Survivor-centered approach: 5 Elements to support women after rape in armed conflict

Rape is a massive attack on a person’s dignity. In times of peace, 50-65 percent of people affected develop traumatic stress reactions with severe long-term consequences. These might include a tendency to withdraw from social life, as well as chronic pain or sleep disturbances. In war and war-like conflicts, the effects of sexualized violence are exacerbated. Women who have experienced gender-based violence often face ongoing insecurity, endangerment and poverty, as well as – as a consequence of rape – stigmatization and social exclusion. To address the needs of women and girls after gender-based violence in armed conflicts, the women’s rights organization medica mondiale has developed an integrated, survivor-centered approach.

1. Setting up long-term support structures

Support provided to affected women and girls needs to be long-term – in its conception, delivery and funding. The services need to be comprehensive and include shelter, food, medical services, psychosocial support, income-generating projects and legal advice. In many contexts, it is still mainly women’s organizations providing expert advice and support. Public services are often not functional and international organizations cannot access remote and insecure areas. Governmental institutions especially of the social sectors are in many cases severely underfunded. They lack expertise and the trauma-sensitive attitude needed to provide appropriate assistance. Systemic support to rebuild and strengthen public institutions in the fields of health, education, social services, jurisdiction and security should be at the core of rehabilitation and reconstruction efforts in the post-conflict phase.

2. Applying a stress- and trauma-sensitive approach

The effects of traumatic experiences depend not only on the characteristics of the events, but significantly on the experiences afterwards. A decisive factor is whether survivors of sexualized violence encounter stigmatization or recognition and appreciation of their community. Instead of a short-term clinical approach, which would focus primarily on reducing trauma symptoms, the Stress- and Trauma-sensitive Approach (STA) developed by medica mondiale focuses on stabilizing survivors in their social context. Important stabilizing factors for survivors of sexualized violence are the setting up of safety and security, their empowerment, and the promotion of solidarity and social connections. The STA approach also addresses professionals and activists in the support system and aims at strengthening self-reflection, self-care and staff empowerment.

3. Addressing gender-based violence as a continuum

Discussions in the Security Council in previous years have mainly focused on the role of sexualized violence as a strategic means of warfare. However, women and girls experience many forms of sexualized and gender-based violence before, during and after armed conflict – within their own communities, families, and by local institutions. Structural factors like economic discrimination and binary gender norms exacerbate the problem. Reducing the discussion to one dimension neither reflects the reality on the ground nor does it meet the needs and rights of survivors. In order to ensure effective protection and support, interventions need to address the continuum of violence against women and girls. They need to follow a transformative approach which aims at overcoming the underlying causes: discriminatory gender relations in patriarchal societies.

4. Applying a multi-level approach

Stigmatization and ostracism are the perpetuation of violence. Providing direct services to women and girls is not enough. Approaches must also take into account the social and political environment and include family mediation, community awareness raising, capacity building of local institutions, and strengthening social movements that promote women’s rights. It is vital for survivors to receive social and political recognition. In Bosnia and Herzegovina as well as in Kosovo, survivors of sexualized wartime violence can apply for the status of ‘civilian war victim’ by law. The status entitles them to draw a monthly financial benefit. Although the laws and their implementation are far from perfect, they are an important social and political recognition of the injustice and could serve as a good practice model.

5. Letting survivors speak

Programs to support survivors need to be developed through participatory processes. These need to bring together the perspectives of survivors and the expertise and experience of women’s rights activists and women’s organizations, both local and international. Often they have worked intimately with survivors for years, developing specific approaches and methods and constantly learning from the survivors as they go. More importantly, over the years they have won the confidence of the survivors.