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Conflict And Catastrophe Medicine > Gender, Sexual Violence & Humanitarianism > Flashcards

Gender, Sexual Violence & Humanitarianism Flashcards

1
Q

Learning Objectives

A
  • 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
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2
Q

What is sexual violence?

A
  • “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.
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3
Q

Define Violence

A

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

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4
Q

What is the correlation between violence and global health?

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  • 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
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5
Q

What are the effects of violence?

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  • 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
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6
Q

What are the additional effects of violence?

A
  • Subject to cultural differences
  • Bridge humanitarian and medical institutions
  • PTSD: Humanitarian: Interventions are a vital aspects of responses to all forms of violence
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7
Q

Describe the different cultures of violence

A
  • Symbols, ideas, images [Juergensmeyer; 2003]
  • Stigma and Shame – basis of honor-based violence
  • Violence is understood through narrative
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8
Q

How do we prevent violence?

A
  • 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
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9
Q

Define gender based violence?

A
  • Gender: Refers to the ‘socially constructed roles, behaviors, activities, and attributes that a given society considers appropriate for men and women’
  • UN Declaration on the Elimination of Violence against Women: “is a manifestation of historically unequal power relations between men and women…”…”a crucial social mechanism”…
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10
Q

What is the role of gender in humanitarian crises?

A
  • 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
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11
Q

What is the role of gender in humanitarian crises?

A
  • 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 the importance of gender
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12
Q

Describe how sexual violence works in conflict

A
  • 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
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13
Q

What was the result of sexual violence being used as a weapon of war?

A
  • 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
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14
Q

What is meant by war rape?

A
  • 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
  • Rape is a “deliberate strategy to undermine community bonds and weaken resistance to aggression”
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15
Q

How do we find stories in relation to war rape and sexual violence?

A
  • The majority of the research is conducted in conflict areas
  • Societies predominantly Islamic, and/or have strong stigmas and sensitivities regarding sexual violence
  • War and/or trauma from sexual violence are a chapter from an entire life history
  • Western psychiatric perspectives magnify trauma
  • Oral story-telling contexts – virtue of story is to ‘pass it on’ – affects sense of privacy/secrets/confidentiality
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16
Q

What are the humanitarian contexts in regards to wars and disasters?

A
  • “It is now more dangerous to be a woman than a soldier in modern conflict”— Major General Patrick Cammaert, former UN Peacekeeping Commander
  • Humanitarian action: Cross cultural interventions crossing boundaries of values —shapes priorities, needs, and determines risk following a disaster
17
Q

Describe Trauma

A
  • 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 is triggered by a terrifying event – either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncomfortable thoughts about the event
18
Q

What is Post Traumatic Stress Disorder in a global context?

A
  • 2 basic groups of potentially traumatic events: intentional or interpersonal including war, abuse and violence, and accidental including natural disasters
  • PTSD studies in Europe suggest presence of long-term emotional and psychological impacts of the Second World War even among second and third generations [Burri and Maercker, 2014]
  • Bearing witness to trauma is also a source of PTSD—high exposure to violence
  • “A person is as weak or as strong as his or hers society assumes them to be” [Derek Summerfield]
19
Q

Describe the disclosure of sexual violence among refugees in humanitarian settings

A
  • Disclosure of trauma is considered to be an essential component of the therapeutic recovery process from Post-traumatic Stress Disorder (PTSD). However, the status of disclosure offers different symbolisms depending on societal contexts.
  • PTSD is a normative prescription classifying suffering.
  • Disasters, conflict, humanitarian crises typically occur in non-Western settings, yet involve humanitarian action including psychological interventions from clinical frameworks dominated by a Western scientific medicine paradigm, which then forms the basis of informing assessment criteria, diagnosis and treatment.
20
Q

What is happening in Syria in relation to sexual violence?

A

“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”

21
Q

Describe the sexual violence occurring in Syria (PART 1)

A
  • 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
22
Q

Describe the sexual violence occurring in Syria (PART 2)

A
  • 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’
23
Q

How is silence used as a strategy in conflict zones?

A
  • 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
24
Q

What are non disclosures and how are they used?

A
  • “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
25
Q

What are the problems in regards to being silent and not silenced?

A
  • Misinterpreting silence as an ‘empty mind’ results in loss of recognition of individual suffering and the way that suffering is endured and/or embodied
  • Suffering is culturally contextualized and must be evaluated aside from normative measurements
26
Q

What are the features of silence?

A
  • Nuances of silence relate to the internal processing of GBV
  • Silence is not necessarily indicative that an individual’s story is omitted or negated
  • Silence and embodiment of trauma are not mutually exclusive
27
Q

What are the current challenges for humanitarian action?

A
  • 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
28
Q

Conclusion

A
  • Women have always suffered most from conflicts and are a vulnerable population following disasters
  • 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)
29
Q

Conclusion

A
  • 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
30
Q

Conclusion

A
  • 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

Conflict And Catastrophe Medicine (34 decks)

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