Gender-based violence (GBV) is a sensitive issue that requires empathetic professionals working with victims and survivors.
The ‘Clinical Manual on the Health Care of Survivors Subject to Intimate Partner Violence and/or Sexual Violence, of the World Health Organization (WHO) in Namibia‘ has helped doctors, social workers and nurses such as Mark Bezuidenhout, registered nurse at the Epako Clinic, to be more sensitive with his patients.
Initially, the manual was intended for doctors; however, nurses and social workers have also found the manual beneficial to their work.
“The manual is very useful.
It makes GBV clients easier to deal with because it helps us treat patients with empathy and in a way that benefits them.
Previously, we often got stuck and didn’t know what to do next or who to involve,” says Bezuidenhout.
He is also more aware of the different forms of gender-based violence.
“I am more aware of how to deal with rape survivors and those who experience other types of gender-based violence,” says Bezuidenhout.
He has had to deal with patients who are physically, emotionally, and sexually abused.
Most are women of reproductive age.
“We refer these patients to social workers for further interventions,” Bezuidenhout explained.
Justina Shoopala is a Senior Registered Nurse at Rundu State Hospital.
One way she has been able to tell that her patients were possibly being abused is when they refused to go home after being discharged from the hospital.
“A lot of times they refuse to tell us why they don’t want to go home, but with further investigation, we tell them that they are experiencing some form of abuse and then we refer them to social workers,” explains Shoopala.
In addition, she points out that when the same patient is admitted to the hospital “many times with no signs of serious physical symptoms, they also investigate further to rule out possible abuse.”
“The training sensitized us on how to ask the customer questions without being insensitive,” says Shoopala.
Audrey Gaes, a social worker for the Ministry of Health and Social Services in the Erongo region, has been working with GBV patients, sometimes identified by doctors or nurses.
Whether patients return to follow-up sessions with social workers depends on their socioeconomic status.
“It is important to establish a good relationship with patients because that determines the willingness of patients to continue.
We teach them independence because some of them stay in relationships due to mental, psychological, and emotional dependency.
So, they have to go through this process,” Gaes said.
Causes of GBV Gender-based violence has several causes, health professionals point out.
Excessive alcohol consumption and poverty are among the factors that contribute to gender-based violence.
“You will find young girls with sugar daddies who end up abusing them,” adds Bezuidenhout.
He feels that nurses should ask questions when underage children come to the hospital for prenatal care.
“Not all nurses or health workers are aware of child rape and that there is a penalty for not reporting it,” Bezuidenhout observed.
This is why it will be crucial to train more nurses on the clinical manual, adds Bezuidenhout.
“A lot of times nurses are only treating the patient for the illness they came in for, so I think more nurses need to be trained to identify cases of GBV so they can refer clients who might be experiencing this to social workers.
It would also be great if there could be a unit for those cases where people can come and feel safe,” Bezuidenhout said.
Training law enforcement officers While this training has helped Bezuidenhout, he believes law enforcement officers should also receive training on the clinical manual.
“The manual is so beneficial that law enforcement officers could benefit from it.
Most cases of gender-based violence are referred to them so they can really benefit from this training,” Bezuidenhout said.
“The manual must be decentralized, involving the Ministry of Gender and the gender-based violence unit because for them, if perhaps they have a rape case, they will simply come and say that we have a rape case without being sensitive to the client.
Confidentiality is important.
So it will be good for them to get training on the brochure,” added Bezuidenhout.
Angaleni Kangayi, the regional chief social worker in Rundu, agrees that the training should be provided to other stakeholders.
“This will help us understand the role that other stakeholders play in addressing gender-based violence,” said Kangayi.
She is the only nurse stationed at the Epako clinic who participated in the training.
The first training took place before the Covid-19 pandemic.
But, when the Covid-19 arrived, his attention was focused on that.
“My work was interrupted by the Covid-19 pandemic because I have been on vaccination campaigns,” he says.
He also does not have a consultation room where he treats GBV patients.
“Right now I’m taking care of TB (tuberculosis) patients,” he said.
Similarly, Shoopala feels that the Covid-19 pandemic has diverted her focus from gender-based violence and calls on the Ministry and partners to continue to support the implementation of the Clinical Manual.