TWEET CONFERENCE

Transcript on “MEDICAL SERVICES AVAILABLE FOR SEXUAL AND GENDER-BASED VIOLENCE (SGBV) SURVIVORS IN NIGERIA” on Friday, 29th January, 2021

  1. Good evening all. Welcome to another Twitter conference on Promoting Social Media Engagement To Eradicate Sexual And Gender-Based Violence. #EndSGBVseries
  2. I am Adeoye Adenike Ruth @AdenikeG1, your Anchor, and our guest, is
    Charles E. Ugwu @CHARLES_CLEVER. #EndSGBVseries @VARCENigeria
  3. This Twitter conference holds between b6pm-7pm Nigerian time. We will attend to your questions and contributions from 6:45pm. #EndSGBVseries @AdenikeG1
  4. I will welcome our guest for today, Charles E. Ugwu @CHARLES_CLEVER to take the floor. Before we answer your questions. #EndSGBVseries @AdenikeG1 @Varcenigeria
  5. Today, our focus is on “Medical Services Available for SGBV Survivors in Nigeria” #EndSGBVseries @AdenikeG1 @Varcenigeria
  6. We will be discussing about Sexual and Gender-Based Violence (SGBV) services as an integral part of SGBV prevention and response intervention. #EndSGBVseries @AdenikeG1 @Varcenigeria
  7. Before we move into our major discussion for today, let’s quickly review some basic information about Sexual and Gender-Based Violence (SGBV). #EndSGBVseries @AdenikeG1 @Varcenigeria

8a. Sexual and Gender-Based Violence (SGBV) refers to any act that is perpetrated against a person’s will and is based on gender norms and unequal power relationships. It is a severe violation of several human rights. #EndSGBVseries @AdenikeG1 @Varcenigeria @UN

8b. United Nations defines Violence Against Women (VAW) as “any act of gender-based violence that results in, or is likely to result in, physical, sexual, or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life”. #EndSGBVseries @AdenikeG1 @Varcenigeria @UN

  1. In recent times, the incidence of Sexual and Gender Based Violence (SGBV) has continued to rise in Nigeria. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  2. Today, many persons are generally aware of SGBV issues, including widespread SGBV occurrence, existence of national and state laws on SGBV. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  3. …but with limited understanding on post-SGBV services and responses. However, below are some factors that can limit uptake of medical and psychosocial support services. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  4. – Lack of awareness about available services.
  • Stigma and lack of self-efficacy to initiate conversations about rape and other forms SGBV with health providers. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  1. Among other post-SGBV services, medical care is: #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
    13a. Treatment, management and care of SGBV case critical in reducing negative outcomes. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
    13b. Rehabilitating women and girls who have been abused and to help them overcome their ordeal. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  2. In Nigeria, medical services for SGBV survivors are available at Primary, Secondary and Tertiary health care levels. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  3. Any survivor of SGBV can present at any of these healthcare levels and disclose his/her experience of the violence to a health care provider. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  4. Additionally, the survivor should also present signs and symptoms of haven experienced the violence, if any, to the health care worker. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  5. At the most basic level, the health care provider and the health system is expected to provide basic care in a private, compassionate, and evidence-informed manner. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  6. Some of the basic medical services includes: Treatment of acute injuries… #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

18a. Provision of HIV post-exposure prophylaxis (PEP) within 72 hours of a sexual assault. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

18b. Provision of emergency contraceptives within 120 hours of a sexual assault as well as empathetic counseling and safety planning are further medical services to be provided. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

19a. For sexual and/or physical violence, the survivor must ensure immediate access to health/medical care services within 72hours (3days). #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

19b…this is to reduce the risk of HIV and other sexually transmitted infections (STIs). #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

20a. Also, for sexual and/or physical violence, the survivor must ensure immediate access to health/medical care services within120 Hours (5 days). #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

20bi. This is important so asto reduce the risk of unwanted pregnancy. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

20bii. At a minimum, health care must include: Examination and treatment of injuries, #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

20biii. Prevention of disease and/or unwanted pregnancy, Collection of minimum forensic evidence medical documentation, & follow-up care. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

  1. In areas where the receiving health facility is limited or ill-equipped to provide any of the aforementioned medical services, they will refer the survivor to the next or sister facility with the required capacity. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria
  2. At the end of the medical care, the survivor will further be referred to other support services such as the police, emergency shelter, mental health, economic empowerment, Et cetera as may be available. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  3. Admittedly, however, a reality check on the state of medical services for SGBV survivors across many states in Nigeria reveal a huge gap between the above described ideal and what is obtainable. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  4. For instance, some assessment and service mapping done in some states revealed that many health providers generally lack the capacity to provide basic first line support to SGBV survivors as regards to counseling, safety planning and referrals. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

