Recently the Ministry of Health held a two day workshop that was aimed at sensitizing the public and health professionals on ways to improve the services provided to victims of Gender Based Violence (GBV) in health facilities.

Gender based violence includes all acts or threats of violence that may result in physical, sexual, psychological harm and suffering to women.

Although violence against women presents a major public health problem that has been ignored too long a time by individuals and society, it should be viewed in a wider context of society norms and cultural beliefs as its legal categorization varies from one country to another.

Physical assault and sexual abuse on women have been linked to various reproductive health problems such as gynecological disorders, unsafe abortion, pregnancy complications, miscarriage, low birth weight, and pelvic inflammatory disease.

"Since women discuss their experiences with health professionals, reproductive health care providers are positioned uniquely to identify and assist victims of gender based violence,” says Dr Bob Kagoro working at kanombe Military hospital.

Based on the report covering cases of gender based violence in Rwanda from 2005 to 2008 that were gathered by the Rwanda National Police, there are increased cases of attacks against women including rape, defilement, subscription to corporal punishment and murder by their spouses.  

The report shows that during the last three years, 259 wives were murdered by their husbands, over 2,000 cases of rape were reported to the police, and there were over 10,000 cases of defilement of children below the age of 18.

The report also clearly shows that young girls are always at risk of gender based violence. Teenagers who have suffered from abuse are more likely to exhibit depressive symptoms and low self esteem problems.

They are also more likely to suffer episodic or chronic depression, post traumatic stress syndrome, and other mental health disorders. These patterns are also more likely to continue into adulthood, often in a series of abusive relationships.

The above mentioned incidents have brought long overdue and well deserved attention and analysis to the complexity of concerns and issues affecting people especially teenagers that often manifest themselves in violent and aggressive acts towards others.

Domestic violence is the number one public health threat to women, responsible for more injuries than any other cause. Intimate partner violence or dating violence is important to consider and address from adolescence in that the prevalence merits serious cause for concern.

The impact of intimate partner violence on the overall health and well being of young girls is significant.
Dating violence has severe consequences.

On addition to physical injuries that may be sustained, young women are three times more likely to report severe emotional trauma when a violent episode occurs in a dating situation.

Other long term consequences can include continued or chronic health problems, increased use of medical services and hospitalizations, and poor self-rated health status.

Rape is a crime primarily committed against girls and young women. Adolescents are considered to be at highest risk for sexual assault. Other health damaging behaviours are also more common in female adolescents experiencing violence.

They are more likely to smoke and use other substances, and are at increased risk for pregnancy, sexually transmitted disease, suicide attempts, and unhealthy weight loss.

Further more, the impact of dating violence and sexual harassment particularly in school settings is also an issue that disproportionately affects adolescent girls.

It is important to understand more about gender socialization and accepted social norms about adolescent development contribute to the varied experiences of males and females in the recent years.

These experiences however, are often stratified in ways that are harmful to adolescent girls and ripen conditions for victimization through violence.

The issue of sexual harassment provides an example. The sexual harassment of girls by boys during adolescence has been socially viewed as a part of normal adolescent development.

This concept that boys will be boys has framed our thinking and responses to this issue, the immediate and long term consequences of which have not been considered until recent years.

Beliefs about gender based violence that exist in our young people and within the larger society can create barriers for young women dealing with violent relationships.

Many young people remain silent about their experiences and harbour feelings of guilt, shame, and responsibility for the acts perpetrated on them, and there are hesitate to tell anyone and seek services.

I think Medical professionals have tremendous opportunities to directly and indirectly impact the health and well being of adolescent girls with respect to gender based violence.

Also the inter disciplinary roles in medical and healthcare settings are particularly critical in enhancing the identification and provision of services to teenagers experiencing violence.

Also to mention is that the involvement of social workers in increasing awareness across disciplines within the medical community will greatly enhance the provision of services to adolescents.

This is one of many ways in which the involvement of social work can result in better health outcomes for adolescent girls.
 
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