A needs assessment by Doctors Without Borders/Médecins Sans Frontières (MSF) in Kenya showed significant gaps in the detection and management of sexual and gender-based violence cases in camps for displaced people in Baringo county.
Following an escalation of conflict in her community early this year, Mary* was forced to flee her home in search of safety. Unlike many of her neighbors who headed to camps for internally displaced people miles away, Mary sought refuge at a distant relative's home that was close to her teenage daughter’s school, in hopes that her daughter would be able to continue her education.
Vulnerability away from home
Mary and her daughter set up a temporary shelter inside the relative’s compound, and although things started out well, Mary’s daughter soon told her about propositions she was getting from the relative’s eldest son, who was over 18 years old.
Mary asked her daughter not to cause trouble with a family that had hosted them, but unfortunately the situation escalated with the relative’s son, and his advances became more aggressive. One night he tried to force himself on Mary’s daughter.
“Were it not for her loud screams, he would have been successful,” said Mary. “I said, ‘enough is enough!’”
That night, Mary and her daughter packed their bags and left for a camp. This story, unfortunately, is not uncommon among internally displaced people in Baringo county.
MSF launches emergency intervention
“On April 29, MSF initiated an emergency intervention focused on supporting displaced people on mental health and specifically sexual violence,” said Jonah Ngugi, nursing activity manager. MSF appointed a clinician with experience addressing sexual violence to be part of outreach activities and medical services supporting the detection of sexual violence cases in the community.
“We had two entry points for sexual violence case detection and management,” explained Ngugi. “One was during therapy sessions with our psychologists, and another was during medical consultations through a clinician with experience in sexual violence case detection.”
Nancy Mutai, an MSF psychologist, says sexual violence is likely underreported. “We received cases of attempted rape and gender-based violence and we have been able to manage them and link [patients] to care, but this is not the true picture,” she said.
Where sexual violence occurs
Further analysis by MSF teams on the ground shows that most sexual violence cases occur in integrated settings rather than the camps. “In the camps, there is a clear separation between where men and women sleep,” said Mutai. “Mothers are more aware of their children’s whereabouts. In the integrated settings, however, the situation is much more complicated; girls tend to walk long distances in search of water and firewood, and this puts them at risk. The internally displaced people are also at the mercy of their hosts and can easily be taken advantage of.”
A lack of awareness about sexual violence and stigma have hindered early detection and management of cases in these communities. In response, MSF partnered with the Ministry of Health to conduct capacity building for 187 community health promoters and 60 health care workers on sexual and gender-based violence response as well as mental health and psychosocial support in June.
*Name changed for privacy
