence on the basis of religious

justification – one survivor saying “they made us convert to Islam and

we all had to say the shahada. They said, “You Yazidis are kufar”…

—abduction of women, women and girls raped, forcibly married from 9

years old, forced abortion if pregnant when captured, intentionally

made pregnant by ISIS fighters in order for the child to inherit their

father’s ethnicity and religion

Nadia Murad

Conclusion

• Women suffer as well as men during conflict and greater recognition of

conflicts as gendered and gender-based violence during conflict is shaping

humanitarian discourses

• Humanitarian action demands both protection of and treatment for women

• Conceptual framework of humanitarian action “depends on controlling

abundant variables including cultural factors, psychological factors,

international factors, social factors, political factors and the relation between

these factors as well” (Zhianpour et al., 2015)

• Need for greater space for women’s narratives

• Clinical decision-making needs to be informed by robust research and

education

• Gender is an important determinant in global health

• Gender is an organizing principle in the effects of disasters

• Gender plays a role in nature of conflict

• Gender-based violence is societal construct and determines nature of

violence

• Violence is closely linked to causing mental distress such as trauma –

by virtue of a violent action, the intention is to traumatize

• Preventive measures is the main approach to tackling violence