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Addressing gender-based violence confronting African women is crucial during COVID-19, writes Nicci Attfield.
[CAPETOWN] Angela Kuntu, an immigrant domestic worker and nanny living in South Africa, took a taxi home from work one night.
According to Kuntu (not her real name), she was raped while in the taxi but told no one. She later had a miscarriage. She believes that the child she lost was her husband’s baby and that she lost the child because of the rape.
“I don’t want my husband to find out about the rape and the baby. I told my employer that I was bleeding and I was raped,” she tells SciDev.Net. “A counsellor arranged a hospital appointment for me but I don’t want to use [public] transport because it reminds me of the rape.”
“The victim is asked what they did to provoke it…. the sexual element introduces morality and judgement.”
Emma Arogundade, Rape Crisis Cape Town Trust
Gender-based violence and healthcare resources available to women have been brought under the spotlight in Sub-Saharan Africa amid the COVID-19-induced stress, unemployment and mental health problems.
Shiralee MacDonald, a counselling coordinator at the Rape Crisis Cape Town Trust in South Africa, explains that during the pandemic many women have been trapped in the same homes as their abusers, owing to lockdown restrictions and unemployment.
Studies show that women who have been subjected to gender-based violence need tailor-made interventions due to feelings of shame and self-criticism, MacDonald says.
Elizabeth Katana, an author of a study on violence in Uganda during the COVID-19 lockdown, explains that gender-based violence is often “shadowed”, and survivors are often unwilling to share their experiences with others. As a result, many cases go unreported or unidentified, she tells SciDev.Net.
Emma Arogundade, an academic who worked with the Rape Crisis Trust, adds that these feelings exist because of the stigma around rape or gender-based violence.
“The victim is asked what they did to provoke it. The sexual element introduces morality and judgement,” she explains.
Because of judgement and shame, many women are afraid to let their partners or communities know about their traumatic experiences. Accessible mental healthcare is therefore crucial.
But Masana Ndinga-Kanga, the Crisis Response Fund Lead at South Africa-based CIVICUS, a global non-profit organisation which aims to strengthen citizen action and civil society, says that the COVID-19 pandemic has cut off much of the community-based care for women in Sub-Saharan Africa.
Available resources are often directed towards treating COVID-19, not the gender-based challenges which accompany it, she says, adding that in Sub-Saharan Africa, only South Africa has allocated a budget to address the gender dimensions of the disease.
Resources for survivors are limited in countries such as Uganda, explains Katana, with most survivors seeking support from trusted community members and family.
She adds that civil society organisations and the Uganda Police are there to assist survivors of gender-based violence, while the non-profit organisation Reach a Hand has a TV show and mobile app to help women tackle abuse. The Ugandan Association of Women Lawyers also offers legal assistance to.
Improved social structures needed
Even in South Africa, Rumbi Goredema Görgens, a researcher from DGMT Embrace, explains that many women are struggling and face extreme hardship. She believes that the COVID-19 pandemic has made an already bad situation worse. During the COVID-19 lockdown in South Africa, many women faced retrenchment or unemployment. Finding new jobs has become increasingly difficult.
Görgens draws on studies which show that while mothers within communities are helping each other to care for children, many are going without food to meet their children’s nutritional needs.
“The data was showing that existing hunger was made worse,” says Görgens. “We were hearing stories of people who were eating grass and feeding their children grass just to fill their stomachs… So, I think the pandemic just accelerated problems we already had.”
Ndinga-Kanga explains that women in Sub-Saharan Africa as a whole do not have the resources they need to support them through the pandemic. This includes access to public services, resources for their children, healthcare, and mental healthcare which are all severely under resourced.
Dealing with trauma during COVID-19
Traumas related to gender-based violence also haunt many pregnant women.
Julia Borbor (not her real name) has a history of sexual assault. COVID-19 presented a double fear for her. Pregnant before the pandemic, she was worried that a COVID-19 infection would put her at risk because of her high blood pressure, and was therefore reluctant to seek care from her local clinic. She was also scared of attending doctors’ appointments as well as giving birth alone because of a past history of sexual assault and a fear of experiencing trauma again.
