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179 Pages·2010·2.17 MB·English

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Throughout the world, gender-based violence
represents a major public health issue l
and an undeniable violation of human rights. a
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g
This leads us to question the strategies o
l
of intervention and the prevention and response o
d
aincttoio ancsc toou ngte nthdee rd-ibffaesreedn tv sioolceinoc-ceu, latulwraaly cso tnatkeinxtgs . thoE /
This guide does not intend to provide responses Ed
mui
but reflexion elements for the development a g
of programmes or activities to fight gender- gENdEr-basEd
related violence.
violENcE
Through the presentation of key concepts, E
methodological tools and field examples s
E n
this guide aims to improve the identification C o prEvENtioN
and the multidisciplinary care and support n p
E s
of the victims of violence, as well as to improve l E aNd
the quality of the awareness-rising and advocacy o r
activities associated to it. vi d
d n rEspoNsE
E a
This guide draws its practical use from MdM’s s n
a >> a mEthodologiCal guidE
know-how on the subject, which the organisation b o
i
has developed thanks to its international programme - t
r n
on gender-based violence, executed with the E E
d v
financial support of the French Development Agency. n E
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[...]
With the support of:
FR
a MethodoloGical Guide
Gender-Based
Violence
PreVention
and resPonse
1 1
Gender-Based Violence PreVention
and resPonse >> A MethodologicAl guide
pAge 11 pAge 33
1. 2.

introduction understandinG
gender-based
violence

pAge 112 pAge 285
3. 4.

key eleMents PreVentatiVe,
to ProVidinG awareness
care and suPPort raisinG
for victims and adVocacy
of gender-based activities
violence
3
editorial
“
StatiSticS
on gender-baSed violence
Speak volumeS
and are…

