Improving Professional Health Care for Survivors of Sexual Violence

The World Health Organization estimates that violence is a greater cause of death among women aged 15-44 than cancer, malaria, and traffic accidents combined. Globally, at least one in three women and girls will experience physical or sexual abuse in her lifetime. War-related sexual violence has been documented in various conflict zones, including Sierra Leone, Rwanda, Bosnia, and Bangladesh. In Sierra Leone, 13% of women and girls experienced physical or sexual violence during the late 1990s. In Rwanda, an estimated 250,000 to 500,000 women and girls were victims of sexual violence in 1994. In Bosnia, over 20,000 women were affected, while in Bangladesh, more than 200,000 women were victims of sexual violence in 1971. Sexual exploitation is another form of gender-based violence, with 37% of prostitutes in Sierra Leone being under the age of 15. Field research in nine countries found that 60-75% of women in prostitution were raped, 70-95% were physically assaulted, and 68% met the criteria for post-traumatic stress disorder. Harmful traditional practices, such as female genital mutilation (FGM), are also prevalent. In Africa, 90 million girls are at risk of FGM, while 60 million girls worldwide are missing due to sex-selective abortion, infanticide, or neglect. Intimate partner violence is another significant concern, with 16% to 41% of women in various countries experiencing physical or sexual violence at the hands of their partners. In Harare, Zimbabwe, over 60% of all murder cases involve husbands accused of murdering their wives. Trafficking is also a major issue, with an estimated 45,000 to 50,000 women and children being brought to the United States every year under false pretenses and forced into prostitution, labor, or servitude. In West and Central Africa, over 200,000 children are enslaved through cross-border smuggling. In Liberia, the situation is particularly dire. According to the Liberia Demographic Health Survey (2007), 38.6% of ever-married women aged 15-49 have experienced physical and/or sexual violence, with 36.3% experiencing it in the past 12 months. The survey also found that 10.8% of ever-married women aged 15-49 have experienced sexual violence from their spouse, while 35.8% have experienced emotional violence and 35.0% physical violence. The Sande Society, a traditional Liberian institution, is also a concern. While 89% of Liberian women aged 15-49 have heard of the Sande Society, 50% of Liberian women aged 15-49 are members, having undergone female genital cutting (FGC). Attitudes toward wife beating are also a concern in Liberia. According to the Liberia Demographic Health Survey (2013), 43% of women believe that a husband is justified in beating his wife for at least one of five specified reasons. Gender-based violence is defined as violence directed against a person on the basis of gender or sex. It includes acts that inflict physical, mental, or sexual harm or suffering, threats of such acts, coercion, and other deprivations of liberty.