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Standards for Response to Sexual and Gender-Based Violence

Sexual violence is a fundamental violation of human rights and has a profound impact on physical, mental, social and economic well being of women and girls both immediately and in the long-term. Acts of sexual violence committed as part of widespread or systematic attacks against a civilian population in Darfur can be classified as crimes against humanity and prosecuted as such.⁴⁸

In addition to the psychological and medical consequences, the social and economic consequences of rape, such as the risk of losing family support and becoming unmarriageable due to stigma, demand that economic security be provided through other means, such as jobs and income-generating activities.

Of the many guidelines available on sexual violence, HIV/AIDS and other sexually transmitted infections and the particular risks faced by refugees and internally displaced persons, there are four guidelines in particular produced by UNHCR, the IASC and the World Health Organization (WHO) that are fundamental for the management of sexual violence and its consequences in the context of armed conflicts and refugee movements:

1. Sexual and Gender-Based Violence against Refugees, Returnees and Internally Displaced Persons: Guidelines for Prevention and Response. UNHCR 2003. (SGBV guidelines)
2. Inter-Agency Standing Committee Task Force on HIV/AIDS in Emergency Settings, Guidelines for HIV/AIDS Interventions in Emergency Settings. IASC 2003. (IASC guidelines)
3. Clinical Management of Rape Survivors: Developing Protocols for Use with Refugees and Internally Displaced Persons. Revised edition, World Health Organization/United Nations High Commissioner for Refugees 2005. (Clinical Management of Rape protocols)
4. Guidelines for the Management of Sexually Transmitted Infections. World Health Organization 2003.

The first three sets of guidelines recognize that sexual violence may be used as a deliberate strategy against civilians, and as such can be war crimes and crimes against humanity. The most recent guidelines, the WHO/UNHCR Clinical Management of Rape protocols state:

Rape in war is internationally recognized as a war crime and a crime against humanity, but is also characterized as a form of torture and, in certain circumstances, as genocide. All individuals, including actual and potential victims of sexual violence, are entitled to the protection of, and respect for, their human rights, such as the right to life, liberty and security of the person, the right to be free from torture and inhuman, cruel or degrading treatment, and the right to health. Governments have a legal obligation to take all appropriate measures to prevent sexual violence and to ensure that quality health services equipped to respond to sexual violence are available and accessible to all.

The rationale for having guidelines and protocols on sexual violence, HIV and emergency preparedness is to facilitate the provision or appropriate services necessary to mitigate not only the immediate effects of the crisis but also the aftermath, which may last for many years. In terms of sexual violence as an element in ethnic cleansing, with all of the attendant health, social and economic consequences, it is essential that these guidelines are fully implemented by humanitarian agencies.

During but also following an armed conflict, the confluence of displaced persons, refugees, sexual violence and HIV/AIDS is a key issue of protection. Thus the dissemination and implementation of the SGBV guidelines and the clinical management of rape protocols are essential. Moreover, as stated by the IASC, “[t]he guidelines are applicable in any emergency setting, regardless of whether the prevalence of HIV/AIDS is high or low.” The guidelines are unambiguous in the recommendation that “[a]ppropriate treatment should be proposed to the victims and post exposure prophylaxis for HIV/AIDS should be provided in places with more than 1 percent HIV prevalence.”⁴⁹

The guidelines also recognize that “prevention and control of STIs are key strategies in reducing the spread of HIV/AIDS.”  This is absolutely essential in an environment where condoms are culturally unacceptable (although condoms are available, the take-up rate is extremely poor, and refugee men freely admit that in their culture, the use of condoms is offensive. Nor are women are in any position to demand the use of condoms.) Treatment of STIs takes many forms, and there are very few facilities to diagnose STIs in order to develop an appropriate treatment protocol for implementation. This is especially important given the findings of high rates of syphilis⁵⁰ in a small sample group of pregnant women in two refugee camps and the recognition of the link between infection with syphilis and HIV risk in some populations.⁵¹

Establishing confidential ways for women and girls to seek treatment and counseling within the camps is essential, particularly where, as in Darfur, admitting to having been raped can result in stigma from spouses, families and communities. Reporting protocols for sexual violence should be adapted to respond to the cultural environment, including the low levels of literacy among Darfurian women, and should ensure confidentiality.

The international community has an obligation to meet the very specific needs of women and girls who have suffered or are suffering sexual and gender-based violence. Protection from violence and comprehensive measures to address the needs of women and girls who have been raped must be implemented without delay.