Dr Hakizimana Fr. Xavier Forensic Medicine Specialist Isange One Stop Center Mombasa, 25thFeb2010

Presentation

 Situation of GBV in Rwanda  Service delivered in Isange center  Expertise of forensic specialist  Discussion

I. Situation of GBV in Rwanda

Statistics Organisation (structure) Law and policy

RWANDA - Background

“GBV does not start when a conflict does, and it's not going to end when a conflict

ends” (Lehmann 2008)

RWANDA - Background

75 – 80% of the victims of war and genocide were male, but: estimated between 250,000 and 500,000 women became victims of rape and other forms of GBV 13.9 % widows 34% households headed by women 860 000 orphans Increased vulnerability to GBV

Data: USAID Gender Assessment Rwanda: 2004 2008, UNICEF 2009

Forms of GBV in Rwanda

Form of Gender-Based Violence in Rwanda Source: National Research on violence against Women MIGEPROF, USAID (2004)

12.7% Physical violence 31.0% 13.2% Psychological violence 51.3% Community-based Domestic-based 25.2% Sexual violence 8.7%

Domestic Violence

67.7% of Rwandan women agree with the statement that a good wife owes unconditional obedience to her husband 63.6% agree that a woman must consent to sexual relationships with her husband even if she doesn’t want to have sex. 45.6% of abused women did not tell anyone 5.8% went to local authorities 0.4% went to Police Alcohol abuse is one of the root causes in 42.5 % of cases of domestic violence

Data: Rwanda National Police 2009 National Research on violence against Women MIGEPROF, USAID (2004)

05 06 07 08 09 10 01 02 03 04 S/NO TYPE OF VIOLENCE Defilement Rape Women murdered by their husbands Men murdered by their wives Non-spouse murder Abortion Infanticide Physical assault Suicide Child abuse????

YEAR 2006 2033 403 35 07 55 66 83 321 2 YEAR 2007 2421 514 22 YEAR 2008 2051 388 27 09 76 106 52 478 28 13 54 95 54 406 13

Administrative Structure

       

The constitution of the Republic of Rwanda (Preamble 9 & 10, article 11) Vision 2020 & EDPRS (gender as integral part of social and economic development) National Gender Policy National AIDS Policy National Decentralization Policy The National Policy on Orphan Children and Other Vulnerable Children The National Policy for Family Promotion Gender Violence Law

       

MINISANTE MINECOFIN MINEDUC MINALOC MININTER MIGEPROFE MIFOTRA MINICOM

Administrative Structure

       

The constitution of the Republic of Rwanda (Preamble 9 & 10, article 11) Vision 2020 & EDPRS (gender as integral part of social and economic development) National Gender Policy National AIDS Policy National Decentralization Policy The National Policy on Orphan Children and Other Vulnerable Children The National Policy for Family Promotion Gender Violence Law

       

MINISANTE



“TWG” of clinical partners within MCH TWG



Manual of Clinical Guidelines for victims of GBV MINECOFIN MINEDUC MINALOC MININTER MIGEPROFE MIFOTRA MINICOM

Administrative Structure

       

The constitution of the Republic of Rwanda (Preamble 9 & 10, article 11) Vision 2020 & EDPRS (gender as integral part of social and economic development) National Gender Policy National AIDS Policy National Decentralization Policy The National Policy on Orphan Children and Other Vulnerable Children The National Policy for Family Promotion Gender Violence Law

 

MINISANTE MINECOFIN



MINEDUC



MINALOC



MININTER



MIGEPROFE ministries



Beijing Office: Gender Mainstreaming in all government introduction of GBV Committees at Umudugudu, Cell, Sector and District level, July 2009 With other government institutions e.g. Institute of Statistics: Gender Monitoring Office (GMO), January 2009



MIFOTRA



MINICOM

Administrative Structure

       

The constitution of the Republic of Rwanda (Preamble 9 & 10, article 11) Vision 2020 & EDPRS (gender as integral part of social and economic development) National Gender Policy National AIDS Policy National Decentralization Policy The National Policy on Orphan Children and Other Vulnerable Children The National Policy for Family Promotion Gender Violence Law

