At health level
Lethal consequences (homicide, suicide, maternal mortality, infant and AIDS mortality) or non-lethal consequences occur at this level, namely:
· Acute physical – injury, shock, disease, infection;
· Chronic physical – disabilities, somatic problems, chronic infections, chronic pain, gastrointestinal problems, appetite and feeding disorders, sleep, drug and/or alcohol abuse);
· Reproductive – miscarriages, unwanted pregnancies, abortions, sexually transmitted diseases including HIV/AIDS, menstrual disorders, pregnancy complications, gynecological conditions, sexual function disorders.
At the psycho-social level
Many societies blame victims/survivors of sexual and gender-based violence. Marginalization and social exclusion cause subsequent disorders, including shame, self-hatred, self-loathing and depression. As a result of stigma, most victims/survivors of sexual and gender-based violence do not report these incidents. There are two categories of consequences in this regard, both of which are difficult to detect and which are remedied over time and with considerable effort:
· Emotional and psychological consequences – post-traumatic stress disorder, depression, anxiety, fear, anger, shame, insecurity, self-hatred, mental illness, suicidal thoughts and behavior.
· Social consequences – victim/survivor blaming, loss of role/function in society, social stigma, social rejection and isolation, feminization of poverty, realization of gender inequalities.
If national legislation does not provide protection against sexual or gender-based violence, or if practices in legal and judicial bodies are discriminatory, this type of violence may be perpetuated by the lack of danger of criminal punishment. Common attitudes of blaming victims/survivors of sexual and gender-based violence are often reflected at court level.
Many reports/complaints of such incidents are dismissed or perpetrators receive light sentences. In some countries, the punishment for perpetrators of violence and gender-based violence is another violation of the rights and freedoms of the victim/survivor, namely forced marriage to the perpetrator. Psychologically, the victim is again victimized by the fact that the perpetrator is recognized as innocent.
The victim/survivor feels unsafe, threatened, fearful, unprotected from the risk of being assaulted again. Another aspect of the security context is that, in working with trafficking incidents, police and security forces may enter these networks. Also, if the police or security forces are not sensitive to the victim’s suffering and need for care, dignity and respect, the trauma can deepen because of the delay in providing assistance.
Sexual and gender-based violence is an issue that affects individuals, communities and institutions. Given its complexity, this type of violence is most effectively addressed when multiple sectors, organizations and disciplines work together to identify and design strategies that can counter this violation of fundamental human rights. All actors involved in the development of these strategies need to jointly agree on a set of guiding principles and realize that sexual and gender-based violence is a serious violation of fundamental human rights.
At the level of refugee assistance, there are several principles that shape the design and design of refugee assistance:
· Involvement of the refugee community, particularly in decision-making;
· Ensuring a balanced participation of men and women, girls and boys in the planning, implementation, monitoring and evaluation of programmers targeted at them;
· Ensuring multispectral coordination of the actions of all actors involved;
· Ensuring written records, data recording, planning of activities
At the individual level, the following set of principles should be taken into account:
· Ensure the safety of victims/survivors of sexual and gender-based violence and their families;
· Respecting the confidentiality of affected persons and their families
· If the victim of sexual and gender-based violence is a child, the principle of the best interests of the child must prevail;
At multi-sectoral level
The foundation of this approach is international protection which aims to ensure that refugees are adequately protected and enjoy the exercise of their rights. Community involvement is essential in the design, planning and implementation of programs (involving community members in preventing and responding to sexual and gender-based violence). There are then principles and operational rules on which all actors involved must agree, thus ensuring a coordination function. It should not be forgotten that there may be many actors whose contribution can be useful and whose roles need to be defined. Preventing and responding to sexual and gender-based violence involves actions carried out by different relevant actors, most of them representing one or more of the following sectors: medical, psycho-social, security and legal.
Only by identifying the factors that contribute to and influence the type and extent of sexual and gender-based violence can appropriate and effective prevention strategies be developed. Prevention activities target potential perpetrators, potential survivors and those who can help them. Activities should therefore target refugee populations, humanitarian aid workers, host country nationals and government authorities. As with all sexual and gender-based violence programs, prevention strategies are most effective when all sectors, including refugees, are involved in their design, implementation and evaluation.
Effective prevention strategies will include actions that focus on five key objectives: transforming socio-cultural norms, with a focus on empowering women and girls; rebuilding family and community structures and support systems; designing effective services and facilities; working with formal and traditional legal systems to ensure their practices are in line with international human rights standards; and monitoring and documenting incidents of sexual and gender-based violence.
Preventing sexual and gender-based violence involves identifying and eliminating those factors that make certain members of the refugee community vulnerable to this type of violence and developing a range of strategies to improve protection for all refugees. These strategies will be most effective when they are designed, implemented and monitored by all sectors involved in protecting and assisting refugees in refugee communities and by refugees themselves.