Sexual and gender based violence (SGBV) is a public health and economic issue routinely ignored by governments.
DICTA ASIIMWE met and talked to a WHO reproductive health researcher who was in Kampala for an East Africa conference on GBV.
WHO and other development organisations seem to have increased their focus on sexual and gender-based violence. What has happened to warrant this?
The WHO has been working to address violence against women for almost 20 years now. When we started out, we had very little information on the magnitude of the problem, so we collected data.
We worked with different partners and now all this data shows that violence against women is rising practically in every country in the world.
In June last year, we put out a study, the “Global Burden of Disease Estimates and the Global Prevalence of Violence Against Women.” This study showed that in over 80 countries, 35 per cent of women have experienced sexual violence.
We also showed in that study that gender-based violence had huge health consequences, everything from HIV/Aids to depression, suicide, unwanted pregnancies, sexually transmitted infections and low birth weight babies.
So people started making a link with the achievement of the Millennium Development Goals and other health problems. I think that the sustainable development agenda has helped to garner attention of the global and development community but now increasingly the health community as well.
I think also that as people grapple with HIV/Aids and other problems, they are seeing how violence against women is linked to all these health problems in their community.
Particularly in Africa because HIV/Aids is such a big problem, people are beginning to see the link between intimate partner violence, sexual violence and HIV. So what has changed is that we now have good data that shows the relationship between bad health statistics and intimate partner violence.
In Uganda, violence is seen as less of a government problem and more of a family issue to be resolved between couples. Women are not even supposed to talk about it with outsiders. Why should governments take it up?
This is not just a socio-cultural issue. It is a public health problem and an economic development problem. A study in Uganda shows that it costs the government Ush56 billion ($21 million). That translates into 0.75 per cent of the country’s GDP.
I advise governments to start allocating budgets. They need to make sure that every sector — education, health, justice, police, social sector — all these have budgets to address GBV and equality.
How and to what do we lose this money?
When women experience violence, there are multiple consequences. Women who are abused often need to seek legal, police and health care services. Safe places like shelters are also needed when these women leave home due to abuse. And governments have to provide these services.
This is a cost to both the government and the economy. The other cost is from lost productivity. But the important cost that is rarely paid attention to is effect on children.
Children who are exposed to violence are traumatised and more likely to be sick and their performance is in most cases poorer than for kids who come from stable homes.
Children in violent homes are also prone to anxiety, depression and other disorders and all this can affect educational outcomes and the future economic status of that child. These children are also more likely to grow up and become perpetrators of violence.
Gender ministries are underfunded. What activities need to be funded that are denied resources?
First, the government has to be very clear on the risk factors for violence against women. And now we know that there are two major groups of risk factors for violence against women.
The first is exposure to violence in childhood. The second is a group of risk factors that are related to gender inequality. So you have to tackle both simultaneously and you have to change how you do programmes.
Most programmes available in these countries are to do with police and judicial response but that comes after the woman has been violated.
What needs to be done is to stop violence before it begins. And the only way to do this is through large scale prevention. This means working in schools.
The Ministry of Education has to make sure schools are a safe place for children; that the children are not experiencing violence and that the curriculum promotes gender equality and respect between boys and girls.
That it teaches boys, to socialise with girls from a very young age. And that the only basis for interaction between boys and girls is mutual respect and equality. The children have to know that violence is not a solution to any conflict.
The second area is to work with communities to change norms around acceptability of violence. We have to show communities that violence against women is not acceptable and that we all have to use our power positively to resolve conflicts in a non-violent way.
There are programmes that have been developed within Uganda, that have been shown to work. You need to scale these up and change norms.
SGBV has mostly been tagged as an issue of men versus women and that the focus on GBV has ignored the men. What carrot are you giving men, to convince them to give up their positions of power?
There is a programme in Uganda called Sasa (Kiswahili for “now”) that helps communities understand negative and positive uses of power in relationships.
The approach in this is to show how men and women can share power without one group feeling like they are losing power or another is gaining.
And the way to do this is to talk about power, sharing it and how this helps relationships become healthier, happier and more productive. It is not about one party losing or another gaining.
It is not a zero-sum game; it is more about thinking that a healthy, happy satisfying relationship between men and women is based on respect, mutual power sharing and equality. So everyone wins, when power is shared.