In Haiti, the number of young people, especially women and girls, who report experiencing sexual and gender-based violence (SGBV) is alarmingly high, especially in the densely populated capital Port-au-Prince.

Yet the issue is not widely discussed, and SGBV cases are likely underreported due to stigma and shame, as well as fear of reprisal from perpetrators or the community. At the same time, the services that are available for survivors, especially for minors (under the age of 18), are insufficient and inadequate.

In May 2015, Doctors Without Borders/Médecins Sans Frontières (MSF) opened the Pran Men’m clinic (Creole for "take my hand") in Port-au-Prince that specializes in providing medical and psychological care to survivors of SGBV. The vast majority of the more than 1,300 survivors of sexual violence who have been treated in the clinic are younger than 25 years, and more than half are minors. 

In July 2017, MSF released Against Their Will: Sexual and Gender-Based Violence Against Young People in Haiti, a report that sheds light on this difficult subject, details the impact of this violence, and calls for action on the provision of medical services for those affected.

 

 

 

 “I met this guy on the street. We started to chat. After a while I told him I was looking for a job. He immediately said that one of his friends was precisely looking for someone like me. He said that he needed to go to his place to pick up some documents. When we got there he pulled out his gun. This is when it happened.” - Marie*, 21 years old, SGBV survivor

 

97% of patients seen in the MSF Pran Men’m clinic are female – But SGBV also affects men and boys.

Given the risk of stigma that contributes to the general underreporting of sexual violence in Haiti, men and boys are even less likely to report incidents or seek the medical care and other support they need after an incident of sexual assault.

Patients younger than 25 years of age represent the vast majority of all survivors that MSF has treated in its Pran Men’m clinic from May 2015 to March 2017 (77%). MSF is particularly concerned by the fact that 53% of patients seen are under 18.

 

“For me, the most difficult cases are always the youngest ones. The medical examination can be painful for young children. Some of them refuse to be touched, even by a doctor. They need to feel safe, trusted, that they won’t be hurt anymore. I always work very closely with the psychologist.” – Judith, MSF doctor

 

Four out of five minors who have experienced SGBV knew their attackers. Most were family acquaintances, and sometimes (11% of the time) they were household members. Most children under 10 years of age (71%) were abused in places where they should feel safe, such as their own homes, or with friends and relatives.

 

 

“He is someone we knew. He lived in the same area than us in the camp. Now he is nowhere to be found. Our tent was broken and had a big hole in it. He came through it. He rape Sarah. She was on her own. Sarah wants to dance, she loves it but I don’t want her to. I feel she is too visible when she dances. Now she stays most of the time with my nieces.” - Sarah’s Mother - Sarah*, 13 years old, SGBV survivor

 

83% of patients seen in the MSF Pran Men’m clinic between May 2015 and March 2017 are rape survivors. SGBV can take several forms and rape is one form of SGBV.

 

 

“My cousin told me that I had bad luck, that something was wrong with me. A friend of my parents said that he was a mason and therefore could help remove the ‘bad eye.’ He took me to an isolated place and asked me to get naked. He touched me and raped me. I also know he is a recidivist. He did the same to two little girls from my neighborhood. The parents are scared so they don’t do anything. The girls are 15 and 12.” - Gisèle*, 20 years old, SGBV & rape survivor

 

Every day, MSF’s clinicians witness the health consequences of SGBV in Haiti. Sexual violence can be a cause of HIV transmission and other sexually-transmitted infections. It can lead to unwanted pregnancies, which for many of MSF’s young patients has grave life-changing consequences. Survivors often have physical injuries (bruises, lacerations, stabbing, fractures), and sexual violence can cause vaginal or anal tearing, bleeding or infection.

 

 

“I had a boyfriend but we were separated. He had a lot of other girlfriends and also children. I even look after one of his boy and also one of his daughters now. She is like my own. One night, he came to my place and we fought. He threw me on the floor and raped me so brutally that I started to bleed. My daughters and children don’t know what happened. I did not tell them anything. I pretended the blood was something else. After a couple of days, I decided to go to the MSF clinic. It is passed now, and my only worry is actually not the rape, it is to become blind; I have eyes problem. If I can’t see anymore, I can’t help my family anymore. This worries me a lot.” - Stéphanie*, 52 years old, SGBV survivor

 

Immediately after sexual attacks, survivors are often in a state of shock; some may feel guilty, believing they could have avoided the rape. Rape survivors can also develop depression and post-traumatic stress disorder. 

 

“There is a high risk of being further exposed to violence if the survivor does not receive adequate psychological care, because she will not realize that she is again a victim. When psychological support is delivered on time, the survivor is empowered and knows that violence, including sexual abuse, is not acceptable. This is particularly critical for the youngest ones.” – Stéphanie, MSF psychologist

 

The consequences of SGBV are physical and psychological, but they are also social and economic. SGBV affects not only the survivors, but also their families and communities. Survivors need comprehensive care, which includes a range of support services.

 

“Sometimes, we’re obliged to keep survivors in our clinic while we seek a suitable solution for them; they cannot go back to their communities where their perpetrators also live.”Judith, medical doctor

 

Conclusion

Sexual and gender-based violence is a significant problem in Haiti and must be recognized as a public health issue. Survivors must have access to adequate medical and psychological care.

It is essential to increase prevention at various levels, and to reinforce rapid availability and accessibility of medical and psychological care for survivors, as well as social support and protection services.

 

*Names have been changed to protect the identities of people interviewed.

All photos © Benedicte Kurzen/Noor for MSF

 

 

 

Follow us on social media:

Find Doctors Without Borders Canada/Médecins Sans Frontières (MSF) Canada on FacebookFind Doctors Without Borders Canada/Médecins Sans Frontières (MSF) Canada on TwitterFind Doctors Without Borders Canada/Médecins Sans Frontières (MSF) Canada on Google+Find Doctors Without Borders Canada/Médecins Sans Frontières (MSF) Canada on TumblrFind Doctors Without Borders Canada/Médecins Sans Frontières (MSF) Canada on LinkedInFind Doctors Without Borders Canada/Médecins Sans Frontières (MSF) Canada on YoutubeFind Doctors Without Borders Canada/Médecins Sans Frontières (MSF) Canada on Email

Related News & Publications