1. Sexual Gender-Based Violence & HIV and AIDS Dr
Sexual Gender-Based Violence & HIV and AIDS Dr. Asia Abdulkadir Regional HIV and AIDS workshop of Handicap International Bujumbura, February 22, 2011

2. Objectives of the orientation training
To understand the differences between ‘Sex’ and ‘gender’.
To Explore social and cultural expectations for males and females, and illustrate the difference between those based on sex and those based on gender.
To identify the many forms of gender-based violence.

3. Objectives of the orientation training
To understand the causes and consequences of gender-based violence.
To highlight the linkage between Gender and HIV/AIDS.
To help participants understand the key indicators related to SGBV.

4. I Introduction to the term Gender
What do we know about the difference between “Gender” and “Sex”?
What is “Gender” and What is “Sex”?

5. The Meaning of Gender and Sex
Gender is the concept used to identify a human being as male, female.
Usually it is used to highlight the social distinctions between men and women; for example the positions they occupy the roles they play and the social status they have are socially constructed and allocated.

6. The Meaning of Gender and Sex
Gender is distinguished from sex, which is biologically determined. Because gender is socially constructed, it is affected by many factors.
All of us are gendered – this means we are socially conditioned to take on roles and responsibilities allocated as given to men and women.

7. The Meaning of Gender and Sex
The meaning and roles expectation can change over time – it can be both progressive and regressive.
In war and conflict situations, women are likely to experience more restrictive practices relating to gender expectations than during peace time (women have to be protected; men have to be the protectors).

8. The Meaning of Gender and Sex
Women often become head of families for a long time during war periods and they might have to expand their activities both within and outside of the home. This sometimes causes family conflict after the war when their male family members return home and women are again subjected to restrictions.

9. The Meaning of Gender and Sex
The term ‘gender’ is widely used in humanitarian aid programs for consideration of existing inequalities between males and females on development issues and how these inequalities can be re-address.

10. 2. Exploring Sexual Gender-Based Violence (GBV): Causes and Consequences
What do we mean when we say “gender-based violence”?

11. Definition of Gender-based violence
Gender-based violence (GBV) is an umbrella terminology for any harm that is perpetrated against a person’s will and that has a negative impact on the physical or psychological health, development, and identity of the person.
GBV may be physical, sexual, psychological, economic violence or socio-cultural.

12. Types of Gender-based violence
Which types/forms of Gender-based violence do exist?
How many of them do we know?

13. Introduction of the different types of GBV
GBV is categorised in four main types:
1. Physical violence: physical assault; murder, physical harassment in public; attempted murder; denied access to medical treatment;, harmful traditional.

14. Introduction of the different types of GBV
2. Sexual violence: Forced marriage; child marriage; forced engagement; forced prostitution; rape; forced sexual intercourse with husband; incest; sexual assault and Female Genital Mutilation (FGM).

15. Introduction of the different types of GBV
3. Psychological/emotional violence: denial of food or basic needs; prevention of education, refusal to communicate; preventing maternal contact with children; using children as threats; physical threats to other family members; verbal insulting; threats to kill; intimidation; restrictions on movement outside the home i.e. to visit own family, talk to neighbours, etc; forced to divorce/ separate; abandoned to own parents.

16. Introduction of the different types of GBV
4. Other types of violence: Other traditional and cultural practices i.e. honour killings; kidnapping; attempted kidnapping, trafficking.

17. Gender-based violence regional overview
According to REPORTS from WHO and UNDP :
SOMALIA
The Practice of FGM is almost universal. It is estimated that 95-98% of women have been circumcised. Almost every girl in Somalia undergoes FGM.
It has been estimated that 86% of all adult Somali women are illiterate.

18. Gender-based violence regional overview
Sexual and Gender-Based violence is not uncommon, particularly in IDP Camps and most of the time against women and girls of rival clans and those of minority groups.

19. Gender-based violence regional overview
Ethiopia
FGM
Close to 90 percent of Ethiopian girls and women are affected by FGM
Early Marriage
41% of girls between the age of are married.

20. Gender-based violence regional overview
Rape
A study from 2000 indicated that 2,263 women were raped in that year. The study indicated that these are only the reported cases and in all the cases perpetrators were close family members.

