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In Nigeria, health workers learn how to help women facing gender-based violence



Like many health workers across the Sahel, Mairama Baba Yadafa has witnessed first-hand the multiple impacts of an unprecedented humanitarian crisis that has gripped the region: drought has fueled hunger amid increasing deprivation and suffering of millions of people affected by armed violence.

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As the world sounds alarm after alarm about unrelenting challenges and tragedies, health workers like Yadafa struggle with a deeper impact that has little voice due to the taboos, humiliation, fear and simple helplessness that keep people silent.

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“Women and girls are frequently subjected to domestic violence and other harmful acts that invade their physical and emotional integrity,” he says.

“As a frontline worker, it would sometimes overwhelm me to see and hear them go through that ordeal.” Yadafa is a midwife at the Lokuwa Primary Health Care/Clinic in Adamawa State, North East Nigeria.

When she was confronted with women and girls who remained silent about signs of trouble that Yadafa could clearly see, Yadafa also felt powerless.

“In the past, I often had to leave them to their own devices because I didn’t know what to do,” she says.

But Yadafa is one of 27 health workers and 23 men from civil society organizations in her northeast Nigerian community included in a training of health workers across the Sahel to respond to gender-based violence.

The training is part of the World Health Organization’s (WHO) emergency response to the humanitarian crisis.

In addition to responding to the spread or threat of disease, high malnutrition, food insecurity and difficult access to basic services, including health, in the six countries of the Sahel region, WHO recognizes the threat of gender-based violence to the physical and mental well-being.

of women and girls, along with the lack of options for most of them.

Gender-based violence includes domestic violence, abuse, trafficking, exploitation and forced marriage, generally perpetrated against women and girls.

“When frontline responders are properly trained to help victims of gender-based violence, they continually make a difference,” says Dr. Richard Lako, WHO Emergency Manager for North-East Nigeria.

Dr. Lako explains that because women are likely to come into contact with health providers, especially during their reproductive years, they are likely to trust health workers enough to disclose any violence they are facing.


Otherwise, they may not tell anyone, or at least no one who can help.

And because reporting violence can have repercussions for the women who experience it, health care providers need guidance on how to provide help carefully and confidentially.

They need to know what steps to take and what to consider when someone seeks their help for domestic violence, says Dr. Lako. The training, he explains, begins with the need for confidentiality.

It includes how to engage with communities to let them know that gender-based violence is unacceptable and a crime, but that help is available.

It involves knowing when and where to make confidential referrals so that people experiencing violence get the services they need.

WHO is piloting gender-based violence training for health workers in Nigeria before making it available in the six countries of the Sahel region.

So far, 385,200 health workers have participated in the Nigerian training.

Training in Nigeria enabled health workers to provide frontline support to 3,895 women and girls experiencing gender-based violence between April and June 2022, compared to 765 people in the first three months of the year.

Of these, 1,967 women and girls were referred to another health center for additional care.

And more than 47,400 women and girls were reached with information about gender-based violence, its consequences, and the role of health workers when seeking help.

Violence and insecurity in the Sahel region are exacerbating the vulnerability of women and girls.

But due to taboos on bringing private family matters to light or fear of retaliation from the perpetrator, many women and girls remain silent about the violence they experience.

Even when women and girls do come forward, the data on such incidence, especially in the Sahel region which is experiencing massive displacement of communities and populations, extreme food insecurity and rising levels of poverty, do not hold up well.

The design of information management systems and secure data collection is also part of the training of health care providers.

Dr. Celine Laori, Director of Public Health for Adamawa State, believes that the training fills a huge and urgent gap.

“With this newly acquired knowledge, health workers can now address gaps and ensure quality GBV care responses are provided,” she says.

Yadafa, who used to feel powerless around women she knew were experiencing violence, now feels that she is of more use.

“The gender-based violence training has given me the knowledge to provide professional care to survivors in a confidential setting, and I am confident that they will now receive timely and appropriate support at our health center.”

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