Medical care for Gender-based violence (GBV) survivors in Kakuma, Dadaab 

Gender-Based Violence (GBV) is violence or any kind of attack on a person because of their gender. GBV impacts on a survivor’s immediate sexual, physical, and mental health. Such acts cause a likelihood of the survivor developing other health issues.

The urgent and life-saving care that healthcare providers give to GBV survivors is essential. This is meant to prevent further injury and the negative effects of GBV on one’s health. This includes treatment for rape, sexual assault, and other forms of GBV. Rape is the penetration with genital organs (vagina or penis) to another genital organ (vagina, penis, or anus) without their permission or expression of willingness. Read more about the other forms of GBV.

What happens when a GBV survivor seeks medical care?

Organizations that support GBV survivors have professional caseworkers and healthcare workers that ensure survivors are handled with respect and dignity. A survivor may choose to have someone in the room for social and moral support during the process. This service is provided for free by organizations in Kakuma and Dadaab.

In case the survivor is a minor (under the age of 18), a parent or their caregiver will be informed of all the steps involved in the provision of medical care. The guardian or parent can allow or decline to grant the permission for the provision of medical care to the child.

The following steps are followed to support the survivors.

1. Receiving the survivor

This is the first step in the process of supporting the survivor through the healing process. The caseworker attending to the survivor will introduce themselves, inquire from the survivor which language is appropriate for them and confirm if they feel safe in the location they are in and with the trained translators. Caseworkers have the responsibility to create a safe, supportive and compassionate environment for people receiving services. They work with the survivor to assess their immediate risks, needs and follow up on services and assistance for the survivor.

       2. Preliminary assessment

This stage is where the caseworker begins to identify the needs of the survivor. This is done by a question-and-answer session to confirm or gather the information that the survivor may have left out. The session focuses on information that is relevant to the incident. This is the start of the assessment stage.

       3. Obtaining informed consent

The staff receiving the survivor seeks their informed permission before beginning to take their history and examination. A consent form provided by the facility is required to be signed. A signed consent form is used to document consent. Additionally, verbal consent is sought for every stage of the medical care or GBV case management process. This ensures that the survivor is fully informed of any risks, benefits and available options for each medical procedure. At this point, the survivor has the power to choose what they are comfortable with.

        4. Taking the survivor's history

At this point, important questions will be asked by the GBV case worker. These are meant to help get information that will help to decide the type of medical examination to be done and the treatment to be provided.

         5. Performing physical examination

A physical examination helps to identify any injuries that the survivor may have from the attack and decide what medical care is needed. The type of examination depends on the kind of violence that the survivor has reported, for example, if it is a sexual assault or a physical assault, and the time that has passed since the incident took place. Different treatment options are available depending on the time that has passed since the incident took place and when it has been reported. A complete physical evaluation may include a general exam, pelvic exam (external genital exam and or vaginal examination) and anal exam.  

All parts of the physical examination are voluntary, and the health care provider will explain what they are going to do and ask if you are okay for them to proceed. You can accept or reject any procedure, take a break at any time or ask for the examination to stop. 

       6. Treatment and disease prevention

At this stage, a survivor is provided with medication if required. This includes administering medicine for:

• Treating physical injuries
• Medications to prevent infections such as sexually transmitted infections like Gonorrhea, Chlamydia infection, Trichomoniasis, Human Immunodeficiency Virus (HIV), Hepatitis B, and Tetanus 
• Education about health risks that may result from the assault
• Discussing of all treatment options. 

The survivor is also provided with emotional support. In some cases, a survivor may be referred to other service providers as needed and based on their willingness. 

Some common medications used include:

• Hepatitis B vaccine: Hepatitis B is preventable through vaccination that has to be given within 14 days of vaginal or anal rape.
• Tetanus Injection: A tetanus injection will be given to prevent tetanus infection. Tetanus infections are caused by bacterial infection entering a wound.
• Emergency Contraceptive Pills (ECP): Female sexual assault survivors who are of of reproductive age are given this drug. Only those who seek medical assistance within 120 hours of a pregnancy test are allowed for the ECP.  The contraceptives are only given if the pregnancy test is negative.

Rape survivors who have tissue injuries (bruises) due to the violent nature of the assault act have an increased risk of HIV infection. 

If a survivor visits a clinic more than 72 hours after the incident, the examination and treatment will depend on their condition and medical history. In cases where a survivor seeks treatment after 72 hours, some treatment options will not be applicable. For example, the survivor will not receive medication meant for preventing HIV. A female survivor will be asked to consent to a pregnancy test if she reports within 120 hours and is of reproductive age. . If the test result is negative, they can be given Emergency Contraceptive Pill (ECP). The pill works best within 72 hours of the sexual assault.  

Graphic: GBV hotline numbers for medical, counseling and legal assistance for survivors in Kakuma and Dadaab.

Why one should seek medical care within 72 hours of a sexual assault.

Violations such as rape, defilement, and incest are all forms of sexual violence. Survivors of these acts should report within 72 hours of the assault. This helps to reduce the risk of contracting HIV infection by administering Post-Exposure Prophylactic medication, also known as PEP. PEP is given within 72 hours of the sexual assault. Timely administration of the medication is critical.

Reporting within 72 hours also helps treat physical injuries that may be present and administer pain medications.

Reporting within 72 hours also helps survivors seek justice. Documenting injuries and collecting samples, such as blood, hair, saliva and sperm, within 72 hours of the incident, may help to support the survivor’s story and might help identify the offenders. You can learn more on legal assistance for GBV survivors seeking justice. 

Health facilitiesin Kakuma

Health facilities in Dadaab

There are hotline numbers that one can call if they face a GBV threat in whichever location. Calling any of these numbers can help you get guidance on where to seek help.

National hotlines 

          1. National Toll-Free Hotline for Gender Based Violence (GBV), 1195. 

The national Gender Based Violence (GBV) hotline is linked to health facilities that provide treatment for survivors of sexual violence, legal aid and rescue centers.  You will not be charged any airtime when calling this line.  

           2. Child helpline: 116 

The Child helpline is a confidential reporting platform that is accessible to children and adults who have identified or witnessed violence against children. Attendants on the line offer one-on-one counseling and connect children with support services in their communities. 

GBV Hotlines numbers in Kakuma and Dadaab

If you have any questions, please write to us via the Julisha.Info Facebook page, or chat with us on WhatsApp (+254110601820) Monday through Friday from 08:00 a.m. to 5:00 p.m.