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Uganda: Providing sexual violence care to South Sudanese refugees

22 Jun 2017

Médecins Sans Frontières started sexual and gender-based violence (SGBV) activities this year in Bidibidi and Imvepi refugee settlement camps to respond to the increasing need for comprehensive SGBV care among South Sudanese refugees in Uganda. Marie-Anne Henry, is a Médecins Sans Frontières midwife activity manager who has been working in Bidi Bidi and Imvepi since April 2017. 

Why did Médecins Sans Frontières start its SGBV activities?

Many of the refugees from South Sudan have gone through high levels of violence, including sexual violence. They were raped or sexually assaulted and many also witnessed their family being killed or raped. Some people have been raped several times. It’s very important for them to get first aid and psychological support as soon as possible but many survivors do not find it easy to talk about what they have experienced. Many of them are traumatised and scared. We started a SGBV clinic to ensure a safe and neutral space where survivors of sexual violence can access timely medical and psychological care. Before we started its activities, when survivors were identified by other actors, cases were first reported to the police and people had to go through a long and uncomfortable process before getting treatment and support. Médecins Sans Frontières does not take cases to the police unless our patients want to do so, and we prioritise providing treatment before it becomes too late.

"The youngest patient we saw was a 5 year old boy raped and physically assaulted several times multiple times in South Sudan"

What SGBV care does Médecins Sans Frontières provide?

At our SGBV clinics we provide first aid treatment and psychological care. In the consultation, we test for HIV and if the assault happened within 72 hours, we give post exposure prophylaxis (PEP) to prevent an infection, as well as emergency contraception to prevent unwanted pregnancies. If a woman is found to be pregnant and wishes a termination, we refer to a regional clinic when it’s less than 16 weeks of pregnancy. We have midwives specifically trained for SGBV care, as well as psychologists and counselors. We also closely collaborate with the Médecins Sans Frontières mental health clinic in Bidi Bidi, as many of our patients need mental health support for symptoms such as PTSD (post-traumatic stress disorder) and depression. We have female and male patients and male clinical officers are available if the male patients prefer them. 

What SGBV care does Médecins Sans Frontières provide?

At our SGBV clinics we provide first aid treatment and psychological care. In the consultation, we test for HIV and if the assault happened within 72 hours, we give post exposure prophylaxis (PEP) to prevent an infection, as well as emergency contraception to prevent unwanted pregnancies. If a woman is found to be pregnant and wishes a termination, we refer to a regional clinic when it’s less than 16 weeks of pregnancy. We have midwives specifically trained for SGBV care, as well as psychologists and counselors. We also closely collaborate with the Médecins Sans Frontières mental health clinic in Bidi Bidi, as many of our patients need mental health support for symptoms such as PTSD (post-traumatic stress disorder) and depression. We have female and male patients and male clinical officers are available if the male patients prefer them.
 

How many patients have we treated so far?

Who are the patients?So far we have treated 49 patients, including 3 men and 20 children under 18 years old. The youngest patient we saw was a 5 year old boy raped and physically assaulted several times multiple times in South Sudan. Among our patients, 33% experienced sexual violence in South Sudan, 23% during the journey to Uganda, 19% at the border area, and 18% in the refugee settlement or reception centre. 

What are the main challenges that Médecins Sans Frontières is facing?

A challenge is following up with patients after they are settled. The refugee settlements are vast and because some people move from one zone to another, it is difficult to figure out who is settled where. We are now working with our surveillance teams on how to improve our capacity of follow up. In general terms, we are seeing a lack of sufficient services available for SGBV survivors. An increased focus and additional capacity should be allocated for protection and essential psychological and medical care for sexual violence.

 

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