21. Gender-based violence regional overview
SGBV in the context of Conflict
In 2007/2008, 650 cases of SGBV related to the post-election crisis in Kenya.
Since 1998 in Eastern Congo (DRC) alone over 41,000 women were raped as a weapon of war and propagating HIV to the enemy.

22. Consequences of GBV/SGBV
The consequences of GBV can be scattered into four main aspects:
1. Health
2. Emotional, social and psychological
3. Community and physical safety and security
4. Legal/justice system

23. Consequences of GBV/SGBV
Health:
Individual consequences to the survivor:
Depression, leading to chronic physical complaints and illnesses.
FGM, resulting in shock, infection, excessive bleeding or death, and longer-term affects such as emotional damage, including anger, fear, self-hate and confusion.

24. Consequences of GBV/SGBV
Loss of desire for sex and painful sexual intercourse.
Difficult pregnancy and labour, chronic pain and infection, infertility.

25. Consequences of GBV/SGBV
Injury, disability, or death. STIs and HIV/AIDS.
Injury to the reproductive system including menstrual disorders, infections, miscarriages, unwanted pregnancies, unsafe abortions.
Impact on wider society: Strain on medical system.

26. Consequences of GBV/SGBV
Emotional/Psychological:
Individual consequences to the survivor:
Emotional damage including anger, fear and self-hate. Shame, insecurity, loss of ability to function and carry out daily activities.
Feelings of depression and isolation.

27. Consequences of GBV/SGBV
Problems sleeping and eating.
Mental illness and thoughts of hopelessness and suicide.
Judgments made about the survivor.
Blaming the survivor.
Treating the survivor as a social outcast.

28. Consequences of GBV/SGBV
Impact on wider society:
Expensive, drain on community resources; family, friends, schools, community leaders, social service agencies, etc.
Survivor unable to continue as contributing member of society; unable to keep up with child care, unable to earn an income.

29. Consequences of GBV/SGBV
If perpetrators not arrested, this sends a strong message that the behaviour is somehow acceptable, leading to further incidents of violence.

30. Consequences of GBV/SGBV
Legal/Justice System
Lack of access to legal system.
Lack of knowledge of existing laws.
Confusion regarding the most appropriate channels i.e. criminal, traditional etc.
Survivors reluctant to report due to heavy stigma attached to sexual abuse.

31. Consequences of GBV/SGBV
Strain on police/court resources already challenged and overburdened.
Lack of sensitivity to the issues expressed by judges and polices forces.
Costs incurred by the survivor.

32. Consequences of GBV/SGBV
Security, Physical Environment of the Community
Survivor feels insecure, threatened, afraid, Climate of fear and insecurity impacting women’s freedom and perception of personal safety.
Lack of female participation in the community life. Fear of going to school and work.

33. The case of an arranged marriage (case study)

34. Gender-based violence and the violation of women‘s human rights
Power
Perpetrators can have “real” or “perceived” power. Some examples of different types of power and powerful people:
Social – peer pressure, leaders, teachers, parents, etc.
Economic – the perpetrator controls money or access to goods/services/money/favours; sometimes husband or father.
Political – elected leaders, discriminatory laws.

35. Gender-based violence and the violation of women‘s human rights
Physical – strength, use of weapons, controlling access or security; soldiers, local commanders, police, robbers, gangs, mafia, etc.
Gender-based (social) – males are usually in a more powerful position than females.
Age-related – often, in traditional societies status/power is granted with age.
Power is directly related to choice. The more power one has, there are more choices available.

36. Gender-based violence and the violation of women‘s human rights
The less power one has, fewer choices are available.
Disempowered people have fewer choices and are therefore more vulnerable to abuse.
Gender-based violence involves the abuse of power.
Unequal power relationships are exploited or abused.

37. Gender-based violence and the violation of women‘s human rights
Violence - use of force
1. “Force” might be physical, emotional, social or economic in nature. It may also involve coercion or pressure. Force also includes intimidation, threats, persecution, or other forms of psychological or social pressure.
Target of such violence is compelled to behave as expected or to do what is being requested, for fear of real and harmful consequences.

38. Gender-based violence and the violation of women‘s human rights
2. Violence consists of the use of physical force or other means of coercion such as threat, inducement or promise of a benefit to obtain something from a weaker or more vulnerable person.
3. Using violence involves forcing someone to do something against her/his will - use of force.

