A study of impediments to addressing the sexual and reproductive health needs of gender based violence survivors carried out in Nairobi
Gender refers to the socially determined ideas and practices of what it is to be female or male. Such ideas are sanctioned and reinforced by a host of cultural, political, and economic institutions, including the household, legal and governance structures, markets, and religion (Meinzen-Dick et aI, 2005 pp 4). Gender-Based Violence, therefore refers to violence that targets individuals or groups of individuals on the basis of their gender (Esplen, 2007; 23). However, the term gender is generally assumed to be synonymous with women; and, as for Gender-Based Violence, the term is more commonly applied in relation to violence against women and girls. The unequal power retatons between females and males in society are the root cause of Gender-Based Violence. The legitimized subordination of women in patriarchal societies, including the treatment of women as the property of men through practices such as payment of bride price, perpetuates violence against women and girls (Okumba et al, 2005; 65-66). Whether violence between men and violence men experience related to sexual orientation, can be included within 'gender based violence' is a further complication (Kelly, 2006; 10). Therefore, for the purposes of this study, Gender-Based Violence refers more to violations against women and girls. Violence against women and girls continues to be a global epidemic that kills, tortures, and maims - physically, psychologically, sexually and economically. It is one of the most pervasive of human rights violations, denying women and girls their equality, security, dignity, self-worth, and their right to enjoy fundamental freedoms. Violence against women is present in every country, cutting across boundaries of culture, class, education, income, ethnicity and age (UNICEF, 2000; 2). As well as emergency medical needs arising from violence, survivors of Gender-Based Violence frequency suffer longer-term complications and chronic conditions which, more often than not are not addressed due to such factors as lack of access to health care, or the inability by women and girls to access reproductive health services due to factors such as poverty, lack of financial support and lack of decision-making capacity by women and girls to make critical decisions to seek medical attention when the need arises. The research intended to establish the extent of long-term reproductive health concerns amongst survivors; that is Sexual and Reproductive Health concerns beyond the immediate medical and counseling. The Sexual and Reproductive Health needs of Kenyan women and girls resulting from Gender-Based Violence and the constraints survivors of violence face accessing reproductive health services were the other area of study that the researched focused on. Other areas of study included to find out whether there was any relationship between Gender-Based Violence (GBV) experienced and any reproductive health complications cited by the participants; and to get subjective views on the causes and consequences of GBV disaggregated by age; socio-economic status; residential area; and gender. The study also purposed to identify and document community based approaches to healing or offering psycho-social support to the survivors in the long-run. The study was done in collaboration with Women's Rights Awareness Programme (WRAP), whose administrative records were availed to the researcher, especially for the purposes of studying case histories of GBV survivors. Sampling of GBV survivors for individual and group interviews was done in the neighbourhood of Kibera, mostly from within the informal settlements. The GBV survivors were requested to involve their daughters in the study. Another sample of GBV survivors was taken from the Oromo Refugee Community, which tries to keep culture and tradition alive. Several men from the Oromo Refugee Community were also requested to participate in the study "WRAP is a non-governmental human rights organization which provides alternative safe and secure accommodation for GBV survivors. WRAP also provides various GBV-related supportive services, directly or through referrals. The organization also addresses itself to the advancement and protection of women's and children's.rights through such strategies as awareness creation and advocacy. Programme implementation also involves some element of research; at least some baseline surveyor rapid appraisal to aid in project planning and· implementation, and evaluative research to assess impact of the interventions put in place. This information goes into WRAP's administrative records, besides ,data on clients seeking G8V-related supportive services.