Opinion: 3 ways health providers can support gender violence survivors

One in 3 women worldwide experience physical or sexual violence. In Papua New Guinea, where I live and work, it’s worse. Here, men’s violence against women is so commonplace that more women experience violence than those who don’t.

A woman in Papua New Guinea is beaten every 30 seconds. And as many as 75% of women in Asia Pacific have experienced sexual harassment. But statistics like these can only tell us so much about this complex and under-reported issue. The impacts of gender-based violence are both blatant and insidious, holding women back from their potential, denying them their safety and autonomy, and in some cases taking their lives.

As a society we must urgently reshape the cultural and social norms that engender men’s violence against women. As a man, I feel strongly about men and boys taking on a more active role in ending this crisis and redefining masculinity, so it’s not entangled with power, violence, and an entitlement to women’s bodies.

Alongside that, we’ve got to deal with what’s at hand: Survivors of sexual and gender-based violence need support. And reproductive health care providers are uniquely placed to offer it.

I work for MSI Reproductive Choices in Papua New Guinea, where we deliver essential women’s health care such as contraception to more than 50,000 clients every year. Sexual assault, forced pregnancy, reproductive coercion — these are all forms of gender-based violence that intersect with our work.

Reproductive health care providers offer a space where women can talk freely about their sexual experiences and health, so it’s no surprise they are often the first (or only) people to whom women will reveal their experiences of sexual and gender-based violence.

It might be a survivor’s only chance to talk to someone about it. My job is to integrate support for survivors into these services. It is essential that anyone accessing sexual and reproductive health care can safely disclose experiences of violence and be met with understanding and support.

I’d like to share three ways front-line health care providers can support survivors.

1. Provide immediate front-line health care

An obvious and affirming way we can help survivors is by providing them with the health care they’re seeking. In cases of sexual violence, we can give women choices such as emergency contraception, pregnancy testing, HIV and STI testing and management, abortion, and post-abortion care.

While my work is based in Papua New Guinea, I hear of amazing work happening across the Asia-Pacific region to support survivors. In one memorable case from Timor-Leste, MSI helped a 25-year-old woman access a contraceptive injection, an invisible form of contraception, when she was being pressured by her partner to remove her implant and become pregnant against her will. This put her back in control of her own body and choices.

2. Respond with compassion and confidentiality

Each week, I travel across the country to mentor health care providers on creating a safe space and having a survivor-centered approach. There’s no one-size-fits-all response here, as every survivor has unique experiences and needs, but I teach providers to ask the right questions at the right times, respond with compassion, validate them, take their privacy seriously, and put them in control of their next steps.

My colleagues in Nepal shared a story with me recently. A survivor called their contact center after hearing the number on the radio. Beaten by her husband and threatened with weapons, the woman felt unsafe and unsure of what to do. The counselor on the line, having recently undergone survivor-response training, had the tools and skills to realize she was at high risk and helped her create a safety plan, letting her know where she could report the violence and how she could access further help. Phone calls like these save lives.

3. Refer survivors for further support

It’s a huge responsibility when a survivor trusts us with their story. Some survivors may need to access other critical services beyond the first response care that reproductive health care providers can give.

To take our duty of care seriously, every health care organization should map out local quality services such as trauma counseling, legal or economic assistance, shelters, and child protection, so we can refer survivors.

Community referral networks of local services mean that clients can be referred to specialist support when they need it. All 37 country programs across our MSI partnership are responding to sexual and gender-based violence in their own contexts and building referral networks.

We should all be able to ensure pathways for survivors who may need specific types of support, including people with disabilities.

My MSI colleagues in Bangladesh started training public health care providers after they saw a 24% rise in reports of gender-based violence during COVID-19. One recently reported back that she felt equipped to help an adolescent who came to her with unusual bruises on her body. The provider was able to offer a safe space and support when the client disclosed that her husband is often physically violent toward her. She knew the pathways and resources to share with the client, including where she could access legal help should she want it, and how a local domestic violence specialist organization could further support her. She provided the survivor with choices and supported them to carve their own pathway to healing.

Bridging the gap

When someone discloses experiences of violence, health care providers should be able to confidently respond in a survivor-centered and empathetic way and help them get the support they need. I believe that’s a goal worth achieving.

With deplorable rates of gender-based violence all over the world, it’s imperative that health care organizations are bridging the gap between first response health care and support for survivors. All health care organizations, and especially those offering sexual and reproductive health care, should have robust support for survivors built into their services.

We can offer pathways and choices, playing a small but critical role in a much wider response to the crisis of gender-based violence. And I’m witnessing first hand every day what a difference we can make.