39. Gender-based violence and the violation of women‘s human rights
Consent
1. Consent means saying “yes,” agreeing to something. Informed consent means making an informed choice freely and voluntarily by persons in an equal power relationship.

40. Gender-based violence and the violation of women‘s human rights
2. Acts of gender-based violence occur without informed consent. Even if she says “yes,” this is not true consent because it was said under pressure - the perpetrator(s) used some kind of force to get her to say yes.

41. Gender-based violence and the violation of women‘s human rights
3. Children (under age 18) in most countries are deemed unable to give informed consent for acts such as marriage, sexual relations, etc.

42. Root causes and contributing factors of Gender-based violence
What are the differences between root causes and contributing factors of Gender-based violence?

43. Root causes and contributing factors of Gender-based violence
Contributing factors are those that perpetuate GBV/SGBV or increase risk of GBV (family, community and state violence).
Contributing factors do not cause GBV although they are associated with some acts of GBV.

44. Root causes and contributing factors of Gender-based violence
Some examples:
Alcohol/drug abuse is a contributing factor - but not all drunks/drug addicts beat their wives or rape women.
War, displacement, and the presence of armed combatants are all contributing factors, but not all soldiers rape civilian women.

45. Root causes and contributing factors of Gender-based violence
Poverty is a contributing factor, but not all poor women are victimized by forced prostitution or sexual exploitation.
Many contributing factors can be eliminated or significantly reduced through preventive activities.

46. The Impact of GBV on children in the family
It is important to understand the impact on children who witness violence against their mothers and women in their extended family, and interventions need to be in place to stop the cycle of violence from becoming an inter-generational problem.

47. The Impact of GBV on children in the family
Children, who repeatedly witness violence directed towards their mothers and other female members, learn and internalize perceptions such as:
Mothers/girl child are not deserving of respect.
Those who love you also hit and abuse you.

48. The Impact of GBV on children in the family
It is socially, culturally, traditionally and morally acceptable to use violence against female members of the family for control and compliance purposes.
Violence is an acceptable conflict resolution strategy.

49. The Impact of GBV on children in the family
It is important to recognize that there are gender differences in the way children internalise the violence they witness.
Boys will learn behaviour in adult relationships that the use of violence is acceptable.
Girls as adults will tolerate the abuse because her mother and other female members did.

50. The Impact of GBV on children in the family
Children respond in different ways to the violence experienced in their family environment.
Possible emotional and behaviour effects could be:
Loss of self esteem and self confidence.
Insecurity, fear and vulnerability

51. The Impact of GBV on children in the family
Being unable to openly discuss frustrations and problems.
Poor anger management skills.
Difficulty in trusting people.

52. The Impact of GBV on children in the family
They may use violence to cope with their own stresses.
They may suffer from depression.
They may have school and other social difficulties i.e. poor concretion, unable to learn.

53. The Impact of GBV on children in the family
They may suffer from guilt, believing that they are the cause of the violence.
Physical symptoms – bed wetting, acting out, eating disorders, self harm/mutilation.
Children who have lived in abusive family environments are often poor achievers in school and have related learning difficulties.

54. The Impact of GBV on children in the family
Do you see similarities in the way how women and children react or respond to violence?
How can/would you support children in such situations?

55. Discussion points (Conclusion part I)
Although violence takes many different forms, gender- inequality is the root cause.
Although culture is often used to justify the use of violence towards women, the right to be free from abuse is a fundamental and universal.
Violence/assault need not always to be present. Threats and coercion are also forms of violence.

56. Conclusion
Gender-based violence includes any physical, mental or social abuse which is directed against a person on the basis of gender or sex and has its roots in gender inequality.
It is therefore important to integrate a gender perspective to effectively prevent and respond to it.

57. Conclusion
This means looking at what causes gender-based violence, analyzing what happens to women and girls because of gender discrimination, etc.

58. Conclusion
The impact of gender-based violence is far-reaching both for the survivor, and for society at large.
Strategies to respond to the many forms of gender-based violence must adopt a holistic approach and extend to all sectors.
Systematically addressing gender inequality at all levels is decisive.