HEALTHCARE AS PART OF INTEGRATED GBV SERVICES: The potential need of a network of expertise and knowledge Dr. Sam Thenya CEO – The Nairobi Women’s Hospital 5th GTZ Health Sector Network Meeting 25th February 2010

About NWH-GVRC GVRC was established in 2001 as a charitable trust of the Nairobi Women’s Hospital to provide free medical treatment and psychosocial support to survivors of sexual and domestic violence. Today the centre has treated over 15,000 survivors of sexual and domestic violence. 90% of the cases are of sexual violence 49% of the cases are women, 45% children and 6% men The youngest survivor of sexual violence is a 1 month old baby and the oldest 105 yrs old grandmother. The centre has 15 staff, runs semi – autonomously from the NWH and depends on donor funding to run its activities. ( Both International and local donors) Other services provided include; Training of other service providers ( health workers, police, magistrates, policy makers, community opinion leaders) on management of gender based violence, Daily collection of data and analysis of GBV stastistics, Advocacy for policy/legislative enactment and implementation Community awareness creation on impact of GBV and HIV/AIDS.

What Difference does GVRC make? GBV cases have no boundaries; economic, social, cultural or religious everyone is directly or indirectly affected, everyone needs these services. All GVRC services are free; we reach out to the poorest of the poor Medical services are aimed at prevention of HIV infection ( PEP within 72hrs and has 99% success rate), prevention of unwanted pregnancy, prevention of Hepatitis B infection, treatment of STI and reconstructive surgeries. GVRC creates awareness on prevention of violence in the society. GVRC has advised police and Kenyans on “red spots” in the city and constantly shared statistics to advise policy change and establishment of structures to prevent the vise. GVRC provides legal support – preservation of evidence, medical reports and doctors evidence at no cost.

NWH/GVRC Linkage with Public Health Best practices – GVRC remains the oldest and leading institution in East and Central Africa. Various institutions learn from NWH/GVRC Capacity building/Trainings – Train health service providers, legal professionals, the police, social workers and counselors on management of GBV and service delivery Participate in the development of standard operating procedures, quality services, regulatory frameworks, policies and professional ethics. Participate in intersectoral coordination, collaboration and partnerships to improve quality of service example referral systems.

Networking organizations GVRC network comprise : Women's Rights Awareness program (WRAP), Coalition of Rights and Education of Abused Women (CREAW), Coalition of Violence Against women (COVAW), UNAIDS, United Nations Population Fund (UNFPA), UNIFEM, Federation of Women Lawyers in Kenya (FIDA), African Women’s development and communication Network (FEMNET), CRADLE, CLAN, ANPPCAN, Plan Kenya, International Justice Mission (IJM), GOAL Kenya Rescue Centre, Oscar Foundation Free Legal Aid Clinic, Child life Trust, Children’s Department, Nairobi Children’s Home, Childline Kenya, Faulu Kenya, Support for Women In Extreme Difficulties (S.W.E.D), and other GBV stakeholders etc.

GVRC’s Achievements through networking GVRC received great support during the post election violence. 653 survivors were treated at the hospital, 286 through partners supported by GVRC and over 2812 through medical camps. Over 180,000 received psychosocial support. GVRC is proud to, in collaboration with Red Cross, establish the psychosocial component of the national emergency response team during PEV where over 180,000 people received psychosocial support. Recruitment of long term project donors namely Safaricom Foundation, Terres des hommes, PLAN International, Childline Kenya, OBA, UNFPA and UAP Insurance Police headquarters ( Gender and children affairs department) currently working closely with GVRC to assist survivors who encounter challenges while trying to report their cases at any police station

Knowledge Sharing GVRC is a pioneer centre for GBV statistics and other centers in Kenya; many NGOs, Government, Media houses and UN agencies rely on the centre’s statistics in providing reports. These including the National Commission on Gender and Development, Kenya National Human Rights Commission, FIDA Kenya, WRAP, MEDEVA among others. UNFPA has come on board to support GVMU expansion to collect and collate data on GBV in the country. This is a pilot program that is hoped to be replicated in all provinces to enable a national reflection of statistics and further enable advocacy for societal change.

Knowledge Sharing GVRC is currently a centre of reference in East Africa for best practices in medical services and psychosocial support for survivors of GBV. GVRC staff have carried out several trainings and presented several papers to service providers and like minded stakeholders in East Africa and U.S.A. The centre’s statistics are also quoted in several UN and NGO publications. For example, the GBV Sub cluster report on PEV, WRAP report on PEV, Action Aid Kenya on the intersection of VAW and HIV/AIDS amongst others.

Achievements through Networking GVRC representative seat in the Childline Kenya board of directors and in the National Steering Committee on the Child 24 hour toll free helpline. GVRC is in partnership with Childline to provide rescue services (Ambulance). GVRC made significant contribution to the enactment of the Sexual Offences Act, 2006, magistrates, police, health service providers among others were trained on implications of sexual violence and statistics collected at the centre used to advocate and lobby for the change in legislation.

Achievements in lobbying through Networking Rape Red spots: Bill boards were initially put in the sites to educate people about rape. The globe cinema roundabout as well as the railway red spot is now matatu terminus, well light and each has a police post. GVRC together with other Civil Society Organizations (CSOs) lobbied the government to convert some of the police stations to set up gender and children desks. This led to the conversion of Kilimani police station to exclusive handle gender based violence meted on women and children

Achievements in Training through Networking Trainings have been done in East Africa through the partnership of TDH and GVRC. 250 personnel have been trained on child protection and management of gender based violence. GVRC has been able to share its best practices as a model institution in the management of GBV in East and Central Africa. The topics of trainings have included medical management, psychosocial support and social support. The partners in region that GVRC has worked with together with TDH are in Tanzania (Moshi and Musoma), Uganda (Kampala and Jinja) and Kenya (Turkana, Bondo, Nairobi) All these partner organization are funded by TDH to carry out activities geared toward the protection of the child in the society against all forms of abuse. Development of Training Health workers, police, CBO’s on management of rape and PEP treatment in Coast region, Rift Valley and Western provinces. A total of 12 hospitals were trained on rape management, 24 doctors, 24 trauma counselors (12 facility based and 12 community based), 24 child counselors, 24 community/opinion leaders, 320 senior police officers between 2005/2006. Developing the manuals used in these training exercises such as training manuals on Rape Management, Trauma counseling, Child counseling and Gender issues.

GAPS IN EXISTING MECHANISIMS DEALING WITH GBV More support to the relevant government and institutions is needed to integrate prevention of GBV and gender equality concerns into their emergency plans of action and improve their capacity to address the problem of GBV. The private sector and faith based organizations should be integrated There is also need for continued partnership for collective and effective results on Gender equality and empowerment of women. coordination mechanisms for prevention and response programming at the national, provincial and district level is important. Need to allocate technical and financial resources to security personnel to address GBV and especially against women and girls who are more vulnerable

GAPS IN EXISTING MECHANISIMS DEALING WITH GBV…cont. Need for greater integration of the private sector, faith based organizations and civil societies by the government in the decision making processes that concern SGBV. Need to improve multi-sectoral prevention and response to GBV at the community level, through sustained support to sectors such as health, legal/justice, security and psychosocial, with a special focus on gaps such as availability of forensic examiners ,legal aid services and judicial response Need to conduct widespread community education aimed at prevention and ensuring survivors know how and where to access services. Need for continued capacity building and training on GBV. Better allocation of taxpayers money towards fighting SGBV