painful to hear.”
editorial
dr olivier BernArd,
dr olivier bernard
preSident oF MÉdecinS du Monde (FrAnce)
>
statistics on gender-based violence speak volumes
and are… painful to hear. Worldwide, one out of
five women will one day be the victim of rape or fondling.
“ an estimated 10 to 69% of women (depending on the country)
the uSe of Sexual violence
have been physically attacked by a male partner at some time in
haS in Some partS
their lives. in asia, 90 million women are “missing” in population
of the world statistics, consequences of selective abortions or infanticide,
become a Strategy because of the widespread preference for male children.
for breaking down between 100 and 140 million women and girls have undergone
genital mutilation for cultural or religious reasons. violence
communitieS.”
against women occurs everywhere in the world, in each region,
each society and each culture. it can be perpetrated within
“ the family or within the social group or community to which they
rape doeS not Simply
belong, or committed during an armed conflict (where rape has
damage phySically
become an actual weapon of war). Whether sexual, physical,
and mentally. moral or institutional, such violence leads to serious psychic
it tearS down damage, in addition to serious physical health disorders. it can
the Social fabric also lead to death, through homicide, serious injury or suicide.
amidst the Hiv/aids epidemic, it has become even more urgent
and createS diSempowerment.”
to address the issue of gender-based violence.
gender-based violence is a major public-health problem that
dr denis mukWege must be addressed immediately, and for many years now and
4 5
editorial / foreword
in many countries (guatemala, Pakistan, nicaragua, moldavia,
Haiti, egypt, niger, Peru, liberia, the drc, Pakistan), médecins
du monde has taken action to prevent and respond to violence
against women. beyond providing care, mdm takes an inclusive
approach that aims, whenever possible, to achieve a social
transformation. mdm intervenes in quite varied contexts, involving
almost all forms of gender-based violence. in their daily work, foreword
médecins du monde teams face these various forms of violence.
dr deniS Mukwege,
in the democratic republic of congo, where sexual violence
is very frequent and its perpetrators most often go unpunished; director-generAl oF pAnZi hoSpitAl (drc)
in algeria, where domestic violence is quite common;
or in Pakistan, where women fleeing violence and the threat >
the stories and testimonies of women victims of rape
of “honour crimes” find refuge in government homes,
are striking and shake us. everyday, i meet these women,
the so-called Dar-Ul-Aman.
as a doctor, at the Panzi Hospital in eastern dr congo; women,
who are survivors of sexual violence, or whose bodies have
in most of these countries, médecins du monde works with the
been destroyed because they do not have access to basic
backing of, and in tandem with, local associations, institutions
reproductive health care. they are paying the price for conflicts
or civil-society organisations. it is only by working together
fuelled by financial interests that undermine the structures that
with all actors and through access to various skills that women
shall uphold the basic human right to protection such as health
who have suffered from violence can be offered the opportunity
care. some people feel the pain in their body everyday, whether
to put their lives fully back on a solid footing.
they are harmed physically, psychologically, or morally.
the fight against gender-based violence is now a policy
However, what we see here is just an expression of something
emergency and a true public health challenge on a worldwide
that is universal; the mechanisms are the same in america,
scale. With the assistance of its partners in the field and based
europe, asia, and africa. everywhere, there are people
on a quality, multi-disciplinary approach, and while respecting
who bear the burden of having been subjected to gender-
the communities involved, médecins du monde intends
based violence. nevertheless, no society, no country is giving
to continue aiding this fight, in both france and internationally,
this phenomenon enough attention.
both here and there.
there are those who believe that the issue is being raised,
that it actually is on the agenda, and that appropriate legislation
is being put in place. there are also those who claim that
the descriptions of gender-based violence are exaggerated.
6 7
foreword
but if the world really understood what gender-based violence one of the most important fights we must take is the fight
is, and what the consequences are, things would look different. against impunity. for as long as we do not seriously apply
this is not the time to minimize the problem; it is time to prioritize. the legislation, making it clear that gender-based violence is not
accepted, women, families and communities will continue
my experience after meeting thousands of survivors of gender- to lose their dignity and their ability to prosper.
based violence has left me convinced that rape does not
simply damage physically and mentally. it tears down the social it is our responsibility to take this fight; we have seen
fabric and creates disempowerment. it takes away a person’s the consequences of gender-based violence with our own eyes
dignity and identity, not only in the eyes of the survivor and heard the stories. if we continue to accept this, we also
herself, but also in the eyes of those around her. accept the destruction of our world.
the use of sexual violence has in some parts of the world
become a strategy for breaking down communities. it is
a weapon that moves slowly but its effects are devastating.
We are very aware of the danger of a firearm or a chemical
weapon, but we should be equally concerned about
the consequences of sexual violence.
different societies and countries view all survivors of sexual
violence similarly. to some, the stigma is strong; so strong
that returning home means going back to a family rejecting
or blaming the woman for the assault. in the same way,
a woman in another part of the world can be accused
of having caused the abuse because she was dressed
inappropriately. it is the victim, the survivor, who has to pay
with her body and her dignity.
i think that if men were subjected to gender-based violence
in the same way that women are today, the world would
react differently. i think the laws would be applied,
that the perpetrators would be tried and convicted for their
deeds. the problem of gender-based violence is complex,
but not complex enough to be pushed aside because
of lack of solutions.
8 9
11..
intRoduction
introduction
pAge 14 19 3 / An approach backed pAge 23
A by developing networks C
and by strengthening
the skills of local partners
19 4 / A community approach
Presentation to combating gender- includinG care
based violence
of tHe guide of VictiMs
14 1 / What it is 20 5 / Taking socio-cultural of gender-based
determinants violence in
into consideration
15 2 / What it is not all of médecins
15 3 / Whom it is for 20 6 / An approach favouring du monde’s
the inclusion of men: Projects
intervening through
the prism of gender 25 1 / Links between
pAge 17 gender-based violence
B 21 7 / Going beyond and primary health
victimhood
26 2 / Links between
22 8 / Protecting victims gender-based violence
of violence is at the heart and reproductive health
médecins of our approach
du monde’s 27 3 / Links between
22 9 / Bearing witness gender-based violence
strateGic to human rights violations and HIV/AIDS
aPProach and denouncing
gender-based violence 29 4 / Links with
17 1 / An overall and emergency situations
integrated approach to
combating gender-based 30 5 / Recommendations
violence
18 2 / A multidisciplinary
approach is a key
principle in caring
for victims of violence
A
1
1A
beyond a general presentation of the issue of gender-based
violence and the various real-world contexts behind that term,
this guide deals with the various aspects of caring for victims
of violence, as well as awareness-raising activities and the
argumentation that can accompany those activities.
as a true methodological tool, it aims to facilitate the
PRESEntAtion
development and implementation of actions to combat
gender-based violence and to enhance the quality
oF thE GuidE
of interventions in the field.
it also helps to disseminate and highlight MdM’s best
>this methodological guide is the fruit practices and know-how in this area by capitalising on its
experiences and the methodologies and tools developed by
of a cross-disciplinary project to consolidate
mdm’s teams and its partners. it is based on internal documents
the experiences and tools developed by mdm
drawn up in the field and at the head office (including technical
and of discussions on the issue of gender-based
datasheets, training and awareness kits, care-providing protocols,
violence. it was put together through
workshop proceedings, exchanges of best practices, testimonies,
an international programme to fight gender-based
etc.) and external documents (reference documents on the issue).
violence that has been funded since 2007
by the french development agency (afd),
2 / what it is not
and under whose aegis this tool has been
developed.
this guide is not a tool detailing in an exhaustive manner all aspects
1 / what it is of caring for and supporting victims of gender-based violence.
it provides no ready-made solutions for setting up gender-based
violence prevention and response activities, as those must
This guide’s purpose is to:
be adapted to each intervention context.
> p rovide some channels for thought and action
to develop programmes, programme components 3 / whoM it is for
or special activities to prevent and/or respond
to gender-based violence:
this guide is meant for all persons wishing to better understand
> to raise awareness of the importance gender-based violence and to develop gender-based violence
of this phenomenon. prevention and response initiatives.
14 15
B
1
introduction
more precisely, the guide is for personnel of mdm
and its partners:
> In the field: persons (coordination and technical positions)
involved in combating gender-based violence or any other
project, internationally or in france, whose users may include
victims of gender-based violence.
> At the head office: employees and volunteers involved MEdEcinS
in designing and monitoring projects fighting gender-based
violence or any other project, internationally or in france, du MondE’S
whose users may include victims of violence.
StRAtEGic
this guide is therefore meant not only for staff involved
in specific programmes fighting gender-based violence. APPRoAch
nor is it solely for medical personnel, but rather for all persons
who may be involved in caring for victims of violence.
>While paying special attention to the diversity
of contexts, médecins du monde is now seeking
to develop a consistent cross-disciplinary approach
to certain interdependent principles of intervention.
1 / an oVerall
and inteGrated aPProach
to combating gender-
based violence
the programmes deal with health as an overall state of well-
being, i.e., that takes into account not just medical care, but
also the political, social, economic, cultural, and family context.
the idea is to go beyond caring for individuals and to think
more in terms of the collective.
16 17