“One of my biggest fears was actually the doctors [in public hospitals],” Borbor says. “In a private hospital you have your own gynaecologist and you can explain how you feel and your doctor will understand. When you go to a public hospital here in South Africa, it isn’t like that. There are many doctors and you don’t know who will see you or why.”
Lack of a single gynaecologist means telling and re-telling a trauma story, something which can be difficult for survivors of violence or rape. Julia explains that she was treated with sensitivity and “given the option to have an elective Caesarean surgery”.
“There were still moments when I was uncomfortable but because I’d had counselling I was able to relax and I understood what the fears were about. I could tell myself I was safe,” she adds.
MacDonald explains that women who have untreated sexual trauma risk re-traumatisation, flashbacks and intrusive memories.
Obstetric violence during the pandemic
Sometimes women who have not experienced sexual trauma can face obstetric violence during childbirth – abuse by medical staff. Gorgens explains that while there are no studies to reveal the extent of this violence, there is a risk that the pandemic could make it worse.
Gorgens explains that women who give birth while a partner is in a hospital with them have someone to both bear witness and to advocate for them. With nobody to bear witness or speak on their behalf, women are more vulnerable.
“As a result of the pandemic you couldn’t have anyone with you. So, the assumption can be that perhaps obstetric violence cases rose, but we don’t know. We only study maternal deaths,” Gorgens tells SciDev.Net
Cheryl Suduka (not her real name) says that she had a terrible experience while giving birth in a public hospital in South Africa.
She explains, “They wouldn’t let me speak to my partner. I could go out and meet him at the gate but he couldn’t be present for the birth. During the process of delivery, I wasn’t in control. They believe they know what is best for you. Even with painkillers, they don’t ask you. They just say ‘you must cooperate with us.
“Even when you try to do what they say they just say ‘you are not cooperating.’ I ended up having an operation.
“The doctor just came in and said I needed one. I didn’t have a choice. I had to sign a form saying that in an emergency they could take out my womb. You have no time to process what they are saying to youand some women can barely understand English. How can they give informed consent?”
Ultimately the pandemic has amplified the struggles women face on a daily basis.
According to Ndinga-Kanga, there is a need to address the gender dimensions of COVID-19 particularly among women who have lived through gender-based violence.
Mental health resources for women
The Thuthuzela Care Centres in South Africa offer medical care, counselling, assistance with filing a police report and court preparation. Survivors are able to receive continuing counselling, and also be transported to a place of safety, on request.
“A lot of our clients are very poor and can’t go for a walk because it would mean risking further violence.”
Shiralee MacDonald, Rape Crisis Cape Town Trust
MacDonald explains that women can go to their local police station or clinic for support. While some community clinics are working hard to reduce the secondary traumas women experience during forensic examination, other women do face stressful experiences.
She says: “The medical exam is definitely traumatising. Services such as those at the Thuthuzela Care Centres which were set up by the South African government to offer assistance to rape survivors are set up to help reduce secondary trauma but they can’t take it away altogether because sadly, the doctor is touching the survivor in the same places the perpetrator did.”
MacDonald explains that many rape survivors prefer to remain anonymous. The Rape Crisis Cape Town Trust offers WhatsApp counselling to rape survivors and the service is free to survivors from all areas who need assistance. Some women use their local clinics to access data for this service.
But Ndinga-Kanga adds that lay counsellors in community-based organisations face challenges while counselling trauma survivors. Bearing witness to the pain of others can be harrowing for lay counsellors who are at risk of secondary trauma. Trauma counsellors can also feel helpless and unable to offer standard coping methods to their clients.
Jenny Potus (not her real name), a lay counsellor, recounts the challenges of assisting victims in Africa.
“International writers suggest going for a walk or having a bath as a means of helping trauma victims. A lot of our clients are very poor and can’t go for a walk because it would mean risking further violence,” she says.
“They can’t have a bath because they don’t have access to running water. They can’t even leave the person who is abusing them because they don’t have employment or access to resources. You’d do anything to prevent people from feeling the way they do, but there is really nothing you can do.”
Many women who have been exposed to gender-based violence do not only need access to counselling, but also to adequate healthcare, MacDonald tells SciDev.Net.
This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.