25a. Additionally, many health workers are not properly trained on sexual and gender-based violence (SGBV), #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

25b…and as result limits their medical response to just the treatment of physical injuries. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

26a. In some health care centers, essential services required to effectively provide post-GBV care at health facilities are conspicuously non-existent, #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

26b. for example a private room for safe counseling, post-exposure prophylaxis for HIV prevention within 72 hours of an assault, etc. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria @sfhNigeria

26c. Furthermore, SGBV prevention and response responsibilities are generally shared by the state and local governments, police, and community-based organizations. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

26d. Regrettably, however, there is inadequacy of coordination, knowledge, funding, communication and collective action across these key stakeholders. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

26e. In many states, medical services to SGBV are basically available in the urban areas, which makes it very difficult for GBV survivors to access due to distance and transportation costs. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

26f. This is bearing in mind that most affected SGBV survivors usually are of low socio-economic status. They can hardly afford transport money to access referral services in the cities. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

  1. To a large extent, therefore, facilities and the health systems in many states across the nation are under-equipped and providers are insufficiently trained to offer post-SGBV care. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  2. In some areas, this poor capacities of medical facilities, combined with survivors’ concerns about their safety and avoiding stigma, #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

28b…have resulted into very few survivors currently seeking post-SGBV medical services. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

  1. SGBV has serious health consequences including death, disability, miscarriage, fistula, stillbirth, Et cetera. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  2. Therefore, there is need for the government, NGOs, CSOs, and other humanitarian/health investors to do everything possible to improve access to post-SGBV medical services across Nigeria. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  3. For instance, more and more healthworkers should be trained and their capacities built to respond to SGBV cases as first line responders. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  4. Additionally, health facilities especially at the primary health care level should be equipped with the necessary facilities required to provide effective and efficient response. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  5. Again, social welfare officers should be available at primary, secondary and tertiary health facilities to counsel SGBV survivors as may be required. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  6. There is need for state owned emergency shelter or safe housesfor SGBV survivors situated possibly across all LGAs close to reach of the people in rural areas. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  7. There is need for a clear referral pathway and protocol made available in health facilities at all levels to ensure survivors are being referred appropriately to access the required care. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  8. Finally, there is need for increased coordination and synergy amongst all the stakeholders and players within the system. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  9. Overall, sensitizations on SGBV prevention and available services, including medical, social and legal, should be scaled up at all levels, especially in the ruralcommunities: #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

36a…to ensure that citizens are increasingly aware of what types of violence constitute SGBV, that it violates human rights and is illegal, that there are serious health consequences from SGBV, #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

36b…that everyone have a role to play in preventing SGBV and finding non-violent methods to resolve conflict, and that there are post-SGBV services available. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria

  1. SGBV poses serious short term and long term health implications. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  2. These negative implications can, however, be averted or reduced minimally if the survivors are aware of and accesses medical services on time and effective response system is provided at all level. #EndSGBVseries @AdenikeG1 @Varcenigeria @USAIDNigeria @Fmohnigeria
  3. There is a need to also promote gender equality to prevent violence against women, shift cultural norms to SGBV, respond to SGBV of all forms and protect victim/survivor’s rights. #EndSGBVseries @AdenikeG1 @Varcenigeria
  4. The @policeNG, @CivilDefenceNGR and other agencies must be alerted towards this urgent call to prosecute every offender/perpetrator of any violence. #EndSGBVseries @AdenikeG1 @Varcenigeria
  5. For more information about SGBV you can visit www.worldbank.org/gender. #EndSGBVseries @AdenikeG1 @Varcenigeria
  6. To learn more about the #EndSGBVseries Campaign, you may follow our social media handles on Facebook, Twitter, and Instagram, using @Varcenigeria. #EndSGBVseries @AdenikeG1 and/or send us mail at info@varce.org or varceng@gmail.com.
  7. At this point, I will end the presentation to give room for questions and contributions from participants. Thank you all for reading our tweets #EndSGBVseries @AdenikeG1 @Varcenigeria
  8. We implore you to re-tweet this trend and also join us next Friday 6-7pm. Visit our social media page @Varcenigeria and @AdenikeG1. #EndSGBVseries