       

MINISANTE MINECOFIN MINEDUC MINALOC MININTER procedures



Rwanda National Police Gender Desk , telephone hotline, CDGBVA policy (GBV police officers), CDGBVA Training Curriculum, CDGBVA Standard operating MIGEPROFE MIFOTRA MINICOM

Law and Policy

 Law No 35/2008 signed on 9th april 2009 : law on prevention and punishment of gender based violence (physical assault, polygamy,concubinage, sexual harrassment,….)  National policy on violence against women and child abuse (definitions of measures to be taken at all level to prevent violence and to help victims)  National manual of reference on clinical management (approved in January 2010)

II. Service delivered in Isange center

INTRODUCTION :  Isange center is a joint program between One UN and RNP.

 Key partners are UNFPA, UNIFEM, UNICEF and Kacyiru police hospital, Gender desk RNP.

MISSION

 Provide timely, affordable, quality services to child ,domestic and gender based violence survivors ; ranging from medical, psychosocial, medico legal, and legal support to all survivors of CDGBV.

 All services at one place  Timely services will result in access to justice.

Beneficiaries

 Men and women who have experienced physical, sexual or psychological violence based on gender, occurring in the family or in the community at large.

 Children who have suffered sexual, physical and psychological abuse.

Cnt’d

 The only place where you can find medical, psychosocial, medico legal care without doing so many kilometers (at the same place)!!

 Social workers for orientation and choice  Medical care of injury and other medical problems (emergency contraceptives, STI prevention, PEP (prevention of HIV),

Cnt’d

 Psychosocial care / prevention of post traumatic streess disorder  Equipped laboratory : STI, sperms, Toxicology and DNA testing (not yet)  Equipped pharmacy : all drogues to prevent STI  Functional VCT/ARVs, PMTCT  Medico-legal report  Linking with NGO’S (social or legal support)  Safe room

Safe room

 A place where survivors can stay for a short period for his/her security.

If the perpetrator of violence is his /her partner or guardian.

A room of 3 beds.

Survivor’s pathway, informed choice

Psycho social care Medical care Reception ( social worker) Legal support Gender desk, RNP

complementarity

Psychologist Medical doctor/ Forensic specialist Judiciary/legal sevice provider Social worker

Social worker’s role

 Reception  Explanation of rendered services  Orientation  Accompany the survivor to the chosen professional

Medical professional’s role

 Based on survivors’consent  Examination of the survivor  Treat injuries and desease  Prevent deseases and pregnancy  Collect evidences  Make a report  Follow up

Psychologist’s role

 Listening  Counselling  Psychological support  Prevent PTSD  Work closely with a social worker to ensure follow up: home visits, social reintegration.

Police staff’s role

 Registration  Explanation  Provide a requisition if absent  Collect reports  Make a statement  Refer the file to the nearest police station for further investigation

III. Expertise of forensic specialist

 Help other health providers in physical examination (identification of lesion,injury, wounds,genito examination,…)  Writing a medico-legal report which is simple for judicial police officer and magistrates in the court.

A report clear, complete, loyal is very important  To give testimony in the court  Bodily injury assessment  Supervision of medical doctor in Forensic medicine

IV. Discussion

 How does your health institution work to support victims of GBV (distance, all sevices, safe room, free of charge)  What are opportunities of the health sector? What are the challenges? (problems to integrate legal support directly in the center, founds, no vehicule to reach area very far

Cnt’d

 What are your needs for exchange beyond your institution and your country?(human ressources, some facilities and extend)  Would a regional network on GBV be of any additional benefit for your work?(very useful+++ : exchange of experience)  What should a regional network deliver? (facilitate study tour, advocacy as one voice, harmonise the protocol, sensitization,…)

Take home message

 A One stop center for survivors of GBV offers a holistic care that people really need to face again a daily life and reintegrate the society. Let us join and show them respect and dignity that they have lost.